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Original Article
The impact of alcohol consumption on hearing loss in male workers with a focus on alcohol flushing reaction: the Kangbuk Samsung Cohort Study
Jaehong Lee, Youshik Jeong, Jihoon Kim, Seonghyeon Kwon, Eunhye Seo, Jinsook Jeong, Woncheol Lee
Ann Occup Environ Med 2024;36:e1.   Published online January 22, 2024
DOI: https://doi.org/10.35371/aoem.2024.36.e1
AbstractAbstract AbstractAbstract in Korean PDFSupplementary MaterialPubReaderePub
Background

Despite hearing loss being a prevalent chronic condition, estimated to nearly 20% of the global population by the World Health Organization, the specific association with individual lifestyle factors, particularly alcohol consumption, remains unclear. In South Korea, approximately 80% of the population engages in alcohol consumption, with a notably high prevalence among males, indicating a high-risk drinking pattern. Therefore, this study aimed to assess the correlation between alcohol consumption and hearing loss in male workers, as well as to analyze additional variables such as alcohol flushing reaction, with the intention of improving worker health.

Methods

The study was conducted from January 2012 to December 2019, targeting 114,114 participants who visited Kangbuk Samsung Hospital Total Healthcare Centers. Data were collected through pure-tone audiometry tests and alcohol-related questionnaire, and statistical analysis was performed using Cox regression analysis. Based on previous studies indicating a potential protective effect of light drinking on hearing loss, this group was designated as the reference. Additionally, stratified analyses were conducted based on the presence of alcohol flushing reaction and different working hours.

Results

The hazard ratio (95% confidence interval) for hearing loss was higher in the heavy drinking group (1.23 [1.11–1.37]) compared to the moderate drinking group (1.09 [0.98–1.20]). Stratified analyses revealed a significantly elevated the hazard ratio of hearing loss in groups with alcohol flushing reaction compared to those without this factor.

Conclusions

Our study demonstrated that moderate or heavy alcohol consumption in male workers can increase the risk of hearing loss, particularly in those with alcohol flushing reaction. These findings underscore the importance of addressing alcohol-related factors concerning hearing health among male workers.

알코올 안면홍조 중심으로 살펴본 남성 근로자에서 음주습관이 청력손실에 미치는 영향: 강북삼성 코호트연구
목적
청력손실은 세계보건기구(WHO)가 인구 20% 가까이로 그 유병률을 추정할 만큼 흔한 만성질환임에도 불구하고 개인의 생활습관 요인, 특히 음주에 따른 연관성은 아직 명확하게 밝혀진 바 없다. 한국건강증진개발원에 따르면 대한민국의 음주 인구는 80%에 육박하며 남성의 고위험 음주율이 특징적으로 높았다. 따라서 우리는 청력손실과 관련된 근로자 건강 증진을 도모하고자 남성 근로자에서 음주습관 및 청력손실 간 연관성 평가 및 알코올 안면홍조 추가 변수 분석을 수행하였다.
방법
연구는 2012년 1월부터 2019년 12월 사이 강북삼성병원 종합건강검진센터에 방문한 114,114명의 수검자들을 대상으로 이루어졌다. 순음청력검사 및 음주 설문으로 데이터를 수집하였고 통계 분석은 Cox 회귀분석을 실시하였다. 과거 연구들에서 가벼운 음주가 오히려 청력손실에 보호효과를 나타내었으므로 해당 그룹을 참조(reference)로 지정하였다. 추가적으로 알코올 안면홍조 여부에 따른 층화분석을 시행하였다.
결과
청력손실의 위험비(95% 신뢰구간)는 중간 음주 그룹 1.09(0.98-1.20)에 비해 대량 음주 그룹이 1.23(1.11-1.37)로 더 높았다. 층화분석에서는 알코올 안면홍조가 있는 음주 그룹에서의 청력손실 위험비가 그렇지 않은 음주 그룹보다 유의하게 높은 경향을 보였다.
결론
우리는 연구를 통해 남성 근로자들에서 중간 또는 대량 음주는 청력손실의 발생 위험을 높일 수 있고, 특히 알코올 안면홍조가 있는 남성 근로자들은 그 위험도가 더 증가함을 밝혀낼 수 있었다.
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Original Article
Overall and cardiovascular mortality according to 10-year cardiovascular risk of the general health checkup: the Kangbuk Samsung Cohort Study
Youshik Jeong, Yesung Lee, Eunchan Mun, Eunhye Seo, Daehoon Kim, Jaehong Lee, Jinsook Jeong, Woncheol Lee
Ann Occup Environ Med 2022;34:e40.   Published online November 23, 2022
DOI: https://doi.org/10.35371/aoem.2022.34.e40
AbstractAbstract AbstractAbstract in Korean PDFPubReaderePub
Background

According to the occupational accident status analysis in 2020, of 1,180 occupational deaths, 463 were caused by cardiovascular disease (CVD). Workers should be assessed for CVD risk at regular intervals to prevent work-related CVD in accordance with the rules on occupational safety and health standards. However, no previous study has addressed risk and mortality. Therefore, this longitudinal study was conducted to evaluate the relationship between 10-year cardiovascular risk of the general health checkup and mortality.

Methods

The study included 545,859 participants who visited Kangbuk Samsung Total Healthcare Centers from January 1, 2002, to December 31, 2017. We performed 10-year cardiovascular risk assessment for the participants and the risk was divided into 4 groups (low, moderate, high, and very high). The study used death data from the Korea National Statistical Office for survival status as an outcome variable by December 31, 2019, and the cause of death based on the International Classification of Diseases, 10th Revision (ICD-10) was identified. Statistical analysis was performed using Cox proportional hazards regression analysis, and the sum of the periods from the first visit to the date of death or December 31, 2019, was used as a time scale. We also performed a stratified analysis for age at baseline and sex.

Results

During 5,253,627.9 person-years, 4,738 overall deaths and 654 cardiovascular deaths occurred. When the low-risk group was set as a reference, in the multivariable-adjusted model, the hazard ratios (HRs) (95% confidence interval [CI]) for overall mortality were 3.36 (2.87–3.95) in the moderate-risk group, 11.08 (9.27–13.25) in the high-risk group, and 21.20 (17.42–25.79) in the very-high-risk group, all of which were statistically significant. In cardiovascular deaths, the difference according to the risk classification was more pronounced. The HRs (95% CI) were 8.57 (4.95–14.83), 38.95 (21.77–69.69), and 78.81 (42.62–145.71) in each group. As a result of a subgroup analysis by age and sex, the HRs of all-cause mortality and cardiovascular mortality tended to be higher in the high-risk group.

Conclusions

This large-scale longitudinal study confirmed that the risk of death increases with the 10-year cardiovascular risk of general health checkup.

일반건강검진 10년 심뇌혈관질환 발병 위험도에 따른 사망률: 강북삼성 코호트 연구
목적
한국산업안전보건공단(KOSHA)의 2020년도 산업재해 현황 분석에 따르면 2020년도 업무상 질병 사망자 1,180명 중 심뇌혈관질환으로 인한 사망자는 463명으로 높은 비중을 차지하였다. 근로자는 산업안전보건기준에 관한 규칙에 의거하여 작업 관련 심뇌혈관질환 예방을 위해 정해진 주기에 따라 뇌심혈관질환 발병 위험도 평가 및 사후 관리를 받아야 한다. 하지만 발병 위험도와 사망률에 대한 기존 연구는 없었다. 따라서 이번 종단 연구는 일반건강검진 10년 심뇌혈관질환 발병 위험도와 사망률 간의 관계를 평가하기 위해 수행되었다.
방법
연구는 2002년 1월 1일부터 2017년 12월 31일까지 강북삼성병원 종합건진센터에 방문한 545,859명의 수검자들을 대상으로 이루어졌다. 연구 대상자들은 KOSHA 가이드라인에 따라 저위험군, 중등도위험군, 고위험군, 최고위험군 총 4개의 군으로 분류되었다. 연구는 강북삼성병원 코호트 자료와 연계된 통계청 사망자료를 이용하여 사망 여부와 사망원인을 확인하였다. 2019년 12월 31일까지의 사망 여부를 확인하여 결과변수로 정했고, 사망원인은 국제질병분류(ICD-10)를 기반으로 확인하였다. 통계 분석은 Cox 회귀 분석으로 하였고, 첫 방문부터 사망일 혹은 2019년 12월 31일까지의 기간들의 합산을 시간 척도로 사용하였다. 또한 나이와 성별에 대해 층화분석을 시행하였다.
결과
추적 관찰 기간 중앙값 9.07년 및 총 5,253,627.9인년 동안 발생한 전체 사망자는 4,738명, 심뇌혈관계 사망자는 654명이었다. 저위험군을 기준으로 하였을 때, 다변수 보정 모형에서 전체 사망의 위험비(HR)(95% 신뢰구간)는 중등도위험군에서 3.36 (2.87-3.95), 고위험군에서 11.08 (9.27-13.25), 최고위험군에서 21.20 (17.42-25.79)으로 통계적으로 유의했다. 심뇌혈관계 사망의 위험비는 각각의 군에서 8.57 (4.95-14.83), 38.95 (21.77-69.69), 78.81 (42.62-145.71)로 차이가 더 두드러지는 것으로 관찰되었다. 또한 나이와 성별의 층화분석을 시행하였을 때도 고위험군에서 전체 사망률과 심뇌혈관계 사망률이 더 높은 경향을 보였다.
결론
이번 대규모 종단 연구를 통해서 일반건강검진 10년 심뇌혈관질환 발병 위험도가 높을수록 실제 사망 위험이 증가한다는 것을 확인할 수 있었다.

Citations

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  • The Association Between Blood Lead Levels and Coronary Artery Calcium Score Determined by Using Coronary Computed Tomography Angiography
    Eunyoung Park, Suwhan Kim, Seunghyeon Cho, Hyeonjun Kim, Inho Jung, Jai-Dong Moon, Won-Ju Park
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
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Research Article
Comparisons of hearing threshold changes in male workers with unilateral conductive hearing loss exposed to workplace noise: a retrospective cohort study for 8 years
Sang Jin Park, Joo Hyun Sung, Chang Sun Sim, Seok Hyeon Yun, Jeong Han Yeom, Joong-Keun Kwon, Jiho Lee
Ann Occup Environ Med 2016;28:51.   Published online September 22, 2016
DOI: https://doi.org/10.1186/s40557-016-0132-1
AbstractAbstract PDFPubReaderePub
Background

The purpose of this study was to investigate hearing threshold changes of workers with unilateral conductive hearing loss who were exposed to workplace noise for 8-years.

Methods

Among 1819 workers at a shipyard in Ulsan, 78 subjects with an air-bone gap ≥10 dBHL in unilateral ears were selected. Factors that could affect hearing were acquired from questionnaires, physical examinations, and biochemistry examinations. Paired t-test was conducted to compare the hearing threshold changes over time between conductive hearing loss (CHL) ear and sensorineural hearing loss (SNHL) ear.

Results

The study included male subjects aged 48.7 ± 2.9, having worked for 29.8 ± 2.7 years. Hearing thresholds increased significantly in CHL ears and SNHL ears at all frequencies (0.5–6 kHz) during follow-up period (p < 0.05). The threshold change at 4 kHz was 3.2 dBHL higher in SNHL ears which was statistically significant (p < 0.05). When workers were exposed to noise levels of 85 dBA and above, threshold change at 4 kHz was 5.6 dBHL higher in SNHL ears which was statistically significant (p < 0.05). Among workers aged below 50, the threshold change values were lower in low-frequency (0.5–2 kHz) in SNHL ears, with a small range of changes, whereas in high-frequency (3–6 kHz), the range of changes was greater SNHL ears (p < 0.05). Among workers aged 50 and above, SNHL ears showed a wider range of changes in both high- and low-frequency areas (p < 0.05).

Conclusions

At high-frequencies, particularly at 4 kHz, the range of hearing threshold changes was lower in ears with conductive hearing loss than in contralateral ears. This is suggested as a protective effect against noise exposure.


Citations

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  • Prevalence of Pre-Existing Hearing Loss Among Patients With Drug-Resistant Tuberculosis in South Africa
    Hyejeong Hong, David W. Dowdy, Kelly E. Dooley, Howard W. Francis, Chakra Budhathoki, Hae-Ra Han, Jason E. Farley
    American Journal of Audiology.2020; 29(2): 199.     CrossRef
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Original Article
Comparison of the Standard Threshold Shift Criteria for Evaluating Hearing Conservation Programs
Chang Sun Sim, Kyoung Sook Jeong, Yu Jung Kim, Na Ri Choy, Choong Ryeol Lee, Hun Lee, Jong Pil Jung, Ok Hyun Kim, Yo Weon Lee, Seung Rim Yang, Sung Soo Oh, Ji Ho Lee
Korean Journal of Occupational and Environmental Medicine 2006;18(3):179-188.   Published online September 30, 2006
DOI: https://doi.org/10.35371/kjoem.2006.18.3.179
AbstractAbstract PDF
OBJECTIVES
Workers from a factory was selected to compare 8 standard threshold shift criteria with the Korean diagnostic criteria of noise-induced hearing loss for this cohort study.
METHODS
From 1990 to 1999, 491 workers at a manufacturing company with complete record of the hearing test covering the range of 0.5~6 kHz for 10 consecutive years were finally selected. Eight standard threshold shift criteria (15 dB once, NIOSH (1972), 10 dB average 3~4 kHz, OSHA STS, AAOHNS, 15 dB twice, 15 dB 1~4 kHz, OSHA STS twice) along with the Korean standard for diagnosing the noise-induced hearing loss (the average hearing threshold at 0.5, 1 and 2 kHz) were compared to calculate the degree of the threshold shift and the minimum time required to detect the change.
RESULTS
Those workers showing at least one positive shift in the 'once'criteria of NIOSH (1972) were 92.5%; the 'average'criteria of 10 dB average 3~4 kHz were 35.8%; 'twice'criteria of 15 dB twice were 44.4%. The duration from the baseline to the year showing the first positive shift was from 3.2 +/- 3.1 years (NIOSH, 1972) to 6.0 +/- 2.1 years (OSHA STS twice). The percentage of true positive shift ranging from 20.4% (AAO-HNS) to 69.8% (NIOSH, 1972). There were 10 (2%) which met the Korean diagnostic criteria of noise-induced hearing loss.
CONCLUSIONS
Currently the concept of hearing threshold shift in diagnosing the hearing loss was adopted in Korea thus in this study we determined the validity and the effect of the various hearing threshold shift criteria and showed that NIOSH (1972) criteria was the best of all. In the future, hearing data from various manufacturing workers should be compared to thoroughly evaluate the threshold shift criteria and to establish adequate standard for Korean workers.

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