Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease characterized by persistent airflow limitation. Therefore, both work ability and workday length may be affected in individuals with this disease. We studied a worker with suspected COPD and assessed fitness to work using post-bronchodilator spirometry, symptom assessment scales, and the exercise stress test.

The patient was a 58-year-old man due to work as a field supervisor in the ship construction sector. He had a 40 pack-year smoking history and experienced occasional dyspnea when climbing stairs. He visited this hospital to receive cardiopulmonary function tests and to determine his ability to work. Post-bronchodilator spirometry revealed severe irreversible airway obstruction corresponding to a modified Medical Research Council grade of 2 on the dyspnea scale. His COPD Assessment Test score was 12, placing him in patient group D (high risk, more symptoms) based on the Global Initiative for Chronic Obstructive Lung Disease classification system. His maximum oxygen uptake (VO_2max) was determined to be 19.16 ml/kg/min, as measured by the exercise stress test, and his acceptable workload for 8 h of physical work was calculated to be 6.51 ml/kg/min. His work tasks required an oxygen demand of 6.89 ml/kg/min, which exceeded the acceptable workload calculated. Accordingly, he was advised to adjust the work tasks that were deemed inappropriate for his exercise capacity.

As COPD incidence is expected to rise, early COPD diagnosis and determination of fitness to work is becoming increasingly important. Performing the exercise stress test, to evaluate the functional capacity of workers with COPD, is considered an acceptable solution.

Obstructive sleep apnea is a common sleep disorder that can cause excessive daytime sleepiness and impairment of cognition. These symptoms may lead to the occurrence of occupational accidents in workers with obstructive sleep apnea.

A 36-year-old man who worked as a dimensional control surveyor caused a vehicle accident while he was driving at the work site. Although he experienced loss of consciousness at the time of the accident, he had no other symptoms. His brain computed tomography and laboratory test did not show any specific findings. Medical tests were conducted to evaluate his fitness for work. Decreased sleep latency was observed on the electroencephalography image, which is suggestive of a sleep disorder. He frequently experienced daytime sleepiness and his Epworth sleepiness score was 13. The polysomnography showed a markedly increased apnea-hypopnea index of 84.3, which led to a diagnosis of severe obstructive sleep apnea. The patient was advised to return to work only when his obstructive sleep apnea improved through proper treatment.

Proper screening for obstructive sleep apnea among workers is important for preventing workplace accidents caused by this disorder, but screening guidelines have not yet been established in Korea. An effort toward preparing practical guidelines for obstructive sleep apnea is needed.