Annals of Occupational and Environmental Medicine

Original Article

Association between ambient particulate matter levels and hypertension: results from the Korean Genome and Epidemiology Study: Sewhan Na, Jong-Tae Park, Seungbeom Kim, Jinwoo Han, Saemi Jung, Kyeongmin Kwak; Ann Occup Environ Med 2023;35:e51. Published online December 4, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e51

Abstract Abstract in Korean PDF Supplementary Material PubReader ePub: Background
Recently, there has been increasing worldwide concern about outdoor air pollution, especially particulate matter (PM), which has been extensively researched for its harmful effects on the respiratory system. However, sufficient research on its effects on cardiovascular diseases, such as hypertension, remains lacking. In this study, we examine the associations between PM levels and hypertension and hypothesize that higher PM concentrations are associated with elevated blood pressure.
Methods
A total of 133,935 adults aged ≥ 40 years who participated in the Korean Genome and Epidemiology Study were analyzed. Multiple linear regression analyses were conducted to investigate the short- (1–14 days), medium- (1 and 3 months), and long-term (1 and 2 years) impacts of PM on blood pressure. Logistic regression analyses were conducted to evaluate the medium- and long-term effects of PM on blood pressure elevation after adjusting for sex, age, body mass index, health-related lifestyle behaviors, and geographic areas.
Results
Using multiple linear regression analyses, both crude and adjusted models generated positive estimates, indicating an association with increased blood pressure, with all results being statistically significant, with the exception of PM levels over the long-term period (1 and 2 years) in non-hypertensive participants. In the logistic regression analyses on non-hypertensive participants, moderate PM₁₀ (particulate matter with diameters < 10 μm) and PM_2.5 (particulate matter with diameters < 2.5 μm) levels over the long-term period and all high PM₁₀ and PM_2.5 levels were statistically significant after adjusting for various covariates. Notably, high PM_2.5 levels of the 1 year exhibited the highest odds ratio of 1.23 (95% confidence interval: 1.19–1.28) after adjustment.
Conclusions
These findings suggest that both short- and long-term exposure to PM is associated with blood pressure elevation.; 대기 중 미세먼지 농도와 고혈압과의 연관성: 한국인유전체역학조사사업 자료를 기반으로
목적
환경보건에서 대기 중 미세먼지 농도의 중요성이 갈수록 커지고 있으나 아직 미세먼지 농도와 고혈압과의 연관성에 대한 연구 결과가 충분하지 못하여 확실한 결론을 내리기 어려운 상황에 처해있다. 본 연구는 대기 중 미세먼지 노출과 혈압 상승의 상관관계를 밝히는 데에 목적을 두고 있다.
방법
본 연구는 질병관리청 국립보건연구원에서 담당하고 있는 한국인유전체역학조사사업 코호트와 대기오염 모니터링 자료가 연계된 데이터에서 추출한 133,935 명을 대상으로 하였다. 다중선형 회귀분석과 로지스틱 회귀분석을 수행하여 대기 중 미세먼지 농도와 혈압 수준과의 상관관계를 평가하였다.
결과
다중선형 회귀분석에서는 성별, 나이 등과 같은 공변수들을 보정하기 전과 후 모두 통계적으로 유의하게 미세먼지 농도가 증가할수록, 혈압이 상승하였다. 로지스틱 회귀분석에서 고혈압의 오즈비(odds ratio; OR)는 높은 대기 중 미세먼지 농도에 노출된 참여자들에서 통계적으로 유의하게 증가한 반면, 중등도의 미세먼지 농도에 노출된 참여자들에서는 노출기간에 따라 결과가 달라지는 양상을 보였다.
결론
본 연구의 결과는 대기 중 미세먼지 노출이 고혈압 위험도 증가와 관련될 수 있음을 시사한다.

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Research Article

The association between cadmium and lead exposure and blood pressure among workers of a smelting industry: a cross-sectional study: Hyun Chan An, Joo Hyun Sung, Jiho Lee, Chang Sun Sim, Sang Hoon Kim, Yangho Kim; Ann Occup Environ Med 2017;29:47. Published online October 4, 2017; DOI: https://doi.org/10.1186/s40557-017-0202-z

Abstract PDF PubReader ePub

Background

Lead and cadmium are harmful heavy metals that are used for a variety of occupational purposes. Considering their potentially hazardous effects on health, studies on the association between exposure to these two heavy metals and health disorders have been actively conducted. This study aimed to determine the association between blood lead and cadmium levels and blood pressure in workers exposed to lead and cadmium in a smelter.

Methods

Nine hundred and sixty-three male workers who worked in a smelter, and underwent medical examinations at the Ulsan University Hospital between January 1 and December 31, 2014, were selected as participants. Among them, 310 subjects whose data on height, weight, blood pressure, fasting blood glucose, lipid profile, and blood lead and cadmium levels were available and who answered the questionnaire were selected as the final participants. We investigated the drinking habit, smoking status, exercise adequacy, and family history of hypertension of these workers using formal questionnaires. A statistical analysis was conducted using Student’s t-test, analysis of variance, and linear or logistic regression.

Results

The association between blood lead and cadmium levels and blood pressure was analyzed through statistical adjustment of the risk factors of hypertension. Results showed an association between blood cadmium level and blood pressure elevation. However, blood lead level was found to be not correlated with blood pressure elevation.

Conclusions

This study shows the association between blood cadmium level and systolic blood pressure (SBP) and diastolic blood pressure (DBP) elevation.

Trial registration

IRB No. 2017–03-037. Retrospectively Registered 30 March 2017.

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Original Article

Distribution of Blood pressure and Current State of Life Style Modification on Male Workers in a Large Factory: Analysis According to JNC-6 Guideline: Seung Ho Jeon, Hye Eun Lee, Do Myung Paek, Yang Ho Kim, Jung Sun Park, Gang Won Park; Korean Journal of Occupational and Environmental Medicine 2003;15(4):364-372. Published online December 31, 2003; DOI: https://doi.org/10.35371/kjoem.2003.15.4.364

Abstract PDF: OBJECTIVES
To describe the distributions of blood pressure level and risk group, and the current state of life style modification in the population of a large factory.
METHODS
We surveyed 1,088 workers in a large factory from June 2002 to August 2002. Information related to hypertension was collected through a questionnaire and medical examination. We classified the blood pressure level and risk group using JNC-VI criteria, and the current state of life style modification and medication according to the blood pressure level in the entire study population. REULTS: The prevalence of hypertension was 30.1% in all workers. The distribution of blood pressure level was 656 (60.3%) in normal stage, 160 (14.7%) in high normal stage, 190 (17.5%) in stage 1, 67 (6.1%) in stage 2, and 15 (1.4%) in stage 3. The numbers of workers in risk groups A, B and C were 296 (27.2%), 690 (63.4%) and 102 (9.4%), respectively. Among all workers, 432 (39.7%) needed to modify their lifestyle; 106 of whom (24.5%) needed to go on hypertensive drug medication. Overweight subjects were more common in stage 2 than in other stages (p=0.02). The numbers of smokers and low-exercisers were signigicantly lower in the higher blood pressure group than the lower blood pressure group (p<0.01). Alcoholic drinking was evenly distributed in all blood pressure level.
CONCLUSION
The prevalence of hypertension was 30.1% in all workers. The most common stage of blood pressure level was normal, followed by stage 1, high normal stage, stage 2, stage 3. The number of subjects in risk group B was more than that in the other risk groups. We recommend total worker education and the practice of lifestyle modification.

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Original Article

Shiftwork Duration and Metabolic Risk Factors of Cardiovascular Disease: Mi na Ha, Sang Chul Roh, Jung sun Park; Korean Journal of Occupational and Environmental Medicine 2003;15(2):132-139. Published online June 30, 2003; DOI: https://doi.org/10.35371/kjoem.2003.15.2.132

Abstract PDF

AIMS: To explore the relationship between shiftwork duration and metabolic risk factors on cardiovascular disease in shiftworkers.
METHODS
The study subjects comprised of 226 nurses, from a hospital, and 130 male workers, from a diaper and feminine hygienic material manufacturing firm. The mean ages of the male workers and nurses were 29 and 28.5 years, respectively. The fasting blood sugar, serum cholesterol, blood pressure, height and weight, waist and hip circumferences (only in nurses), and number of step for a shift as indices of physical activity were measured. Using the Korean version of Karasek's job contents questionnaire, the job stress was assessed. Information about the number of years worked, duration of shiftwork, and past medical and behavioral histories, including smoking, were obtained by self-administrated questionnaires. Linear regression analyses were performed, to show the relationships between shiftwork duration and metabolic risk factors, using simple and multivariate models, adjusted for age, smoking, job strain and physical activity. The following criteria were defined: hypertension as a SBP>or160 or a DBP>or=90 mmHg at least once, hypercholesterolemia, as a serum total cholesterol >or=240 mg/dl, obesity as BMI (Body Mass Index) >or=25kg/m2 and central obesity as a WHR (Waist to Hip Ratio) >or=0.85; and the logistic regression analyses, according to years of shiftwork, were performed using simple and adjusted models.
RESULTS
The cholesterol and fasting blood sugar showed increasing trends, but without statistical significances, according to the increase in shiftwork duration of the male workers, although, the increases in the blood pressure and BMI were statistically significant. In the nurses, only the WHR showed a significant increase in relation to the shiftwork duration. In the logistic regression analyses, hypercholesterolemia and obesity showed significant increasing risks according to the number of years of shiftwork (OR=3.32 95%CI 1.27-8.72 and OR=3.21 95%CI 1.24-8.32 respectively) in the male workers, but hypertension showed no significance. In the nurses, only an increased central obesity was significant as a risk factor (OR=1.30 95%CI 1.05-1.62).
CONCLUSIONS
These results provide evidence of the associations between shiftwork and metabolic risk factors for cardiovascular disease, although healthy shiftworker effects might exist in our cross sectional study design.

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Effect of shift work on hypertension: cross sectional study
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Original Article

The Association of Workplace Cumulative Noise Exposure and Blood Pressure: Sang Yun Lee, Jai Young Kim, Hyoung June Im, Ki Jung Yoon, Hong Ryul Choi, Sang Baek Koh, Dae Hee Kang, Soo Hun Cho; Korean Journal of Occupational and Environmental Medicine 2001;13(2):200-208. Published online June 30, 2001; DOI: https://doi.org/10.35371/kjoem.2001.13.2.200

Abstract PDF

OBJECTIVES
The association of workplace cumulative noise exposure and blood pressure was investigated in this study using cross-sectional design.
METHODS
The study population comprised 852 manufacturing male workers of whom occupational health examination data, questionnaire and personnel records were available. Workplace ambient noise monitoring data was used for calculating individual cumulative noise exposure level. Mean of each systolic and diastolic blood pressure of occupational health examination data was used for individual systolic and diastolic blood pressure level. Possible confounding variables including family history of hypertension, smoking habit, alcohol drinking habit were collected by questionnaire. On the basis of job location and duration of work at the location, a cumulative time-weighted average noise level was calculated for each workers. According to this cumulative noise exposure level, each study subject was categorized as low noise exposure group, moderate noise exposure group, high noise exposure group, very high noise exposure group. Among noise exposure groups, mean of systolic and diastolic blood pressure was compared after adjusting possible confounding variables such as age, body mass index, serum cholesterol level, family history of hypertension, smoking history, alcohol drinking habit.
RESULTS
After adjusting possible confounding variables, noise exposure group was significant explanatory variables for both systolic and diastolic blood pressure, and mean of both systolic and diastolic blood pressure of very high exposure group was higher than that of low exposure group.
CONCLUSIONS
These findings suggested that the high cumulative noise exposure might elevate the blood pressure.

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ChoHye Youn, LeeBom Chung, Minji Kang, Juyoung Lee
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Cohort study for the effect of chronic noise exposure on blood pressure among male workers in Busan, Korea
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Original Article

Influence of Shiftwork Duration on Blood Pressure and Heart Rate Variability in Short Rotating 8-hour Shiftworkers: Mi Na Ha, Jai Young Kim, Jung Sun Park, Ho Keun Chung; Korean Journal of Occupational and Environmental Medicine 2001;13(2):180-189. Published online June 30, 2001; DOI: https://doi.org/10.35371/kjoem.2001.13.2.180

Abstract PDF

OBJECTIVES
This study was performed to investigate the chronic health effect of shiftwork on cardiovascular system.
METHODS
We checked blood pressure(BP) and heart rate variability(HRV) at every shift on 134 male workers whose shift type was 8-hour and short rotating of 3 days shift interval. As confoundings, job stress was measured by Karasek's JCQ 49 items questionnaire and circardian type was assessed by morningness-eveningness questionnaire. Smoking and alcohol drinking habit, marital status and past medical history were also acquired. We used the method of repeated measured data analysis with mixed model to show the association between shiftwork duration and BP or HRV.
RESULTS
Average age of workers was 29 years olds(range 25~44). Among them, 77.9 % were current smokers, 50 % were the passive type of job strain in Karasek's model. Mean shiftwork duration was 5.21 years(range 5.4 months~10 years). In circadian type, no one was definitely morning type or definitely evening type. In multivariate analyses adjusted by age, job strain, shift, circadian rhythm and smoking, blood pressure were showed significantly increasing trends according to shiftwork duration in both systolic and diastolic(p<0.05). Heart rate variability were also showed significantly decreasing trends according to shiftwork duration in both parasympathetic and sympathetic functions(p<0.05).
CONCLUSIONS
The results of this studs suggests the chronic negative health effect of shiftwork on cardiovascular system.

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Original Article

Ambulatory Blood Pressure and Heart Rate of the Workers Exposed to Industrial Noise: Young Kee Kim, Tae Joon Cha, Joo Hyun Byun, Kwang Ook Koh, Yong Hwan Lee; Korean Journal of Occupational and Environmental Medicine 2000;12(1):99-110. Published online March 31, 2000; DOI: https://doi.org/10.35371/kjoem.2000.12.1.99

Abstract PDF: OBJECTIVES
This study was carried out to evaluate the effects of industrial noise on blood pressure and heart rate.
METHODS
Resting blood pressure, hearing loss, and general characteristics of the 102 subjects who were engaged in a factory in Pusan were measured from March to June for two years, in 1998 and 1999. With noise dosimeter, noise exposure level was measured from 8 A.M. to 4 P.M. Ambulatory blood pressure and heart rate were also measured every 30 minutes from 8 A.M. to 10 P. M.
RESULTS
Controlling for age, smoking, and Quetelet's index, in subjects of under 40 years old exposed to higher than 85dBA, noise exposure and systolic blood pressure had a statistically significant correlation, and the same result was obtained in all subjects. The daily variability of ambulatory blood pressure and heart rate were observed in older than 40 years old group, but only heart rate in under 40 years old.
CONCLUSIONS
The blood pressure and heart rate would be elevated when the workers exposed to noise. And in under 40 years old, the systolic blood pressure was elevated to the workers exposed to higher than 85dBA.

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Original Article

Health Effects of Aircraft Noise on Residents Living Near an Airport: Kyung Jong Lee, Jae Beom Park, Jae Yeon Jang, Sun Mi Cho, Se Wi Lee, Jong Goo Kim, Soon Young Lee, Jong Ja Kwak, Ho Keun Chung; Korean Journal of Occupational and Environmental Medicine 1999;11(4):534-545. Published online December 31, 1999; DOI: https://doi.org/10.35371/kjoem.1999.11.4.534

Abstract PDF

Objectives
; This study was conducted to reveal the health effects of aircraft noise on the residents live near the military airport.
METHODS
We sampled systematically 87 residents as the high exposed group, 58 residents as the low exposed group according to the geographical distance from the airport. We also sampled 67 residents as the control group lived far from the airport. Noise levels were measured for conform the exposures. Self-administered questionnaires for symptoms, air conduction hearing threshold level, blood pressure blood cholesterol with health examinations, and SCL-90-R were introduced to get the data from the residents.
RESULTS
The Ld/n at the area near the airport was 72.4 dB, however that of control area was 67. 7 dB. The value of pure tone average, high pure tone average, and threshold of 4,000 Hz were decreased with exposure level significantly. Linear regression analysis showed that the noise exposure level of the airport was related to the hearing threshold at pure tone average, threshold of 4,000 Hz, and high pure tone average. The systemic and diastolic blood pressure showed dose-response relationship with noise exposure. The prevalence of hypertension was higher in exposed group, but not statistically significant. In linear regression, noise level was related to systolic and diastolic blood pressure with other variables such as age, sex, BMI (Body Mass Index), and family history of hypertension. SCL-90-R showed that exposed group had higher score significantly in neurotic and psychologic variable and felt the various somatic symptoms.
CONCLUSIONS
These results suggest that aircraft noise would influence hearing loss at low frequencies as well as 4,000 Hz and higher frequencies, systolic and diastolic blood pressure, and psychological response.

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Journal of Preventive Medicine and Public Health.2008; 41(5): 307. CrossRef

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Original Article

Effect of Noise Exposure and Psychosocial Factors on Blood Pressure in Manufacturing Workers: Bong Suk Cha, Sang Baek Koh, Sei Jin Chang, Jung Ku Park, Myung Guen Kang, Sang Yul Koh; Korean Journal of Occupational and Environmental Medicine 1997;9(2):244-257. Published online June 30, 1997; DOI: https://doi.org/10.35371/kjoem.1997.9.2.244

Abstract PDF

This study was conducted to assess the effects of noise exposure and psychosocial factor on blood pressure in manufacturing workers. The study subjects are 414 workers (243 males, 171 females) employed at the noisy department. The mean age of low exposed group (<85dB) was 34.65+/-9.53 years, and that of high exposed group (> or =85dB) was 36.37+/-11.15 years. The difference in mean age wart not significant. The mean and distribution of working duration, smoking status, drinking status were not significantly different between two groups. The mean systolic blood pressure of the low exposed groups was 120.01+/-12.06 mmHg, and that of high exposed group wart 126.27+/-13.84 mmHg. The mean diastolic blood pressure of the low exposed and the high exposed group were 77.18+/-10.83 mmHg, and 83.46+/-11.22 mmHg respectively. These differences of blood pressure were statistically significant(p<0.05). The workers in noisy department have significantly less work environmental satisfaction, higher job demand, and higher social support. The mean values of psychosocial distress were higher in the workers of the noisy department, but the difference was not statistically significant. This study was to speculate whether the work environmental satisfaction and social supports modify the association between the noise exposure level and the blood pressure. The results showed that work environmental satisfaction could not modify the association between the blood pressure and the noise exposure. Social support at work did not modify the association. Furthermore, we evaluated the high job strain from a combination of high job demand and low job control at work. Compared to the low strain group, the olds ratio of the high job strain group for hypertension in diastolic blood pressure were statistically significant, but not in systolic blood pressure. Hierarchical multiple regression analysis was used to determine whether the independent variables contributed to explaining the blood pressure. After controlling for possible confounders, we found that the noise exposure level was a correlate of the diastolic blood pressure. But no association between the noise exposure level and the systolic blood pressure. No significant result was found for psychosocial factor.

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Relationship Between the Psychosocial Factors and Job Stress Among Clerical Public Officers
Ho-Jin Park, Sung-Kyeong Park, Young-Chae Cho
Journal of the Korea Academia-Industrial cooperation Society.2014; 15(9): 5610. CrossRef
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Sung-Kyeong Park, Jong-Oh Kim, Young-Chae Cho
Journal of the Korea Academia-Industrial cooperation Society.2011; 12(9): 3887. CrossRef

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Original Article

Effect of Long-Term Noise Exposure on the Blood Pressure in Factory Workers: Bok Youn Kim, Cheon Tae Kim, Jung Jeung Lee, Hong Chin Park, Chang Yoon Kim, Pock Soo Kang; Korean Journal of Occupational and Environmental Medicine 1996;8(1):43-58. Published online February 29, 1996; DOI: https://doi.org/10.35371/kjoem.1996.8.1.43

Abstract PDF

The question of an association between occupational noise exposure and blood pressure has important public health implications. The harmful effects of hypertension are well known and noise is considered the mosts pervasive problem of all occupational exposures in Taegu City, Korea. A cross-sectional study on the effect of long-term noise exposure on blood pressure was done for 276 noise exposed workers (203 male workers, 73 female workers). Long-term noise exposure was measured by cumulative noise exposure level and noise-induced hearing loss. Hearing loss=(500Hz+2x1,000Hz+2x2,000Hz+4,000Hz)/6 Questionaire was administered to the workers, which includes age, sex, occupational history on the noise exposure, habits on alcohol drinking and smoking, practice of regular exercise, family history of hypertension. Type A behavior, question on stress, height, weight and blood pressure were measured. Serum triglyceride and low density lipoprotein (LDL) were also measured. Audiometry was done in the closed booth at 1,000, 2,000, 3,000, 4,000, 6,000, 8,000, 1,000 and 500Hz in order. Mutiple logistic regression analysis revealed that cumulative noise exposure level(p<0.05), serum triglyceride(p<0.01), age(p<0.01) and family history of hypertension (p<0.05) predict hypertension (systolic blood pressure: 160mmHg or above, or diastolic blood pressure: 95mmHg or above) in male workers. In female workers, serum triglyceride (p<0.01), LDL (p<0.01) and family history of hypertension(p<0.05) were predictors of hypertension (systolic blood pressure: 160mmHg or above, or diastolic blood pressure: 95mmHg or above). As the number of female workers with hypertension was too small, the multiple logistic regression was done according to hypertension criteria of systolic blood pressure greater than or equal to 140mmHg, or diastolic blood pressure greater than or equal to 90mmHg. Based on this criteria, cumulative noise exposure level (p=0.055) and age (p=0.057) predict hypertension. It is suggested that long-term noise exposure which was calculated by cumulative noise exposure level was a significant predictor of hypertension in noise exposed workers.

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Overview of the Environmental Damage, Property Loss, and Health Impairment of Residents around a US Air Force Firing Range
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Ji Ho Lee, Weechang Kang, Seung Rim Yaang, Nari Choy, Choong Ryeol Lee
American Journal of Industrial Medicine.2009; 52(6): 509. CrossRef

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