Annals of Occupational and Environmental Medicine

Research Article

Association between urinary phthalate metabolites and obesity in adult Korean population: Korean National Environmental Health Survey (KoNEHS), 2012–2014: Yangwon Kang, Juha Park, Kanwoo Youn; Ann Occup Environ Med 2019;31:e23. Published online September 9, 2019; DOI: https://doi.org/10.35371/aoem.2019.31.e23

Background

Phthalate is a chemical that is commonly used as a plasticizer in processing plastic products and as a solvent in personal care products. Although previous experimental studies have reported that phthalate metabolites are associated with obesity, epidemiological study results have been inconsistent and insufficient. The objective of the present study was to investigate the association between urinary phthalate metabolites and obesity in adult Korean population.

Methods

The present study selected 4,752 Korean adults aged 19 years or older from the 2012–2014 Korean National Environmental Health Survey data. The concentrations of urinary di-(2-ethyl-5-carboxypentyl) phthalate (DEHP) metabolites—i.e., mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP) and mono-(2-ethyl-5-carboxypentyl) phthalate—mono-benzyl phthalate (MBzP) and mono-n-butyl phthalate (MnBP) were adjusted using the urinary creatinine. We used logistic regression analysis to investigate the association between urinary phthalate metabolite concentration and body mass index (BMI) with respect to sex and age.

Results

Among women, urinary MEHHP and DEHP concentrations were found to have statistically significantly positive associations with obesity (Q4 versus Q1; odds ratio (OR): 1.72, 95% confidence interval (CI): 1.19–2.49 for MEHHP and OR: 1.52, 95% CI: 1.04–2.21 for DEHP). Among men, urinary MnBP concentration was found to have statistically significantly negative association with obesity (Q4 versus Q1; OR: 0.71, 95% CI: 0.50–0.99). In the analysis stratified by sex and age, women aged ≥ 50 years showed statistically significantly positive associations between the concentrations of urinary DEHP metabolites, DEHP, MBzP, and obesity (Q4 versus Q1; OR: 1.94, 95% CI: 1.28–2.94 for MEHHP, OR: 1.88, 95% CI: 1.21–2.94 for MEOHP, OR: 2.04, 95% CI: 1.31–3.18 for DEHP, and Q3 versus Q1; OR: 1.45, 95% CI: 1.02–2.05 for MBzP). Meanwhile, men aged ≥ 50 years showed no significant associations between urinary phthalate concentrations and obesity.

Conclusions

In the present study, we found differences in the associations between urinary phthalate metabolites and BMI according to sex and age. However, because the present study was cross-sectional in nature, additional support through prospective studies is needed to estimate the causal associations.

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Research Article

Long working hours and overweight and obesity in working adults: Byung-Mi Kim, Bo-Eun Lee, Hye-Sook Park, Young-Ju Kim, Young-Ju Suh, Jeong-youn Kim, Ji-Young Shin, Eun-Hee Ha; Ann Occup Environ Med 2016;28:36. Published online August 22, 2016; DOI: https://doi.org/10.1186/s40557-016-0110-7

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Background

Previous studies have identified a link between gender and the various risk factors associated with obesity. We examined obesity risk factors in working adults to identify the effects of differences in body mass index (BMI) and percentage body fat (PBF) between women and men.

Methods

A total of 1,120 adults agreed to participate in the study. Data from 711 participants, including 411 women and 300 men, were analyzed. Multiple logistic regression analysis was used to estimate the effects of risk factors on obesity and being overweight. In addition, the least-squares (LS) means of both BMI and PBF were estimated by analysis of covariance (ANCOVA) in a generalized linear model.

Results

Increases in BMI and PBF were significantly related to an age > 50 years and long working hours in women after compensating for confounding factors. Using the PBF criterion, the odds ratio (OR) of being overweight or obese in women > 50 years of age who worked for > 9 h a day was 3.9 (95% confidence interval [CI], 1.05–11.00). For BMI, women who were > 50 years of age and worked for > 9 h a day were 3.82 times (95% CI, 1.31–11.14) more likely to be overweight or obese than those who were < 50 years of age and worked for < 9 h a day.

Conclusion

Obesity in working adults was associated with > 50 years of age and long working hours in women. Further studies are needed to investigate the underlying mechanisms of this relationship and its potential implications for the prevention and management of excess weight and obesity.

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Research Article

Occupational Factors Associated with Changes in the Body Mass Index of Korean Male Manual Workers: In-Woong Song, Kuck-Hyun Woo, Jin-Seok Kim, Seong-Yong Yoon, Joo-Yong Na, Jin-Hyun Yu, Seong-Yong Cho; Ann Occup Environ Med 2013;25:40-40. Published online December 27, 2013; DOI: https://doi.org/10.1186/2052-4374-25-40

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Objectives

This study was carried out to analyze and compare the occupational factors that could influence changes in body mass index (BMI) in male manual workers stratified into short-term and long-term work experience groups.

Methods

The subjects were 299 male manual workers (sampled systematically) from 27 workplaces, who had undergone travelling medical examinations at a university hospital between March 28 and May 10, 2013, and had also undergone medical examinations at the same hospital in 2012. Their general and occupational characteristics were investigated through a structured, self-administered questionnaire. The BMI at each point in time was calculated based on the anthropometric results of the medical examinations. Multiple regression analyses were conducted on outcomes of the BMI change and predictors composed of the general and occupational characteristics, with the subjects stratified into groups with 5 years or less (short-term) versus more than 5 years (long-term) of work experience at the present post.

Results

In the short-term work experience group, the BMI increases of 3-shift workers and groups reporting disagreement with feeling “insufficient job control” and “lack of reward” at work, two of the subscales of job stress, were significantly higher than those of daytime workers and high-stress groups, respectively. In the long-term work experience group, However, although the BMI increase for 3-shift workers was also significantly higher than that of daytime workers, none of the job stress factors were significantly associated with a BMI increase, whereas the social factors of education and marital status were significant, and some lifestyle factors (such as smoking and regular exercise) were also significant.

Conclusion

This study showed that, except for 3-shift work, the factors associated with BMI increase could differ depending on the length of job experience. Consequently, different strategies may be needed for workers with short-term versus long-term job experience when designing interventions for preventing their obesity.

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Original Article

Influence of Job Stress Change on Body Mass Index (BMI) and Waist Circumference among Male White-Collar Workers: A Two-Year Longitudinal Study: Jiwon Kim, Hyoung Ryoul Kim, Se Eun Kim, Sung Mi Jang, Jung Wan Koo; Korean Journal of Occupational and Environmental Medicine 2012;24(2):180-188. Published online June 30, 2012; DOI: https://doi.org/10.35371/kjoem.2012.24.2.180

Abstract PDF

OBJECTIVES
To reveal the influence of job stress change on body mass index (BMI) and waist circumference in white-collar male workers.
METHODS
A total of 277 male workers in a Korean R&D company were enrolled between 2008 and 2010. Baseline and follow-up data were collected with structured self-administered questionnaires and anthropometric measurements by nurses. The questionnaire survey included general and work-related characteristics and the Korean Occupational Stress Scale-Short Form (KOSS-SF). The job stress scores in each examination were dichotomized at the median values for the Korean workers and categorized into four groups as follows: Group I: Both low job stress (2008, 2010), Group II: High job stress (2008) & low job stress (2010), Group III: Low job stress (2008) & high job stress (2010), Group IV: Both high job stress (2008, 2010). Multiple logistic regression modeling was used to determine the influence of job stress change on BMI and waist circumference.
RESULTS
The adjusted odds ratio for the change in waist circumference above the 75th percentile for Group IV in 'job demand' increased more than in Group I (OR = 2.54 95% CI=1.06~5.55). Also, Group IV in 'job demand' has higher odds ratio for change in BMI above the 75th percentile than Group I (OR=2.25 95% CI=1.01~5.00). Adjusted odds ratios comparing Group II to Group I for the change in waist circumference above the 75th percentile were 0.36 (95% CI=0.15~0.87) in 'inadequate social support', 0.12 (95% CI=0.02~0.98) in 'lack of reward', 0.25 (95% CI=0.08~0.80) in 'total score', respectively.
CONCLUSIONS
These results suggest that sustained high job control is a risk factor for abdominal obesity and weight gain. Also, diminished job stress has a negative influence on change in abdominal obesity. Further studies are required to establish job stress intervention plans.

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The association between occupational stress level and health-related productivity loss among Korean employees
Jonghee Chung, Jin-Hyo Kim, Jae Yoon Lee, Hee Seok Kang, Dong-wook Lee, Yun-Chul Hong, Mo-Yeol Kang
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Original Article

The Association Between Hypertension and Lifestyle in Express Bus Drivers: Jin Woo Lee, Nam Soo Lee, Kyung Jae Lee, Joo Ja Kim; Korean Journal of Occupational and Environmental Medicine 2011;23(3):270-278. Published online September 30, 2011; DOI: https://doi.org/10.35371/kjoem.2011.23.3.270

Abstract PDF: OBJECTIVES
To examine whether or not there is an association between blood pressure and lifestyle habits in male express bus drivers.
METHODS
The study subjects were 249 male express bus drivers. The data was obtained from annual health surveillance. A structured questionnaire was used to assess smoking, alcohol consumption, exercise, daily hours of sleep, work duration and weekly working hours. The subjects' BMI (Body Mass Index) was classified using the World Health Organization diagnostic criteria for obesity in Asians, and their blood pressure was classified according to the JNC (Joint National Committee) 7 classification. Multiple cases of logistic regression modeling were used to determine associations between hypertension and the subjects' common characteristics, lifestyle habits and obesity were used as the independent variables.
RESULTS
We found that lack of sleep was associated with hypertension (OR 1.85, 95% CI 1.01~3.39) and obesity was also associated with hypertension (OR 2.81, 95% CI 1.59~4.98).
CONCLUSIONS
These results indicate that daily hours of sleep and obesity were associated with hypertension in male express bus drivers. Due to the characteristics of this job, such as long hours and lack of exercise, it can result in obesity and lack of sleep, which can in turn influence occurrences of hypertension. Therefore, consideration of lack of sleep and obesity in their workers will be helpful for the management in the prevention of hypertension.

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Original Article

The Relationship between Job Stress and Liver Dysfunction among Male White-Collar Workers: Jung Yeon Hong, Hyoung Ryoul Kim, Bo Ram Lee, Yong Kyu Kim, Jung Wan Koo, Chung Yill Park; Korean Journal of Occupational and Environmental Medicine 2009;21(2):165-173. Published online June 30, 2009; DOI: https://doi.org/10.35371/kjoem.2009.21.2.165

Abstract PDF

OBJECTIVES
We wanted to investigate the relationship between job stress and liver dysfunction in Korean male white collar workers.
METHODS
A total of 700 male white collar workers who worked at one electronic institute and who participated in an annual surveillance program were recruited: 664(94.9%) workers were initially recruited and the data for 36 workers was excluded due to poor responses and a past history of liver disease. The questionnaire survey included the participants' general characteristics, the job-related factors, the health-related behaviors and job stress. Job stress was assessed using the Korean Occupational Stress Scale-Short Form (KOSS-SF). We merged the job stress data with the individual liver function results by conducting annual surveillance. Multiple logistic regression analysis with adjusting it for the confounding variables, including alcohol drinking and the body mass index (BMI), was used to evaluate the relationship between job stress and liver dysfunction.
RESULTS
After adjustment for the confounding variables, the proportion of liver dysfunction cases was significantly higher in the groups with a high level of job stress, as assessed by the 'job demands and total score'. After conducting a stratified analysis with considering alcohol drinking and the BMI, the prevalence odds ratio of liver dysfunction was higher in the groups with a high level of job stress, as assessed by the 'job demands and total score'.
CONCLUSIONS
The results of this study suggest that the level of job stress (and especially that assessed by the job demands and total score) is related to liver dysfunction. Thus, further preventive efforts and studies are needed to reduce job stress and address liver dysfunction.

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Yoo-Mi Chae, Jeong-bae Rhie, Sook Lee
Journal of the Korea Academia-Industrial cooperation Society.2016; 17(7): 389. CrossRef

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Original Article

Body Mass Index according to Working Processes in Some Workers: Daegu City: Sung Hee Kim, Choong Won Lee, Mi Young Lee; Korean Journal of Occupational and Environmental Medicine 2002;14(2):107-116. Published online June 30, 2002; DOI: https://doi.org/10.35371/kjoem.2002.14.2.107

Abstract PDF: OBJECTIVES
This study was carried to survey obesity and to screen high risk working processes related to obesity in the workplace.
METHODS
In 1999, a total of 12,518 workers (men 8,379, women 4,139) residing in Daegu underwent an annual health examination at the Dongsan Medical Center. Grade of obesity was classified using body mass index (BMI) according to the following criteria; underweight ( <18.5), normal (19-22.9), overweight (23.0-24.9), mild obesity (25-29.9), severe Obesity ( >30.0). One industrial hygienist classified the working processes.
RESULTS
The BMI mean and standard error was 22.63+/-0.03 in men and 22.18+/-0 . 0 4 in women. Age was a strong indicator of obesity, which peaked at 50-54 years old in men and over 60 years old in women. After adjustment for age by ANCOVA, the working process showing the highest BMI for men was 'Sales', at 23.93+/-0.18 while the lowest was 'Mill rolling', at 21.49+/-0.27. For Women 'Foundry Molding', at 22.84+/-0.49 was the highest while 'Office work', 21.78+/-0.12 was the lowest.
CONCLUSIONS
Physical activities at work were inversely related to BMI in men but, were directly related in women. Women, over 50 years old and working in the process demanding high physical activity were the group most susceptible to obesity.

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Original Article

Low Back Pain Assessment Using Surface Electromyography and Digital Infrared Thermographic Imaging: Kang Jin Lee, In Sung Choi, So Young Lee, Jae Young Han, Sam Gyu Lee, Hong Jae Chai, Seong Kwan Lee, Jai Dong Moon; Korean Journal of Occupational and Environmental Medicine 2001;13(3):306-314. Published online September 30, 2001; DOI: https://doi.org/10.35371/kjoem.2001.13.3.306

Abstract PDF

OBJECTIVES
We studied the efficacy of surface electromyography(SEMG) and digital infrared thermographic imaging(DITI) in the assessment of low back pain both(LBP) quantitatively and qualitatively.
METHODS
We compared electromygraphic signals from electrodes placed in the lumbar area and the digital thermographic images in 16 LBP patients and 16 control subjects. The LBP patients and the control subjects were matched for age, gender, and body mass index(BMI) to adjust for any confounding effects RESULTS: In the static analyses of SEMG, median value was 198.1 microV for the LBP patients and 161.3 microV for the controls on the right side, and they were 194.2 microV and 180.5 microV on left side respectively. There was a statistically significant difference between the two groups on the right side(p<0.01), but not on the left side. In the dynamic analyses of the SEMG, the median values of the extension per flexion ratio of right side were 1.12 for LBP patients and 1.39 for controls. and those on the left side were 1.08 and 1.21 respectively. There were statistically significant differences in both sides(p<0.05). The sensitivity and specificity were 100% and 81.3% in DITI, 78.6% and 72.2% in SEMG .
CONCLUSIONS
These results indicate that SEMG and DITI are useful methods for indirect assessments of LBP, and that DITI is more sensitive and specific than SEMG.

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