Annals of Occupational and Environmental Medicine

Special Article

Standards for recognition and approval rate of occupational cerebro-cardiovascular diseases in Korea: Ui-Jin Kim, Won-Jun Choi, Seong-Kyu Kang, Wanhyung Lee, Seunghon Ham, Junhyeong Lee, Yongho Lee, Eunseun Han, Sanghyuk Lee, Yongkyu Kim, Inah Kim; Ann Occup Environ Med 2022;34:e30. Published online October 25, 2022; DOI: https://doi.org/10.35371/aoem.2022.34.e30

Abstract Abstract in Korean PDF Supplementary Material PubReader ePub

Background

Although working hours have decreased in Korea, they are still high compared to that of other countries. In Korea, cardiovascular and cerebrovascular diseases (CCVDs) related to overwork in Korea continually occur, and the social burden from overwork is estimated to be high. This study investigated the amendment of regulations affecting the approval rate of occupational CCVDs.

Methods

The change in approval rate of occupational CCVDs and related regulations were investigated using the Act and public notice on the standards for recognition of occupational CCVDs and the yearbooks of the Ministry of Employment and Labor. The CCVD mortality was estimated using data on the number of deaths according to the cause of death, the number of employed people, and resident registration population aged 15–64 years. The cumulative mortality of CCVDs was estimated using the Kaplan-Meier method.

Results

Since the establishment of the standards for recognition in Korea in 1982, the scope of occupational diseases has been expanded to include intracerebral hemorrhage, subarachnoid hemorrhage, cerebral infarction, myocardial infarction, and aortic dissection. In 2013, the concept of working hours was introduced in chronic overwork. The approval rate of occupational CCVDs was 44.7% in 2006, which decreased to 12.9% in 2011. After the improvement of related regulations, the approval rate increased to 41.3% in 2018. From 2000 to 2017, the CCVD mortality of both the unemployed and employed tended to decrease, and their cumulative CCVD mortalities were 549.3 and 319.7 per 100,000 people, respectively.

Conclusions

CCVDs are recognized as occupational diseases in Korea. The amendments to the standards for recognition, the introduction of the Occupational Disease Adjudication Committee, the principle of presumption, and the reduction of working hours have changed the approval rate of occupational CCVDs. A strategic approach is needed to further reduce the incidence of CCVDs.

한국의 직업성 뇌심혈관계 질환에 대한 연구
목적
근로기준법 개정 적용 사업장 확대로 우리나라의 근무시간은 지속적으로 감소 추세에 있으나 타 국가에 비하면 여전히 높은 수준이다. 우리나라의 과로 관련 뇌심혈관계 질환은 지속적으로 나타나고 있으며 과로로 인한 사회적 부담이 클 것으로 추정된다. 이번 연구에서는 우리나라 뇌심혈관계 질환의 업무상 질병 승인율 변화 및 관련된 제도의 변화를 요약하고자 하였다.
방법
뇌심혈관계 질환 업무상 질병 인정기준에 관한 법령 및 고시와 고용노동부 사업연보를 통해 뇌심혈관계 질환 산재 승인율 변화 및 관련 규정을 조사하였다. 국가통계포털의 사망 원인, 취업자 수 및 주민등록인구 자료를 사용하여 우리나라의 뇌심혈관계 질환 사망자수, 사망률을 조사하고 Kaplan-Meier 방법을 통해 누적사망률을 산출하였다.
결과
1982년 우리나라에서 뇌졸중과 급성심장사에 대한 업무상 질병 인정기준이 제정된 이후 수차례 개정을 거쳐 인정 대상 질병 범위가 뇌실질내출혈, 지주막하출혈, 뇌경색, 심근경색증, 해리성대동맥류로 확대되었다. 2013년 만성과로 인정기준에 근무시간 개념이 도입되었다. 뇌심혈관계 질환 업무상 질병 승인율은 2006년 44.7%였다가 2011년 12.9%건까지 감소하였다. 제도적인 개선 후 승인율은 2018년 41.3%까지 증가하였다. 2000년부터 2017년까지 뇌심혈관계 질환 사망률은 미취업자 및 취업자 모두에서 감소하는 경향을 보였으며 이 기간 동안 미취업자 및 취업자의 뇌심혈관계 질환 누적사망률은 각각 10만 명당 549.3명 및 319.7명이었다.
결론
우리나라는 뇌심혈관계 질환을 업무상 질병으로 받아들이고 있다. 뇌심혈관계 질환 업무상 질병 승인율은 업무상 질병 인정기준 개정, 업무상질병판정위원회 제도 도입, 추정의 원칙 도입 및 평균 근무시간 감소 등에 의해서 변동되었다. 뇌심혈관계 질환은 그 경제적 부담이 크고 예방 가능한 질환으로 지속적인 예방 사업 등 발병 예방을 위한 전략적 접근이 필요하다.

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Review

Radiation-related occupational cancer and its recognition criteria in South Korea: Songwon Seo, Dalnim Lee, Ki Moon Seong, Sunhoo Park, Soo-Geun Kim, Jong-Uk Won, Young Woo Jin; Ann Occup Environ Med 2018;30:9. Published online February 2, 2018; DOI: https://doi.org/10.1186/s40557-018-0219-y

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Ionizing radiation is a well-known carcinogen, and is listed as one carcinogenic agent of occupational cancer. Given the increase in the number of workers exposed to radiation, as well as the increase in concern regarding occupational cancer, the number of radiation-related occupational cancer claims is expected to increase. Unlike exposure assessment of other carcinogenic agents in the workplace, such as asbestos and benzene, radiation exposure is usually assessed on an individual basis with personal dosimeters, which makes it feasible to assess whether a worker’s cancer occurrence is associated with their individual exposure. However, given the absence of a threshold dose for cancer initiation, it remains difficult to identify radiation exposure as the root cause of occupational cancer. Moreover, the association between cancer and radiation exposure in the workplace has not been clearly established due to a lack of scientific evidence. Therefore, criteria for the recognition of radiation-related occupational cancer should be carefully reviewed and updated with new scientific evidence and social consensus. The current criteria in Korea are valid in terms of eligible radiogenic cancer sites, adequate latent period, assessment of radiation exposure, and probability of causation. However, reducing uncertainty with respect to the determination of causation between exposure and cancer and developing more specific criteria that considers mixed exposure to radiation and other carcinogenic agents remains an important open question.

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Research Article

Effect of maternal job strain during pregnancy on infant neurodevelopment by gender at 6 and 12 months: Mothers and Children’s Environmental Health (MOCEH) study: Eunjeong Kim, HyeSook Park, Yun-Chul Hong, Mina Ha, Yangho Kim, Bo-Eun Lee, Eun-Hee Ha; Ann Occup Environ Med 2015;27:8. Published online March 20, 2015; DOI: https://doi.org/10.1186/s40557-015-0059-y

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Objectives

Limited evidence is available regarding the association between prenatal job strain and infant neurodevelopment. Most studies used stress indicators other than job strain to explain the relationship between prenatal maternal stress and child development. The objective of this study was to investigate the association between maternal job strain during pregnancy and neurodevelopment in infancy.

Methods

Mothers and Children’s Environmental Health (MOCEH) study, an on-going prospective birth cohort study, has been conducted in South Korea since 2006. Job strain during pregnancy was measured using Korean version of Job Content Questionnaire (JCQ). Infant neurodevelopment was assessed using Korean Bayley Scale of Infant Development II (K-BSID-II) at 6 and 12 months of age. A total of 343 mother-child pairs that completed JCQ and K-BSID-II more than once were included. Mental Developmental Index (MDI) and Psychomotor Developmental Index (PDI) defined in the K-BSID-II were used as outcome variables.

Results

Compared to infants from mothers with low job strain, significant (p < 0.05) decreases in PDI were found in infants from mothers with active and passive job at 6 months of age. After stratification by infant sex, boys in the high strain group had a lower MDI score than boys in the low job strain group at 12 months. On the other hand, girls in the high strain and active groups had higher MDI scores than girls in the low job strain group at 12 months. PDI at 12 months also showed different results by sex. Boys in the high strain and passive job groups had lower PDI scores than boys in the low job strain group. However, such difference was not observed in girls.

Conclusions

The findings of this study suggest that prenatal job strain affects infant neurodevelopment in a gender-dependent manner.

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Original Article

The Health Effects of Formaldehyde during an Anatomy Dissection Course: Si Young Park, Chang Yoon Kim, Joo Young Kim, Joon Sakong; Korean Journal of Occupational and Environmental Medicine 2006;18(3):171-178. Published online September 30, 2006; DOI: https://doi.org/10.35371/kjoem.2006.18.3.171

Abstract PDF

OBJECTIVES
This study evaluated the acute health effect of formaldehyde during an anatomy dissection course.
METHODS
The formaldehyde concentrations in a gross anatomy laboratory were measured and analyzed during an anatomy dissection course attended by eighty medical students. The Pulmonary Function Test and three tests of the Korean Computerized Neurobehavioral Test (digit classification, digit addition and symbol digit) were given to thirty of the eighty medical students at the pre- and post-exposure. A questionnaire survey was administered to the eighty medical students at the pre- and post-exposure.
RESULTS
The differences in the mean FVC and FEV(1) were statistically significant (p<0.01) at the preand post-exposure. In the low exposed group (<2 ppm), only the decreases in FEV(1) on post-exposure were statistically significant (p<0.05) compared with FEV(1) on pre-exposure. In the high exposed group (> or = 2 ppm), decreases in both FVC and FEV(1) on post-exposure were statistically significant (p<0.05). The overall performance on the digit classification, digit addition and symbol digit of the Korean Computerized Neurobehavioral Test on post-exposure was lower than that on pre-exposure. In the low exposed group, the performances on the digit classification and symbol digit were lower than those on pre-exposure. In the high exposed group, the performances on digit classification, digit addition and symbol digit were lower than those on pre-exposure. Complaints involving the eyes, nose and throat increased substantially on post-practice compared with pre-practice in both groups. There were statistically significant differences in the complaints involving the eyes, nose and throat between the pre-practice and post-practice in both groups (p<0.05). There were more complaints in the high exposed group than in the low exposed group.
CONCLUSIONS
Formaldehyde exposure during a dissection can decrease the pulmonary function and neurobehavioral performance, and can increase the complaints involving the eyes, nose and throat. The effect on the symptoms, pulmonary function and neurobehavioral performance is positively correlated with the formaldehyde level.

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Original Article

The Relationship between Health Value Cognition, Health Promotion Behavior and Health Examination Results Among Transit Corporation's Workers: Sun Joo Lee, Chung Yill Park, Hyun Woo Yim, Young Man Roh, Chee Kyung Chung; Korean Journal of Occupational and Environmental Medicine 2000;12(3):356-366. Published online September 30, 2000; DOI: https://doi.org/10.35371/kjoem.2000.12.3.356

Abstract PDF: OBJECTIVES
This study was performed to compare health value cognition and health promotion behavior compliance between healthy group and not being healthy group, and to evaluate the difference of health promotion behaviors compliance between high group and low group in health value cognition.
METHODS
The subjects of this study were 565 workers, 233 healthy workers, 172 observation cases and 160 disease cases, selected from 4,919 transit coporations workers.
RESULTS
In health promoting behavior compliance, not being healthy group showed lower level than healthy group in exercise and showed higher level than healthy group in interpersonal support significantly. A worker who replied on health as the most value in life was consisted in 37.3% of healthy group and 36. 1% of not being healthy group, Health value cognition according to general characteristics showed no significant difference except only variable of age in healthy group. Health promoting behavior compliance according to cognition of health value showed in healthy group that a high level group of health value cognition was more significant difference than a low level group in self actualization and health responsibility of health promoting behavior and didn't show difference significantly in not being healthy group.
CONCLUSIONS
In conclusion, the relationship between health value cognition, health promotion behavior compliance and periodic health examination results showed weakly. Therefore, in order to develop and apply spontaneous health promotion program, it was considered that should emphasize compliance than cognition.

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Original Article

A Survey for Worker's Satisfaction and Need of Occupational Health Service (OHS) in a Shipbuilding Industry: Eun Hee Ha; Korean Journal of Occupational and Environmental Medicine 1998;10(1):61-70. Published online February 28, 1998; DOI: https://doi.org/10.35371/kjoem.1998.10.1.61

Abstract PDF: In order to make an effective occupational health service program in a shipbuilding industry, I surveyed the workers' recognition of current occupational health service provided in health department of the workplace, their satisfaction with it and their need of future service. During 4 months in 1995(from April 1st to July 31th) , structured questionnaires were administered to 680 participants in health education program in a shipbuilding industry in Inchon. Most of them were men. They were young workers of 20-29 years old and their work tenures were short(5 years or less). They knew that main activity of current OHS was treatment of disease in workplace, but their satisfaction with current OHS was not good. Their satisfaction with management of general diseases was high in the case of acute disease, namely, URI, diarrhea, abdominal pain, however their need of future service in general diseases was high in the case of chronic disease, namely, hepatitis, back pain and so on. Their concern of work related disease, their recognition of and satisfaction with preplacement medical examination was high, and they need more medical care of occupational disease. In working environmental management service, recognition of and satisfaction with the activities related to the personal protectives, safety management were high, and they need highly communication of environmental evaluation and improvement of working environment. The opinions of workers strongly showed the need of improvement in specific health examination and evaluation of work environment. Conclusively the workers were not satisfied with current in plant occupational health service. They wanted better services, especially in the medical care of occupational disease and the management of work environment.

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