Annals of Occupational and Environmental Medicine

Original Article

The effect of long working hours on developing type 2 diabetes in adults with prediabetes: The Kangbuk Samsung Cohort Study: Eunhye Seo, Yesung Lee, Eunchan Mun, Dae Hoon Kim, Youshik Jeong, Jaehong Lee, Jinsook Jeong, Woncheol Lee; Ann Occup Environ Med 2022;34:e4. Published online March 14, 2022; DOI: https://doi.org/10.35371/aoem.2022.34.e4

Abstract Abstract in Korean PDF Supplementary Material PubReader ePub

Background

Long working hours are known to account for approximately one-third of the total expected work-related diseases, and much interest and research on long working hours have recently been conducted. Additionally, as the prevalence of prediabetes and the high-risk group for diabetes are increasing worldwide, interest in prediabetes is also rising. However, few studies have addressed the development of type 2 diabetes and long working hours in prediabetes. Therefore, the aim of this longitudinal study was to evaluate the relationship between long working hours and the development of diabetes in prediabetes.

Methods

We included 14,258 prediabetes participants with hemoglobinA1c (HbA1c) level of 5.7 to 6.4 in the Kangbuk Samsung Cohort Study. According to a self-reported questionnaire, we evaluated weekly working hours, which were categorized into 35–40, 41–52, and > 52 hours. Development of diabetes was defined as an HbA1c level ≥ 6.5%. Hazard ratios (HRs) and 95% confidence intervals (CIs) for the development of diabetes were estimated using Cox proportional hazards analyses with weekly working 35–40 hours as the reference.

Results

During a median follow-up of 3.0 years, 776 participants developed diabetes (incidence density, 1.66 per 100 person-years). Multivariable-adjusted HRs of development of diabetes for weekly working > 52 hours compared with working 35–40 hours were 2.00 (95% CI: 1.50–2.67). In subgroup analyses by age (< 40 years old, ≥ 40 years old), sex (men, women), and household income (< 6 million KRW, ≥ 6 million KRW), consistent and significant positive associations were observed in all groups.

Conclusions

In our large-scale longitudinal study, long working hours increases the risk of developing diabetes in prediabetes patients.

당뇨전단계 성인의 제 2형 당뇨로 진행에 대한 장시간 근무의 영향: 강북삼성 코호트 연구
목적
이 연구의 목적은 당뇨전단계라는 고위험그룹에서 장시간 노동과 당뇨로의 진행 사이의 관계를 종단적 연구로 평가하는 것이다.
방법
연구는 강북 삼성 종합 건진 센터에서 2012년 1월 1일부터 2018년 12월 31 일 사이에 최소 두번의 건강검진을 받은 수검자 중, HbA1c 수치가 5.7~6.4인 당뇨전단계 기준을 만족하는 14,258명을 포함했다. 참가자들은 자체 보고된 설문지를 사용하여 3개 그룹 (35-40시간, 41-52시간 및 >52시간)으로 나뉘었고 당뇨로의 진행은 HbA1c 수치 ≥6.5%로 정의되었다. 당뇨 발병에 대한 위험 비율(HR) 및 95% 신뢰 구간(CI)은 주당 35-40시간 근무하는 그룹을 기준으로 Cox 비례 위험 분석을 사용하여 추정되었다.
결과
중앙값 3.0년의 추적 기간 동안 776명의 참가자가 당뇨(발병률, 100인년당 1.66)로 발전했습니다. 주당 근무시간이 35-40시간인 그룹과 비교하여 52시간 초과 근무한 그룹의 다 변수 조정 당뇨 발생 위험비율은 2.00(95% 신뢰구간 [1.50–2.67])이었다. 연령(40세 미만, 40세 이상), 성별(남성, 여성) 및 가계 소득(600만원, 600만원)에 따른 하위 그룹 분석에서 모든 그룹에서 일관되고 유의한 연관성이 관찰되었다.
결론
이 대규모 종단 연구는 당뇨전단계에서 긴 근무 시간이 당뇨 발병과 관련이 있음을 보여주었다.

Citations

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Association between long working hours and diet quality and patterns: A latent profile analysis of a nationally representative sample of Korean workers
Seong-Uk Baek, Jong-Uk Won, Yu-Min Lee, Jin-Ha Yoon
Preventive Medicine.2024; 180: 107890. CrossRef
Working Hours, Shift, and Remote Work by Industry and Occupation in U.S. Full-time Workers
Guang X. Chen
Workplace Health & Safety.2024; 72(9): 392. CrossRef
The impact of long working hours on daily sodium intake
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Journal of Preventive Medicine and Public Health.2022; 55(5): 464. CrossRef

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Original Article

Association between urinary trans,trans-muconic acid and diabetes: a cross-sectional analysis of data from Korean National Environmental Health Survey (KoNEHS) cycle 3 (2015–2017): Eun Hye Yang, Do Jin Nam, Hyo Choon Lee, Soon Su Shin, Jae-Hong Ryoo; Ann Occup Environ Med 2021;33:e35. Published online December 6, 2021; DOI: https://doi.org/10.35371/aoem.2021.33.e35

Abstract Abstract in Korean PDF Supplementary Material PubReader ePub

Background

Benzene is a ubiquitous air pollutant that is well known to cause hematopoietic effects in humans including leukemia. Recently, several studies have discussed its non-carcinogenic effects such as diabetes. This study aimed to investigate the association between diabetes and urinary trans,trans-muconic acid (t,t-MA), one of benzene metabolite, using adult data from Korean National Environmental Health Survey (KoNEHS) cycle 3 (2015–2017).

Methods

This study analyzed 3,777 adults (1,645 men and 2,132 women) from the KoNEHS cycle 3 (2015–2017). The distribution and fraction of each independent variable were presented separately according to the urinary benzene metabolite levels (t,t-MA quartiles) and diabetes to determine the general characteristics of the subjects. Odds ratios (ORs) were calculated using logistic regression after stratification by gender and smoking status to identify the association between urinary t,t-MA and diabetes.

Results

Compared with the first quartile (reference), the risk of diabetes significantly increased above the 4th (1.834 [1.107–3.039]) quartile in men and above the 3rd (1.826 [1.095–3.044]) and 4th (2.243 [1.332–3.776]) quartiles in women after adjustment. Stratified analysis based on smoking revealed that the ORs for the 3rd (1.847 [1.146–2.976]) and 4th (1.862 [1.136–3.052]) quartiles in non-smokers and those for the 2nd (1.721 [1.046–2.832]), 3rd (1.797 [1.059–3.050]), and 4th (2.546 [1.509–4.293]) quartiles in smokers were significantly higher.

Conclusions

We confirmed that urinary t,t-MA is significantly associated with diabetes regardless of gender and smoking status. And further studies are necessary to access the clinical impacts of this findings.

소변 내 뮤콘산 농도와 당뇨의 연관성 : 제 3기 국민환경보건기초조사(2015-2017)를 이용한 단면연구
목적
본 연구는 일반인구집단을 대상으로 환경적인 벤젠 노출과 당뇨와의 연관성을 알아보기 위해 제 3기 국민환경보건기초조사 성인 데이터를 이용하여 벤젠 대사물질 중 하나인 소변 내 뮤콘산의 농도와 당뇨와의 관계를 알아보았다.
방법
제 3기 국민환경보건기초조사 성인 3,777명(남성 1,645명, 여성 2,132명)을 분석하였다. 대상자의 일반적인 특성을 확인하기 위해 각 독립변수의 분포 및 분율을 소변 내 뮤콘산 농도(사분위수)와 당뇨유무에 따라 제시하였다. 소변 내 뮤콘산 농도와 당뇨와의 연관성을 알아보기 위해 성별과 흡연으로 각각 층화 후 로지스틱 회귀분석을 사용하여 오즈비를 구하였다.
결과
보정 후, 남성은 제 4사분위 구간 1.834(1.106-3.039), 여성은 제 3사분위 구간 1.825(1.095-3.044), 제 4사분위 구간 2.241(1.331-3.773)에서 오즈비가 유의하게 증가하였으며, 소변 내 뮤콘산 농도가 증가할수록 당뇨위험이 증가하는 경향성을 보였다. 흡연으로 층화 후 분석한 결과 비흡연자의 경우 제 3분위수 1.847(1.146-2.976), 제 4분위수 1.861(1.135-3.050), 흡연자의 경우 제 2분위수 1.721(1.046-2.832), 제 3분위수 1.796(1.058-3.048), 제 4분위수 2.544(1.509-4.291)가 보정 후 통계적으로 유의하였다.
결론
본 연구에서 벤젠 대사체인 소변 내 뮤콘산 농도가 성별과 흡연 상태에 관계없이 당뇨와 유의하게 관련이 있다는 것을 확인하였으며, 추후 환경적인 벤젠 노출에 대한 당뇨 연관성에 대하여 연구가 필요하다.

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Association Between Benzene and Other Volatile Organic Compounds Exposure and Diabetes Mellitus Among Korean Adults: Findings from the Nationwide Biomonitoring Data
Seong-Uk Baek, Minseo Choi, Yu-Min Lee, Jin-Ha Yoon
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Distribution of volatile organic compounds by distance from industrial complexes and potential health impact on the residents
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Soon Su Shin, Eun Hye Yang, Hyo Choon Lee, Seong Ho Moon, Jae-Hong Ryoo
BMC Public Health.2022;[Epub] CrossRef

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Research Article

Relationship between urinary phthalate metabolites and diabetes: Korean National Environmental Health Survey (KoNEHS) cycle 3 (2015–2017): Do Jin Nam, Yeji Kim, Eun Hye Yang, Hyo Choon Lee, Jae-Hong Ryoo; Ann Occup Environ Med 2020;32:e34. Published online September 18, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e34

Abstract PDF PubReader ePub

Background

We aimed to determine relationship diabetes according to urinary phthalate metabolites using adult data from Korean National Environmental Health Survey cycle 3 (2015–2017).

Method

This study was conducted on 3,781 adults aged 19 years and older (1,648 men and 2,133 women) based on KoNEHS cycle 3. Participants' data were analyzed by gender; Relationship between phthalate metabolites in the urine and diabetes was analyzed by dividing the sociodemographic variables, health behavior-related variables, and urinary phthalate metabolite concentrations into quartiles. To determine the relationship between urinary phthalate metabolites and the prevalence of diabetes, the odds ratio (OR) was calculated using logistic regression analysis.

Results

Based on the 1st quartile of each metabolite, the ORs for di-2-ethylhexyl phthalate (DEHP) (4th quartile), mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) (2nd quartile, 3rd quartile and 4th quartile), mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP) (4th quartile), mono-(2-ethyl-5-carboxypentyl) phthalate (MECCP) (4th quartile), mono-n-butyl phthalate (MnBP) (3rd quartile and 4th quartile), mono-benzyl phthalate (MBzP) (2nd quartile) and 4th quartile), and mono (3-carboxypropyl) phthalate (MCPP) (3rd quartile and 4th quartile) were significantly higher after the adjustment in men. The ORs for DEHP (2nd quartile, 3rd quartile and 4th quartile), MEHHP (2nd quartile, 3rd quartile and 4th quartile), MEOHP (4th quartile), MECCP (4th quartile), MBzP (4th quartile), and MCPP (4th quartile) were significantly higher after the adjustment in women.

Conclusion

This study investigated relationship between urinary phthalate metabolites and diabetes. The higher urinary phthalate metabolites, the higher the prevalence of diabetes. Further regulation of phthalate may be needed, and further studies are warranted to confirm the association between phthalate concentration and other chronic diseases (such as hypertension, hyperlipidemia, and cardiovascular disease).

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Annals of Occupational and Environmental Medicine.2021;[Epub] CrossRef

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Research Article

Effect of night shift work on the control of hypertension and diabetes in workers taking medication: Juha Park, Sang-Yeop Shin, Yangwon Kang, Jeongbae Rhie; Ann Occup Environ Med 2019;31:e27. Published online October 10, 2019; DOI: https://doi.org/10.35371/aoem.2019.31.e27

Abstract PDF PubReader ePub

Background

Night shift work induces physiological and psychological stress by altering sleep and biological rhythms and is associated with hypertension, diabetes, obesity, and cardiovascular diseases. Few studies have been conducted on the control of hypertension and diabetes. This study aimed to examine the effect of night shift work on the control rate of hypertension and diabetes.

Methods

Subjects comprised workers aged 20–65 years who underwent specific health examination at a single facility in seven different affiliated examination centers from 1 January to 31 December 2016. Workers were categorised into day workers and night shift workers. Demographic and medical history were taken, and physical examination was done. Blood pressure (BP) and fasting glucose were measured. The control rate of each disease was evaluated based on treatment goals presented in the treatment guidelines of the Korean Society of Hypertension and the Korean Diabetes Association (systolic BP < 140 mmHg and diastolic BP < 90 mmHg; fasting glucose ≤ 130 mg/dL).

Results

Among 631,418 subjects, 11.2% (70,450) were night shift workers. Of whom 6.1% (4,319) were taking antihypertensive medication and 2.5% (1,775) were taking diabetes medication. Among patients taking antihypertensive medications, the proportion of those whose BP was controlled to suit treatment goals was 81.7% (26,635) of day workers and 77.4% (3,343) of night shift workers, which was significantly different (p < 0.001). Among patients taking diabetes medications, the proportion of those whose blood glucose was controlled to suit treatment goals was 37.4% (4,489) of day workers and 36.5% (647) of night shift workers, but the difference was not significant. The control rates for patients taking antihypertensive medications (odds ratio [OR]: 0.74, 95% confidence interval [CI]: 0.68–0.80) were lower among night shift workers than day workers with adjustment for age, sex, smoking history, alcohol consumption, exercise, and obesity. However, there were no differences in control rates for patients taking diabetes medications (OR: 0.99, 95% CI: 0.87–1.10) between day workers and night shift workers.

Conclusions

Night shift work can have an effect on the uncontrolled BP in workers taking antihypertensive medications. Therefore, additional efforts for disease control are necessary for night shift workers with hypertension.

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Research Article

The effect of diabetes on 4-year changes of hearing thresholds in male workers exposed to noise in a single company: a longitudinal study: Dae Yun Kim, A Ram Kim, Joo Hyun Sung, Choong Ryeol Lee, Jiho Lee; Ann Occup Environ Med 2019;31:e11. Published online June 28, 2019; DOI: https://doi.org/10.35371/aoem.2019.31.e11

Abstract PDF PubReader ePub: Background
Recently, several studies have assessed the association between diabetes and hearing impairment. However, the effect of diabetes on hearing impairment is not well known in diabetic patients exposed to noise, a typical cause of hearing impairment. The aim of this study is to longitudinally analyze the effect of diabetes on hearing impairment in workers exposed to similar noise levels from 2013 to 2017 who had experienced little change in their working conditions.
Methods
The study subjects included 2,087 male workers exposed to noise in a single company and who underwent health examinations at the same hospital in Ulsan city in 2013 and 2017. Hearing impairment was defined that a pure-tone average of pure-tone audiometry (PTA) thresholds at 1,000, 2,000, 3,000, and 4,000 Hz was 25 dB and over in both ears. Statistical analyses were conducted using χ² tests, ANOVA, and Cox proportional hazard models. We analyzed covariates that might affect hearing impairment, including age; working period; levels of total cholesterol, triglyceride, and serum creatinine; smoking and alcohol history; and noise level.
Results
The average PTA thresholds and their average changes between 2013 and 2017 were significant in the diabetes mellitus (DM) group than those in the normal and impaired fasting glucose group. Among the subjects with the same status of fasting glucose group in 2013 and 2017, the adjusted hazard ratios for incident hearing impairment among those in the DM group compared to normal group were 3.35 (95% confidence interval [CI], 1.54–7.29) in the left ear and 5.66 (95% CI, 2.01–15.98) in the right ear.
Conclusions
This study suggested that the risk of hearing impairment in the DM group was significantly higher than that in the normal group in both ears, even when exposed to similar noise levels.

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Research Article

Association of arsenobetaine with beta-cell function assessed by homeostasis model assessment (HOMA) in nondiabetic Koreans: data from the fourth Korea National Health and Nutrition Examination Survey (KNHANES) 2008-2009: Kiook Baek, Namhoon Lee, Insung Chung; Ann Occup Environ Med 2017;29:31. Published online July 10, 2017; DOI: https://doi.org/10.1186/s40557-017-0181-0

Abstract PDF Supplementary Material PubReader ePub

Background

Arsenic is known as an endocrine disruptor that people are exposed to through various sources such as drinking water and indigestion of marine products. Although some epidemiological and animal studies have reported a correlation between arsenic exposure and diabetes development, there are limited studies regarding the toxic effects of organic arsenic including arsenobetaine on the human body. Here, we analyzed the association between urine arsenobetaine and the homeostasis model assessment of β-cell function (HOMA-β), which is an index for predicting diabetes development and reflecting the function of pancreatic β-cells.

Methods

In the fourth Korea National Health and Nutrition Examination Survey (KNHANES), health and nutrition surveys and screening tests were performed. Of the total survey population, people with confirmed values for urine total arsenic and arsenobetaine were included, and known diabetic patients were excluded. A total 369 participants were finally included in the study. We collected surveys on health, height, body weight, body mass index, blood mercury level, fasting glucose level, and serum insulin level and calculated HOMA index. Owing to sexual discrepancy, we performed sexually stratified analysis.

Results

Urine total arsenic and total arsenic minus arsenobetaine was not associated with HOMA-IR and HOMA-β in univariate analysis or in sexually stratified analysis. However, urine arsenobetaine showed a statistically significant relationship with HOMA-β in univariate analysis, and only male participants showed a significant correlation in sexually stratified analysis. In the analysis adjusted for age, BMI, smoking, alcohol drinking, physical activity and blood mercury, the HOMA-β value in the group below the 25th percentile of arsenobetaine was significantly higher than the group between 50 and 75th percentile, while no difference was shown for HOMA-IR. In sexually stratified analysis, The value of HOMA-β was significantly higher in male participants with below the 25th percentile urine arsenobetaine than the group between 25 and 50th and between 50 and 75th, while no difference was shown for HOMA-IR. However, female participants did not demonstrate a relationship between HOMA–IR, HOMA-β and urine arsenobetaine.

Conclusion

This study revealed the association between urine arsenobetaine and pancreatic β-cell function assessed by HOMA-β in the normal population (without diabetes), especially in males, despite adjusting for factors affecting pancreatic β-cell function and diabetes.

Electronic supplementary material

The online version of this article (doi:10.1186/s40557-017-0181-0) contains supplementary material, which is available to authorized users.

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Research for type 2 diabetes mellitus in endemic arsenism areas in central China: role of low level of arsenic exposure and KEAP1 rs11545829 polymorphism
Chenlu Fan, Zaihong Zhan, Xin Zhang, Qun Lou, Ning Guo, Mengyao Su, Yue Gao, Ming Qin, Liaowei Wu, Wei Huang, Meichen Zhang, Fanshuo Yin, Yanhui Wu, Jingbo Pi, Yuanyuan Xu, Yanmei Yang, Yanhui Gao
Archives of Toxicology.2022; 96(6): 1673. CrossRef
Arsenic exposure during pregnancy and postpartum maternal glucose tolerance: evidence from Bangladesh
Abby F. Fleisch, Sudipta Kumer Mukherjee, Subrata K. Biswas, John F. Obrycki, Sheikh Muhammad Ekramullah, D. M. Arman, Joynul Islam, David C. Christiani, Maitreyi Mazumdar
Environmental Health.2022;[Epub] CrossRef
Maternal and childhood exposure to inorganic arsenic and airway allergy – A 15-Year birth cohort follow-up study
Tsung-Lin Tsai, Wei-Te Lei, Chin-Chi Kuo, Hai-Lun Sun, Pen-Hua Su, Shu-Li Wang
Environment International.2021; 146: 106243. CrossRef
Joint effect of urinary arsenic species and serum one-carbon metabolism nutrients on gestational diabetes mellitus: A cross-sectional study of Chinese pregnant women
Qiang Zhang, Xumei Zhang, Shuying Li, Huihuan Liu, Liangpo Liu, Qingyu Huang, Yaxing Hou, Xiaoshan Liang, Bo Cui, Ming Zhang, Liting Xia, Liwen Zhang, Chen Li, Jing Li, Guifan Sun, Naijun Tang
Environment International.2021; 156: 106741. CrossRef
Insulin resistance and pancreatic β cell dysfunction are associated with thyroid hormone functions: A cross-sectional hospital-based study in Turkey
Evin Kocatürk, Ezgi Kar, Zeynep Küskü Kiraz, Özkan Alataş
Diabetes & Metabolic Syndrome: Clinical Research & Reviews.2020; 14(6): 2147. CrossRef
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Radhika Gupta, Prashant Kumar, Nighat Fahmi, Bhaskar Garg, Sriparna Dutta, Shilpee Sachar, Avtar S. Matharu, Karani S. Vimaleswaran
Current Research in Green and Sustainable Chemistry.2020; 3: 100009. CrossRef
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Tania Ruíz-Vera, Ángeles C. Ochoa-Martínez, Sergio Zarazúa, Leticia Carrizales-Yáñez, Iván N. Pérez-Maldonado
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Tahereh Farkhondeh, Saeed Samarghandian, Mohsen Azimi‐Nezhad
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Arsenic and fasting blood glucose in the context of other drinking water chemicals: a cross-sectional study in Bangladesh
Shadassa Ourshalimian, Abu Mohd Naser, Mahbubur Rahman, Solaiman Doza, Jennifer Stowell, K.M. Venkat Narayan, Mohammad Shamsudduha, Matthew O. Gribble
Environmental Research.2019; 172: 249. CrossRef

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Research Article

The current condition of the workers’ general health examination in South Korea: a retrospective study: Young Joong Kang, Jun-Pyo Myong, Huisu Eom, Bowha Choi, Jong Heon Park, Eun-A L Kim; Ann Occup Environ Med 2017;29:6. Published online March 7, 2017; DOI: https://doi.org/10.1186/s40557-017-0157-0

Abstract PDF PubReader ePub

Background

Business owners in the Republic of Korea must take part in the workers’ general health examination. However, there have been few formal analyses of the uptake of this examination by employees. In the present study, we examined the rates of participation in medical examinations according to age group, health insurance type, and enterprise size, and then compared these results with those of the national general health screening. Furthermore, we determined the distribution of patients with abnormal results for diabetes and hypertension, and outlined the significance and history of domestic health examinations.

Methods

We started by comparing participation rates extracted from the among health examination data of the National Health Insurance Service from 2006–2013 by sex, age, insurance type, and enterprise size of workplace health insurance beneficiaries (i.e., those whose insurance is provided by their workplace). In addition, we analyzed the prevalence rates of abnormal results for hypertension and diabetes, and explored the history and significance of health examinations in the Republic of Korea.

Results

The overall participation rate in the primary health examination in 2006 was 56%, and this increased to 72% in 2013. However, the rates of the secondary screening did not increase much. Among workplace policyholders (i.e., those whose insurance is provided by their workplace), the participation rates of workers in enterprises with less than 50 employees were lower than were those in enterprises with 50 or more employees. Notably, the rates and odds ratios of patients with abnormal results for diabetes and hypertension were relatively high, particularly among those working in smaller enterprises.

Conclusions

Although the workers’ general health examination has been replaced with the national general health screening, it remains necessary to ensure uniform health management services among all workers in the Republic of Korea. This can, in turn, promote occupational health and improve working conditions throughout the Republic of Korea.

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Risk of Cardiovascular Disease according to Baseline Low-Density Lipoprotein Cholesterol Level in Different Age Groups in Korean Diabetes Population: A Cohort Study
Tae Kyung Yoo, Kyung-Do Han, Eun-Jung Rhee, Won-Young Lee
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Altered Risk of Incident Gout According to Changes in Metabolic Syndrome Status: A Nationwide, Population‐Based Cohort Study of 1.29 Million Young Men
Yeonghee Eun, Kyungdo Han, Seung Woo Lee, Kyunga Kim, Seonyoung Kang, Seulkee Lee, Hoon‐Suk Cha, Eun‐Mi Koh, Hyungjin Kim, Jaejoon Lee
Arthritis & Rheumatology.2023; 75(5): 806. CrossRef
Association with Combined Occupational Hazards Exposure and Risk of Metabolic Syndrome: A Workers' Health Examination Cohort 2012–2021
Dongmug Kang, Eun-Soo Lee, Tae-Kyoung Kim, Yoon-Ji Kim, Seungho Lee, Woojoo Lee, Hyunman Sim, Se-Yeong Kim
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Kamal Ebrahimi, Reza Tajik, Taybeh Karami, Samira Rahimnejad, Farshad Arghavani
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Soojin Park, Songwon Seo, Dalnim Lee, Sunhoo Park, Young Woo Jin
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Sung-Shil Lim, Wanhyung Lee, Yeong-Kwang Kim, Jihyun Kim, Jong Heon Park, Bo Ram Park, Jin-Ha Yoon
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SangJune Kim, Jee Hey Song, Yoo Min Oh, Sang Min Park, Geofrey Musinguzi
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Hwee-Soo Jeong
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Erratum to: The current condition of the workers’ general health examination in South Korea: a retrospective study
Young Joong Kang, Jun-Pyo Myong, Huisu Eom, Bowha Choi, Jong Heon Park, Eun-A L Kim
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Research Article

Risks of borderline liver enzyme abnormalities to the incidence of impaired fasting glucose and diabetes mellitus: a 7 year follow up study of workers: Jin-Hyun Yu, Jin-Seok Kim, Mee-Ra Lee, Seong-Yong Yoon, Seong-Yong Cho, Seung-Hyun Yoo, Boo-Il Kim; Ann Occup Environ Med 2016;28:18. Published online April 7, 2016; DOI: https://doi.org/10.1186/s40557-016-0105-4

Abstract PDF PubReader ePub

Background

The aim of this study was to identify the relationships between borderline serum liver enzyme abnormalities and the incidence of impaired fasting glucose (IFG) and diabetes mellitus (DM) during a 7-year follow-up of workers, and to evaluate the quantitative level of risks.

Methods

A total of 749 workers in an electronics manufacturing company were divided into the normal fasting blood glucose (n = 633), IFG (n = 98), and DM (n = 18) groups, according to the results of their health checkup in 2006. Among 633 workers in the normal group, excluding 55 workers who were impossible to follow, incidence rate and relative risks of 578 workers to the IFG or DM in 2013 according to the levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma-glutamyltransferase (γ-GTP) were investigated. The liver enzyme levels were categorized as A (normal), B (borderline elevation), and R (definite elevation) following the standard of the National Health Insurance Service of Korea.

Results

The incidence rate of IFG or DM based on ALT level was 9.7 % for the A, 30.0 % for B, and 15.4 % for R. According to γ-GTP, the incidence rate was 9.8 % for A, 34.5 % for B, and 25.0 % for R. The relative risk(RR) to the incidence of IFG or DM depending on the level of ALT were 3.09 in B and 1.59 in R compared to A. According to γ-GTP, RR was 3.52 in B and 2.55 in R compared to A. AST level was not related to the incidence of IFG or DM. A multiple logistic regression analysis with the incidence of IFG or DM as a dependent variable resulted in an odds ratio of 2.664(1.214–5.849) for B level ALT, 3.685(1.405–9.667) for B level of γ-GTP even after adjustment for other variables such as age, sex, body mass index, AUDIT score, systolic blood pressure, and triglyceride.

Conclusions

Even borderline elevations of ALT and γ-GTP, but not AST, increased the incidence and risk of IFG or DM after 7 years. Borderline elevation of ALT and γ-GTP was identified as an independent risk factor of IFG or DM.

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Considering serum alanine aminotransferase and gamma-glutamyltransferase levels together strengthen the prediction of impaired fasting glucose risk: a cross-sectional and longitudinal study
Ji Hye Jeong, Susie Jung, Kyu-Nam Kim
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Research Article

Association of cadmium with diabetes in middle-aged residents of abandoned metal mines: the first health effect surveillance for residents in abandoned metal mines: Hee-seung Son, Soo-geun Kim, Byung-seong Suh, Dong-uk Park, Dae-seon Kim, Seung-do Yu, Yeong-seoub Hong, Jung-duck Park, Byung-kook Lee, Jai-dong Moon, Joon Sakong; Ann Occup Environ Med 2015;27:20. Published online August 24, 2015; DOI: https://doi.org/10.1186/s40557-015-0071-2

Abstract PDF PubReader ePub

Objective

The aim of this study was to determine the association between urinary cadmium (U-cd) concentration and diabetes in middle-aged Korean residents of abandoned mines using the first Health Effect Surveillance for Residents in Abandoned Metal mines (HESRAM).

Methods

This study was cross-sectional study conducted on 719 residents between 40–70 years in 38 abandoned metal mines in Korea. Data was collected by HESRAM from 2008 to 2011. The correlation coefficient of U-cd and fasting blood glucose, odds ratio in urinary cadmium tertiles and diabetes prevalence was analyzed according to the sex category.

Results

The correlation coefficient U-cd concentration and fasting blood glucose was 0.182 in male. Logistic regression analysis in male revealed a third tertile odds ratio of U-cd (2 μg/g creatinine < U-cd) while diabetes prevalence was 1.81 (95 % CI 1.05-3.12) with adjusted age, BMI, smoking and alcohol consumption, region, family income. On the other hand, the odds ratio for third tertile of U-cd (3 μg/g creatinine < U-cd) between diabetes prevalence in female was 1.39 (95 % CI 0.52-3.72) in addition to adjusted menopausal status.

Conclusions

Environmental exposure to cadmium in abandoned mine residents was associated with diabetes in male. Closed monitoring and periodic evaluation of the health effects of chronic environmental exposure on abandoned mines residents will be needed.

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Tommaso Filippini, Lauren A. Wise, Marco Vinceti
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Research Article

Association of Diabetes Mellitus with a Combination of Vitamin D Deficiency and Arsenic Exposure in the Korean General Population: Analysis of 2008–2009 Korean National Health and Nutrition Examination Survey Data: Byung-Kook Lee, Yangho Kim; Ann Occup Environ Med 2013;25:7-7. Published online May 21, 2013; DOI: https://doi.org/10.1186/2052-4374-25-7

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Objectives

We present data from the Korean National Health and Nutritional Examination Survey (KNHANES) 2008–2009 on the combination of vitamin D deficiency and arsenic exposure on diabetes mellitus (DM) in a representative sample of the adult Korean population.

Methods

This study was based on data obtained from the KNHANES 2008–2009, which was conducted for 3 years (2007–2009) using a rolling sampling design that involved a complex, stratified, multistage, probability-cluster survey of a representative sample of the non-institutionalized civilian population in South Korea.

Results

Data analysis revealed that subjects who showed both vitamin D levels in the 1^st quartile (Q) and urinary arsenic levels in the 4^th Q, had a 302% increased risk of having DM, as compared with those whose vitamin D and urinary arsenic levels were in the 4^th Q and 1^st Q, respectively.

Conclusion

The present study reconfirmed an association of DM with low vitamin D levels and arsenic exposure, and further showed a combination of vitamin D deficiency and arsenic exposure on DM in the general Korean population. To the best of our knowledge, this is the first report describing a combination of vitamin D deficiency and arsenic exposure on DM. The present findings have important public health implications.

Citations

Citations to this article as recorded by

Potential association between arsenic and vitamin D
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Frontiers in Endocrinology.2024;[Epub] CrossRef
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Samaneh Abolli, Samaneh Dehghani, Rasha Atlasi, Zahra Maleki, Masud Yunesian, Ozra Tabatabaei-Malazy, Maryam Saraei, Mina Khosravifar, Zahra Soleimani
Results in Engineering.2024; 22: 102054. CrossRef
Association between urinary arsenic species and vitamin D deficiency: a cross-sectional study in Chinese pregnant women
Jingran Zhang, Yuxuan Bai, Xi Chen, Shuying Li, Xiangmin Meng, Aifeng Jia, Xueli Yang, Fenglei Huang, Xumei Zhang, Qiang Zhang
Frontiers in Public Health.2024;[Epub] CrossRef
An updated systematic review and dose-response meta-analysis on the relation between exposure to arsenic and risk of type 2 diabetes
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Toxicology Letters.2023; 384: 115. CrossRef
Dietary Selenium Deficiency Partially Mimics the Metabolic Effects of Arsenic
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Nutrients.2021; 13(8): 2894. CrossRef
Arsenic Exposure Decreases Adiposity During High‐Fat Feeding
Christopher M. Carmean, Andrew G. Kirkley, Michael Landeche, Honggang Ye, Bijoy Chellan, Hani Aldirawi, Austin A. Roberts, Patrick J. Parsons, Robert M. Sargis
Obesity.2020; 28(5): 932. CrossRef
The health effects of exposure to arsenic-contaminated drinking water: a review by global geographical distribution
Lei Huang, Haiyun Wu, Tsering Jan van der Kuijp
International Journal of Environmental Health Research.2015; 25(4): 432. CrossRef
Association between Arsenic Exposure and Diabetes: A Meta-Analysis
Tzu-Ching Sung, Jhih-Wei Huang, How-Ran Guo
BioMed Research International.2015; 2015: 1. CrossRef
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BioMed Research International.2015; 2015: 1. CrossRef

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Original Article

A Cost-Effectiveness Analysis of Mass Screening for Diabetes Mellitus: Kyung Eun Lee, Byung Yeol Chun, Sin Kam, Jae Yong Park; Korean Journal of Occupational and Environmental Medicine 1995;7(2):269-281. Published online October 31, 1995; DOI: https://doi.org/10.35371/kjoem.1995.7.2.269

Abstract PDF: To evaluate the efficiency of the diabetes mellitus screening program, the records of screening examinations for general workers and official workers at a general hospital in Taegu city were analysed. Six alternatives of the diabetes mellitus screening program were compared in terms of cost-effectiveness. The screening program I which was already used in the examination for general workers, screening program II for official workers, alternative program (A) which was the same method as screening program I without urine sugar test for the second examination in a hospital, a1ternative program (B) with the test for fasting blood sugar (FBS) in a worksite, alternative program (C) with the test for postprandial blood sugar (PPBS) in a worksite, alternative program (D) with the first test for FBS and the second test for PPBS of negatives for FBS test in a worksite, alternative program (E) with the first test for PPBS and the second test for FBS of negatives for PPBS test, and alternative program (F) with the test for urine sugar in a worksite. To compare the cost-effectiveness between alternatives, the cost (Won) per positive detected for diabetes mellitus (cost-effectiveness ratio) was calculated. The cost per positive detected was 37,767 Won for screening program I, 50,441 for screening program II, 37,433 for alternative program (A) , 27,645 for alternative program (B), and if it was assumed that the positive rate for negatives of FBS would be 2.0 %, 28,541 for alternative program (C) , 35,458 for alternative program (D) , 38,488 for alternative program (E) . However, that for alternative program (F) was varied with the positive predictive value (PPV) of urine sugar test for diabetes. The cost per positive detected was lowest(18,689 Won) when PPV was 93 %, whereas, highest (88,106) when PPV was 20 %. The critical value of PPV was 64 %. The alternative program (F) was most efficient when PPV was 64% or more. Considering the prevalence for diabetes mellitus, PPV for urine suger test, and feasibility of screening examination, alternative program (B) will be proved as the most efficient screening program. In conclusion, either program (B) or program (F) will be the most efficient method for screening a large population depending on the positive predictive value of fasting urine suger test.

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