OBJECTIVE: This study was conducted to compare the job characteristics (work demand, decision latitude, and job insecurity) and psychosocial stress levels of typical workers in the parent firm, to those of atypical workers in subcontracted firms. In addition the risk factors for psychosocial stress of atypical workers are evaluated. METHOD The study design was cross-sectional, and 1,713 shipbuilding workers (681; typical workers, 1,032; atypical workers) were recruited. A structured-questionnaire was used to assess the general characteristics, job characteristics and psychosocial stress levels. We used the chi-square test for univariate and multiple regression analyses. RESULTS In univariate analyses, there were significant differences in smoking, hobby, insufficient sleeping, work hours per week, quitting, unemployment, job demand, job decision latitude and job insecurity. The job strain was significantly higher in the atypical workers than in the typical workers. The proportion of iso-strain groups was significantly greater in the atypical workers than typical workers. Using psychosocial stress as the dependent variable, multiple regression models were estimated. After adjustment for sociodemographic factors, unemployment, quitting, employment type, job demand, job decision latitude and job insecurity were all found to be significantly associated with psychosocial stress. CONCLUSION This result suggests that the psychosocial stress of atypical workers is related to job characteristics such as job insecurity and labor flexibility.
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OBJECTIVE: This study evaluated the complaint rates of musculoskeletal symptoms and investigated the related factors of musculoskeletal symptoms in the caddies. METHODS For 316 caddies working at 6 regular golf courses, we used the self-recording questionnaires to examine general characteristics, job stress factors, subjective musculoskeletal symptoms designed by NIOSH, working environments, and working contents. RESULTS The complaint rates of musculoskeletal symptoms according to the musculoskeletal criteria of NIOSH were 41.8% in the leg/knee/ankle/foot, 35.8% in the shoulder, 35.8% in the upper back/lower back, 28.8% in the neck, and 28.5% in the arm/wrist/fingers. Important factors affecting musculoskeletal symptoms were daily working hours during the high-demand season in all anatomical sites except the arm/wrist/fingers. Other related factors were degrees of winding and inclined in the golf courses, violent language and violence of customers, inability to regulate the velocity and work load control, heavy physical burden, instability of employment, and possibility of unemployment according to the specialty of caddies. As a results of multivariate logistic regression analysis, musculoskeletal symptoms of the neck, shoulders, back/lower back and leg/knee/ankle/foot were significantly influenced by working time over 12 hours in the high-demand season, and symptoms of the arm/wrist/fingers by low decision latitude (P<0.05). CONCLUSIONS The complaint rates of musculoskeletal symptoms in the caddies were affected by working time over 12 hours and low decision latitude against excessively high psychological job demand.
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OBJECTIVES To evaluate the association of urinary 2-naphthol level and air pollution caused by exposure to smoking, traffic and residential factors. METHODS The study subjects consisted of 300 university students in Incheon. The questionnaires concerning subject characteristics, smoking amount, traffic, distance between housing and main road, heating and cooking fuel including urinary cotinine levels were checked. RESULTS There was not any significant association between urinary 2-naphthol level and age, sex, body mass index, distance from mainroad, traffic, heating and cooking fuel. The urinary 2-naphthol level was higher in smokers or high urinary cotinine level group(p=0.0001)than in nonsmokers or low urinary cotinine group. After adjusting for age, sex, and body mass index in the basic model, the 2-naphthol level was also higher in the smokers or high urinary cotinine level group, too(p<0.0005). The model included both traffic and residential variables and it had a good fitness as compared to other models. CONCLUSIONS It has been known that as one of PAH metabolites, urinary 2-naphthol is a respiration-selective biological marker. We showed that tabacco smoking has a much stronger effects on urinary 2-naphthol levels than when subjects were exposed to air pollution, such as traffic, and other residential factors at the same time.
OBJECTIVE: A growing body of literature has documented that job stress is associated with the development of cardiovascular disease. Nevertheless, the pathophysiological mechanism of this association remains unclear. Therefore, we tried to elucidate the relationship between job stress, heart rate variability and metabolic syndrome. METHOD The study design was cross-sectional, and 169 industrial workers were recruited. A structured-questionnaire was used to assess the general characteristics and job characteristics (work demand, decision latitude). Heart rate variability (HRV) was recorded using SA-2000 (medi-core). HRV was assessed by time-domain and by frequency-domain analyses. Time domain analysis was performed for SDNN (Standard Deviation of NN interval), and spectral analysis for low-frequency (LF), high-frequency (HF) and total frequency power. Metabolic syndrome was defined on the basis of clustering of risk factors, when three or more of the following cardiovascular risk factors were included in the fifth quintile: glucose, systolic blood pressure, HDL-cholesterol (bottom quintile), triglyceride and waist-hip ratio. RESULTS The results showed that job characteristics were not associated with cardiovascular risk factors. The high strain group had a less favorable cardiovascular risk profile with higher levels of blood pressure, glucose, homocysteine, and clotting factor than the lower strain group (low strain+passive+active group), but the difference was not statistically significant. The SDNN of HRV was significantly lower in the high strain group than in the low strain group. The prevalence of metabolic syndrome in the low strain, passive, active and high strain groups was 9.7%, 13.9%, 14.9% and 23.8%, respectively. In the high strain group, the metabolic syndrome was significantly related to a decreased SDNN. However, we could not find a significant association in LF/HF ratio. CONCLUSION This result suggests that decreased HRV does not play a role in the development of disease; however, it can induce cardiovascular abnormalities or dysfunctions related to the onset of heart disease among high risk groups.
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OBJECTIVE: Workload is known to affect the hypothalamus-pituitary-adrenal axis. Although many studies had revealed that job stress related factors could affect the neuroendocrine system among blue-collar workers, these studies had limitations as they had not evaluated the workload by objective methods which took into consideration individual physiological differences. This study was conducted to evaluate the effects of physical workload adjusted job stress on cortisol regulation by using objective tools for workers having various job tasks. METHODS Among 110 foundry workers, shipyard workers, and fine machine assemblers for whom saliva samples were obtained, 102 without any past history of conditions that could affect hormonal regulation such as diabetes, and hypertension were included in this study. Among the 102 study participants, 15 workers whose saliva for morning or afternoon or heart rate monitoring data was not attained were excluded from the final analysis. Workload was evaluated by RHR (relative heart rate) using a heart rate monitor, and job stress was evaluated by Karasek's Job Content Questionnaire. Saliva samples were gathered during 8 - 9 am and 5 - 6 pm, and salivary cortisol levels were analysed by radioimmunoassay. RESULTS After adjusting several variables which could effect cortisol secretion including job stress, among the higher RHR group morning salivary cortisol level was increased (beta=60.32, S.E.=26.35, p=0.0266), afternoon salivary cortisol level was decreased (beta=-7.43, S.E.=29.73, p=0.8044), and salivary cortisol level difference between morning and afternoon was increased (beta=72.10, SE=35.50, p=0.0509). CONCLUSIONS As physical workload increases morning cortisol level, which is caused by the effect of arousal, and decreases afternoon cortisol level, which is caused by exhaustion, physical workload enlarges the width of diurnal cortisol variance. Therefore, physical exhaustion due to excessive workload could have adverse effects on the neuroendocrine system.
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OBJECTIVES Mass poisoning by carbon disulfide (CS2) occurred in a viscose rayon factory in Korea. Up until 1998, 830 employees, including 38 who had died, were diagnosed with CS2 poisoning. Among the CS2 poisoned subjects, heart rate variability (HRV) was evaluated to investigate whether the toxic effect of CS2 persists after the exposure has ceased. The dose-response relationship between carbon disulfide exposure and HRV was also evaluated. METHODS The case group was comprised of 71 retired male workers diagnosed as being CS2 poisoned. The control group was comprised of 127 males of same age-range who had no history of CS2 exposure and cardiovascular diseases. Information on individual age, height, weight, cigarette smoking, alcohol drinking, regular exercise, medical and occupational history, chest x-ray, and ECG recording of the two groups were collected through a self-administered questionnaire and with a medical examination. Time (maximum, average, minimum RR interval) and frequency domain measures (low frequency - LF, high frequency - HF, total power spectrum TPS, and LF/HF ratio) of the two groups were analyzed. CS2 exposure indices of the case group (duration of employment, exposure level per work department, cumulative exposure index and duration of retirement) were investigated. RESULTS Using a univariate analysis, the frequency domain measures for the case group were significantly lower than those in the control group, except for HF. In the multivariate analysis, previous history of CS2 poisoning was inversely related to all frequency domain parameters and it significantly affected the LF (p<0.05) and the LF/HF ratio (p<0.05). There was no significant dose-response relationship between CS2 exposure indices and HRV parameters in the case group. CONCLUSION This study suggests that further studies are necessary to evaluate the residual effects of CS2 poisoning even after the CS2 exposure has ceased.
Woo Chul Jeong, Ho Jang Kwon, Mina Ha, Sang Chul Roh, Beom Seon Kwon, Jeong Gun Hyun, Seong Jae Lee, Jong Min Lee, Jeong Yi Kwon, Jun Seong Kim, Nam Jong Baek, Ho Lee, Kyng Woo Lee, Sam Kyu Lee
Korean Journal of Occupational and Environmental Medicine 2004;16(1):37-47. Published online March 31, 2004
OBJECTIVES Carpal tunnel syndrome (CTS) is one of the most important work related musculo-skeletal diseases in Korea. However, there are few epidemiologic studies on the work-related CTS (WR-CTS). This study aimed to investigate the epidemiologic characteristics of WR-CTS in Korea. METHODS Data obtained from the"CTS Surveillance System". Physician case-reports in the surveillance were used to document patterns of WR-CTS by age, gender, occupation, sign, symptom, working history. RESULTS Six hundred and seventy-two cases of WR-CTS were ascertained. of which 314 with complete information on occupational history were analyzed. It has been estimated that as many as 72% of all CTS cases are work-related. The highest proportion of WR-CTS was observed in 'elementary occupation workers', followed by 'skilled agricultural, forestry and fishery workers'. The distributions of WR-CTS cases were similar with respect to age, obesity, and past medical history. The proportion of WR-CTS was higher in females. There was no significant difference in physical examination findings between WR-CTS and non WR-CTS cases. Repetitive work and the inappropriate hand posture seemed to be the risks for WR-CTS. CONCLUSION WR-CTS is a significant public health problem. The CTS surveillance system is quite useful to elucidate the characteristics of WR-CTS, but it remains of limited use in targeting specific industries and occupations for intervention.
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OBJECTIVE: Recently, chronic renal failure has become a major public health problem all around the world, and the number of patients in Korea affected by this disease has sharply increased since the 1980's. Between 3% and 50% of all cases of chronic renal failure may be induced by toxic agents. The purpose of our study was to investigate the occupational hazards associated with chronic renal failure, in order to use the findings as a reference for further epidemiologic studies. METHODS The author conducted a questionnaire and reviewed the medical records of chronic renal failure patients (161 people out of 238) in Gyeongju-si and Pohang-si from March 2 to 31, 2003. Those cases of chronic renal failure which were related to work were classified as either 'probable case' if they were of unknown origin or 'suspected case' if they were of known origin and were related to hypertension or diabetes mellitus. RESULTS The study subjects consisted of 92 males (57.1%) and 69 females (42.9%). The causalities listed in the medical records were diabetes mellitus in 55 cases (40.4%), hypertension in 28 cases (20.6%), chronic glomerulonephritis in 14 cases (10.3%), and other diseases. There were 10 cases (6.2%) that were believed to be related to the patients' occupations. The hazards that these 10 patients had previously been exposed to were silica, organic solvents, tin, copper, lead, cadmium, and other hazards. CONCLUSIONS Through this study, 10 cases that were reportedly related to occupational chronic renal failure were discovered. Further studies such as a case-control study of occupational risk factors related to chronic renal failure will be needed.
BACKGROUND S: The objective of this study is to explore the relationships of working hours and work intensity with sleep disturbance among 12-hour shift workers in the automobile factory in Korea. METHODS A questionnaire and a sleep diary were distributed among 2200 (25% of total workers) and 300 workers who were randomly selected in the 8700 workers in one car factory. Among the 300 randomely selected workers, who were randomly selected, 262 workers filled out a sleep diary. For a questionnaire, 2200 (25%) among 8700 workers were randomly selected, 1200 (54% response rate) of whom filled out the questionnaire. The cross-sectional questionnaire and the sleep diary during 14 consecutive days were distributed and collected by workers' representatives, who were trained for the participatory action research in this study. One hundred and sixty workers' sleep diaries and questionnaires were merged by the same worker and used for the analysis in this study. Logistic regression analysis for repeated measurements was modeled using the prevalence of severe sleepiness at work (i.e. Karonlinska Sleepiness Scale 7 or higher) as dependent variable and working hours, sleep pattern, work intensity and health behaviours as independent variables. RESULTS The prevalence of severe sleepiness at the end of work was more than 60% after finishing night shift in the automobile factory. The main risk factors related to the severe sleepiness at the end of work were the night shift, long working hours more than 10 hours, the higher frequency of night shift per month, less free time between shifts, poor quality of sleep, deficit of sleeping hours and intensified work (reducing tendency of rest time per day and increasing tendency of additional working time) such as increasing tendency of absolute surplus value. DISCUSSION We suggest that the 12-hour shift system, long working hours, intensified work and poor quantity as well as quality of sleep were the main risk factors for the severe sleepiness among the shift workers in the automobile factory in Korea.
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Jung Il Kim, Byung Gwan Kim, Jung Won Kim, Chang Ho Chae, Cheol Ho Yi, Dongmug Kang, Ji Hong Kim, Jin Ha Kim, Young Wook Kim, Young Ha Lee, Ji Ho Lee, Younghee Choi, Jung Ho Kim, Hyung Ryul Yun, Cheol In Yoo, Baek Geun Jeong, Tae Won Jang, Yun Gyu Kim, Dong Young Yun, Jin Uk Kang, Jong Eun Kim, Jin Hong Ahn, Dong Joon Lee, Joon Ho Jang, Kwang Young Lee, Hyu Ran Song, Yong Hwan Lee, Byung Man Cho, Hong Ryul Choi, Sang Baek Koh, Euna Kim, Yu Jin Lee, Young Seoub Hong, Kap Yeol Jung, Jung Man Kim, Joon Youn Kim
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OBJECTIVE: Occupational medicine specialists in the Busan, Ulsan and Kyung-Nam areas established an area-based occupational disease surveillance system and used this system to collected case information for the purpose of preventing occupational diseases METHODS: 11 hospitals participated in this system. The authors selected five main diseases, which were hand-arm vibration syndrome (HAVS), work-related musculoskeletal disorder (WRMSD), occupational asthma, occupational skin disease and occupational lung cancer and established their case definitions. All cases were reported on the web, and real time analysis was conducted. RESULTS Between Apri1 2001 and April 2003, 192 cases of HAVS, 118 cases of WRMSD, 33 cases of occupational asthma, 17 cases of occupational skin disease and 17 cases of occupational lung cancer (for a total of 377 cases of these five main diseases) were reported. Most of the HAVS cases came from shipbuilding, and 172 of them (92.7 %) were associated with grinding. Of the four main types of WRMSD, carpal tunnel syndrome (CTS) was the most prevalent with 46 cases and shipbuilding was also the main industry involved (83.9 %). The ergonomic risk factors involved mainly associated with the hand. In 19 (57.6 %) and 4 (12.1 %) cases of occupational asthma, the agents included isocyanate and welding fume, respectively. 64.7 % of the cases of occupational skin diseases were contact dermatitis, and organic solvents and welding fume were the main agents involved. The causative agents of occupational lung cancer included Cr, welding fume, PAH, Ni, etc. 10 (58.8 %) of the cases were diagnosed as squamous cell carcinoma and 5 (29.4 %) as adenoma. CONCLUSION This result showed that an area-based occupational disease surveillance system might provide an effective method of evaluating the prevalence of such diseases, however the Busan, Ulsan and Kyung-Nam provinces are too large to be treated as individual areas. Therefore, the authors suggest that each province should establish its own surveillance system.
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