{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T16:15:57Z","timestamp":1782231357630,"version":"3.54.5"},"reference-count":71,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T00:00:00Z","timestamp":1742256000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Global Catalyst Faculty Research Program"},{"name":"College of Nursing Funds at the University of Tennessee, Knoxville"},{"name":"University of South Florida, College of Nursing"},{"name":"University of Tennessee\u2019s Open Publishing Support Fund"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Firefighters across the world face higher risks of occupational hazards, such as exposure to chemicals, extreme heat, traumatic stressors, and intense physical demands, which can increase their vulnerability to a range of psychological and physiological difficulties. These challenges include the risk of developing chronic stress, depression, and post-traumatic stress disorder (PTSD), potentially leading to detrimental negative coping patterns such as alcohol abuse. The consequent health implications impact both short-term and long-term health and well-being. This study aimed to explore the relationship between mental health status, alcohol consumption patterns, and gut microbiome alterations in firefighters from two different regions\u2014America and Korea. By investigating these relationships, we hope to gain insights into how repeated exposure to severe stressors impacts gut health. Healthy male firefighters (ages 21\u201350) and controls (matched sex, geography, and age) were recruited via flyers and snowball sampling in the United States and South Korea, resulting in 203 participants (102 firefighters and 101 controls). Firefighters reported significantly higher PTSD symptoms and depression and drank 2.3 times more alcohol than the control group. American firefighters reported more drinking than Koreans. There was a significant correlation between higher alcohol consumption and the likelihood of witnessing deaths by suicide. However, there were no correlations between alcohol consumption and PTSD symptom severity. There were associations between alcohol consumption patterns and aspects of the gut microbiome. This study highlights the mental health challenges faced by firefighters, including elevated rates of PTSD, depression, and alcohol consumption, with specific microbial imbalances linked to PTSD and alcohol use, emphasizing the role of the gut\u2013brain axis.<\/jats:p>","DOI":"10.3390\/microorganisms13030680","type":"journal-article","created":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T10:43:51Z","timestamp":1742294631000},"page":"680","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Gut Microbiome Alterations, Mental Health, and Alcohol Consumption: Investigating the Gut\u2013Brain Axis in Firefighters"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9528-0815","authenticated-orcid":false,"given":"Ji Youn","family":"Yoo","sequence":"first","affiliation":[{"name":"College of Nursing, University of Tennessee, Knoxville, TN 37996, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anujit","family":"Sarkar","sequence":"additional","affiliation":[{"name":"College of Nursing, University of Tennessee, Knoxville, TN 37996, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyo-Sook","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Paramedicine, Bucheon University, Bucheon 14632, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunghwan","family":"Bang","sequence":"additional","affiliation":[{"name":"Department of Paramedicine, Bucheon University, Bucheon 14632, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gyusik","family":"Shim","sequence":"additional","affiliation":[{"name":"Department of Paramedicine, Korea Nazarene University, Cheonan 31172, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3682-360X","authenticated-orcid":false,"given":"Cary","family":"Springer","sequence":"additional","affiliation":[{"name":"Research Computing Support, Office of Innovative Technologies, University of Tennessee, Knoxville, TN 37996, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgan E.","family":"O\u2019Brien","sequence":"additional","affiliation":[{"name":"Department of Public Health, University of Tennessee, Knoxville, TN 37996, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoonhwa","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Songhyun","family":"Ju","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunhee","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6817-7668","authenticated-orcid":false,"given":"Sung Soo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Usha","family":"Menon","sequence":"additional","affiliation":[{"name":"College of Nursing, University of South Florida, Tampa, FL 33612, USA"},{"name":"Tampa General Hospital Cancer Institute, Tampa, FL 33606, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tae Gyu","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Pathogenic Laboratory Research, Institute of Occupation and Environment, Korea Workers\u2019 Compensation & Welfare Service, Incheon 21417, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maureen E.","family":"Groer","sequence":"additional","affiliation":[{"name":"College of Nursing, University of Tennessee, Knoxville, TN 37996, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1007\/s10608-018-9892-y","article-title":"Posttraumatic stress and suicidality among firefighters: The moderating role of distress tolerance","volume":"42","author":"Bartlett","year":"2018","journal-title":"Cogn. 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