Annals of Occupational and Environmental Medicine

Volume 32; 2020

Research Article

Related factors for preserving firefighter's pulmonary function: Seonggyu Kim, Ye-eun Jeon, Hyeseung Ryu, Mi-Young Lee, Insung Chung; Ann Occup Environ Med 2020;32:e40. Published online December 18, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e40

Background

Firefighters are constantly exposed to harmful substances in the respiratory tract and require management measures. We comprehensively compared factors affecting the lung function of firefighters to identify management measures that can reduce the deterioration of lung function.

Methods

A cross-sectional study was conducted in 1,108 male firefighters. Subjects were surveyed with self-written questionnaires that included a history of smoking, number of workouts per week, work department, and medical history, including diseases that could affect lung function. Body mass index was calculated using an automatic body measurement instrument and body fat, body fat percentage, muscle mass, and skeletal muscle mass were measured using Inbody 770. Based on the body weight obtained from body measurements, skeletal muscle mass height-adjusted skeletal muscle index (hSMI) compared to height was determined. For lung function, forced expiratory volume in one second (FEV₁), forced vital capacity (FVC), FEV₁/FVC, and peak expiratory flow (PEF) were measured using a spirometer HI-801. Analysis of variance and independent t-tests were performed for univariate analysis of factors that could affect lung function, and multiple regression analysis was performed for multivariate analysis.

Results

When the factors relating lung function were analyzed using regression analysis, FEV₁ was negatively correlated with age, body fat percentage, and duty year, positively with height and hSMI. FVC increased with height and hSMI, decreased with age, body fat percentage, and duty year. FEV₁/FVC was related with age, height, body fat percentage and working history. Height and muscle mass were analyzed as related factors on PEF. When the analysis was conducted on firefighters who exercised more than 3 times a week, working history had lower relation with FEV₁ and body fat percentage had no relation with FEV₁/FVC.

Conclusion

We suggest management measures to reduce body fat percentage and increase skeletal muscle mass to maintain lung function in firefighters.

Citations

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Muscle, Fat, Bone, and Lungs: Unlocking the Fitness and Health Equation of Firefighters in Porto, Portugal
Giorjines Boppre, João Pedro Rocha Nunes, David Gomes Fernandes, Bruno João de Castro Sousa e Ribeiro Carlos, João Miguel Neves Barros, Aline Teixeira Maia de Freitas, José Augusto Rodrigues dos Santos, Rodrigo Zacca
Life.2025; 15(3): 334. CrossRef
A 7-Month Multidisciplinary Healthy Lifestyle Intervention Effectively Improved Cardiometabolic Risk Profile of Firefighters
Daniel Rodrigues Ferreira Saint-Martin, Kevin Alves Barreto, Edgard M. K. Von Koenig Soares, Marcelo Serejo Machado, Cristiana Soares dos Santos Morais, Adriana Mendonça Bonadio Barbosa, Rosenkranz Maciel Nogueira, Susanne D’Isabel, Denise L. Smith, Guilh
Journal of Occupational & Environmental Medicine.2024; 66(8): 605. CrossRef
Longitudinal lung function in urban firefighters: A group‐based multi‐trajectory modelling approach
Catherine Pendergrast, Terry Boyle, Alan J. Crockett, Roger Eston, Kylie N. Johnston
Respirology.2023; 28(3): 247. CrossRef

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Research Article

A descriptive study of claims for occupational mental disorder: adjustment disorder: Kyuyeon Kim, Inah Kim, Kanwoo Youn; Ann Occup Environ Med 2020;32:e39. Published online December 9, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e39

Abstract PDF

Background

The number of claims of Industrial Accidents Compensation Insurance (IACI) for mental illness has increased. In particular, the approval rate was higher in cases with confirmed incident circumstances such as adjustment disorder, acute stress disorder, and post-traumatic stress disorder. With increased numbers of filed IACI applications and their approval rates, the need to evaluate various work-related incidents and stressors consistently is also increasing.

Method

In January 2015–December 2017, among the cases of industrial accidents filed for mental illness and suicide by the Korea Workers' Compensation and Welfare Service, 76 filed or approved adjustment disorder cases were included. The cases of adjustment disorder were applied in this study to the “Criteria for Recognition of Mental Disorders by Psychological Loads” established in Japan in 2011 and investigated if cases were approved/rejected consistently. Additionally, features with the greatest influence on approval/rejection were examined quantitatively.

Results

The number of applications more than doubled from 2015 to 2017, with the approval rate rising from 66.7% to 90.6%. Among the major categories, applications of adjustment disorder related to “interpersonal relationships” were the largest number of applications. Applications related to “sexual harassment”, “interpersonal relationships”, and “accidents and experiences including fires” showed relatively higher approval rate. The approval rate was the lowest in the case of “change in the amount and quality of work”.

Conclusions

Approved cases tend to have special precedents and strong intensity. The main reasons for the rejection were that there were no special precedents and that the intensity of the case was weak. These 2 were the most important factors in determining approval/rejection.

Citations

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Reciprocal longitudinal associations of supportive workplace relationships with depressive symptoms and self-rated health: A study of Korean women
Seong-Uk Baek, Jin-Ha Yoon, Jong-Uk Won
Social Science & Medicine.2023; 333: 116176. CrossRef

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Research Article

Cogeneration plant and environmental allergic diseases: is it really an eco-friendly energy source?: Jinyoung Moon; Ann Occup Environ Med 2020;32:e38. Published online December 2, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e38

Abstract PDF Supplementary Material

Background

Combined heat and power generation (CHP generation, also called ‘cogeneration’) is attracting public attention for its high thermal efficiency, without considering possible adverse environmental health effects.This study investigated the potential role of cogeneration plants in inducing 3 environmental diseases: asthma, allergic rhinitis, and atopic dermatitis.

Methods

From 1 January 2013 to 31 December 2017, the towns (dongs) of South Korea in which a cogeneration plant started operation were selected as study sites. For comparison, a matched control dong with the most similar Gross Regional Domestic Product for each case dong was selected. The numbers of outpatient visits, inpatient admissions, and emergency visits provided by the National Health Insurance Sharing Service (NHISS) were analyzed using an interrupted time-series design. For air pollutants, the concentrations of 5 air pollutants from the AIRKOREA dataset were used.

Results

A total of 6 cogeneration plants in 6 case dongs started operation during the study period. For overall case dongs, the pre-CHP trend was 1.04 (95% confidence interval [CI]: 1.038–1.042), and the post-CHP trend was 1.248 (95% CI: 1.244–1.253). The intercept change due to the CHP plant was 1.15 (95% CI: 1.137–1.162). For overall control dongs, the pre-CHP trend was 1.133 (95% CI: 1.132–1.135), and the post-CHP trend was 1.065 (95% CI: 1.06–1.069). The intercept change due to the CHP plant was 0.888 (95% CI: 0.878–0.899). Only for CO and NO₂, the relative risk (RR) for overall case dongs was statistically significantly increased, and the RR for the overall control dongs was statistically insignificant.

Conclusions

Possible hazardous emissions, like CO and NO_2, from cogeneration plants could induce environmental diseases in nearby community populations. The emissions from cogeneration plants should be investigated regularly by a governmental agency, and the long-term health outcomes of nearby community residents should be investigated.

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Elaheh Safaei Kouchaksaraei, Ali Khosravani Semnani, Kody M. Powell, Kerry E. Kelly
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Risk perceptions of a population living near a municipal waste incinerator and associated factors with the prevalence of environmental disease
Dong Hyun Kim, Chae Kwan Lee, Jeong Ho Kim, Byung Chul Son, Chunhui Suh, Kunhyung Kim, Byeong Jin Ye
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Research Article

Work-related factors of knee osteoarthritis in Korean farmers: a cross-sectional study: Han Soo Song, Dong Hwi Kim, Gwang Chul Lee, Kweon Young Kim, So Yeon Ryu, Chul Gab Lee; Ann Occup Environ Med 2020;32:e37. Published online November 13, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e37

Abstract PDF

Background

Several studies have reported a high prevalence of osteoarthritis (OA) of the knee among agricultural workers. We investigated work-related factors that increase the risk of knee OA among Korean farmers.

Methods

Data were extracted from the Jeonnam Center for Farmer's Safety and Health survey, conducted between 2013 and 2015. The sample included 489 farmers (man 240, woman 249). We defined knee OA as radiographic knee OA (≥ Kellgren-Lawrence grade 2) with symptoms (≥ Western Ontario and McMaster Universities Osteoarthritis, Korean version score 29.5). We considered covariates such as cumulative squatting working time (CSWT), cumulative heavy lifting working time (CLWT), body mass index (BMI), and history of knee injury. Odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) were calculated for knee OA and adjusted for relevant covariates.

Results

The results of multivariate logistic regression analysis indicated that knee OA was correlated by factors such as sex, age, BMI, history of knee injury, CSWT, and CLWT. Particularly, CSWT > 20,000 hours (OR: 2.83; 95% CI: 1.35–5.92; reference < 10,000 hours) and CLWT > 5,000 hours (OR: 2.62; 95% CI: 1.14–6.06; reference < 2,000 hours) were associated with an increased risk of knee OA after adjustment for covariates.

Conclusions

Squatting posture and heavy lifting associated with farm work might increase the risk of knee OA among Korean farmers.

Citations

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Jangwhon Yoon
Applied Ergonomics.2025; 128: 104533. CrossRef
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Hansoo Song, Yong Soo Cho, Hye-min Kim, Soo Hyeong Park, Dong Hwi Kim, Chul Gab Lee
Safety and Health at Work.2025;[Epub] CrossRef
Radiographic Knee Osteoarthritis Is a Risk Factor for the Development of Dementia: Locomotive Syndrome and Health Outcomes in the Aizu Cohort Study
Yuji Endo, Hiroshi Kobayashi, Kazuyuki Watanabe, Koji Otani, Kenichi Otoshi, Hironori Numazaki, Miho Sekiguchi, Mari Sato, Takuya Nikaido, Rei Ono, Shin-ichi Konno, Yoshihiro Matsumoto
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Research Article

Association between the prevalence of allergic reactions to skin prick tests and workplace types among agricultural workers in South Korea: Jiyoung Han, Yangwoo Kim, Sooyeon Lee, Soo-Jin Lee; Ann Occup Environ Med 2020;32:e36. Published online November 11, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e36

Abstract PDF

Background

Farmers are often exposed to dust, molds, pollen, animal products, insects, and chemicals. Accordingly, they have a high prevalence of respiratory and allergic diseases. Some studies have shown that farmers have a high prevalence of respiratory diseases and symptoms depending on where farmers work. The objective of the present study was to investigate whether certain types of agricultural workplaces are associated with the prevalence of allergic reactions in skin prick tests (SPTs) in South Korea.

Method

A total of 149 farmers, grouped according to their workplaces in greenhouses, poultry houses, or outdoors, answered a self-reported questionnaire about the prevalence of respiratory diseases and symptoms. They were skin-tested using 12 allergens. The questionnaire and the prevalence of positive skin tests were determined for each of the participant groups, and the results were analyzed by multivariate logistic regression.

Results

There were significant differences in the prevalence of allergic reactions to the SPT, chronic obstructive pulmonary diseases (COPDs) and asthma symptoms (wheezing) among the subgroups. The allergic reaction to SPT was the highest in greenhouse workers (30.9%), followed by poultry house workers (15.9%), and outdoor workers (8.1%). The prevalence of COPD was 6.8% in poultry house workers alone and not in other groups. The prevalence of wheezing was the highest at 9.1% in poultry house workers. According to the results of the logistic analysis, the prevalence of allergic reactions to SPT had positive correlations with the types of workplaces. Greenhouse workers had higher risk of SPT sensitization compared to outdoor workers (adjusted odds ratio [OR]: 5.55, 95% confidence interval [CI]: 1.32–32.24). The prevalence of SPT positivity also had an association with the symptoms of sneezing, rhinorrhea, or nasal congestion (adjusted OR: 6.64, 95% CI: 2.06–23.63).

Conclusions

These data demonstrate that the types of workplaces were associated with the prevalence of allergic sensitization. This could be explained by the difference in the type or level of airborne exposures in each workplace. It is also likely that this was caused by differences between groups of individual factors such as age and BMI that influence SPT sensitization.

Citations

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List of occupational diseases among farmers in Korea: a literature review
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Ann Occup Environ Med.2025; 37: e2. CrossRef
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Research Article

Relationship between long work hours and self-reported sleep disorders of non-shift daytime wage workers in South Korea: data from the 5th Korean Working Conditions Survey: Hongsuk Choi, Sungho Lee, Man-Joong Jeon, Young-Sun Min; Ann Occup Environ Med 2020;32:e35. Published online November 3, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e35

Abstract PDF

Background

Studies have investigated the relationship between long work hours and sleep disorders; however, they have focused on shift workers or specific workers who are at high risk of industrial accidents rather than wage workers in general. The purpose of this study is to investigate the effects of long work hours on sleep disorders among non-shift daytime wage workers.

Methods

We conducted a secondary analysis of data from the 5th Korean Working Conditions Survey. From the 50,205 total participants, we included 26,522 non-shift daytime wage workers after excluding self-employed people, business owners, unpaid family employees, and wage workers who work nights and shifts. Sleep disorders were categorized into “difficulty in falling asleep,” “frequent waking,” and “waking up with fatigue.” Logistic regression analysis was used to evaluate the influence of long work hours on sleep disorders, and the odds ratios (ORs) were calculated.

Results

The OR of working > 52 hours per week was 1.183 (95% confidence interval [CI]: 1.002–1.394) for the risk of developing insomnia compared with working ≤ 40 hours per week. The OR of waking up with fatigue was 1.531 (95% CI: 1.302–1.801). Long work hours showed no significant relationship with difficulty in falling asleep or with frequent waking.

Conclusions

Working for extended hours was associated with increased fatigue upon waking in non-shift daytime wage workers.

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Research Article

Relationship between urinary phthalate metabolites and diabetes: Korean National Environmental Health Survey (KoNEHS) cycle 3 (2015–2017): Do Jin Nam, Yeji Kim, Eun Hye Yang, Hyo Choon Lee, Jae-Hong Ryoo; Ann Occup Environ Med 2020;32:e34. Published online September 18, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e34

Abstract PDF

Background

We aimed to determine relationship diabetes according to urinary phthalate metabolites using adult data from Korean National Environmental Health Survey cycle 3 (2015–2017).

Method

This study was conducted on 3,781 adults aged 19 years and older (1,648 men and 2,133 women) based on KoNEHS cycle 3. Participants' data were analyzed by gender; Relationship between phthalate metabolites in the urine and diabetes was analyzed by dividing the sociodemographic variables, health behavior-related variables, and urinary phthalate metabolite concentrations into quartiles. To determine the relationship between urinary phthalate metabolites and the prevalence of diabetes, the odds ratio (OR) was calculated using logistic regression analysis.

Results

Based on the 1st quartile of each metabolite, the ORs for di-2-ethylhexyl phthalate (DEHP) (4th quartile), mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) (2nd quartile, 3rd quartile and 4th quartile), mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP) (4th quartile), mono-(2-ethyl-5-carboxypentyl) phthalate (MECCP) (4th quartile), mono-n-butyl phthalate (MnBP) (3rd quartile and 4th quartile), mono-benzyl phthalate (MBzP) (2nd quartile) and 4th quartile), and mono (3-carboxypropyl) phthalate (MCPP) (3rd quartile and 4th quartile) were significantly higher after the adjustment in men. The ORs for DEHP (2nd quartile, 3rd quartile and 4th quartile), MEHHP (2nd quartile, 3rd quartile and 4th quartile), MEOHP (4th quartile), MECCP (4th quartile), MBzP (4th quartile), and MCPP (4th quartile) were significantly higher after the adjustment in women.

Conclusion

This study investigated relationship between urinary phthalate metabolites and diabetes. The higher urinary phthalate metabolites, the higher the prevalence of diabetes. Further regulation of phthalate may be needed, and further studies are warranted to confirm the association between phthalate concentration and other chronic diseases (such as hypertension, hyperlipidemia, and cardiovascular disease).

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Research Article

Combined effect of emotional labor and job insecurity on sleep disturbance among customer service workers: Sunguk Choi, Kwon Ko, Jae Bum Park, Kyung-Jong Lee, Seungho Lee, Inchul Jeong; Ann Occup Environ Med 2020;32:e33. Published online September 10, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e33

Abstract PDF

Background

Job insecurity and emotional labor are poor job-related factors that are known to cause sleep disturbances in customer service workers. This study investigates the combined effect of emotional labor and job insecurity on sleep disturbance.

Methods

This study used data from the Fifth Korean Working Condition Survey and included 15,147 paid workers who serve customers below 65 years. We re-classified into 6 groups based on whether the degree of emotional labor increased (Rarely/Sometimes/Always) or whether job insecurity (No/Yes) was present. We performed propensity score matching for several covariates and calculated odds ratio (OR) and 95% confidence intervals (CIs) for sleep disturbance by logistic regression models using only matched subjects.

Results

Workers exposed to emotional labor and job insecurity had significantly higher risk for 3 dimensions of sleep disturbance (difficulty falling asleep, waking up repeatedly during the sleep, and waking up with feeling of fatigue) (OR [95% CI]: 1.44 [1.22–1.69], 1.18 [0.99–1.40], 1.52 [1.30–1.79] for emotional labor; and 2.00 [1.75–2.29], 2.20 [1.91–2.53], 1.67 [1.45–1.92] for job insecurity). Compared to those who were exposed to both emotional labor rarely and without job insecurity, when workers had both poor job factors, the OR (95% CI) for sleep disturbance for difficulty falling asleep, waking up repeatedly during the sleep, and waking up with feeling of fatigue were 3.05 (2.42–3.86), 2.89 (2.26–3.69), and 2.60 (2.06–3.29), respectively. The relative excess risk due to Interaction of job insecurity and emotional labor was significant only for difficulty falling asleep, but not the other 2 sleep disturbance dimensions.

Conclusions

Customer service workers suffered from severe sleep disturbances according to the existing degree of emotional labor and job insecurity. The combined effect of both could have an additive influence on serious sleep disturbance among customer service workers.

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The Long Reach of Unemployment: Sensitizing or Inoculating Employee Reactions to Job Insecurity?
Maike E. Debus, Tahira M. Probst, Andrea Bazzoli, Hyun Jung Lee
Journal of Business and Psychology.2025;[Epub] CrossRef
Emotional labor, fatigue, and presenteeism in Chinese nurses: the role of organizational identification
Zheng Ren, Chao Zhou, Xiumin Zhang, Aoqi Yang, Wenjun Li, Hongjian Liu
BMC Nursing.2024;[Epub] CrossRef
Associations between precarious employment and smoking and regular exercise: Results from a Korean longitudinal panel study from 2005 to 2020
Seong-Uk Baek, Jin-Ha Yoon, Jong-Uk Won
Preventive Medicine.2023; 168: 107420. CrossRef
Association between high emotional demand at work, burnout symptoms, and sleep disturbance among Korean workers: a cross-sectional mediation analysis
Seong-Uk Baek, Jin-Ha Yoon, Jong-Uk Won
Scientific Reports.2023;[Epub] CrossRef
Association between Precarious Employment and Smoking and Regular Exercise: Results from Nationally Representative Surveys from 2005 to 2020
Seong-Uk Baek, Jin-Ha Yoon, Jong-Uk Won
SSRN Electronic Journal .2022;[Epub] CrossRef
Association between Workers’ Anxiety over Technological Automation and Sleep Disturbance: Results from a Nationally Representative Survey
Seong-Uk Baek, Jin-Ha Yoon, Jong-Uk Won
International Journal of Environmental Research and Public Health.2022; 19(16): 10051. CrossRef
The Importance of an Emotional Expression Guide to Prevent Work-Related Health Problems in Emotional Laborers
Ji Sun Ha, Jin Ah Kim
International Journal of Environmental Research and Public Health.2021; 18(13): 6710. CrossRef
What Are the Experiences of Emotional Labor and Workplace Violence that Are More Harmful to Health in Korean Workforce?
Won Ju Hwang, Hye Kyung Yang, Ji Hye Kim
International Journal of Environmental Research and Public Health.2020; 17(21): 8019. CrossRef

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Research Article

Asbestos exposure and autoantibody titers: Eunsoo Lee, Youngki Kim, Se Yeong Kim, Dongmug Kang; Ann Occup Environ Med 2020;32:e32. Published online September 1, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e32

Abstract PDF

Background

Asbestos is a well-known hazardous substance that causes occupational and environmental diseases including asbestosis (lung fibrosis). Silica exposure which causes silicosis (another type of lung fibrosis) has long been linked to the development of autoimmune diseases; however, there are few studies on the relationship between asbestos exposure and autoimmune diseases.

Methods

A total of 54 individuals who had worked in a former asbestos textile factory underwent autoantibody-related blood tests, chest X-ray imaging, and pulmonary function tests. Based on the job exposure matrix (JEM), the estimated asbestos exposure concentrations were determined, and the presence of asbestosis was determined by chest radiography.

Results

Scleroderma (Scl-70) and ribonucleoprotein (RNP) antibodies were significantly lowered in the pleural plaque present group than in the absent group. Additionally, Scl-70, RNP, and Sjögren's syndrome type B (SS-B) antibodies were significantly lowered in the asbestosis present group. When stratifying variables with or without asbestosis, Scl-70, Smith, SS-B, and RNP antibodies decreased in female, crocidolite handling group, and higher estimated asbestos exposure level group.

Conclusions

Contrary to our expectations that autoantibody titers would be higher in groups with high asbestos exposure or in the asbestosis group, those with asbestosis showed lower titers. But as our research has some methodological limitations, the lowered titer of autoimmune antibody in our asbestos exposed subjects could not be simply interpreted as a lowered risk of autoimmune diseases. So careful interpreting should be taken when examine autoantibodies to screening or diagnose autoimmune diseases in people with asbestos exposure. In addition, it is necessary to establish relevance of asbestosis and autoantibodies through further studies of larger scale and higher confidence levels.

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Amphibole asbestos as an environmental trigger for systemic autoimmune diseases
Jean C. Pfau, Brett McLaurin, Brenda J. Buck, Frederick W. Miller
Autoimmunity Reviews.2024; 23(7-8): 103603. CrossRef
The Effect of Superficial Heat–Cold Application on the Sleep Quality of Patients With Restless Leg Syndrome: A Systematic Review and Meta‐Analysis
Mohammad Mehdi Mohammadi, Maryam Ahmadi, Ali Akbar Vaisi Raygani
Nursing Open.2024;[Epub] CrossRef

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Review

A work-relatedness assessment in epidemiological case investigation of occupational cancers: II. Practice: an upper urinary tract cancer in a dyer: Kihun Kim, Hyeoncheol Oh, Jungwon Kim; Ann Occup Environ Med 2020;32:e31. Published online September 1, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e31

Abstract PDF: An epidemiological case investigation of occupational cancer is conducted to determine the causation between the cancer and the worker's job. This review describes the overall process of work-relatedness assessment of the epidemiological case investigation through a case of upper urinary tract cancer (UUTC) in benzidine exposed worker in dyeing industry. Medical referrals, occupational history, material safety data sheet, and working environment monitoring submitted by the Korea Workers' Compensation and Welfare Service were reviewed. We further investigated literatures about the cotton dyeing industry, the domestic law and working environment monitoring reports. Benzidine was listed as an International Agency for Research on Cancer risk factor only for bladder cancer among urinary tract cancers, requiring different logical grounds for establishing causation. A literature review was conducted on the metabolic pathways of benzidine to establish biological plausibility. In addition, several papers were investigated that UUTC and bladder cancer share risk factors to extrapolate the epidemiological studies of bladder cancer. Epidemiologic studies of benzidine and bladder cancer were investigated. The worker is a 71-year-old man and performed dyeing and transporting at several dyeing factories for 29 years. The worker was diagnosed with UUTC based on radiologic and histologic results. It was critical to consider that he worked as a dyer for 3 years. The cancer was diagnosed in 2018, with a latent period of approximately 35 years. The worker performed cotton dyeing, and benzidine-based dye was mainly used. The quantitative exposure level of benzidine was reported from non-detection to 397.4 µg/m³. In biological metabolisms, N-acetylhydroxylamine changes DNA structure of urothelium. As a result of reviewing 4 epidemiological studies, the standardized incidence ratio and standardized mortality ratio were significantly high with 3 years of exposure. Work-relatedness was finally assessed as probable based on biological mechanisms and epidemiological evidence. This review will help solutions for work-relatedness assessment processes.

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Review

A work-relatedness assessment in epidemiological case investigation of occupational cancers: I. Principles: Kihun Kim, Jungwon Kim; Ann Occup Environ Med 2020;32:e30. Published online September 1, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e30

Abstract PDF

It is important to identify the causal relationship between occupational exposure and the disease in the area of compensation because most cancers have long latent period. This review presents the principles that should be considered when evaluating the work-relatedness. We reviewed reports on occupational cancers published by the International Agency for Research on Cancer, American Conference of Governmental Industrial Hygienists, National Toxicology Program, Environmental Protection Agency, European Union, which are the world's most prestigious organizations. In addition, we reviewed relevant papers and books published in Korea. The process is conducted in the order of cancer diagnosis, exposure assessment for carcinogens, and work-relatedness assessment. The probability of causation is determined stochastically rather than deterministically. There is no absolute standard for accreditation criteria and results may vary according to expert opinions and in each country or organization. Revealing the causal relationship of occupational cancers is a difficult process owing to inconsistency in relevant epidemiological studies, lack of well-established biological mechanisms, loss of objective occupational historical data, and other complexity of individual cases. Causation is unclear in many cases. Nevertheless, the data should be reviewed in detail for each case suspected of work-related cancers, and an assessment should be made through valid and plausible logic and literature evidences.

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Nadia Mohamad, Sakshaleni Rajendiran, Nurul Amalina Khairul Hasni, Nik Muhammad Nizam Nik Hassan, Rafiza Shaharudin, Ros Suzanna Ahmad Bustamam, Nolia Luhong Bilang, Mohd Azahadi Omar, Nik Khairol Reza Md Yazin, Rohaida Ismail
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Taewoong Ha, Hyeoncheol Oh, Jungwon Kim
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Research Article

Association between sleep duration and impaired fasting glucose according to work type in non-regular workers: data from the first and second year (2016, 2017) of the 7th Korean National Health and Nutrition Examination (KNHANE) (a cross-sectional study): JaeHan Joo, Jae-Gwang Lee, SangWoo Kim, JaeHan Lee, June-Hee Lee, Kyung-Jae Lee; Ann Occup Environ Med 2020;32:e29. Published online July 30, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e29

Abstract PDF

Background

We aimed to find the relationship between sleep duration and impaired fasting glucose according to working type in non-regular workers using the 2016 and 2017 Korean National Health And Nutrition Examination (KNHANE, 7th revision).

Method

In the 1st and 2nd year (2016, 2017) of the 7th KNHANE, 16,277 people participated. Minors were excluded because this study was intended for individuals aged 19 years and older. As this study was based on wage workers, unemployment, self-employed workers, employers, unpaid family workers, and those who have insufficient answers such as unknown or no response were excluded. Regular workers were excluded because this study was intended for non-regular workers. Finally, a total of 2,168 people were included in the survey, except those who had been diagnosed with diabetes, had a fasting blood glucose level of 126 mg/dL or higher, or taking hypoglycemic agents or receiving insulin injections. To find the relationship between sleep duration and impaired fasting glucose according to work type in non-regular workers, multiple logistic regression analysis was performed by adjusting the general and occupational characteristics after stratification according to work type. All statistical analyses were performed using the SPSS software (version 26.0; SPSS Inc., Chicago, IL, USA).

Results

In the case of insufficient sleep duration in irregular female workers, the odds ratio (OR) of impaired fasting glucose was statistically insignificant, but in the case of insufficient sleep duration in irregular male workers who have shift work, the odds ratio (OR) of impaired fasting glucose was significantly higher than that of sufficient sleep duration (Model 1, OR: 3.05, 95% confidence interval [CI]: 1.18–7.90; Model 2, OR: 2.81, 95% CI: 1.08–7.29).

Conclusions

Our findings demonstrate that insufficient sleep duration was associated with an increase in fasting blood glucose levels in non-regular male workers working shifts. This means that non-regular workers are in desperate need for adequate sleep and health care. We hope that our study will help improve the health of non-regular workers and more systematic and prospective follow-up studies will be conducted to further improve the health of non-regular workers.

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A Study to Evaluate Association of Sleep Quality with Blood Pressure and Obesity
Munwar us Salam, Binafsha Manzoor Syed, Husan Bano Channar, Fasiha Shah, Shaneela Khowaja, Rubina Parveen
Indus Journal of Bioscience Research.2025; 3(3): 702. CrossRef
The Impact of Night Work on the Sleep and Health of Medical Staff—A Review of the Latest Scientific Reports
Katarzyna Czyż-Szypenbejl, Wioletta Mędrzycka-Dąbrowska
Journal of Clinical Medicine.2024; 13(15): 4505. CrossRef
Peripheral blood lipid and liver and kidney function test results in long-term night shift nurses: a cross-sectional study in South China
Yang Zhao, Xunhao Lu, Yanghua Wang, Yiyi Cheng, Qiao He, Rongqi Qin, Wenrui Li, Haizhou Liu, Yuanfang Liu
Frontiers in Endocrinology.2023;[Epub] CrossRef
Unraveling the associations and causalities between glucose metabolism and multiple sleep traits
Minhan Yi, Quanming Fei, Ziliang Chen, Wangcheng Zhao, Kun Liu, Shijie Jian, Bin Liu, Meng He, Xiaoli Su, Yuan Zhang
Frontiers in Endocrinology.2023;[Epub] CrossRef
Nutritional Biomarkers and Factors Correlated with Poor Sleep Status among Young Females: A Case-Control Study
Sara AL-Musharaf, Lama AlAjllan, Ghadeer Aljuraiban, Munirah AlSuhaibani, Noura Alafif, Syed Danish Hussain
Nutrients.2022; 14(14): 2898. CrossRef

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Case Report

Severe chemical burns related to dermal exposure to herbicide containing glyphosate and glufosinate with surfactant in Korea: Jihyun Shin, Namkyu Lim, Sangchul Roh; Ann Occup Environ Med 2020;32:e28. Published online July 20, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e28

Abstract PDF

Background

Glyphosate and glufosinate use widely used as herbicide ingredients. There have been several reported cases of chemical burns caused by dermal exposure to glyphosate-containing herbicide, and patients in these cases were discharged without fatal complications. There were no cases of severe symptoms due to non-oral exposure of glufosinate-containing herbicides. Here, we report a case of fatality accompanied with severe chemical burns in an 81-year-old man who did not wash his skin for more than 48 hours after dermal exposure to herbicide containing glyphosate and glufosinate with surfactant (HGlyGluS).

Case presentation

An 81-year-old male with no underlying disease was admitted to the emergency department (ED). He had sprayed HGlyGluS with a manual knapsack sprayer 3 days ago and had not wash away the herbicide. On arrival, he was drowsy and had multiple severe corrosive skin lesions. Skin necrosis (10 × 15 cm) on the right shoulder and skin lesions with subcutaneous fat exposure (15 × 20 cm) on the right thigh were observed. Although he was treated including continuous renal replacement therapy, antibiotic apply, debridement operations, and so on, he was unable to recover and expired.

Conclusions

We suggest that prolonged dermal exposure to HGlyGluS induces fatality. Further studies including prolonged dermal exposure and ingredients of surfactants should be carried out. Also, it is necessary to educate farmers that it is very important to wash immediately after dermal exposure to pesticide.

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Prospective applications of chitosan and chitosan-based nanoparticles formulations in sustainable agricultural practices
Bhoomika M. Karamchandani, Sunil G. Dalvi, Mahima Bagayatkar, Ibrahim M. Banat, Surekha K. Satpute
Biocatalysis and Agricultural Biotechnology.2024; 58: 103210. CrossRef
Overview of human health effects related to glyphosate exposure
Flavia Silvia Galli, Marta Mollari, Valentina Tassinari, Cristian Alimonti, Alessandro Ubaldi, Camilla Cuva, Daniele Marcoccia
Frontiers in Toxicology.2024;[Epub] CrossRef

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Research Article

Validation of the Work Engagement Scale-3, used in the 5th Korean Working Conditions Survey: Maro Choi, Chunhui Suh, Seong Pil Choi, Chae Kwan Lee, Byung Chul Son; Ann Occup Environ Med 2020;32:e27. Published online July 16, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e27

Abstract PDF

Background

The purpose of this study was to assess the reliability and validity of the 3-item version of the Work Engagement Scale (WES-3), which is based on the Job Demands-Resources (JD-R) model and was used in the 5^th Korean Working Conditions Survey (KWCS).

Methods

This study used data from the 5th KWCS (n = 50,205), which was conducted in 2017 with a sample of the Korean working population. The survey gathered comprehensive information on working conditions to define workforce changes and the quality of work and life. The reliability and internal consistency of the WES-3 were assessed using the corrected item-total correlation and Cronbach's alpha coefficient. Confirmatory factor analysis (CFA) was used to test the construct validity of work engagement. The convergent validity was assessed using the correlation with the WHO-5 well-being index. Correlations between work engagement and JD-R factors were also calculated.

Results

The Cronbach's alpha for work engagement was 0.776, indicating acceptable internal consistency. The model comprising 3 work engagement and 2 burnout items showed an excellent fit (χ²: 382.05, Tucker-Lewis index: 0.984, comparative fit index: 0.994, root mean square error of approximation: 0.043). The convergent validity was significant (correlation coefficient: 0.42). Correlations with burnout and job demands were negligible, whereas correlations with job resources and job satisfaction were weakly positive.

Conclusions

The results of our study confirm that the WES-3 has acceptable reliability and validity.

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Sojin Yoon, Na Yeon Lee, Yerim Lim, Sehee Hong
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Qian Zhang
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Seong-Uk Baek, Jin-Ha Yoon, Jong-Uk Won
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Clara González-Seda, Ramón Rodríguez-Montalbán, Miguel E. Martínez-Lugo
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Fatih Bilici
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Mohammed Yasin Ghadi
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Paula Maria Rattis Teixeira, Fernando Cesar Almada Santos
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Genevieve Southgate, John K. Aderibigbe, Tolulope V. Balogun, Bright Mahembe
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Xuebing Su, Victor Wong, Charlie Yip
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SangJin Park, Chulyong Park, Joo Hyun Sung
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Research Article

Risk factors including night shift work of colorectal polyp: Kanghyun Um, Chung-soo Park, Cheolin Yoo, Yeon-Soon Ahn, Moonchan Kim, Kyoung Sook Jeong; Ann Occup Environ Med 2020;32:e26. Published online July 13, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e26

Abstract PDF

Background

The destruction of circadian rhythms by night shift work affects major circadian genes, which are known to play a role in advancing or killing the cell cycle through tumor suppressor genes. To find out whether night shift work affects the incidence of colorectal cancer, which was found to be associated with long-term night shift work in previous studies, we surveyed effect of night shift work on colorectal polyps that have a higher incidence than colorectal cancer and can progress to colorectal cancer.

Methods

To examine the correlation between rotating night shifts and colorectal polyps, a survey was conducted with 299 men aged 40–60 years from two university hospitals. We examined lifestyle, work history, work patterns, and colonoscopy results. The differences in prevalence among the groups was compared, and prevalence ratio (PR) was calculated via generalized linear modeling.

Results

The prevalence of colorectal polyps in night shift and non-shift workers were 53.0% and 33.5%, respectively. After adjusting for age, smoking status, dietary habits, family history of colorectal cancer, obesity, job type, night shift work (PR: 1.13, 95% CI: 1.02–1.25) was a risk factor of colorectal polyps.

Conclusions

The risk of colorectal polyps was greater in night shift workers than non-shift workers. Also risk of colorectal polyp was higher in older group. Our study investigated colorectal polyp instead of colorectal cancer and lacks information about types and gene mutations of colorectal polyps. Further study is needed to clarify effect of night shift work on development of colorectal cancer.

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Research Article

Effects of job stress on symptoms of bipolar spectrum disorder in an electronic parts manufacturing company: Hyeonchoel Oh, Kihun Kim, Taewoong Ha, Jungwon Kim; Ann Occup Environ Med 2020;32:e25. Published online July 13, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e25

Abstract PDF

Background

Mental illness is known to be caused by genetic, biological, and environmental risk factors. Although previous studies have established the link between mental illness and job stress, most of them are limited to major depression disorder. Therefore, this study examined the relationship between job stress and bipolar spectrum disorder (BSD).

Methods

This is a cross-sectional study based on a survey conducted in April 2017 at an electronic parts manufacturing company in Busan. In a total of 441 workers, the degree of BSD was identified using the Korean version of the Mood Disorder Questionnaire, and the degree of job stress was identified using the Korean Occupational Stress Scale Short Form. This study also identified general characteristics of workers and job-related factors. The χ² test and Fisher's exact test was conducted to determine the differences among the variables, based on BSD. Multiple logistic regression analysis was conducted to determine the influence of independent variables on BSD.

Results

Cross-analysis showed significant differences between the BSD high-risk and low-risk groups regarding age, sex, occupation, smoking, problem drinking, job stress total score, occupational climate, and major depression disorder symptom. In addition, the significant differences between the BSD high-risk and low-risk groups about job stress were observed in terms of job demand, job insecurity, and occupational climate. A multiple logistic regression analysis revealed that the high-risk group in the job stress group had a higher effect on BSD than the low-risk group (odds ratio [OR]: 2.32, 95% confidence interval [CI]: 1.10–4.88). Among the categories of job stress, high-risk groups in 3 areas—job demand (OR: 2.56, 95% CI: 1.27–5.17), job insecurity (OR: 4.42, 95% CI: 1.19–16.42), and occupational climate (OR: 2.55, 95% CI: 1.29–5.05)—were more likely to have an impact on BSD than the low-risk groups.

Conclusions

This study demonstrated that the high-risk groups of job stress total score, job demand, job insecurity, and occupational climate had a more significant effect on BSD than the low-risk groups. As workers with BSD may have difficulties in their work and personal lives, there is a need to manage job stress to prevention of BSD.

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Research Article

Validation of urinary 1,2-dichloropropane concentration as a biological exposure index for workers exposed to 1,2-dichloropropane: Chung-Soo Park, Hyun-Soo Kim, Yeon-Soon Ahn, Jung-Ho Ahn, Kyoung Sook Jeong; Ann Occup Environ Med 2020;32:e24. Published online July 7, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e24

Abstract PDF

Background

The International Agency for Research on Cancer classified 1,2-dichloropropane (1,2-DCP) as a human carcinogen in 2016. It is necessary to establish a health monitoring system for workers exposed to 1,2-DCP. We investigated the correlation between 1,2-DCP concentration in air and urine to determine whether it is appropriate to measure 1,2-DCP in urine as a biological exposure index (BEI).

Methods

Twenty-seven workers from 3 manufacturing industries handling 1,2-DCP participated in this study. Airborne 1,2-DCP was collected by personal air. Urine samples were collected at the end of work and analyzed using gas chromatography-mass spectrometry. Correlation analysis and simple regression analysis were performed to investigate the relationship between 1,2-DCP concentration in urine and air.

Results

Pearson correlation coefficients between total 1,2-DCP in air and urine (uncorrected, creatinine-corrected) were 0.720 and 0.819, respectively. For urine samples analyzed within 2 weeks, the Spearman's rho of 1,2-DCP concentration in urine (uncorrected and creatinine-corrected) was 0.906 and 0.836, respectively. Simple regression analysis of 1,2-DCP in air and urinary 1,2-DCP concentrations within 2 weeks, which showed the highest correlation, revealed that the coefficient of determination of 1,2-DCP concentration in urine (uncorrected and creatinine-corrected) was 0.801 and 0.784, respectively.

Conclusions

As a BEI for workers exposed to 1,2-DCP, urinary 1,2-DCP without creatinine correction better reflects the exposure levels of 1,2-DCP in air.

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Research Article

Factors related to femoral bowing among Korean female farmers: a cross-sectional study: Sangyoon Do, Chul Gab Lee, Dong Hwi Kim, GwangChul Lee, Kweon Young Kim, So Yeon Ryu, Hansoo Song; Ann Occup Environ Med 2020;32:e23. Published online July 2, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e23

Abstract PDF Supplementary Material

Background

Female farmers have a high prevalence of knee osteoarthritis (KOA) in South Korea. Femoral bowing has been reported to be related to KOA by increasing load on the mechanical axis. This study aimed to investigate factors related to femoral bowing in Korean female farmers.

Methods

We analyzed the legs of 264 female farmers registered with the Korea farmers' knee cohort of Jeonnam Center for Farmers' Safety and Health. A structured questionnaire was used to determine sociodemographic variables, agricultural career, cumulative squatting working time (CSWT), and cumulative heavy lifting working time. Femoral bone density was measured and Kellgren-Lawrence (KL) grades were obtained from the knee radiographs. Mechanical axis angle (MAA), femoral bowing angle (FBA), anatomical lateral distal femoral angle (aLDFA), anatomical medial proximal tibial angle (aMPTA), and condylar-plateau angle (CPA) were measured. We examined the relationship between the FBA and related factors by using multiple linear regression.

Results

The proportion of individuals with radiographic KOA (≥ KL grade 2) in this study was 37.9%. As KL grades increased, MAA, FBA, and CPA increased, whereas aLDFA and aMPTA decreased. FBA increased with age. Multiple linear regression analyses using FBA as a dependent variable showed relationship with higher age, lower height, higher BMI, lower bone mineral density, longer CSWT, and longer agricultural careers.

Conclusions

The results of this study suggest that external factors related to agricultural work in female farmers was associated with femoral bowing, in addition to internal factors such as age, bone density, height, and obesity.

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Short Communication

Fighting the COVID-19 pandemic: onsite mass workplace testing for COVID-19 in the Republic of Korea: Eunhye Seo, Eunchan Mun, Wonsool Kim, Changhwan Lee; Ann Occup Environ Med 2020;32:e22. Published online July 2, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e22

Abstract PDF

The ongoing coronavirus disease 2019 (COVID-19) pandemic is causing tremendous damage globally. The Republic of Korea (ROK), a highly export-dependent nation, is a leader in the fight against the COVID-19 pandemic and coping well with the disaster. Like the drive-through COVID-19 testing, which reflects the brilliant flexibility of the Korean medical system, onsite mass workplace testing for COVID-19, which our hospital has been performing over the past few months, is a unique and valuable countermeasure. We believe it is time that the current health examination system for workers in the ROK considered the risk of transmissible diseases.

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Research Article

Distribution of working position among workers with varicose veins based on the National Health Insurance and National Employment Insurance data: Saemi Jung, Youngki Kim, Dongmug Kang, Se Yeong Kim, Inah Kim, Eun Mi Kim; Ann Occup Environ Med 2020;32:e21. Published online July 1, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e21

Abstract PDF

Background

This study aimed to determine the effect of specific working postures on the development of varicose veins (VV). By using Korea's National Health Insurance (NHI) and National Employment Insurance (NEI) data, we analyzed the general characteristic and difference in proportions of VV cases according to occupational working posture.

Methods

From the NEI and NHI data, participant demographics, such as gender, age, body mass index, and number of workers in specific occupations or industries were obtained. We classified the 240 occupations into blue-collar (BC) and white-collar (WC) occupations and subdivided them into standing, sitting, and walking groups according to the dominant working posture.

Results

The number of VV patients per 100,000 individuals increased with age, with a higher number of women than men and a higher number of patients in the BC than WC groups. For the BC group, the proportion of VV cases was the highest in the standing group, followed by the walking and sitting groups, but there was no significant difference between standing and walking groups in man. For the WC group, the standing group had a higher proportion of VV cases than the sitting group, but there was no significant difference between the standing and sitting group in man. In the BC group, the proportion of VV cases was the highest among medical and welfare-related elementary workers, bakers and cookie makers, automobile assemblers, cleaning and guarding-related elemental workers, and nurses and dental hygienists. In the WC group, the proportion of VV cases was the highest among food/lodging/tourism/entertainment/sports-related managers, environment/cleaning/protective services-related managers, finance and insurance clerks, accounting book-keeping clerks, and social welfare and counseling professionals.

Conclusions

This study was performed to determine the characteristics of VV with different working posture among Korean workers. It is expected to be the basis of further studies on occupational musculoskeletal diseases.

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Abdullah M. Alwahbi
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Research Article

Association of work–life balance with occupational injury and work-related musculoskeletal pain among Korean workers: Jong-min An, Jinseok Kim, Seongyong Yoon, Kuck-Hyun Woo, Seong-yong Cho, Kibeom Kim, Ha-ram Jo; Ann Occup Environ Med 2020;32:e20. Published online June 30, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e20

Abstract PDF

Background

The concept of work-life balance (WLB) has become an important issue in workers' health and safety. This study aims to investigate the relationship between WLB and occupational injury and work-related musculoskeletal pain.

Method

The study included 27,383 workers who participated in the Fifth Korean Working Conditions Survey. Participants were divided into good WLB and poor WLB groups based on their responses to the five question items which comprised two dimensions: work-on-life conflict (items, 1–3) and life-on-work conflict (items 4 and 5). Occupational injury and musculoskeletal pain were also assessed using the question items. The χ² test and multivariate logistic regression analyses were performed to examine the relationship of WLB to occupational injury and musculoskeletal pain while considering socio-demographic and occupational characteristics and ergonomic and psychological risk factors.

Results

Of the 27,383 participants, 252 (0.9%) had experienced an occupational injury and 6,408 (23.4%) had musculoskeletal pain. The poor WLB group had higher injury rates for both men (1.7%) and women (0.9%) than the good WLB group (1.1% and 0.4%, respectively). Additionally, the prevalence of musculoskeletal pain was higher for both men and women in the poor WLB group (25.2% and 28.0%, respectively) than for men and women in the good WLB group (18.7% and 23.6%, respectively). In the logistic regression analysis, the adjusted odds ratio of WLB for occupational injury was 1.37 (95% confidence interval [CI]: 1.06–1.78), and that for musculoskeletal pain was 1.14 (95% CI: 1.07–1.21), showing positive associations of WLB with both occupational injury and musculoskeletal pain.

Conclusions

Poor WLB causes an increase in occupational injury and musculoskeletal pain. Therefore, an improvement in WLB may reduce the incidence of occupational injury and musculoskeletal pain among workers. Social and policy-related initiatives are needed to improve workers' WLB to reduce occupational injury and musculoskeletal pain.

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Avrasya Sağlık Bilimleri Dergisi.2025; 8(2): 117. CrossRef
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Saketh ASPVS, Vinnisa Nithiakala Vetrivel, T. Priyadarshini, Krishna Subramanyam, Naofumi Hashiguchi, Sangeetha Balaji
Journal of Clinical Orthopaedics and Trauma.2025; 70: 103184. CrossRef
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Haili Zhao, Hong Dou, Xianting Yong, Wei Liu, Saiyidan Yalimaimaiti, Ying Yang, Xiaoqiao Liang, Lili Sun, Jiwen Liu, Li Ning
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Research Article

The association between mercury concentrations and lipid profiles in the Korean National Environmental Health Survey (KoNEHS) cycle 3: Soo Ho Sohn, Han Cheol Heo, Seongmin Jo, Chulyong Park, Joon Sakong; Ann Occup Environ Med 2020;32:e19. Published online June 22, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e19

Abstract PDF

Background

High concentrations of mercury intake from seafood are known to cause various side effects in humans, including on the nervous system. Various studies have reported the effects of mercury concentrations in humans; however, the association between dyslipidemia, a cardiovascular disease risk factor, and mercury remains controversial. Therefore, this study aimed to investigate the association between mercury accumulation and cholesterol concentrations in a Korean population.

Methods

We analyzed data of a sample of 3,228 respondents obtained from the Korean National Environmental Health Survey cycle 3, surveyed between 2015 and 2017, to determine how lipid profiles changed according to the blood mercury concentrations (BHg) and urine mercury concentrations (UHg). Multiple regression analysis was used to determine the effects of mercury concentrations among various factors affecting blood cholesterol levels.

Results

The arithmetic mean (AM) of BHg was 2.91 (2.81–3.02) μg/L, and the geometric mean (GM) was 2.71 (2.59–2.85) μg/L. The AM of UHg was 0.52 (0.48–0.56) μg/L, and the GM was 0.35 (0.33–0.38) μg/L. Lipid profiles were more related to the BHg than to the UHg. Total cholesterol (total-C), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels increased significantly as BHg increased in males, and total-C, triglyceride, and LDL-C levels increased significantly in females. Multiple regression analysis indicated that BHg were significantly associated with total-C, HDL-C, and LDL-C levels.

Conclusions

We found an association between mercury exposure and the risk of dyslipidemia; however, further studies are required to elucidate a causal association.

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Research Article

Association between change in working time arrangements and sleep disturbance: Ryun Ha, Jae Bum Park, Kyung-Jong Lee, Sunguk Choi, Inchul Jeong; Ann Occup Environ Med 2020;32:e18. Published online June 18, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e18

Abstract PDF Supplementary Material

Background

Change in working time arrangement (WTA) can be harmful to workers' sleep and health. This study aimed to investigate the association between change in working time arrangement and sleep disturbance.

Methods

This study used data from the Fifth Korean Working Condition Survey and included 33,203 paid workers. We performed a stratified analysis by sex. After dividing the participants into 6 groups based on whether or not they experienced WTA changes, and their weekly working hours (≤40, 41–52, ≥53 hours), we calculated odds ratio (OR) using the weekly working hours ≤40 hours and with no WTA change as the reference group.

Results

Of the 33,203 paid workers, participants who experienced change in working time arrangement had higher prevalence of all three types of sleep disturbance symptoms (difficulty in falling asleep, waking up repeatedly during sleep, and waking up with a feeling of exhaustion and fatigue) in both sexes. Compared to the reference group at 95% confidence interval (CI), the group with change in WTA showed elevated OR values of 1.91 (95% CI: 1.73–2.11), 1.93 (95% CI: 1.74–2.14), 2.47 (95% CI: 2.26–2.71) for male workers; and 1.93 (95% CI: 1.73–2.16), 2.02 (95% CI: 1.80–2.27), 2.24 (95% CI: 2.01–2.50) for female workers, for difficulty in falling asleep, waking up repeatedly during the sleep, waking up with a feeling of exhaustion, and fatigue, respectively.

Conclusions

Workers who experience change in work time arrangement show a high risk of sleep disturbance in both sexes.

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Christine Erhel, Mathilde Guergoat-Larivière, Malo Mofakhami
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Research Article

Association between employment status and sickness presenteeism among Korean employees: a cross-sectional study: Jeong Woo Park, Seong Sik Cho, JongWoo Lee, Jonghyun Hwang, Jung Il Kim, Byoung Gwon Kim, Young Seoub Hong; Ann Occup Environ Med 2020;32:e17. Published online June 12, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e17

Abstract PDF

Background

Sickness presenteeism (SP) indicates “going to work while being ill.” The importance of SP has only recently been investigated, and the association between SP and employment status has been inconsistent across studies. Therefore, we conducted this study to explore the association between SP and employment status by using presenteeism propensity (PP), which can reflect the individual decision-making process.

Methods

The study population included employees participating in the 5th Korean Working Condition Survey. We analyzed data of only employees with at least one health event, which was calculated as the sum of SP and sickness absenteeism days. Employment status was grouped into 3 categories: stable employment, unstable employment (contract period ≥ 1 year), and unstable employment (contract period < 1 year). Survey-weighted logistic regression analysis was conducted to assess the association between employment status and PP (dichotomized as “≤ 0.5” and “> 0.5”).

Results

Unstable employees (contract period ≥ 1 year) had higher odds of PP than stable employees (odds ratio [OR]: 1.23, 95% confidence interval [CI]: 1.03–1.47), whereas unstable employees (contract period < 1 year) had lower odds of PP than stable employees (OR: 0.82, 95% CI: 0.71–0.96).

Conclusions

Employment status was associated with SP. Given the negative health impact of SP, social efforts, such as paid sick leave, are required to reduce SP and enhance the health status of unstable workers.

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Eiko Goto, Hirono Ishikawa, Tsuyoshi Okuhara, Hiroko Okada, Aiko Tsunezumi, Yumi Kagawa, Yoshihisa Fujino, Takahiro Kiuchi
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Research Article

A study of job stress, suicidal ideation and suicide attempts in display manufacturing workers: a cross-sectional study: Seung-hwan Ahn, Yong-Jin Lee, Eun-Chul Jang, Soon-Chan Kwon, Young-Sun Min, Seung-Hoon Ryu; Ann Occup Environ Med 2020;32:e16. Published online June 2, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e16

Abstract PDF

Background

This study aimed to investigate the association between job stress and suicide ideation/attempts among display manufacturing workers.

Methods

Data were collected from 836 workers in a display manufacturing company who participated in health screenings from May 22 to June 16, 2017. The data included general characteristics, night work, job tenure, previous physician-diagnosed chronic diseases, suicidal ideation/suicide attempts, and job stress. We investigated suicidal ideation/suicide attempts that covered the past year by using a self-reported questionnaire. Job stress was measured using the 43-item Korean Occupational Stress Scale. Multiple logistic regression analysis was used to investigate the association between job stress and suicidal ideation/suicide attempts. The mediator effect of depression on suicidal ideation/suicide attempts was tested using a series of logistic regression by applying Baron and Kenny's mediation method.

Results

In the model adjusting for variables (e.g., age, body mass index, smoking, alcohol consumption, regular exercise, shift work, job tenure, chronic disease and depression), physical environment (OR: 3.60, 95% CI: 1.08–12.02), lack of reward (OR: 5.31, 95% CI: 1.54–18.34), and occupation climate (OR: 7.36, 95% CI: 2.28–23.72) were correlated with suicidal ideation/suicide attempts in women. However, all subscales of job stress were not significantly correlated with suicidal ideation/suicide attempts in men. In mediation analysis, job instability and occupational climate were correlated with suicidal ideation/suicide attempts and were mediated by depression in men workers.

Conclusions

In women workers, the experiences of suicidal ideation/suicide attempts were significantly correlated with the physical environment, lack of reward, and occupational climate that were subscales of job stress. In men workers, depression rather than job stress was correlated with experiences of suicidal ideation/suicide attempts.

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Relationship between job stress and impaired fasting glucose in male steel industry workers: a cross-sectional study
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General work stress and suicide cognitions in health-care workers: mediating effect of hopelessness and job satisfaction
Abdulselami Sarigül, Alican Kaya, Izaddin Ahmad Aziz, Murat Yıldırım, Halil Ibrahim Özok, Francesco Chirico, Salvatore Zaffina
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Ethics, Medicine and Public Health.2022; 21: 100756. CrossRef

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Case Report

Mental health impact on a humidifier disinfectant disaster victim: a case report: Ye-Sung Lee, Min-Woo Nam, Hyun-Il Kim, Hyeong-Cheol Kim, Eun-Chan Mun, So-Young Park; Ann Occup Environ Med 2020;32:e15. Published online June 1, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e15

Abstract PDF

In Korea, the cause of lung disease of unknown origin was identified as humidifier disinfectants in November 2011. In February 2017, the ‘Special Act on Remedy for Damage Caused by Humidifier Disinfectants’ was promulgated. Even though emotional and mental injuries caused by humidifier disinfectants have been reported, the focus of the special act has been on physical injury only, and criteria for recognizing mental health impact have not been considered. This case considers emotional and mental injury caused by humidifier disinfectants. After a humidifier disinfectant was used from January 2005 to April 2006, the patient's son aged 20 months was hospitalized with respiratory symptoms, and he died within two weeks. Also, the patient was hospitalized for a month with the same symptoms, and then she led a normal life with no symptoms. After both mother and son were diagnosed with definite (level 1) humidifier disinfectant lung injury (HDLI) in 2017, she took to drinking alcohol because of extreme guilt over her son's death. In March 2018 she died from acute liver failure due to alcohol use disorder. The patient's death was caused by continuous alcoholism, due to emotional and mental trauma caused by her son's death after HDLI was revealed as the cause. The government did not acknowledge her death was due to humidifier disinfectants, but the company that sold the humidifier disinfectants recognized her as a victim and compensated the family of the victim. There are still lots of psychological responses among humidifier disinfectant disaster victims. Mental health impact on humidifier disinfectant victims should be considered more carefully, and institutional improvements should be made into establish psychological interventions and measures.

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In vitro neurotoxicity evaluation of biocidal disinfectants in a human neuron–astrocyte co-culture model
Ha-Na Oh, Seungmin Park, Sangwoo Lee, Hang-Suk Chun, Won-Ho Shin, Woo-Keun Kim
Toxicology in Vitro.2022; 84: 105449. CrossRef
Health Effects Associated With Humidifier Disinfectant Use: A Systematic Review for Exploration
Ji-Hun Song, Joonho Ahn, Min Young Park, Jaeyoung Park, Yu Min Lee, Jun-Pyo Myong, Jung-Wan Koo, Jongin Lee
Journal of Korean Medical Science.2022;[Epub] CrossRef
Developmental Toxicity and Thyroid Endocrine Disruption of Polyhexamethylene Guanidine Hydrochloride and Humidifier Disinfectant in Zebrafish Larvae
Suhyun Park, Hyojin Kim, Kyunghee Ji
Applied Sciences.2021; 11(11): 4884. CrossRef
Development of blood brain barrier permeation prediction models for organic and inorganic biocidal active substances
Hyun Kil Shin, Sangwoo Lee, Ha-Na Oh, Donggon Yoo, Seungmin Park, Woo-Keun Kim, Myung-Gyun Kang
Chemosphere.2021; 277: 130330. CrossRef
Need for individual-based evaluation to determine the association between humidifier disinfectants and health injuries
Hyeong-Cheol Kim, Hyunil Kim, Eun-Chan Mun, Yesung Lee, Soyoung Park
Annals of Occupational and Environmental Medicine.2021;[Epub] CrossRef

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Research Article

Relationship of spouses' weekly working hours and sleep problems in Korean wage workers: the 5th Korean working conditions survey: Chan Park, Eun-Chul Jang, Yong-Jin Lee, Soon-Chan Kwon, Young-Sun Min, Seong-Ryoul Chai; Ann Occup Environ Med 2020;32:e14. Published online June 1, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e14

Abstract PDF

Background

Sleep disorders are common and serious problems for mental health. This study investigated the relationship between spouses' weekly working hours (SWWH) and sleep problems by using the data from the 5th Korean Working Conditions Survey.

Methods

Data from 14,921 wage workers were used in the 5th Korean Working Conditions Survey. General and occupational characteristics, sleep problems are included in the questionnaire. Multivariate logistic regression analysis was used after adjustment for general and occupational characteristics to find the relationship between SWWH and sleep problems.

Results

Compared to those whose spouses worked less than 40 hours per week, risk of trouble falling asleep, waking up repeatedly while sleeping, and waking up with a feeling of exhaustion and fatigue was significantly higher as SWWH increase among those whose spouses worked 53 or more hours per week (odds ratio [OR]: 1.40, 95% confidence interval [CI]: 1.16–1.70; OR: 1.50, 95% CI: 1.23–1.82; OR: 1.51, 95% CI: 1.24–1.83).

Conclusions

SWWH were related to sleep problems among Korean wage workers.

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Associations of socioeconomic status and sleep disorder with depression among US adults
Wenzhen Li, Wenyu Ruan, Ying Peng, Zuxun Lu, Dongming Wang
Journal of Affective Disorders.2021; 295: 21. CrossRef

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Research Article

Longitudinal associations between occupational stress and depressive symptoms: Hyung Doo Kim, Shin-Goo Park, Youna Won, Hyeonwoo Ju, Sung Wook Jang, Go Choi, Hyun-Suk Jang, Hwan-Cheol Kim, Jong-Han Leem; Ann Occup Environ Med 2020;32:e13. Published online May 7, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e13

Abstract PDF

Background

Most of the studies that have examined the association between the sub-factors of occupational stress and depressive symptoms have used cross-sectional data. However, our study has longitudinally measured the occupational stress and depressive symptoms of Korean workers of a semiconductor manufacturing company across six years to intending to investigate the associations between the sub-factors of occupational stress and depressive symptoms using longitudinal data.

Methods

Data collected from the workers of a semiconductor manufacturing company. Out of 1,013 recruited workers, 405 (40.0%) completed the survey questionnaires at 3 and 6-year follow-ups. Occupational stress was measured using a shorter version of the Korean Occupational Stress Scale (KOSS), whereas depressive symptoms were assessed using the Korean version of the Center for Epidemiological Studies-Depressive Symptoms Scale (CES-D). The data of male and female participants independently analyzed. Longitudinal associations were analyzed using panel data analysis with fixed effects.

Results

In panel data analysis with fixed effects, job insecurity (B = 0.048, p-value = 0.004) was associated with depressive symptoms among male workers. In female workers, inadequate social support (B = 0.080, p-value < 0.001), job insecurity (B = 0.039, p-value = 0.004), lack of reward (B = 0.059, p-value = 0.004) and discomfort in occupational climate (B = 0.074, p-value < 0.001) were associated with depressive symptoms among female workers.

Conclusions

Temporal changes in the sub-factors of occupational stress were associated with changes in depressive symptoms within the same period. There was a gender difference in occupational stress sub-factors related to depressive symptoms.

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The correlation among occupational stress, coping style and depressive symptoms in 2083 Chinese manufacturing workers
Xiaoyi Li, Huiqing Chen, Xiqing Liao, Manqi Huang, Xiaoman Liu, Yao Guo, Jiabin Chen, Shuang Li
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Exploring Subjective Well-Being in Human-Machine Interaction: Protocol for a Mixed Methods, Cross-Sectional Analysis in Manufacturing 5.0
Giulia Bassi, Valeria Orso, Silvia Salcuni, Luciano Gamberini
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Fernanda Corsino Lima Hubner, Rosa Weiss Telles, Luana Giatti, Luciana A. C. Machado, Rosane Harter Griep, Maria Carmen Viana, Sandhi Maria Barreto, Lidyane V. Camelo
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Research Article

Psychosocial factors affecting sleep quality of pre-employed firefighters: a cross-sectional study: MyeongSeob Lim, Solam Lee, Kwanghyun Seo, Hyun-Jeong Oh, Ji-Su Shin, Sung-Kyung Kim, Hee-Tae Kang, Kyeong-Sook Jeong, Sung-Soo Oh, Sang-Baek Koh, Yeon-Soon Ahn; Ann Occup Environ Med 2020;32:e12. Published online May 8, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e12

Abstract PDF

Background

There have been no health-related studies of pre-employed firefighters without firefighter-specific job-related factors (FSJRF). This study aimed to evaluate the sleep quality of pre-employed firefighters and to examine the relationship between sleep quality and psychosocial factors.

Methods

We conducted a self-report questionnaire survey for 602 pre-employed firefighters at 3 Fire Service Academies after brief lecture about sleep. Sleep quality and psychosocial variables such as depression, anxiety, stress and social support were evaluated. The independent 2 sample t-test, χ² test and multiple logistic regression analysis were used to evaluate the effect of the variables on the sleep quality of pre-employed firefighters.

Results

Among a total of 602 people, 347 (57.6%) had good sleep quality and 255 (42.4%) had poor sleep quality. Pittsburgh Sleep Quality Index score of them was 3.29 ± 1.41) and 7.87 ± 2.20), respectively. 24 (4.0%) were evaluated to have insomnia by Insomnia Severity Index. Logistic regression analyses showed that the depression (adjusted odds ratio [aOR]: 5.940, 95% confidence interval [CI]: 3.124–11.292), anxiety (aOR: 4.233, 95% CI: 2.138–8.381), stress (aOR: 2.880, 95% CI: 1.915–4.330) and social support (aOR: 0.959, 95% CI: 0.939–0.980) have a significant effect on sleep quality after adjusted by sex, age, smoking status, drinking status, caffeine intake, past shift working and circadian rhythm type.

Conclusions

Depression, anxiety, stress and social support were associated with sleep quality among pre-employed firefighters. Repeated follow-up studies of pre-employed firefighters are needed to further assess their change of sleep quality and identify the FSJRF that may affect the sleep quality of firefighters.

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Nunnapat Piyachaiseth, Pornchai Sithisarankul, Jate Ratanachina
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Nancy A. Hamilton, Julia Russell, Kareem Hamadah, Westley Youngren, Addie Toon, Thu A. Nguyen, Kevin Joles
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The risk of insomnia by work schedule instability in Korean firefighters
Saebomi Jeong, Jeonghun Kim, Sung-Soo Oh, Hee-Tae Kang, Yeon-Soon Ahn, Kyoung Sook Jeong
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Amir Hossein Khoshakhlagh, Saleh Al Sulaie, Saeid Yazdanirad, Robin Marc Orr, Hossein Dehdarirad, Alireza Milajerdi
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Amensisa Hailu Tesfaye, Addisu Genene Masresha, Tirhas Tadesse, Fantu Mamo Aragaw, Belay Desye, Giziew Abere
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Brett A Messman, Danica C Slavish, Madasen Briggs, Camilo J Ruggero, Benjamin J Luft, Roman Kotov
Annals of Behavioral Medicine.2023; 57(7): 582. CrossRef
Heterogeneity in patterns of posttraumatic stress disorder symptoms and sleep disturbances among firefighters: Latent profile analyses
Elizabeth L. Griffith, Ling Jin, Ateka A. Contractor, Danica C. Slavish, Anka A. Vujanovic
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Hyun-Jeong Oh, Chang Sun Sim, Tae-Won Jang, Yeon Soon Ahn, Kyoung Sook Jeong
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Joel M. Billings
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Research Article

The relationship between precarious employment and subjective well-being in Korean wage workers through the Cantril ladder Scale: Go Choi, Shin-Goo Park, Youna Won, Hyeonwoo Ju, Sung Wook Jang, Hyung Doo Kim, Hyun-Suk Jang, Hwan-Cheol Kim, Jong-Han Leem; Ann Occup Environ Med 2020;32:e11. Published online April 17, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e11

Abstract PDF

Background

The global labor market is moving towards increasing job instability. Relatively few studies have examined the relationship between precarious employment and subjective well-being using quantitative scales. We evaluated the association between wage workers' employment status and their subjective well-being through the Cantril ladder scale using Korean Welfare Panel Survey data (KOWEPS).

Methods

This study used KOWEPS data. A total of 4,423 wage workers were divided into permanently employed workers, temporarily employed workers and daily employed workers. The relationship between precarious employment and subjective well-being was analyzed by multiple linear regression adjusted for potential confounding factors.

Results

The more unstable the employment status, the lower the subjective well-being, which can be expressed by the Cantril ladder scale. The mean score of both temporarily employed and daily employed workers were statistically significantly lower (B = −0.454, p < 0.001; B = −0.994, p < 0.001, respectively) than permanently employed workers. This appeared to be the same when occupational and sociodemographic factors were adjusted (B = −0.153, p = 0.002 for temporarily employed, B = −0.610, p < 0.001 for daily employed).

Conclusions

The more unstable the employment status, the lower the subjective well-being score according to the Cantril ladder scale.

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Employment Quality: A Social Determinant of Health and Well-Being in a Changing Labor Market in Korea
Julie Vanderleyden, Hyojin Seo, Christophe Vanroelen, Deborah De Moortel
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Living in Limbo: Exploring the Lived Experience of University Post-Graduates with Precarious Jobs in Iran and Effects on Their Well-Being
Aida Navabi, Sara Makki Alamdari, Nooh Monavvary, Abu Fakhri
Sociological Research Online.2025; 30(4): 960. CrossRef
Interaction between old age and precarious employment on poor mental well‐being in workers: Evidence from a nationally representative sample in Korea
Seong‐Uk Baek, Yu‐Min Lee, Jong‐Uk Won, Jin‐Ha Yoon
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Seong Chan Gong, Sungjin Park
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Leszek Sułkowski, Mateusz Rubinkiewicz, Andrzej Matyja, Maciej Matyja
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Seong-Uk Baek, Jin-Ha Yoon, Jong-Uk Won
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Inmyung Song, Hye-Jae Lee, José Antonio Ortega
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Research Article

Relationship between seafood consumption and bisphenol A exposure: the Second Korean National Environmental Health Survey (KoNEHS 2012–2014): Yeji Kim, Minkyu Park, Do Jin Nam, Eun Hye Yang, Jae-Hong Ryoo; Ann Occup Environ Med 2020;32:e10. Published online March 5, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e10

Abstract PDF

Background

This study aimed to identify the relationship between exposure to bisphenol A (BPA) and seafood consumption using a nationally representative data of the general Korean population.

Methods

This study was conducted on 5,402 adults aged 19 years and older (2,488 men, 2,914 women) based on the second Korean National Environmental Health Survey (2012–2014). We stratified the data according to gender and analyzed urinary BPA concentrations in terms of sociodemographic characteristics, health behavior, dietary factor, and seafood consumption. In the high and low BPA exposure groups, the odds ratios (ORs) were calculated using logistic regression analysis according to the top 75th percentile concentration.

Results

In men, large fish and tuna and other seafood categories had significantly higher ORs before and after adjustment in the group who consumed seafood more than once a week than in the group who rarely consumed seafood, with an adjusted value of 1.97 (95% confidence interval [CI]: 1.12–3.48) and 1.74 (95% CI: 1.10–2.75), respectively. In the shellfish category, the unadjusted OR was 1.61 (95% CI: 1.00–2.59), which was significantly higher in the group who consumed seafood more than once a week than in the group who rarely consumed seafood. However, the OR after adjusting for the variables was not statistically significant. In women, the frequency of seafood consumption and the concentration of urinary BPA were not significantly associated.

Conclusions

BPA concentration was higher in men who frequently consumed large fish and tuna, shellfish and other seafood in this study.

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V. Supornsilchai, L. Sutthirat, I. Kaewkamnerdpong, C. Jantarat, N. Sakorn, W. Nosoongnoen, T. Chaiboonyarak, L. Samaranayake, S. Wacharasindhu, T. Porntaveetus
JDR Clinical & Translational Research.2026; 11(1): 53. CrossRef
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Siyu Yang, Weiyi Jin, Chunhai Gao, Yeqing Jia, Xinghua Li, Jianping Li, Yi Zhang
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Siyoung Kim, Seong-yong Cho, Seongyong Yoon, Daehwan Kim, Hyun Woo Park, Jisoo Kang, Sung Woo Huh
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Jisoo Kang, Seong-yong Cho, Jinseok Kim, Seongyong Yoon, Jong-min An, Gayoung Kim, Si young Kim
Annals of Occupational and Environmental Medicine.2023;[Epub] CrossRef
Endocrine disrupting chemicals: A promoter of non-alcoholic fatty liver disease
Yajie Chen, Yang Wang, Ziqiang Cui, Wenpeng Liu, Baowang Liu, Qiang Zeng, Xin Zhao, Jian Dou, Jinglin Cao
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Jisoo Kang, Seong-yong Cho, Seongyong Yoon
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Bisphenol S Impairs Oestradiol Secretion during In Vitro Basal Folliculogenesis in a Mono-Ovulatory Species Model
Claire Vignault, Véronique Cadoret, Peggy Jarrier-Gaillard, Pascal Papillier, Ophélie Téteau, Alice Desmarchais, Svetlana Uzbekova, Aurélien Binet, Fabrice Guérif, Sebastien Elis, Virginie Maillard
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Jun Young Uhm, Hyoung-Ryoul Kim
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Research Article

Association between use of humidifier disinfectant and allergic rhinitis in Korean children: a cross-sectional study based on the eighth Panel Study on Korean Children (PSKC): Tae Hwan Koh, Jong-Tae Park, Daeil Kwon, Kyeongmin Kwak; Ann Occup Environ Med 2020;32:e9. Published online February 17, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e9

Abstract PDF Supplementary Material

Background

Rhinitis was the most frequently diagnosed disorder among users of humidifier disinfectants (HDs). The aim of our study was to investigate on the relationship between allergic rhinitis (AR) and HD uses.

Methods

Our study used the data from the eighth Panel Study on Korean Children; a total of 1,540 participants were enrolled. The χ² test and multiple logistic regression analyses were conducted to debunk the association between AR and HD uses.

Results

In our analysis, odds ratios (ORs) of doctor-diagnosed AR increased significantly when simply the response of whether HDs were used in the past was considered. When the brands of HD were considered, ORs of doctor-diagnosed AR were found to be increased significantly for those who have used polyhexamethylene guanidine phosphate/oligo(2-[2-ethoxy]-ethoxyethyl)guanidinium-containing HDs (model 3: 1.41, 95% confidence interval [CI]: 1.02–1.95). However, once duration of usage was additionally considered, ORs of doctor-diagnosed AR increased significantly only for those who have used chloromethylisothiazolinone/methylisothiazolinone-containing HDs for more than or equal to 3 months (model 3: 2.08, 95% CI: 1.17–3.69). Further, past use of HD was associated with significantly increased ORs of AR diagnosed before 2013 (model 3: 1.35, 95% CI: 1.02–1.79).

Conclusions

Results of our study suggest that past uses of HDs may be associated with an increased risk of AR.

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Exposures to humidifier disinfectant and various health conditions in Korean based on personal exposure assessment data of claimants for compensation
Myeongjin Hong, Min Jae Ju, Jeonggyo Yoon, Wonyoung Lee, Seula Lee, Eun-kyung Jo, Seo-Youn Choi, Wonho Yang, Yoon-Hyeong Choi
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Ji-Hun Song, Joonho Ahn, Min Young Park, Jaeyoung Park, Yu Min Lee, Jun-Pyo Myong, Jung-Wan Koo, Jongin Lee
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Hyeong-Cheol Kim, Hyunil Kim, Eun-Chan Mun, Yesung Lee, Soyoung Park
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Research Article

Pregnancy, childbirth, and puerperium outcomes in female firefighters in Korea: Juha Park, Yeon-Soon Ahn, Min-Gi Kim; Ann Occup Environ Med 2020;32:e8. Published online January 31, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e8

Abstract PDF

Background

Female firefighters are exposed to hazardous environmental (chemical and physical) and working (shift work, psychological, and ergonomic factors) conditions that have reported or are suspected of adverse effects on reproductive health. However, no previous studies have reported on pregnancy, childbirth, and puerperium outcomes (PCPOs) in female firefighters.

Methods

The present study compared hospital admissions for PCPOs, based on 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) codes, among Korean female firefighters with those of the general Korean population. Standardized admission ratios (SARs) and their 95% confidence intervals (CIs) were calculated.

Results

The study population included 1,766 female firefighters. Total follow-up duration was 9,659 person-years. Compared to the general female population, the female firefighters' SARs were higher in all admissions for PCPOs (SAR, 1.92; 95% CI: 1.79–2.05); pregnancy and abortive outcomes (SAR, 1.56; 95% CI: 1.12–2.12); other maternal disorders predominantly related to pregnancy (SAR, 2.65; 95% CI: 1.99–3.46); maternal care related to the fetus, amniotic cavity, and possible delivery problems (SAR, 2.13; 95% CI: 1.74–2.57); labor and delivery complications (SAR, 1.55; 95% CI: 1.15–2.06); delivery (SAR, 1.94; 95% CI: 1.80–2.08); and complications predominantly related to puerperium (SAR, 4.68; 95% CI: 2.02–9.23).

Conclusion

The results of this study showed high SARs in all and specific subcategories of PCPOs in female firefighters.

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Birth defects associated with paternal firefighting in the National Birth Defects Prevention Study
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Research Article

Descriptive analysis of prevalence and medical expenses of cancer, cardio-cerebrovascular disease, psychiatric disease, and musculoskeletal disease in Korean firefighters: Jeehee Min, Yangwoo Kim, Hye Sim Kim, Jiyoung Han, Inah Kim, Jaechul Song, Sang-Baek Koh, Tae-Won Jang; Ann Occup Environ Med 2020;32:e7. Published online January 30, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e7

Abstract PDF Supplementary Material

Background

Firefighters are exposed to many dangerous working conditions. Many studies have identified the risk of disease for firefighters, but only a few studies have addressed the medical expenses of firefighters, which represents a concrete scale of disease. Our purpose in this study was to determine the medical expenditures of firefighters to assess the overall scale of disease in Korea. We focused on cancer, mental disorders, cardio-cerebrovascular disease, and musculoskeletal disease, the prevalence of which was expected to be high in firefighters.

Methods

This study utilized National Health Insurance Service data. We targeted firefighters, police officers, and government officials. We classified disease based on the 10th revision of the International Statistical Classification of Diseases and Related Health Problems codes. We compared prevalence by the age-standardized prevalence rate, considering standard distribution of the population. Medical expenditure of disease was defined as outpatient fees, hospitalization fees, and drug costs. Total medical expenditures were calculated by the sum of those 3 categories.

Results

The age-standardized prevalence of cancer, mental disorders, and cardiovascular disease in firefighters was slightly higher than or similar to that of government officials and police officers (no significant difference). However, medical expenditures for stomach cancer, mental disorders, and most cardio-cerebrovascular diseases were higher in firefighters than in others. In particular, firefighters spent 12 times more money for ischemic heart disease than did government officials. Of musculoskeletal diseases, lumbar disc disorder had the highest expenditures among firefighters.

Conclusions

The age-standardized prevalence of most of diseases of firefighters was not as high as in the other groups, but the medical expenses of firefighters were much higher than those of government officials and police officers.

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Joel Martin, Nasser McCummings, Yosef Shaul, Marcie Fyock-Martin, Jodi McConnell
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Amir Hossein Khoshakhlagh, Saeid Yazdanirad, Saleh Al Sulaie, Abdollah Mohammadian-Hafshejani, Robin Marc Orr
International Journal of Occupational Safety and Ergonomics.2024; 30(1): 272. CrossRef
Cohort Profile: The Registry-based Epidemiological Study of Cancer in Fire Unit and Emergency Officers (RESCUE) cohort
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Research Article

Multidimensional sleep quality of dependent self-employment workers: Sang Ha Lee, Dukyun Kang, Junhyeong Lee, Uijin Kim, Seunghon Ham, Wanhyung Lee, Won-Jun Choi, Seong-Kyu Kang; Ann Occup Environ Med 2020;32:e6. Published online January 22, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e6

Abstract PDF

Background

The number of workers in non-standard employment (NSE) is increasing due to industrial change and technological development. Dependent self-employment (DSE), a type of NSE, was created decades ago. Despite the problems associated with this new type of employment, few studies have been conducted on the effects by DSE on health, especially sleep quality. This study aims to determine the relationship between DSE and sleep quality.

Methods

This study analyzed data of 50,250 wage workers from the fifth Korean Working Conditions Survey. Workers that did not respond or refused to answer any questions related to variables were excluded, and finally 36,709 participants were included in this study. A total of 2,287 workers (6.2%) were compared with non-DSE (34,422; 93.8%) workers, and multiple logistic regression analyses were applied.

Results

DSE status had a significant association with difficulty falling asleep (odds ratio [OR]: 1.331, 95% confidence interval [CI]: 1.178–1.504), difficulty maintaining sleep (OR: 1.279; 95% CI: 1.125–1.455), and extreme fatigue after waking up (OR: 1.331; 95% CI: 1.184–1.496). A multiple logistic regression of the variables for sleep quality in DSE showed a significant association with exposure to physical factors for all types of poor sleep quality as well as shift work for difficulty maintaining sleep with extreme fatigue after waking up. Long working hours and emotional labor were also associated with extreme fatigue after waking up.

Conclusions

This study shows a significant association between DSE and poor sleep quality, especially when workers were exposed to physical risk factors (noise, vibration, abnormal temperature, etc.) and shift work.

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Minji Kim, Inho Park, Hyojin An, Byungyoon Yun, Jin-Ha Yoon
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Self-employment and health inequality of migrant workers
Deshui Zhou, Xin Wen
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Mental health symptoms among dependent contractors in Korea: a cross-sectional study based on the Fifth Korean Working Condition Survey
Seong-Uk Baek, Sung-Shil Lim, Sehyun Yun, Won-Tae Lee, Min-Seok Kim, Jin-Ha Yoon, Jong-Uk Won
Annals of Occupational and Environmental Medicine.2022;[Epub] CrossRef
The Effect of Job Demands, Job Resources, and Musculoskeletal Complaints on Presenteeism Among the Dependent Self-employment Workers in Korea
Jiyun Kim, Sookja Choi
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Research Article

Association between green areas and allergic disease in Korean adults: a cross-sectional study: Hyun-Jin Kim, Jin-young Min, Hye-Jin Kim, Kyoung-bok Min; Ann Occup Environ Med 2020;32:e5. Published online January 22, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e5

Abstract PDF

Background

Although many epidemiological studies have reported the inverse associations between greenness and health outcomes, inconsistent associations in allergic diseases remain an issue. We aimed to identify associations between greenness and allergic diseases among Korean adults.

Methods

In total, 219,298 adults from the 2009 Korea Community Health Survey were included in this study. Individuals' allergy-related conditions, such as atopic dermatitis and allergic rhinitis, were evaluated. To identify the amount of green areas (m²) per capita in each administrative region, we used the 2009 data for green areas from the Korean Statistical Information Service.

Results

The risk for atopic dermatitis in the highest quartile of green areas was significantly lower compared with that of the lowest quartile. Physician's diagnosis and current treatment of odds ratios (ORs) with 95% confidence intervals (CIs) were 0.82 (0.73–0.91) and 0.77 (0.64–0.92), respectively. Similarly, the association results for allergic rhinitis showed that the highest level of green areas was significantly associated with a decreased risk of allergic rhinitis in full-adjustment model quartiles. Physician's diagnosis and current treatment of OR (95% CI) were 0.94 (0.89–0.99) and 0.91 (0.82–1.00), respectively.

Conclusions

We observed inverse associations of green areas with atopic dermatitis and allergic rhinitis in Korean adults.

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International Journal of Chronic Obstructive Pulmonary Disease.2025; Volume 20: 3035. CrossRef
Association between residential greenness and allergic diseases among adolescents in South Korea: A nationwide representative study
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Case Report

Gastric and rectal cancers in workers exposed to asbestos: a case series: Byeong Ju Choi, Saerom Lee, Iu Jin Lee, Soon Woo Park, Sanggil Lee; Ann Occup Environ Med 2020;32:e4. Published online January 2, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e4

Abstract PDF

Background

The Occupational Safety and Health Research Institute (OSHRI) of the Korea had not recognized gastrointestinal cancer as work-related disease during their evaluation. However, in 2018 OSHRI recognized gastric and rectal cancers as work-related disease in asbestos-exposed workers. We present 2 such cases along supportive evidence of causation.

Case presentation

Patient A: A 57-year-old man had worked for about 40 years since 1978 as an oxygen cutter at workplaces that dismantle ships, buildings, boilers, and thermal power plants. In November 2016, endoscopy and biopsy confirmed the diagnosis of advanced gastric cancer, for which he underwent subtotal gastrectomy and chemotherapy; however, he later died of the cancer. Patient B: A 71-year-old man had worked in shipbuilding and repair workplaces for approximately 49 years, being employed in pipe laying, asbestos insulation installation, grinding, and other ship repair work. In 2003, he was diagnosed of rectal cancer by abdominal computed tomography. He accordingly underwent surgical removal of the cancer. Based on the occupational history of the 2 patients and our review of the relevant literature addressing the occupational environment, we concluded that both patients had continuous exposure to high levels of asbestos while performing their jobs for 40 and 49 years, respectively.

Conclusion

Both patients had a history of smoking and drinking (non-occupational personal risk factors). However, the possibility of an increased risk of gastric and rectal cancers from asbestos exposure cannot be excluded. Therefore, we considered that occupational exposure to asbestos had contributed to the cancer diagnosis in these cases. Workers exposed to asbestos should be made aware of the possibility of gastric or rectal cancer, and should undergo monitoring and medical examinations. Appropriate compensation for gastric and rectal cancers that occur in workers exposed to asbestos are anticipated in future.

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Yi-Jen Fang, Hung-Yi Chuang, Chih-Hong Pan, Yu-Yin Chang, Yawen Cheng, Lukas Jyuhn-Hsiarn Lee, Jung-Der Wang
International Journal of Environmental Research and Public Health.2021; 18(14): 7521. CrossRef
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Research Article

Mercury concentration in shark meat from traditional markets of Gyeongsangbuk-do, South Korea: Han Cheol Heo, Yeon Hee Lim, Young Seok Byun, Joon Sakong; Ann Occup Environ Med 2020;32:e3. Published online January 2, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e3

Abstract PDF

Background

Although unusually high levels of blood mercury have been reported in the North Gyeongsang Province (Gyeongsangbuk-do), mercury contents from shark meat distributed in this region have not been assessed yet. Thus, this study aims to identify the hazard by evaluating the mercury contents of the shark meat sold in the traditional market of Gyeongsangbuk-do.

Methods

The shark meat in the form of muscle meat was obtained from 15 traditional markets of Gyeongsangbuk-do in the summer and winter of 2013. Out of 105 samples in total, 49 were collected in the summer and 56 in the winter. The total mercury concentration was measured by the combustion-gold amalgamation method using an automatic mercury analyzer (Milestone DMA-80, Milestone).

Results

The average mercury concentration of shark meat was 2.29 ± 1.77 µg/g, ranging between 0.06–8.93 µg/g with a geometric mean of 1.44 µg/g, which is higher than those reported in many countries. The mercury concentration in 77 of 105 shark meat samples exceeded 1 µg/g. Mercury concentration ranged between 0.09–8.93 µg/g (geometric mean: 1.45) in the summer and 0.06–6.73 µg/g (geometric mean: 1.48) in the winter.

Conclusions

Shark meat sold in the market contained a substantial amount of mercury. This suggests that it is difficult to reduce mercury intake by simply strengthening the standard level of mercury concentration in shark meat. Therefore, it is need to communication and awareness programs with consumers about hazardous effects of mercury inherent in shark meat.

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Jin-Wook Chung, Dilaram Acharya, Jitendra Kumar Singh, Joon Sakong
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Research Article

Validity assessment of self-reported smoking status in firefighters using the urine cotinine test: Han Cheol Heo, Young Seok Byun, Soo Ho Sohn, Seong Min Jo, Sung Kyu Park, Joon Sakong; Ann Occup Environ Med 2020;32:e2. Published online January 2, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e2

Abstract PDF

Background

In firefighters, smoking management is important because they are exposed to various harmful substances in their occupational environment. Accurate surveys of smoking status are essential to control tobacco use. The main disadvantage of self-report questionnaires, which are commonly used for investigating smoking status, is the possibility that the subjects' response are invalid. If the validity of firefighters' answers on smoking questionnaires is not adequate, different methods will be needed for investigating smoking status in firefighters.

Methods

This study was conducted on 445 male firefighters from 9 fire stations in Daegu (the city in South Korea) who visited a medical institution for medical checkup in 2016. The urine cotinine test strip (DCT-102; CLIAwaived Inc., cut-off value = 200 ng/mL) was used to classify the actual smoking status and to assess the validity of self-reported smoking status on questionnaires. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the smoking questionnaires were analyzed. Subjects testing positive in the urine cotinine test (assumed the actual current smokers) were selected. The frequency at which actual current smokers were misclassified as current non-smokers by the questionnaire was calculated. Subjects' characteristics were analyzed for possible association with any discrepancy between self-reported smoking status and urine cotinine test results.

Results

The smoking rates among firefighters surveyed using the smoking questionnaire and the urine cotinine test were 22.47% and 51.24%, respectively. Of the all subjects, 29.66% (n = 132) were misclassified. The sensitivity of the smoking questionnaire was 42.98%, the specificity was 99.08%, the PPV was 98.00%, and the NPV was 62.32%. In the 228 subjects classified as current actual smokers by the urine cotinine test, 57.02% (n = 130) were misclassified on the questionnaire. The misclassification rate increased with age. The degree of misclassification also increased when subjects had a history of disease.

Conclusions

In present study, the validity of the smoking questionnaire for firefighters was not suitable for investigating smoking status due to low sensitivity. To increase the validity of smoking status monitoring in firefighters, consideration of the various factors like survey environment, subjects' characteristics, and occupational factors is needed.

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Case Report

Problems with diagnostic criteria for humidifier disinfectant lung injury (HDLI): two cases of radiologically improved HDLI: Min-Woo Nam, So-Young Park, Byung-Seong Suh, Soo-Youn Ham, Kyung-Hun Son, Hyunil Kim, Hyeong-Cheol Kim; Ann Occup Environ Med 2020;32:e1. Published online January 2, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e1

Abstract PDF

Background

In Korea, to investigate the casual relationship between humidifier disinfectant and lung disease, four rounds of investigation and judgment were conducted. During this investigation, two adults who performed lung biopsy were recognized for their relevance between humidifier disinfectants and lung disease. At first, we did not think of the relationship to humidifier disinfectant because chest computed tomography (CT) finding of 2 cases were improved. However, they performed lung biopsy and it showed typical humidifier disinfectant lung injury (HDLI) pathologic findings, they could be recognized as HDLI. We report these cases here.

Case presentation

We selected 2 cases from the fourth-round investigation at Kangbuk Samsung Hospital. Patient of case 1 used humidifier disinfectants since September 2010. The patient was admitted 6 months later to the intensive care unit (ICU) due to severe dyspnea. Pathology following a lung biopsy revealed typical HDLI finding which was determined to be due to humidifier disinfectant exposure. Patient of case 2 used humidifier disinfectant from 2001 to 2008 for about 3 months each winter. The patient's cough and sputum production symptoms began in December of 2007. The patient was admitted to the respiratory medicine department due to worsening dyspnea. Pathology following a lung biopsy revealed typical HDLI finding. This was determined to have been caused by humidifier disinfectant exposure.

Conclusions

Because the typical radiologic findings associated with HDLI can improve over time, it is necessary to consider the revision of current diagnostic criteria that the presence of radiologic findings is important.

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Takumi Kagawa
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Ji-Hun Song, Joonho Ahn, Min Young Park, Jaeyoung Park, Yu Min Lee, Jun-Pyo Myong, Jung-Wan Koo, Jongin Lee
Journal of Korean Medical Science.2022;[Epub] CrossRef
A comprehensive study of deaths due to exposure to humidifier disinfectant in Korea: focusing on medical records, assessment of exposure to humidifier disinfectants, and causes of death
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Epidemiology and Health.2021; 43: e2021091. CrossRef

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