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Case Report
Recognized cases of amyotrophic lateral sclerosis in automobile workers by the Korean Epidemiologic Investigation Evaluation Committee
Yongjin Kim, Jong-Hyeop O, Hyungyoel Cho, Shinhee Ye
Ann Occup Environ Med 2024;36:e28.   Published online October 17, 2024
DOI: https://doi.org/10.35371/aoem.2024.36.e28
AbstractAbstract AbstractAbstract in Korean PDFPubReaderePub
Background
Three automobile company workers (one from Factory D and two from Factory E) were diagnosed with amyotrophic lateral sclerosis. The Korean Epidemiologic Investigation and Evaluation Committee determined that there is considerable scientific evidence supporting the association between amyotrophic lateral sclerosis and combined exposure to heavy metals, organic solvents, and diesel exhaust at the manufacturing plant. Case presentation: Patient A, who primarily engaged in engine processing and completed vehicle inspection at Factory D, was exposed to considerable amounts of heavy metals and organic solvents during medium- and large-engine processing, welding, and painting for over 23 years. Additionally, the patient was likely exposed to diesel exhaust for 33 years from forklifts delivering engines in the workshop. Patients B and C, who were responsible for engine assembly, ignition testing, and engine shipment at Factory E since around 1990, were exposed to lead and benzene from gasoline during engine ignition tests in the engine department for 15 and 16 years, respectively. They also encountered welding fumes, heavy metals, and organic solvents during welding and painting tasks. In addition, Patients B and C were continuously exposed to diesel exhaust from logistics vehicles on standby during work hours for 25 and 30 years, respectively. Conclusions: Although the specific level of lead exposure causing amyotrophic lateral sclerosis remains undetermined, numerous studies have consistently reported a relationship between lead exposure and disease development. Limited evidence suggests that exposure to organic solvents and diesel exhaust may increase the risk of amyotrophic lateral sclerosis. Therefore, the Epidemiological Investigation and Evaluation Committee concluded that the three patients’ work-related exposure to heavy metals, organic solvents, and diesel exhaust is significantly supported by scientific evidence as a cause of their amyotrophic lateral sclerosis.
일개 자동차 회사 근로자에서 발생한 근위축성 측삭경화증: 3개 사례보고
배경
일개 자동차 회사의 3명의 근로자(공장 D에서 1명, 공장 E에서 2명)가 근위축성 측삭경화증(Amyotrophic lateral sclerosis) 진단을 받았다. 역학조사평가위원회는 근로자에서 중금속, 유기용제, 디젤 배기가스에 대한 복합 노출과 근위축성 측삭경화증 발병 사이에 상당한 과학적 증거가 있다고 판단하였다.
증례
근로자 A는 공장 D에서 주로 엔진 가공 및 완성 차량 검사 업무를 담당하며, 약 23년 동안 중대형 엔진 가공, 용접 및 도장 작업 중 상당한 양의 중금속 및 유기용제에 노출되었다. 또한, 약 33년동안 지게차로 엔진을 운반하는 업무를 하며 발생하는 디젤 배기가스에 노출되었다. 근로자 B와 C는 1990년대 초부터 공장 E에서 엔진 조립, 엔진 착화테스트 및 엔진 출하 업무를 담당했으며, 각각 약 15년, 약 16년 동안 엔진 착화테스트 업무를 하며 휘발유에 포함된 납 및 벤젠 등에 노출되었다. 그리고 용접 및 도장 작업을 하며 용접 흄, 중금속 및 유기용제 등에 노출되었다. 또한 근로자 B와 C는 각각 약 25년, 약 30년 동안 작업 중 인근에 대기 중인 물류 차량으로부터 지속적으로 디젤 배기가스에 노출되었다.
결론
근위축성 측삭경화증을 발생시킬 수 있는 납 노출 수준은 명확하게 밝혀지지 않았지만, 비교적 많은 연구에서 납 노출과 질병의 발병 사이 관계를 일관되게 보고하고 있었다. 유기용제 및 디젤 배기가스에 대한 노출이 근위축성 측삭경화증의 발생 위험을 증가시킬 수 있다는 제한적인 증거도 있었다. 따라서, 역학조사평가위원회는 3명의 근로자가 근무 중 노출된 중금속, 유기용제 및 디젤 배기가스가 근위축성 측삭경화증의 원인이라는 과학적 근거가 상당하다고 판단하였다.
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Original Article
Cardiometabolic diseases according to the type and degree of hearing loss in noise-exposed workers
KyooSang Kim, Sun-Haeng Choi
Ann Occup Environ Med 2024;36:e3.   Published online February 19, 2024
DOI: https://doi.org/10.35371/aoem.2024.36.e3
AbstractAbstract AbstractAbstract in Korean PDFPubReaderePub
Background

This study aimed to determine the association between cardiometabolic diseases, including metabolic syndrome, hypertension, and diabetes, and the type and degree of hearing loss in noise-exposed workers.

Methods

A total of 237,028 workers underwent air conduction pure tone audiometry in 2015 to assess their health and diagnose cardiometabolic diseases. The study defined metabolic syndrome, hypertension, and diabetes using blood pressure, fasting blood sugar, cholesterol, and triglyceride levels. Mid-frequency hearing loss was defined as ≥ 30 dB at 2,000 Hz, whereas high-frequency hearing loss was ≥ 40 dB at 4,000 Hz. The average air conduction hearing thresholds at these frequencies were used to determine hearing loss degrees.

Results

The odds ratio (OR) of combined exposure to noise and night-shift work in all cardiometabolic diseases was higher than that of noise exposure alone. The risk of cardiometabolic diseases was dose-response, with higher hearing loss causing higher ORs. The ORs of hypertension compared with the normal group were 1.147 (1.098–1.198), 1.196 (1.127–1.270), and 1.212 (1.124–1.306), and those of diabetes were 1.177 (1.119–1.239), 1.234 (1.154–1.319), and 1.346 (1.241–1.459) for mild, moderate, and moderate-severe hearing loss, respectively.

Conclusions

Workers who are exposed to noise tend to demonstrate high risks of hearing loss and cardiometabolic diseases; thus, bio-monitoring of cardiometabolic diseases, as well as auditory observation, is necessary.

소음 노출 근로자의 난청 유형 및 정도에 따른 심혈관대사성 질환
목적
본 연구는 소음 노출 근로자의 사회인구학적 특성, 직업적 특성, 야간 근무 및 난청 여부에 따른 대사증후군, 고혈압, 당뇨병을 포함한 심장-대사성 질환과의 관련성을 파악하고자 하였다.
방법
2015년 237,028명의 근로자들의 기도 순음청력검사를 시행하여 난청 유형과 정도를 평가하고 심장-대사성 질환을 진단하였다. 이 연구는 혈압, 공복 혈당, 콜레스테롤 및 중성지방 수치를 이용하여 대사증후군, 고혈압 및 당뇨병을 정의하였다. 중음역 난청은 2000 Hz에서 30 dB 이상으로 정의한 반면 고음역 난청은 4000 Hz에서 40 dB 이상으로 정의하였다. 난청의 중증도는 이들 주파수의 기도 순음 청력역치의 평균으로 정하였다.
결과
모든 심장-대사성 질환에서 소음 노출과 야간 교대근무에 복합 노출된 경우 소음에만 노출된 경우보다 오즈비가 높았다. 청력손실이 클수록 유의하게 오즈비가 높으며 심장-대사성 질환과의 용량-반응 관계를 보였다. 정상군에 비해 고혈압의 오즈비는 경도 난청의 경우 1.147 (1.098 - 1.198), 중등도 난청의 경우 1.196 (1.127 - 1.270), 중등고도 난청의 경우 1.212(1.124 - 1.306)였다. 정상군에 비해 당뇨병의 오즈비는 경도 난청의 경우 1.177 (1.119 - 1.239), 중등도 난청의 경우 1.234 (1.154 - 1.319), 중등고도 난청의 경우 1.346 (1.241 - 1.459)이었다.
결론
소음에 노출된 근로자는 난청 및 심혈관계 질환의 위험이 높은 경향이 있으므로 청각적 관찰 뿐만 아니라 심혈관계 질환에 대한 생체 모니터링이 필요하다.
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Original Article
The relationship between skeletal muscle mass and the KOSHA cardiovascular risk in obese male workers
Hyo Won Chong, JunSeok Son, Changho Chae, Changho Jae
Ann Occup Environ Med 2023;35:e40.   Published online October 4, 2023
DOI: https://doi.org/10.35371/aoem.2023.35.e40
AbstractAbstract AbstractAbstract in Korean PDFPubReaderePub
Background

Efforts for the prevention and management of cardiovascular diseases (CVDs) in workers have been actively pursued. Obesity is one of the important risk factors related to CVDs. Obesity has various metabolic characteristics, and some individuals can be metabolically healthy. Body composition including skeletal muscle mass is known to have protective effect in obesity. The study aims to investigate the association between skeletal muscle mass and Korea Occupational Safety and Health Agency (KOSHA) CVD risk among obese male manufacturing workers in Korea and to identify appropriate indicators of skeletal muscle mass for predicting risk of CVDs.

Methods

The study was conducted on 2,007 obese male workers at a manufacturing industry aged more than 19 years. Skeletal muscle mass, skeletal muscle index (SMI), skeletal muscle mass percent (SMM%) and skeletal muscle to body fat ratio (MFR) were used to evaluate body composition and these indicators were divided into quartiles. The odds ratios (ORs) and 95% confidence intervals (CIs) for the KOSHA CVD risk groups according to quartiles of skeletal muscle mass indicators were estimated using ordinal logistic regression analysis.

Results

The OR for the KOSHA CVD risk groups in the highest quartile of SMI was 1.67 (95% CI: 1.42–1.92), while the ORs for the KOSHA CVD risk groups in the highest quartiles of SMM%, SMM/body mass index (BMI), and MFR were 0.47 (95% CI: 0.22–0.72), 0.51 (95% CI: 0.05–0.76), and 0.48 (95% CI: 0.23–0.74), respectively.

Conclusions

We found that high SMI increase the likelihood of high risk of CVDs, while high SMM%, SMM/BMI, and MFR lower the likelihood of high risk of CVDs. Accurate evaluation of skeletal muscle mass can help assess the cardiovascular risk in obese male workers.

비만 남성 근로자에서 골격근량과 KOSHA 심혈관질환 위험도와의 연관성
목적
근로자의 심혈관질환의 예방과 사후관리를 위한 노력이 활발이 이루어지고 있다. 비만은 심혈관질환과 관련한 중요한 위험인자로 알려져 있다. 비만은 다양한 대사 특성을 나타내며 일부는 대사적으로 건강하다. 기전 중 하나로 골격근량을 포함한 체성분 구성의 대사적 보호 효과가 알려져 있다. 본 연구를 통해 국내 제조업 비만 남성 근로자를 대상으로 골격근량과 KOSHA 심혈관질환 위험도 간의 연관성을 확인하고, 심혈관질환 위험도를 예측할 수 있는 적절한 골격근량 지표를 확인하고자 하였다.
방법
제조업에 근무하는 19세 이상의 비만 남성 근로자 2,007명을 대상으로 연구를 진행하였다. 체성분을 평가하기 위해 골격근량, skeletal muscle index (SMI), skeletal muscle mass percent (SMM%) 및 skeletal muscle to body fat ratio (MFR) 지표를 사용하였으며 4분위수로 나누었다. 순서형 로지스틱 회귀분석을 시행하여 골격근량 지표의 사분위수에 대한 KOSHA 심혈관질환 위험도의 교차비와 95% 신뢰구간을 산출하였다.
결과
순서형 로지스틱 회귀분석을 시행한 결과, SMI 의 높은 사분위수에서 심혈관질환 위험군의 교차비는 1.67 (95% CI, 1.42-1.92) 으로 나타났다. SMM%, SMM/BMI 및 MFR 의 높은 사분위수에서 MHO 군의 심혈관질환 위험군의 교차비는 각각 0.47 (95% CI, 0.22-0.72), 0.51 (95% CI, 0.05-0.76), 및 0.48 (95% CI, 0.23-0.74) 으로 나타났다.
결론
본 연구에서 높은 SMI 에서 KOSHA 심혈관질환 위험도가 높게 나타날 가능성이 높으며, 높은 SMM%, SMM/BMI 및 MFR 에서 KOSHA 심혈관질환 위험도가 높게 나타날 가능성이 낮았다. 정확한 골격근량의 평가는 비만 남성 근로자의 심혈관질환 위험도를 가늠하는데 도움이 될 것으로 보인다.
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Original Article
Association between hearing loss and high-sensitivity C-reactive protein: the Kangbuk Samsung Cohort Study
Jihoon Kim, Yesung Lee, Eunhye Seo, Daehoon Kim, Jaehong Lee, Youshik Jeong, Seonghyun Kwon, Jinsook Jeong, Woncheol Lee
Ann Occup Environ Med 2023;35:e38.   Published online September 11, 2023
DOI: https://doi.org/10.35371/aoem.2023.35.e38
AbstractAbstract AbstractAbstract in Korean PDFPubReaderePub
Background

Hearing loss (HL) is linked to an elevated risk of cardiovascular diseases (CVDs). The pathogeneses of HL and CVD commonly involve inflammatory responses. Previous studies investigated elevated levels of inflammatory biomarkers in subjects with HL, however, their findings did not demonstrate statistical significance. In our cross-sectional and longitudinal study, we investigated the correlation between HL and increased high-sensitivity C-reactive protein (hsCRP) levels to determine how HL is associated with CVDs.

Methods

We conducted a cross-sectional study with workers aged over 18 years who underwent health check-ups at our institution between 2012 and 2018 (n = 566,507), followed by conducting a longitudinal study of workers aged > 18 who underwent health checkups at least twice at our institution between 2012 and 2018 (n = 173,794). The definition of HL was as an average threshold of ≥ 20 dB in pure-tone air conduction at 0.5, 1.0, and 2.0 kHz in both ears. The incidence of increased hsCRP levels throughout the follow-up period was defined as a level exceeding 3 mg/L. Logistic regression and generalized estimating equations were performed to estimate the risk of increased hsCRP levels according to the occurrence of HL in groups stratified by age.

Results

In the cross-sectional study, the multivariate-adjusted odds ratio (OR) was 1.17 (95% confidence interval [CI]: 1.02–1.34); the OR was 0.99 (95% CI: 0.80–1.22) in those under 40 and 1.28 (1.08–1.53) in those over 40. In the longitudinal study, the multivariable-adjusted OR was 1.05 (95% CI: 0.92–1.19); the OR was 1.10 (95% CI: 0.90–1.35) in those under 40 and 1.20 (1.01–1.43) in those over 40.

Conclusions

This cross-sectional and longitudinal study identified an association between HL and increased hsCRP levels in workers aged over 40 years.

청력손실과 고감도 C-반응단백의 연관성
목적
청력손실은 심혈관질환 발생 및 사망률 증가와 관련 있다. 청력손실과 심혈관질환의 병인은 공통으로 염증반응을 포함한다. 몇몇 연구에서 청력손실 환자의 염증성 바이오마커 수치가 증가했음을 연구하였으나 유의하지 않은 결과를 제시하였다. 따라서 본 단면연구 및 종단연구에서는 청력손실이 심혈관질환과 어떠한 관련성이 있는지 알아보기 위해 청력손실과 염증성 바이오마커인 고감도 C-반응단백의 연관성을 연구하였다.
방법
2012년부터 2018년까지 우리 기관에서 건강검진을 받은 18세 이상의 근로자를 대상으로 단면연구를 수행하였다 (n=566,507). 이후 2012년부터 2018년까지 우리 기관에서 건강검진을 2회 이상 받은 18세 이상의 근로자를 대상으로 종단연구를 수행하였다 (n=173,794). 청력손실은 3분법에 의한 순음청력역치가 양측 모두 20 dB 이상인 경우로 정의하였다. 추적관찰 동안 고감도 C-반응단백의 증가는 혈중 농도 3 mg/L 초과인 경우로 정의하였다. 청력손실 발생에 따른 고감도 C-반응단백 증가의 위험을 분석하기 위해 로지스틱 회귀분석과 일반화 추정방정식을 활용하였다. 또한 연령에 따라 계층화하여 추가적인 분석을 하였다.
결과
단면연구에서 최종참가자 204,091명 중 난청 유병률은 0.02% 이었다. 다변량 보정 교차비는 1.17 (95% 신뢰구간 1.02-1.34) 이었다. 40세 이하와 초과인 군에서는 각각 0.99 (0.80-1.22) 와 1.28 (1.08-1.53) 이었다. 종단연구에서 추적관찰 동안 고감도 C-반응단백 수치는 청력손실군 2,349 명 중 272 명, 비청력손실군 116,301명 중 11,049 명에서 증가하였다. 다변수 보정 교차비는 1.05 (95% 신뢰구간 0.92-1.19) 이었다. 40세 이하와 초과인 군에서는 각각 1.10 (0.90-1.35) 과 1.20 (1.01-1.43) 이었다.
결론
본 단면연구 및 종단연구에서는 40세 초과하는 근로자에서 청력손실과 고감도 C-반응단백의 증가에 유의한 연관성이 있음을 확인하였다.
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Case Report
A case of syncope in a villager with hypertrophic cardiomyopathy after hydrogen sulfide exposure by an unauthorized discharge of wastewater
Hyeonjun Kim, Seunghyeon Cho, Inho Jung, Sunjin Jung, Won-Ju Park
Ann Occup Environ Med 2023;35:e34.   Published online August 21, 2023
DOI: https://doi.org/10.35371/aoem.2023.35.e34
AbstractAbstract AbstractAbstract in Korean PDFPubReaderePub
Background

Hydrogen sulfide is a toxic substance that humans can be exposed to occupationally, and cases of hydrogen sulfide poisoning of workers in industrial sites are commonly reported. However, there have been no cases of poisoning of the public due to an unauthorized discharge of wastewater, so it is important to describe this incident.

Case presentation

In a small village in Jeollanam-do, Republic of Korea, accounts of a terrible stench had been reported. A 26-year-old man who lived and worked in a foul-smelling area was taken to the emergency room with a headache, dizziness, nausea, and repeated syncope. A subsequent police and Ministry of Environment investigation determined that the cause of the stench was the unauthorized discharge of 9 tons of wastewater containing hydrogen sulfide through a stormwater pipe while the villagers were sleeping. The patient had no previous medical history or experience of symptoms. Leukocytes and cardiac markers were elevated, an electrocardiogram indicated biatrial enlargement, left ventricular hypertrophy, and corrected QT interval prolongation. Myocardial hypertrophy was detected on a chest computed tomography scan, and hypertrophic cardiomyopathy was confirmed on echocardiography. After hospitalization, cardiac marker concentrations declined, symptoms improved, and the patient was discharged after 7 days of hospitalization. There was no recurrence of symptoms after discharge.

Conclusions

We suspect that previously unrecognized heart disease manifested or was aggravated in this patient due to exposure to hydrogen sulfide. Attention should be paid to the possibility of unauthorized discharge of hydrogen sulfide, etc., in occasional local incidents and damage to public health. In the event of such an accident, it is necessary to have government guidelines in place to investigate health impact and follow-up clinical management of exposed residents.

무단 방류된 황화수소 노출에 의해 비후성심근증이 악화되어 실신한 마을 주민 사례
배경
황화수소 중독은 산업현장, 하수처리시설 또는 관리되지 않는 화장실 등에서 흔하게 보고된다. 다만 폐수 무단 방류로 인해 일반 주민에게 건강 영향이 발생한 사례는 보고된 바 없어 이를 보고한다.
증례
전라남도 한 지역에서 새벽부터 심한 악취가 난다는 주민 신고가 다수 발생하였다. 경찰과 환경청의 조사 결과 악취의 원인은 새벽에 주민들이 잠든 사이 폐수처리업체에서 황화수소가 포함된 폐수 9톤을 우수관을 통해 무단으로 방류한 것으로 밝혀졌다. 심한 악취가 나는 지역에서 장시간 활동했던 26살 남성이 두통, 어지럼증, 메스꺼움과 짧은 실신을 반복하여 119를 통해 응급실로 내원하였다. 환자는 과거에 특별한 병력이나 증상 경험은 없었다. 검사상 환자의 백혈구와 심장 표지자 수치가 상승되어 있었다. 심전도에서 양측 심방 확장, 좌심실 비대 및 QTc 연장이 관찰되었다. 흉부 컴퓨터 단층 촬영 상 심근비대 소견과 심장 초음파 검사 상 비후성심근증이 확인되었다. 입원하여 대증치료 후 심장 표지자 수치는 감소하였고, 증상은 호전되어 입원 7일 만에 퇴원하였다. 퇴원 이후 추적관찰 동안 특별한 증상은 재발하지 않았다.
결과
본 사례는 환자가 이전에 인지하지 못하고 증상도 없었던 비후성심근증이 황화수소 노출로 인해 급성 악화된 것으로 판단된다. 종종 발생하는 지역의 악취 사건에 황화수소가 무단 방류되었을 가능성을 고려해야 할 것이며, 향후 이러한 화학사고 발생 시 화학물질관리법에 따른 주민 건강영향조사를 실시하여 주민 건강을 관리해야 할 것이다.
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Original Article
Comparing Korea Occupational Safety & Health Agency and National Health Insurance Service’s cardio-cerebrovascular diseases risk-assessment tools using data from one hospital’s health checkups
Yunrae Cho, Dong Geon Kim, Byung-Chan Park, Seonhee Yang, Sang Kyu Kim
Ann Occup Environ Med 2023;35:e35.   Published online August 21, 2023
DOI: https://doi.org/10.35371/aoem.2023.35.e35
AbstractAbstract AbstractAbstract in Korean PDFPubReaderePub
Background

Cardio-cerebrovascular diseases (CVDs) are the most common cause of death worldwide. Various CVD risk assessment tools have been developed. In South Korea, the Korea Occupational Safety & Health Agency (KOSHA) and the National Health Insurance Service (NHIS) have provided CVD risk assessments with health checkups. Since 2018, the KOSHA guide has stated that NHIS CVD risk assessment tool could be used as an alternative of KOSHA assessment tool for evaluating CVD risk of workers. The objective of this study was to determine the correlation and agreement between the KOSHA and the NHIS CVD risk assessment tools.

Methods

Subjects of this study were 17,485 examinees aged 20 to 64 years who had undergone medical examinations from January 2021 to December 2021 at a general hospital. We classified subjects into low-risk, moderate-risk, high-risk, and highest-risk groups according to KOSHA and NHIS’s CVD risk assessment tools. We then compared them with cross-analysis, Spearman correlation analysis, and linearly weighted kappa coefficient.

Results

The correlation between KOSHA and NHIS tools was statistically significant (p-value < 0.001), with a correlation coefficient of 0.403 and a kappa coefficient of 0.203. When we compared risk group distribution using KOSHA and NHIS tools, CVD risk of 6,498 (37.1%) participants showed a concordance. Compared to the NHIS tool, the KOSHA tool classified 9,908 (56.7%) participants into a lower risk category and 1,079 (6.2%) participants into a higher risk category.

Conclusions

In this study, KOSHA and NHIS tools showed a moderate correlation with a fair agreement. The NHIS tool showed a tendency to classify participants to higher CVD risk group than the KOSHA tool. To prevent CVD more effectively, a higher estimation tool among verified CVD risk assessment methods should be selected and managements such as early intervention and treatment of risk factors should be performed targeting the high-risk group.

일개 병원 건강검진 자료를 이용한 한국산업안전보건공단과 건강보험공단의 심뇌혈관질환 위험도 평가의 비교
목적
심뇌혈관질환은 전 세계적으로 가장 많은 사망원인으로, 국내외에서 다양한 위험도 예측모형이 개발되었다. 국내에서는 한국산업안전보건공단의 뇌심혈관계질환 발병위험도 평가와 건강보험공단의 심뇌혈관질환 위험 평가가 있으며, 국가건강검진과 함께 제공되고 있다. 한국산업안전보건공단은 2018년부터 건강보험공단의 심뇌혈관질환 위험 평가의 결과를 평가에 이용할 수 있도록 하고 있어, 두가지 위험도 평가도구를 비교하고 그 상관관계와 일치도를 확인하고자 하였다.
방법
이 연구는 경주의 일개 종합병원에서 2021년 1월부터 12월까지 건강검진을 시행한 17,485명의 수검자를 대상으로 하였다. 건강검진 결과를 이용하여 한국산업안전보건공단와 건강보험공단의 지침에 따라 위험도 평가를 실시하였으며, 저위험군, 중등도위험군, 고위험군, 최고위험군으로 분류하였다. 이후 각각의 위험도 평가에 따른 위험군에 대하여 교차분석 및 스피어만 상관분석, 그리고 선형가중카파를 이용한 일치도 분석을 실시하였다.
결과
한국산업안전보건공단과 건강보험공단의 위험도 평가도구의 상관관계와 일치도는 통계적으로 유의하게 나타났고(p-value < 0.001), 상관계수는 0.403, 카파계수는 0.203으로 나타났다. 두가지 도구의 위험군 분포를 비교하였을 때, 6,498명(37.2%)는 동일한 위험군으로 평가되었다. 건강보험공단의 도구에서 더 높은 위험군으로 평가한 경우는 9,908명(56.7%), 한국산업안전보건공단의 도구에서 더 높은 위험군으로 평가한 경우는 1,079명(6.2%)로 나타났다.
결론
이 연구에서 한국산업안전보건공단과 건강보험공단의 위험도 평가도구는 중간정도의 상관관계와 어느정도의 일치도를 보였다. 두가지 도구 중 한가지만 사용할 경우에는 도구와 수검자의 특성에 따른 신중한 선택이 필요하다. 두가지 도구 중 건강보험공단의 도구가 더 높은 위험군으로 평가하는 경향을 보였다. 검증된 두가지 도구 중 더 높은 위험군으로 평가하는 쪽을 선택함으로써 위험요인을 조기에 발견하고 관리한다면 심뇌혈관질환의 효과적인 예방에 도움이 될 것이다.
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Original Article
Incidence rates of injury, musculoskeletal, skin, pulmonary and chronic diseases among construction workers by classification of occupations in South Korea: a 1,027 subject-based cohort of the Korean Construction Worker’s Cohort (KCWC)
Seungho Lee, Yoon-Ji Kim, Youngki Kim, Dongmug Kang, Seung Chan Kim, Se-Yeong Kim
Ann Occup Environ Med 2023;35:e26.   Published online July 24, 2023
DOI: https://doi.org/10.35371/aoem.2023.35.e26
AbstractAbstract AbstractAbstract in Korean PDFSupplementary MaterialPubReaderePub
Background

The objective of this study is to investigate the differences in incidence rates of targeted diseases by classification of occupations among construction workers in Korea.

Methods

In a subject-based cohort of the Korean Construction Worker’s Cohort, we surveyed a total of 1,027 construction workers. As occupational exposure, the classification of occupations was developed using two axes: construction business and job type. To analyze disease incidence, we linked survey data with National Health Insurance Service data. Eleven target disease categories with high prevalence or estimated work-relatedness among construction workers were evaluated in our study. The average incidence rates were calculated as cases per 1,000 person-years (PY).

Results

Injury, poisoning, and certain other consequences of external causes had the highest incidence rate of 344.08 per 1,000 PY, followed by disease of the musculoskeletal system and connective tissue for 208.64 and diseases of the skin and subcutaneous tissue for 197.87 in our cohort. We especially found that chronic obstructive pulmonary disease was more common in construction painters, civil engineering welders, and civil engineering frame mold carpenters, asthma in construction painters, landscape, and construction water proofers, interstitial lung diseases in construction water proofers.

Conclusions

This is the first study to systematically classify complex construction occupations in order to analyze occupational diseases in Korean construction workers. There were differences in disease incidences among construction workers based on the classification of occupations. It is necessary to develop customized occupational safety and health policies for high-risk occupations for each disease in the construction industry.

한국 건설업 종사자의 손상, 근골격계 질환, 피부, 호흡기 및 만성질환의 건설 직종에 따른 발생률: 한국 건설업 종사자 코호트(KCWC) 의 1027명 대상자 기반 세부 코호트 분석
목적
본 연구의 목적은 한국 건설업 종사자에 있어 주요 질환의 건설 직종별 발생률 차이를 알아보는 것이다.
방법
한국 건설업 종사자 코호트(KCWC)의 대상자 기반 세부 코호트로 총 1,027명의 건설업 종사자가 1:1면접설문조사를 통해 입적되었다. 직업적 노출요인으로 직종은 크게 건설산업환경과 직무 두 가지 축으로 분류되었다: 직업적 노출(설문조사) 자료와 국민건강보험공단 청구 맞춤형 자료를 연계하여 질환의 평균 발생률을 분석하였다. 주요 질환은 건설업 종사자에서 유병률이 높거나 업무 관련성이 있을 것으로 추정되는 11개의 대상 질환을 평가하였다. 질환별 평균 발생률은 1,000인년당 발병 사례수(명)으로 계산하였다.
결과
손상, 중독 및 외인에 의한 특정 기타 결과가 1,000인년당 344.08명으로 가장 높은 발생률을 보였고, 그 다음으로 근골격계 및 결체조직의 질환이 1,000인년당 208.64명, 피부 및 피하조직 질환이 1,000인녕당 197.87명 순으로 높았다. 특히, 만성 폐쇄성 폐질환이 건축 도장공, 토목 용접공, 토목 형틀목공에서 타 직종에 비해 상대적으로 높은 발생률을 보였고, 천식은 건축 도장공, 조경, 건축 방수공에서, 간질성 폐질환은 건축 방수공에서 상대적으로 높은 발생률을 보였다.
결론
본 연구는 한국 건설업 종사자의 주요 직업성 질환 및 호발 질환 등을 복잡한 건설산업의 직종을 체계적으로 분류하여 분석한 최초의 연구로 연구진들은 건설업 종사자의 질환별 발생률에 있어 직종별 차이를 확인하였다. 건설 산업에서 각 질환별 고위험 직종별로 맞춤형 산업안전보건정책 개발이 필요하다.

Citations

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  • Work Performance Among Workers without Disabilities after Industrial Accidents: A Longitudinal Study
    Chong Min Hong
    The Open Public Health Journal.2024;[Epub]     CrossRef
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Special Issue
Statement by the Korean Society of Occupational and Environmental Medicine on the proposed reform of working hours in South Korea
Hee-Tae Kang, Chul-Ju Kim, Dong-Wook Lee, Seung-Gwon Park, Jinwoo Lee, Kanwoo Youn, Hwan-Cheol Kim, Kyoung Sook Jeong, Hansoo Song, Sung-Kyung Kim, Sang-Baek Koh
Ann Occup Environ Med 2023;35:e17.   Published online July 5, 2023
DOI: https://doi.org/10.35371/aoem.2023.35.e17
AbstractAbstract PDFSupplementary MaterialPubReaderePub

The current 52-hour workweek in South Korea consists of 40 hours of regular work and 12 hours of overtime. Although the average working hours in South Korea is declining, it is still 199 hours longer than the Organisation for Economic Co-operation and Development average of 1,716 hours per year. In view to this, the South Korean government has now proposed to reform the workweek, mainly intending to increase the workweek to 69 hours when the workload is heavy. This reform, by increasing the labor intensity due to long working hours, goes against the global trend of reducing work hours for a safe and healthy working environment. Long working hours can lead to increased cerebrovascular and cardiovascular diseases, industrial accidents, mental health problems, and safety accidents due to lack of concentration. In conclusion, the Korean government’s working hour reform plan can have a negative impact on workers’ health, and therefore it should be thoroughly reviewed and modified.


Citations

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  • Association between long working hours and metabolic dysfunction–associated steatotic liver disease: a nationwide population-based study in Korea
    S.-U. Baek, J.-U. Won, Y.-M. Lee, J.-H. Yoon
    Public Health.2024; 232: 188.     CrossRef
  • Association between long working hours and engagement in preventive healthcare services in Korean workers: Findings from the Korean National Health and Nutrition Examination Survey
    Seong-Uk Baek, Yu-Min Lee, Jin-Ha Yoon
    Preventive Medicine.2024; 180: 107849.     CrossRef
  • Long working hours, work-life imbalance, and poor mental health: a cross-sectional mediation analysis based on the sixth Korean Working Conditions Survey, 2020–2021
    Seong-Uk Baek, Yu-Min Lee, Jin-Ha Yoon, Jong-Uk Won
    Journal of Epidemiology.2024;[Epub]     CrossRef
  • Association between long working hours and the onset of problematic alcohol use in young workers: A population-based longitudinal analysis in South Korea
    Seong-Uk Baek, Jong-Uk Won, Jin-Ha Yoon
    Journal of Affective Disorders.2024; 344: 141.     CrossRef
  • Changes in Korea’s working time policy: the need for research on flexible working hours considering socioeconomic inequality
    Inah KIM
    Industrial Health.2024; 62(2): 77.     CrossRef
  • Effect of long working hours on psychological distress among young workers in different types of occupation
    Seong-Uk Baek, Jin-Ha Yoon
    Preventive Medicine.2024; 179: 107829.     CrossRef
  • Association between long working hours and the development of suicidal ideation among female workers: An 8-year population-based study using the Korean Longitudinal Survey of Women & Family (2012–2020)
    Seong-Uk Baek, Yu-Min Lee, Jin-Ha Yoon
    Psychiatry Research.2024; 333: 115731.     CrossRef
  • Special Series I: Working hours as a social determinant of workers’ health
    Kyunghee Jung-Choi, Tae-Won Jang, Mo-Yeol Kang, Jungwon Kim, Eun-A Kim
    Annals of Occupational and Environmental Medicine.2023;[Epub]     CrossRef
  • Association between long working hours and cigarette smoking, leisure-time physical activity, and risky alcohol use: Findings from the Korea National Health and Nutrition Examination Survey (2014–2021)
    Seong-Uk Baek, Jin-Ha Yoon
    Preventive Medicine.2023; 175: 107691.     CrossRef
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Original Article
Effect of night shift work on the reduction of glomerular filtration rate using data from Korea Medical Institute (2016-2020)
Beom Seok Ko, Sang Yop Shin, Ji Eun Hong, Sungbeom Kim, Jihhyeon Yi, Jeongbae Rhie
Ann Occup Environ Med 2023;35:e22.   Published online June 30, 2023
DOI: https://doi.org/10.35371/aoem.2023.35.e22
AbstractAbstract AbstractAbstract in Korean PDFPubReaderePub
Background

Shift work increases the risk of chronic diseases, including metabolic diseases. However, studies on the relationship between shift work and renal function are limited. The aim of this study was to investigate the association between shift work and a decreased glomerular filtration rate (GFR).

Methods

Data were evaluated for 1,324,930 workers who visited the Korean Medical Institute from January 1, 2016 to December 31, 2020 and underwent a health checkup. Daytime workers were randomly extracted at a ratio of 1:4 after matching for age and sex. In total, 18,190 workers aged over 40 years were included in the analyses; these included 3,638 shift workers and 14,552 daytime workers. Participants were categorized into the shift work group when they underwent a specific health checkup for night shift work or indicated that they were shift workers in the questionnaire. The odds ratio was calculated using a conditional logistic regression to investigate the relevance of shift work for changes in GFR.

Results

35 workers in the shift group and 54 in the daytime group exhibited an estimated GFR (eGFR) value of < 60 mL/min/1.73m2 (p < 0.01). The difference in eGFR values between two checkups differed significantly depending on the type of work (p < 0.01); the difference in the shift work group (−9.64 mL/min/1.73 m2) was larger than that in the daytime work group (−7.45 mL/min/1.73 m2). The odds ratio for eGFR reduction to < 60 mL/min/1.73 m2 in the shift group versus the daytime group was 4.07 (95% confidence interval: 2.54–6.52), which was statistically significant.

Conclusions

The results of this study suggest that eGFR decreases by a significantly larger value in shift workers than in daytime workers; thus, shift work could be a contributing factor for chronic kidney disease (CKD). Further prospective studies are necessary to validate this finding and identify measures to prevent CKD in shift workers.

교대근무가 신사구체 여과율에 미치는 영향
목적
교대근무는 대사질환을 포함한 만성질환의 위험도를 증가시키는 것으로 알려져 있다. 하지만 교대근무와 신기능과 관련된 연구는 제한적이다. 때문에, 본 연구의 목적은 교대 근무와 사구체 여과율 감소와의 연관성을 보고자 하는 것이다.
방법
본 연구는 2016년 1월 1일부터 2020년 12월 31일까지 한국의학연구소(KMI)에 내원하여 건강검진을 받은 1,324,930명의 직장인을 대상으로 시행하였다. 나이와 성별에 대해 매칭한 후, 낮 근무자를 4:1의 비율로 무작위 추출하였다. 총 18,190 명의 40세 이상 근로자를 분석 대상으로 하였으며, 교대 근무자 3,638 명과 낮 근무자 14,552 명이 포함되었다. 참가자들은 야간 특수 건강검진을 받았거나 설문지에서 교대 근무자임을 표시했을 때 교대 근무 그룹으로 분류하였다. 조건부 로지스틱 회귀분석을 사용하여 교대 근무의 관련성과 신기능 변화 간의 상관 관계를 조사하였다.
결과
교대 근무 그룹의 35 명과 낮 근무 그룹의 54 명이 추정 GFR(eGFR) 값이 60 mL/min/1.73m2 미만임을 보였다(P<0.01). 두 검진 간 eGFR 값 차이는 근무 형태에 따라 유의하게 차이가 나며(P<0.01), 교대 근무 그룹(-9.64 mL/min/1.73m2)의 차이가 낮 근무 그룹(-7.45 mL/min/1.73m2)보다 크게 나타났다. 주간근무군에 비해 교대근무군에서 사구체 여과율이 60ml/min/1.73m2 미만으로 떨어질 교차비는 4.07(95% CI 2.54-6.52) 로 통계적으로 유의하게 증가하였다.
결론
본 연구 결과 교대 근무자들의 eGFR 값이 주간 근무자들보다 유의하게 감소하였으며, 교대 근무는 만성 신질환 발생의 요인이 될 수 있다는 것을 알 수 있었다.
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Original Article
Organic solvent exposure for the chronic kidney disease: updated systematic review with meta-analysis
Chaeseong Lim, Hyeoncheol Oh
Ann Occup Environ Med 2023;35:e11.   Published online May 17, 2023
DOI: https://doi.org/10.35371/aoem.2023.35.e11
AbstractAbstract AbstractAbstract in Korean PDFPubReaderePub
Background

Studies on the relationship between organic solvent exposure and chronic kidney disease (CKD) have presented inconsistent results. Definition of CKD has changed in 2012, and other cohort studies have been newly published. Therefore, this study aimed to newly confirm the relationship between organic solvent exposure and CKD through an updated meta-analysis including additional studies.

Methods

This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The search was conducted on January 2, 2023 using Embase and MEDLINE databases. Case-control and cohort studies on the relationship between organic solvent exposure and CKD were included. Two authors independently reviewed full-text.

Results

Of 5,109 studies identified, a total of 19 studies (control studies: 14 and cohort studies: 5) were finally included in our meta-analysis. The pooled risk of CKD in the organic solvent exposed group was 2.44 (1.72–3.47). The risk of a low-level exposure group was 1.07 (0.77–1.49). The total risk of a high-level exposure group was 2.44 (1.19–5.00). The risk of glomerulonephritis was 2.69 (1.18–6.11). The risk was 1.46 (1.29–1.64) for worsening of renal function. The pooled risk was 2.41 (1.57–3.70) in case-control studies and 2.51 (1.34–4.70) in cohort studies. The risk of subgroup classified as ‘good’ by the Newcastle Ottawa scale score was 1.93 (1.43–2.61).

Conclusions

This study confirmed that the risk of CKD was significantly increased in workers exposed to mixed organic solvents. Further research is needed to determine the exact mechanisms and thresholds. Surveillance for kidney damage in the group exposed to high levels of organic solvents should be conducted.

Trial Registration

PROSPERO Identifier: CRD42022306521

유기용제와 만성 콩팥병 ; 갱신된 메타-분석
목적
유기용제는 많은 산업현장에서 널리 사용되고 있는 물질로, 산업현장 근로자들의 건강에 나쁜 영향을 초래하고 있다. U.Ravnskov et al, 2000 에서는 유기용제 노출과 만성 신부전에 대해 조사했던 환자-대조군 연구들을 모아 메타분석을 시행하였다. 해당 메타 분석이 발표된 이후 만성 신부전의 정의가 변경되었으며 새로운 코호트 연구들도 새로 발표되었다. 따라서 본 연구에서는 기존 메타 분석에서 포함되지 못한 연구들을 추가로 포함하여 업데이트된 메타 분석을 시행하였다.
방법
본 체계적 검토는 Preferred Reporting Items For Systematic Reviews and Meta-Analysis(PRISMA) guideline 에 의거하여 진행되었다. 검색은 Embase 와 MEDLINE 데이터베이스를 활용하여 2021년 11월 9일날 시행되었다. 유기용제 노출에 의한 만성 신부전에 대한 총 위험도와 더불어, 저도 노출, 중등도 노출, 고도 노출로 구분된 논문들을 모아 노출강도에 따른 하위그룹의 위험도 또한 분석하였다.
결과
유기용제 노출군은 비노출군에 비해 만성 신부전에 대한 총 위험도 (pooled risk) 는 2.44(1.72-3.47) 로 나왔다. 저도 노출의 경우 위험도 1.07(0.77-1.49) 로 나타났고 고도 노출군의 경우 총 위험도 2.44(1.19-5.00) 로 나타났다. 사구체 신염 발생의 경우 위험도가 2.69(1.18-6.11), 신기능 악화의 경우 1.46(1.29-1.64) 로 나타났다. 환자-대조군 연구들의 경우 2.41(1.57-3.70), 코호트 연구들의 경우 2.51(1.34-4.70) 으로 나타났다. Newcastle Ottawa scale 점수가 ‘좋음’으로 분류된 연구들의 경우 1.93(1.43-2.61)로 나타났다.
결론
선행 연구와 마찬가지로 혼합 유기용제 노출 근로자에서 만성 신부전의 위험성이 유의하게 증가한 것을 확인하였다. 이는 현재 석유 관련 제품 취급자, 도장공, 금속가공, 실험실 근로자 등 혼합 유기용제 고용량 노출군에 대한 특수건강진단 시 신기능 검사나 단백뇨 검사의 범위를 넓혀야 함을 시사할 수 있다.
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Original Article
Association between shift work and serum homocysteine level in female electronic manufacturing services workers
Jae Won Lim, Chan Woo Kim, Hyoung Ouk Park, Eui Yup Chung, Changho Chae, JunSeok Son, Young Hoo Shin, Seung Hyun Park, Sang Moon Choi
Ann Occup Environ Med 2023;35:e4.   Published online March 10, 2023
DOI: https://doi.org/10.35371/aoem.2023.35.e4
AbstractAbstract AbstractAbstract in Korean PDFSupplementary MaterialPubReaderePub
Background

Shift work has been shown to increase the risk of cardiovascular disease (CVD) based on several evidences. The classic risk factors of CVD include age, hypertension, smoking, obesity and diabetes. Recently, the serum homocysteine level has been reported to be a valuable indicator of CVD risk. This study aimed to determine the variation in serum homocysteine level as a cardiovascular risk indicator among female workers according to shift work.

Methods

The data of regular health examination of workers at an electronic manufacturing services company in Yeongnam region, South Korea in 2019 were examined in this study. The investigation was based on a cross-sectional study conducted on 697 female workers (199 day workers and 498 shift workers). The sociodemographic and biochemical characteristics were compared between day workers and shift workers. Through a logistic regression analysis, the odds ratio (OR) of the increased serum homocysteine level in relation to shift work was determined.

Results

Compared to female day workers, female shift workers showed significantly higher level of serum homocysteine (8.85 ± 2.16 vs. 9.42 ± 2.04 μmol/mL; p = 0.001). The OR of day workers against shift workers was 1.81 (95% confidence interval [CI]: 1.25–2.63). With the adjustment of variables that may influence the level of serum homocysteine, the adjusted OR was 1.68 (95% CI: 1.09–2.60).

Conclusions

The serum homocysteine level was significantly higher in shift workers than in day workers. It is thus likely to be a useful predictor of CVD in shift workers.

전자제조서비스업 회사의 여성 근로자에서 교대근무와 혈청 호모시스테인 수준과의 연관성
목적
교대근무가 심혈관계질환의 발병위험도를 증가시킨다는 여러 증거들이 있다. 심혈관계질환의 고전적 위험인자로는 나이, 고혈압, 흡연, 비만, 이상지질, 당뇨병 등이 있으며, 최근 혈청 호모시스테인 수치는 심혈관계 질환의 위험도 지표로 유용한 것으로 알려지고 있다. 본 연구에서는 여성 근로자에서 교대근무 여부에 따라 심혈관계 질환의 위험도 지표인 혈청 호모시스테인의 수준 차이가 있는지를 알아보고자 하였다.
방법
본 연구는 2019년 영남지방의 한 전자제조서비스업회사 근로자의 정기건강검진 자료를 이용하여 수행하였다. 총 697명의 여성근로자(주간근무자 199명, 교대근무자 498명)의 데이터로 단면연구를 수행하였다. 주간 근무자와 교대근무자의 인구사회학적, 생화학적 특성을 비교하였다. 로지스틱 회귀분석을 사용하여 교대근무와 상승된 혈청 호모시스테인 수치의 교차비를 조사하였다.
결과
여성 주간 근로자와 비교하여 여성 교대근무자의 혈청 호모시스테인 수치가 통계적으로 유의하게 더 높았다. (8.85 ± 2.16 vs 9.42 ± 2.04 μmol/ml ; p=0.001). 교대근무자에 비해 주간 근무자의 교차비는 1.81(95% CI : 1.25-2.63) 였으며, 혈청 호모시스테인 수치에 영향을 미칠 수 있는 변수를 보정한 후, 수정된 OR은 1.68(95% CI : 1.09-2.60) 이었다.
결론
혈청 호모시스테인 수치는 주간 근무자에 비해 교대근무자에서 통계적으로 유의하게 높았다. 교대근로자의 심혈관계 질환 발병의 예측에 있어 혈청 호모시스테인 수치가 유용하겠다.

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  • Dietary habits of night shift workers: A reason or an excuse for poor nutrition
    Svetlana Anđelković, Maja Babić
    Srpski medicinski casopis Lekarske komore.2024; 5(1): 75.     CrossRef
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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.

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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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Original Article
Risk perceptions of a population living near a municipal waste incinerator and associated factors with the prevalence of environmental disease
Dong Hyun Kim, Chae Kwan Lee, Jeong Ho Kim, Byung Chul Son, Chunhui Suh, Kunhyung Kim, Byeong Jin Ye
Ann Occup Environ Med 2022;34:e38.   Published online November 11, 2022
DOI: https://doi.org/10.35371/aoem.2022.34.e38
AbstractAbstract AbstractAbstract in Korean PDFPubReaderePub
Background

This study investigated the risk perceptions, prevalence of environmental diseases (EDs) and associated factors with the prevalence of environmental disease among the population living near an incinerator

Methods

Study area were divided into 3 local areas near the incinerator by distance (A, B, C) and control area (D) by distance and geographic isolation. A Questionnaire was conducted with 1,380 in local residents (A, B, C) and 390 in control area (D), gathered information of demographic characteristics, lifestyle, perception of damage by incinerators, experience of EDs (atopic dermatitis, allergic rhinitis, asthma) diagnosed by physician. Analysis of variance, χ2 test, and Kruskal Wallis test was applied to determine the difference by area. Logistic regression analysis was performed to identify factors associated with the prevalence of allergic rhinitis.

Results

Residents residing closer to the incinerator had negative perception in most items in questionnaire compared with control. The prevalence of allergic rhinitis was higher as they lived nearby the incinerator (p = 0.008). The associated factors with the prevalence of allergic rhinitis were carpet (odds ratio [OR]: 1.79, p = 0.001), residential area (marginally significant), duration of residence (OR: 1.09, p < 0.001). The perception of environmental pollution around the residential area was inversely associated with the prevalence of allergic rhinitis: perceived as very dissatisfied (OR: 4.21, p = 0.02) compared with very satisfied.

Conclusions

As closer to the incinerator, the risk perception tend to negative and prevalence of EDs were increased. Carpet, residential area, duration of residence and perception of environmental air pollution around the residential area were associated with prevalence of allergic rhinitis. These results may be useful for the communication with residents to discuss the environmental problems caused by the incinerator.

자원순환시설 주변에 거주하는 주민의 환경성질환에 영향을 주는 위험인식도 및 생활습관
목적
이 연구는 소각장 주변에 거주지역 주민의 위험 인식도, 환경성 질환의 유병률, 환경 질환과 유병률과 관련된 요인을 조사했다.
방법
2020년 자원순환시설 인근에 거주중인 주민 1380명과 대조군 주민 390명을 대상으로 설문조사를 실시하여 인구통계학적 특성, 생활습관, 자원순환시설에 대한 인식, 환경성질환 과거력을 확인하였다. 환경성질환 과거력의 지역 간 차이를 확인하기 위해 카이 제곱 검정을 사용하여 분석하였다. 마지막으로 환경성질환 과거력에 영향을 주는 요인을 찾기 위해 로지스틱 회귀분석을 시행하였다.
결과
자원순환시설에 가까이 거주하는 주민은 대조군에 비해 주변환경 인식도, 자원순환시설에 대한 인식도 항목에서 부정적 인식을 보였다. 설문 조사에서 확인한 알레르기 비염의 과거력은 소각장 근처에 거주할수록 높았다. 알레르기 비염 유병률과 연관된 요인은 카펫 (OR = 1.79 p-value = 0.001), 거주지역, 거주기간 (OR = 1.09, p-value < 0.001) 으로 확인되었다. 거주지역 대기환경이 매우 좋지 않다고 인식하는 주민에서 (OR = 4.21, p-value = 0.02) 알레르기 유병률이 높아진 결과를 보였다.
결론
소각장에 가까이 거주할수록 소각장과 환경에 대한 위험 인식이 부정적으로 나타났고 환경성 질환의 유병률의 증가를 보였다. 카펫 사용, 소각장으로부터의 거리, 거주 기간, 주거 지역 주변의 대기 오염에 대한 인식도는 알레르기성 비염의 유병률과 관련을 보였다. 이 결과는 소각로로 인한 환경문제에 대해 주민들과 소통하는 데 유용할 것이다.

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  • The effect of distance on risk perception towards waste incineration plants: a comparison between local residents living within 0–3 km versus 3–8 km in Dongguan, Southern China
    Lizhou Zhang, Tippawan Liabsuetrakul
    Environmental Research Communications.2023; 5(11): 115011.     CrossRef
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Original Article
Association between shift work and inflammatory markers in workers at an electronics manufacturing company
Sung-Joon Woo, Chang-Ho Chae, Jae-Won Lim
Ann Occup Environ Med 2022;34:e35.   Published online November 7, 2022
DOI: https://doi.org/10.35371/aoem.2022.34.e35
AbstractAbstract AbstractAbstract in Korean PDFPubReaderePub
Background

Shift work is known to be associated with cardiovascular disease (CVD). It has been found that inflammatory reactions are involved in the onset and progression of CVD. Therefore, the purpose of this study was to investigate the association between shift work and inflammatory markers.

Methods

Among workers at an electronics manufacturing company, 2,329 workers who had a health checkup from January 2019 to December 2019 were targeted. The general and biochemical characteristics of daytime workers and shift workers were compared through the Independent-test and the χ2 test. Through multiple linear regression analysis, the association with shift work and inflammatory markers was investigated. Through multiple logistic regression analysis, the association with shift work and high inflammatory markers

Results

The mean total leukocytes, neutrophils, monocytes, lymphocytes of shift workers were significantly higher than those of daytime worker. The mean high-sensitivity C-reactive protein (hs-CRP) of shift workers was also higher than that of daytime workers but not significantly. In multiple linear regression, shift work was associated with increase of total leukocyte count (β = 0.367, p < 0.001) and hs-CRP (β = 0.140, p = 0.005) after adjusting for all variables. In multiple logistic regression analysis, shift work showed 2.27 times risk of high leukocyte count and 1.8 times risk of high hs-CRP level compared to daytime work after adjusting for all variables.

Conclusions

This study confirmed that shift work is associated with high inflammatory markers. Considering that high inflammatory markers is independent indicator of CVD, the association between shift work and high inflammatory markers may help to understand the CVD risk of shift workers.

일개 전자제품 제조업 근로자에서 교대근무와 염증 표지자의 연관성
목적
교대근무는 심혈관 질환과 관련이 있는 것으로 알려져 있다. 염증반응이 심혈관질환의 발병과 진행에 관여하는 것으로 나타났다. 따라서 본 연구의 목적은 교대근무와 염증표지와의 연관성을 조사하는 것이었다..
방법
전자제품 제조업체 근로자 중 2019년 1월부터 2019년 12월까지 건강검진을 받은 근로자 2,329명을 대상으로 했다. Independent-test와 chi-square test를 통해 주간근로자와 교대근무자의 일반 및 생화학적 특성을 비교하였다. 다중선형회귀분석을 통해 교대근무와 염증표지와의 연관성을 조사하였고, 다중 로지스틱 회귀분석을 통해 교대근무와 높은 수준의 염증성 마커와의 연관성을 조사하였다.
결과
교대근무자의 평균 총 백혈구, 호중구, 단핵구, 림프구는 주간근무자에 비해 유의하게 높았다. 교대근무자의 평균 hs-CRP도 주간근무자에 비해 높았지만 유의미하지는 않았다. 다중 선형 회귀 분석에서 교대 근무는 모든 변수를 조정한 후 총 백혈구 수 증가(β = 0.367, p-value < 0.001)와 hs-CRP(β = 0.140, p-value = 0.005)와 관련이 있었다. 다중 로지스틱 회귀분석에서 교대근무는 모든 변수를 조정한 후 주간근무에 비해 높은 백혈구 수의 위험이 2.27배, 높은 hs-CRP 수준의 위험이 1.8배였다.
결론
이 연구는 교대 근무가 높은 염증 지표와 관련이 있다는 것을 확인 하였다. 높은 염증 지표는 심혈관 질환의 독립적인 지표라는 점을 고려할 때 교대 근무와 높은 염증 지표 사이의 연관성은 교대 근무자의 CVD 위험을 이해하는 데 도움이 될 수 있다.

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  • Current perspective on circadian function of the kidney
    Jazmine I. Benjamin, David M. Pollock
    American Journal of Physiology-Renal Physiology.2024; 326(3): F438.     CrossRef
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Original Article
Correlation between shift work and non-alcoholic fatty liver disease among male workers in the steel manufacturing company of Korea: a cross-sectional study
Kiseok Kim, Yong-Jin Lee, Soon-Chan Kwon, Young-Sun Min, Hyun Kyo Lee, Gwangin Baek, Sang Hyeon Kim, Eun-Chul Jang
Ann Occup Environ Med 2022;34:e33.   Published online November 2, 2022
DOI: https://doi.org/10.35371/aoem.2022.34.e33
AbstractAbstract AbstractAbstract in Korean PDFPubReaderePub
Background

Circadian rhythm disturbance caused by shift work has adverse effects on the metabolic homeostasis of the liver. Disruption of the metabolic homeostasis of the liver causes fat accumulation in the liver. The aim of this study was to investigate the correlation between shift work and non-alcoholic fatty liver disease (NAFLD) among male workers in the steel manufacturing industry of Korea.

Methods

Based on medical examination data collected in June 2020, 2,511 male subjects from one steel manufacturing company in Korea were selected in total. NAFLD was evaluated using abdominal ultrasound, which was performed by two experienced radiologists. The multinomial logistic regression analysis was performed by adjusting for age, physical activity, smoking history, alcohol consumption, body mass index, waist circumference, blood pressure, blood glucose, lipidemia, liver function test, employment duration, and hepatotoxic materials exposure status.

Results

Compared to daytime workers, the odds ratio (OR) of moderate-severe NAFLD in shift workers was 1.449 (95% confidence interval [CI], 1.028–2.043). Compared to daytime workers, the ORs of moderate-severe NAFLD were significantly higher for the group that engaged in total shift work for more than 20 years (OR, 2.285; 95% CI, 1.051–4.970), the group that was not allowed to sleep during night shift work (OR, 1.463; 95% CI, 1.030–2.078), and the group that consumed food during night shift work (OR, 1.580; 95% CI, 1.093–2.284).

Conclusions

There was a correlation between shift work and moderate-severe NAFLD in male steel manufacturing workers. There will be a need for more research related to the correlation of shift work with steatohepatitis and cirrhosis in the future.

한국 철강 제조업 남성 근로자의 교대근무와 비알코올성 지방간 질환의 상관관계 연구 : 단면연구.
목적
교대근무로 인한 일주기 리듬 교란은 간의 신진대사 항상성에 부정적인 영향을 미친다. 간의 신진대사 항상성 교란은 간에 지방 축적을 일으킨다. 본 연구의 목적은 한국 철강 제조업 남성 근로자의 교대근무와 비알코올성 지방간 질환의 상관관계를 조사하는 것이다.
방법
2020년 6월 수집한 건강검진 자료를 바탕으로 국내 1개 철강 제조업 사업장에서 총 2,511명의 대상자를 선정하였다. 비알코올성 지방간은 두 명의 숙련된 방사선사가 수행한 복부 초음파를 기준으로 평가되었다. 연령, 신체활동, 흡연력, 알코올 소비량, 체질량 지수, 허리둘레, 혈압, 혈당, 지질혈증, 간 기능 검사, 근무 기간 및 간 독성 물질 노출 상태에 대한 보정을 시행한 다항 로지스틱 회귀분석을 실시하였다.
결과
주간 근로자 대비 교대 근무자의 중등도-고도 비알코올성 지방간의 오즈 비는 1.499 (95% 신뢰구간: 1.028-2.043)이었다. 총 교대근무 종사 기간 20년 이상인 군, 야간교대근무 중 수면이 불가능한 군, 그리고 야간교대근무 중 음식 섭취를 하는 군에서 주간 근로자 대비 통계적으로 유의미하게 큰 중등도-고도 비알코올성 지방간의 오즈 비를 보였다.
결론
교대근무는 한국 철강 제조업에 종사하는 남성 근로자의 중등도-고도 비알코올성 지방간과 상관관계가 있다. 앞으로 교대근무와 지방간염, 간경변과의 상관관계와 관련된 추가 연구가 필요할 것이다.

Citations

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  • Nonalcoholic Fatty Liver Disease in Shift Workers and Its Effect on Peripheral Nerve Conduction: A Cross-Sectional Study
    Dipali K Chatur, Saroj K Pati, Jayshri R Ghate, Rachita Nanda, Meenakshi Sinha, Kalpana Kodapi
    Cureus.2024;[Epub]     CrossRef
  • Shift work promotes adipogenesis via cortisol-dependent downregulation of EGR3-HDAC6 pathway
    Xinxing Wan, Linghao Wang, Md Asaduzzaman Khan, Lin Peng, Keke Zhang, Xiaoying Sun, Xuan Yi, Zhouqi Wang, Ke Chen
    Cell Death Discovery.2024;[Epub]     CrossRef
  • Inter-individual variations in circadian misalignment-induced NAFLD pathophysiology in mice
    Nobuya Koike, Yasuhiro Umemura, Hitoshi Inokawa, Isao Tokuda, Yoshiki Tsuchiya, Yuh Sasawaki, Atsushi Umemura, Naoko Masuzawa, Kazuya Yabumoto, Takashi Seya, Akira Sugimoto, Seung-Hee Yoo, Zheng Chen, Kazuhiro Yagita
    iScience.2024; 27(2): 108934.     CrossRef
  • Effects of Oat β-Glucan and Inulin on Alleviation of Nonalcoholic Steatohepatitis Aggravated by Circadian Disruption in C57BL/6J Mice
    Nelson Kei, Kam Kuen Cheung, Ka Lee Ma, Tsz Kwan Yau, Susana Lauw, Vincent Wai Sun Wong, Lijun You, Peter Chi Keung Cheung
    Journal of Agricultural and Food Chemistry.2024; 72(7): 3520.     CrossRef
  • Assessing Dust Emissions, Health Impacts, and Accident Risks in Prefabricated and Conventional Construction: A Comprehensive Comparative Study
    Louis Kumi, Jaewook Jeong, Jaemin Jeong
    Buildings.2023; 13(9): 2305.     CrossRef
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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
AbstractAbstract AbstractAbstract in Korean PDFSupplementary MaterialPubReaderePub
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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  • Association between long working hours and the development of suicidal ideation among female workers: An 8-year population-based study using the Korean Longitudinal Survey of Women & Family (2012–2020)
    Seong-Uk Baek, Yu-Min Lee, Jin-Ha Yoon
    Psychiatry Research.2024; 333: 115731.     CrossRef
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    Seong-Uk Baek, Jong-Uk Won, Yu-Min Lee, Jin-Ha Yoon
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    Seong-Uk Baek, Won-Tae Lee, Min-Seok Kim, Myeong-Hun Lim, Jin-Ha Yoon, Jong-Uk Won
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
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Review
Technetium-99m hand perfusion scintigraphy (Raynaud’s scan) as a method of verification in hand arm vibration syndrome: a review
Taewoong Ha, Hyeoncheol Oh, Jungwon Kim
Ann Occup Environ Med 2022;34:e26.   Published online October 11, 2022
DOI: https://doi.org/10.35371/aoem.2022.34.e26
AbstractAbstract AbstractAbstract in Korean PDFPubReaderePub

It is important to assess the blood flow of fingers in the verification of hand-arm vibration syndrome. In the Republic of Korea, most assessments of the blood flow in the fingers are performed using a cold provocation test with finger skin color change. However, this test is a non-objective method with a relatively low sensitivity, leading to possible social and legal problems. Thus, we reviewed the characteristics of several tests that assess the blood flow in the fingers. Among these tests, using the radioactive isotope method, Raynaud’s scan has a relatively higher sensitivity and specificity than other tests, provides objective results, and is approachable in many hospitals. So we suggest using Raynaud's scan as an alternative test when cold provocation test with finger skin color change is negative in vibration exposed worker.

테크네튬-99m 레이노 스캔을 이용한 수완진동 증후군 진단 리뷰
수완진동증후군의 검증에서는 손가락의 혈류를 평가하는 것이 중요하다. 대한민국에서는 레이노증후군의 업무관련성 평가 시 대부분 손가락의 혈류량 평가를 냉각부하 손가락 피부색 변화 검사만으로 시행하고 있다. 그러나 이 검사는 상대적으로 민감도가 낮은 주관적인 검사방법으로 사회적, 법적 문제가 발생할 수 있다. 따라서 우리는 손가락의 혈류를 평가할 수 있는 여러 검사의 특성을 검토하였다. 이 검사 방법들 중, 방사성 동위원소법을 이용한 레이노스캔은 객관적인 결과를 제공하며 다른 검사방법들에 비하여 상대적으로 민감도와 특이도가 높고 많은 병원에서 접근성이 좋다. 따라서 진동노출작업자에서 냉각부하 손가락 피부색 검사 결과가 음성인 경우 대안검사로서 레이노스캔을 사용할 것을 제안한다.

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  • Raynaud’s Phenomenon: A Current Update on Pathogenesis, Diagnostic Workup, and Treatment
    Hirut Yadeta Ture, Nan Young Lee, Na Ri Kim, Eon Jeong Nam
    Vascular Specialist International.2024;[Epub]     CrossRef
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Original Article
Impacts of presenteeism on work-related injury absence and disease absence
Youna Won, Hwan-Cheol Kim, Jiho Kim, Minsun Kim, Seong-Cheol Yang, Shin-Goo Park, Jong-Han Leem
Ann Occup Environ Med 2022;34:e25.   Published online September 23, 2022
DOI: https://doi.org/10.35371/aoem.2022.34.e25
AbstractAbstract AbstractAbstract in Korean PDFPubReaderePub
Background

Many studies have been conducted on presenteeism and absenteeism, but the relationship between presenteeism and absenteeism is unclear. This study was undertaken to investigate the effect of presenteeism on future absenteeism.

Methods

This study was conducted on non-white collar workers that underwent general health examinations in 2014 and 2015. We asked subjects to fill out a questionnaire about their experiences of presenteeism for the past one year in 2014. In 2015, it was checked whether the same subjects had any experience of absence from work due to injury or disease during the past year. The χ2 test was used to analyze relationships between sociodemographic and occupational characteristics, presenteeism, and absence. Odds ratios (ORs) were calculated by logistic regression analysis controlled for confounding factors.

Results

A total of 12,572 workers were included in the study. For workers who experienced presenteeism, the OR for injury absence was 2.705 (95% confidence interval [CI]: 2.044–3.581), and the OR for disease absence was 4.906 (95% CI: 3.996–6.024) after adjusting for sociodemographic and occupational confounding factors. For men that experienced presenteeism, the OR for injury absence was 3.035 (95% CI: 2.258–4.081), and the OR for disease absence was 5.508 (95% CI: 4.340–6.989). For women that experienced presenteeism, the OR for injury absence was 1.322 (95% CI: 0.577–3.028), which was not significant, and the OR for disease absence was 3.629 (95% CI: 2.405–5.475).

Conclusions

This study suggests that presenteeism can influence future absenteeism. The effect of presenteeism may depend on cause of absence. Men who experienced presenteeism showed greater effects on injury and disease absence than women. For women, experience of presenteeism had a significant effect on disease absence but not on injury absence.

작업관련 손상결근과 질병결근에 대한 프리젠티즘의 영향
목적
프리젠티즘과 결근에 대한 많은 연구가 있어왔지만 그 상관관계는 여전히 불분명하다. 본 연구는 프리젠티즘이 미래의 결근에 미치는 영향을 조사하기 위해 수행되었다.
방법
본 연구는 2014년과 2015년에 한 대학병원에서 일반건강검진을 받은 비사무직근로자를 대상으로 실시하였다. 2014년 설문지 작성을 통해 지난 1년간의 프리젠티즘 여부를 조사하였다. 동일 근로자를 대상으로 2015년에는 1년간의 손상 및 질병 결근 여부를 확인하였다. 카이제곱 검정을 통해 사회인구통계학적, 직업적 특성과 프리젠티즘, 결근 간의 관계를 분석하였다. 교란 요인을 통제하여 로지스틱 회귀분석을 수행해 오즈비(OR)를 계산했다.
결과
총 12,572명의 근로자가 연구에 포함되었다. 사회인구학적 및 직업적 교란 요인을 조정한 후 프리젠티즘을 경험한 근로자에서 손상결근의 오즈비는 2.705(95% CI: 2.044-3.581), 질병결근의 오즈비는 4.906(95% CI: 3.996-6.024)이었다. 성별에 따라 나눈 결과, 프리젠티즘을 경험한 남성에서 손상결근의 오즈비는 3.035(95% CI: 2.258~4.081), 질병결근의 오즈비는 5.508(95% CI: 4.340~6.989)이었다. 여성의 경우는 프리젠티즘을 경험한 후 손상결근 오즈비가 1.322(95% CI: 0.577-3.028)로 유의미하지 않았고, 질병결근 오즈비는 3.629(95% CI: 2.405-5.475)로 나타났다.
결론
본 연구는 프리젠티즘이 미래 결근의 요인이 될 수 있음을 시사한다. 결근의 원인에 따라서 프리젠티즘의 영향은 달라질 수 있다. 남성과 여성을 분류했을 때, 프리젠티즘을 경험한 남성은 여성보다 손상과 질병 결근 모두에서 더 큰 영향을 보였고, 여성은 질병결근과 달리 손상결근에서는 이러한 영향이 나타나지 않았다.

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  • Association between sickness presenteeism and depressive symptoms: a cross-sectional study using the 6th Korean working conditions survey
    Myeong-Hun Lim, Min-Seok Kim, Seong-Uk Baek, Tae-Yeon Kim, Jong-Uk Won, Jin-Ha Yoon
    International Archives of Occupational and Environmental Health.2024; 97(5): 537.     CrossRef
  • Self-Esteem Trajectories After Occupational Injuries and Diseases and Their Relation to Changes in Subjective Health: Result From the Panel Study of Workers’ Compensation Insurance (PSWCI)
    Seong-Uk Baek, Won-Tae Lee, Min-Seok Kim, Myeong-Hun Lim, Jin-Ha Yoon, Jong-Uk Won
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
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Original Article
Population attributable fraction of indicators for musculoskeletal diseases: a cross-sectional study of fishers in Korea
Jaehoo Lee, Bohyun Sim, Bonggyun Ju, Chul Gab Lee, Ki-Soo Park, Mi-Ji Kim, Jeong Ho Kim, Kunhyung Kim, Hansoo Song
Ann Occup Environ Med 2022;34:e23.   Published online September 7, 2022
DOI: https://doi.org/10.35371/aoem.2022.34.e23
AbstractAbstract AbstractAbstract in Korean PDFSupplementary MaterialPubReaderePub
Background

The musculoskeletal disease (MSD) burden is an important health problem among Korean fishers. We aimed to investigate the indicators of the prevalence of MSD and contributions of significant indicators to MSD in Korean fishers.

Methods

This cross-section study included 927 fishers (male, 371; female, 556) aged 40 to 79 years who were enrolled from 3 fishery safety and health centers. The outcome variable was one-year prevalence of MSD in 5 body parts (the neck, shoulder, hand, back, and knee). Independent variables were sex, age, educational attainment, household income, job classification, employment xlink:type, hazardous working environment (cold, heat, and noise), ergonomic risk by the 5 body parts, anxiety disorder, depression, hypertension, diabetes, and hyperlipidemia. The adjusted odds ratio of MSDs by the 5 body parts were calculated using multiple logistic regression analysis. We computed the population attributable fraction (PAF) for each indicators of MSDs using binary regression models.

Results

The one-year prevalence of MSD in the neck, shoulder, hand, back, and knee was 7.8%, 17.8%, 7.8%, 27.2%, and 16.2% in males vs. 16.4%, 28.1%, 23.0%, 38.7%, and 30.0% in females, respectively. The ergonomic risk PAF according to the body parts ranged from 22.8%–59.6% in males and 22.8%–50.3% in female. Mental diseases showed a significant PAF for all body parts only among female (PAF 9.1%–21.4%). Cold exposure showed a significant PAF for the neck, shoulder, and hand MSD only among female (25.6%–26.8%). Age was not a significant indicator except for the knee MSD among female.

Conclusions

Ergonomic risk contributed majorly as indicators of MSDs in both sexes of fishers. Mental disease and cold exposure were indicators of MSDs only among female fishers. This information may be important for determining priority risk groups for the prevention of work-related MSD among Korean fishers.

어업인의 근골격계질환 관련인자의 인구집단 기여위험분율에 관한 단면연구
목적
한국 어업인들의 근골격계질환 유병률에 대한 관련인자의 인구집단 기여위험도를 조사하는 것이다.
방법
본 연구의 대상은 3개 어업안전보건센터에 소속된 40-79세 어업인 927명(남성 371명, 여성 556명)이다. 결과 변수는 구조화된 설문지에 따른 5개 신체 부위(목, 어깨, 손, 허리, 무릎)의 근골격계질환 1년 유병률이다. 독립변수는 성별, 연령, 최종학력, 가구소득, 고용형태, 세부업종, 유해 작업환경(추위, 더위, 소음), 신체부담작업수준, 불안장애, 우울증, 고혈압, 당뇨, 고지혈증이다. 다중 로지스틱 회귀분석을 사용하여5개 신체부위별 근골격계질환의 오즈비를 산출하였다. 이를 이용하여 근골격계질환에 대한 각 변수별로 인구집단 기여위험분율(PAF)를 계산하였다.
결과
남성에서 근골격계질환 1년 유병률은 목7.8%, 어깨17.8%, 손7.8%, 허리27.2%, 무릎16.2% 이다. 여성의 1년 근골격계질환 1년유병률은 목 16.4%, 어깨 28.1%, 손 23.0%, 등 38.7%, 무릎 30.0% 이다. 신체 부위에 따른 신체부담작업의 기여위험분율은 남성 22.8-59.6%, 여성 22.8-50.3%이다. 정신질환은 여성에서만 모든 신체부위에서 유의한 기여위험분율을 보였다(9.1%-21.4%). 추위 노출은 여성에서만 목, 어깨, 손 근골격계질환에 대해 유의미한 기여위험분율을 보였다(25.6%-26.8%). 나이는 여성에서 무릎을 제외하고는 유의한 인자가 아니다.
결론
신체부담작업은 남성, 여성 모두에서 근골격계질환에 대한 주요 기여 변수이다. 정신 질환과 추위 노출은 여성 어업인에서만 근골격계질환에 기여를 한다. 본 연구는 어업인들의 업무관련성 근골격계질환 예방을 위한 우선순위 판단에 정보를 제공할 것이다.
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Original Article
Association between sitting-time at work and incidence of erosive esophagitis diagnosed by esophagogastroduodenoscopy: a Korean cohort study
Daehoon Kim, Yesung Lee, Eunchan Mun, Eunhye Seo, Jaehong Lee, Youshik Jeong, Jinsook Jeong, Woncheol Lee
Ann Occup Environ Med 2022;34:e15.   Published online July 21, 2022
DOI: https://doi.org/10.35371/aoem.2022.34.e15
AbstractAbstract AbstractAbstract in Korean PDFPubReaderePub
Background

Most previous longitudinal studies on lifestyle and gastroesophageal reflux disease (GERD) have focused on physical activity rather than sitting time. The main purpose of this study was to investigate the relationship between prolonged sitting time and the development of erosive esophagitis (EE).

Methods

A self-report questionnaire was used for measuring sitting time in the Kangbuk Samsung Health Study. Sitting time was categorized into four groups: ≤ 6, 7–8, 9–10, and ≥ 11 hours/day. Esophagogastroduodenoscopy (EGD) was performed by experienced endoscopists who were unawared of the aims of this study. Hazard ratios (HRs) and 95% confidence intervals (CIs) for the development of EE were estimated using Cox proportional hazards analyses with ≤ 6 hours/day sitting time as the reference.

Results

There were 6,524 participants included in the study. During a mean follow-up of 3.14 years, 2,048 incident cases developed EE. In age- and sex-adjusted models, the HR in the group sitting ≥ 11 hours per day compared ≤ 6 hours per day was 0.88 (95% CI: 0.76–0.99). After further adjusting for alcohol intake, smoking status, educational level, history of diabetes, and history of dyslipidemia, sitting time was still significantly related to the risk of EE (HR, 0.87; 95% CI: 0.76–0.98). After further adjustment for exercise frequency, this association persisted (HR, 0.86; 95% CI: 0.76–0.98). In subgroup analysis by obesity, the relationship between sitting time and EE was only significant among participants with body mass index < 25 kg/m2 (HR, 0.82; 95% CI: 0.71–0.95).

Conclusions

Generally, prolonged sitting time is harmful to health, but with regard to EE, it is difficult to conclude that this is the case.

업무상 앉아 있는 시간과 식도위 십이지장 내시경으로 진단된 미란성 식도염 발병률의 연관성: 일개 한국인 코호트 연구
목적
생활습관이 역류성 식도염에 어떤 영향을 미치는지에 대한 종단 연구는 대부분 신체활동에 대한 내용이다. 따라서 이번 연구에서는 하루 중 앉아 있는 시간이 Erosive esophagitis 발병에 어떤 영향을 미치는지에 대해 알아보고자 한다.
방법
본원 건강검진센터를 방문한 수검자의 데이터를 이용하였다. Sitting time 의 측정은 설문지를 사용하였으며, 다음과 같이 총 4그룹으로 범주화하였다: ≤6, 7–8, 9–10, and ≥11 hours/day. 내시경 전문가에 의해 시행된 위내시경 소견 자료를 이용하였으며, Sitting time 이 Erosive esophagitis 발병에 어떤 영향을 미치는지 알아보고자 하루 평균 6시간 이하 앉아 있는 그룹을 기준으로 Cox proportional hazard model 을 이용해 생존분석을 시행했다.
결과
총 6,524 명의 대상자를 평균 3.14년 추적관찰하였고, 그 결과 2,048 명의 incident cases 를 발견하였다. 연령과 성별을 보정한 모델 1에서 기준 그룹보다 하루 평균 11시간 이상 앉아 있는 그룹에서 Hazard ratio(HR) 가 0.88 (95% CI 0.76-0.99) 로 발병위험도가 낮은 것으로 나타났다. 음주, 흡연, 교육 수준, 당뇨병 및 고지혈증 과거력을 보정한 모델 2에서도 HR 가 0.87(95% CI 0.76-0.98) 로 발병위험도가 여전히 낮았으며, 운동 빈도를 추가로 보정한 모델 3에서도 HR 가 0.86(0.76-0.98) 으로 발병위험도가 낮은 것으로 나타났다. 비만 유무에 따라 층화분석을 시행하였을 때, BMI < 25 kg/m2 인 비비만 그룹에서만 통계적으로 유의미한 결과를 보였다. (HR = 0.82, 95% CI : 0.71–0.95).
결론
일반적으로, prolonged sitting time 은 건강에 해롭지만, 역류성 식도염에 대해서는 그렇게 결론 내리기 어렵다.

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  • Causal links between socioeconomic status, leisure sedentary behaviours and gastro-oesophageal reflux disease: a multivariable two-sample Mendelian randomisation study
    Xingji Lian, Yifen Lin, Xiaohui Peng, Yanhui Wang, Ting He, Ziyong He, Wenlong Gu, Hongwu Wang, Feng He, Yuyu Huang
    Journal of Epidemiology and Community Health.2023; 77(7): 460.     CrossRef
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Original Article
Hospital admissions due to endocrine diseases in Korean male firefighters
Seunghoon Ryu, Yong-Jin Lee, Eun-Chul Jang, Soon-Chan Kwon, KiSeok Kim, Yeon-Soon Ahn, Young-Sun Min
Ann Occup Environ Med 2021;33:e32.   Published online October 28, 2021
DOI: https://doi.org/10.35371/aoem.2021.33.e32
AbstractAbstract AbstractAbstract in Korean PDFPubReaderePub
Background

The aim of this study was to investigate the relationship between occupational exposure to various hazards and hospital admission due to endocrine diseases in Korean male firefighters.

Methods

From 2000 to 2008, former and current male firefighters registered in the Korean National Emergency Management Agency were investigated based on their hospitalized health insurance admission data for the same period. Admission data for endocrine, nutritional, and metabolic diseases were obtained from the Korean National Health Insurance Service database. Standardized admission ratio (SAR) with reference to the general population of Korean men was analyzed.

Results

SAR for firefighters with endocrine, nutritional, and metabolic diseases was 0.56 (95% confidence interval [CI]: 0.49–0.65), which was significantly less than that of the general population of Korean men. For those with endocrine, nutritional, and metabolic diseases, SARs for those with a history of fire suppression tasks and those without experience of fire suppression tasks were 0.58 (95% CI: 0.49–0.68) and 0.53 (95% CI: 0.40–0.70), respectively.

Conclusions

The admission rate of Korean male firefighters due to endocrine, nutritional and metabolic diseases was significantly lower than that of the general Korean men population, the hazardous potential of endocrine disruptors remains an open question. Further studies of firefighters with longer follow-up are needed.

한국 남성 소방관에서 내분비 질환으로 인한 입원
목적
본 연구의 목적은 남성 소방관들을 대상으로 유해인자 노출과 내분비질환과의 관련성을 조사해보고자 하였다.
방법
2000년부터 2008년까지 소방방재청에 등록된 총 34,875명의 전·현직 남성 소방관들의 건강검진 자료와 동일 기간 건강보험 입원자료를 근간으로 전·현직 남성 소방관들에 대해 조사하였고, 이를 일반인구집단과 비교하여 표준화입원비를 분석하였다.
결과
내분비, 영양 및 대사질환의 표준화입원비는 0.56(95% 신뢰구간: 0.49-0.65)으로 우리나라 일반 남성들에 비하여 통계적으로 유의하게 적게 입원하였다. 또한, 화재진압 유무에 따라 분석하였을 때, 내분비, 영양 및 대사질환의 표준화입원비는 화재진압 유경력자는 0.58(95% 신뢰구간:0.49-0.68), 무경력자는 0.53(95% 신뢰구간: 0.40-0.70)으로 두 집단 모두 우리나라 일반 남성들에 비하여 통계적으로 유의하게 적게 입원하였다.
결론
우리나라 남성 소방관들의 내분비, 영양 및 대사질환의 표준화입원비는 우리나라 일반 남성에 비하여 통계적으로 유의하게 낮았다.
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Original Article
The relationship between chronotypes and musculoskeletal problems in male automobile manufacturing workers
Suwhan Kim, Won-Ju Park, Seunghyeon Cho, Dae-Young Lim, Yeongjae Yoo, Hyeonjun Kim, Wonyang Kang, Kyung Wook Kang, Jai-Dong Moon
Ann Occup Environ Med 2021;33:e26.   Published online August 13, 2021
DOI: https://doi.org/10.35371/aoem.2021.33.e26
AbstractAbstract AbstractAbstract in Korean PDFPubReaderePub
Background

Previous studies have shown that morning types are less sensitive to pain. This study aimed to examine the relationship between chronotypes and musculoskeletal problems in workers with musculoskeletal burdens at work.

Methods

This cross-sectional study included 119 male production workers from a large automobile manufacturing plant. All the participants worked 2 shifts and worked on the automobile assembly line. Data were obtained using structured questionnaires, including the reduced Morningness-Eveningness Questionnaire (rMEQ), and musculoskeletal symptom questionnaire. Participants with an rMEQ score of 18 points or more were defined as morning-type workers (MTWs). Participants whose scores were less than 18 points were defined as neither-type workers (NTWs).

Results

The arithmetic mean age was 51.8 ± 5.3 years. MTWs and NTWs accounted for 35.3% and 64.7% of the total participants, respectively. Evening- and intermediate-type workers accounted form 6.7% and 58.0% of the participants, respectively. There was no significant difference in the health indicators when the MTW and NTW groups were compared. However, the musculoskeletal symptom questionnaire demonstrated a significant difference between the MTW and NTW groups. In the preceding year, the MTW group had significantly lower musculoskeletal pain and treatment ratios compared to the NTW group (35.7% vs. 62.3%, p = 0.005 and 14.3% vs. 32.5%, p = 0.031, respectively). After adjusting for variables, the odds ratio (OR) for musculoskeletal pain was significantly higher in the NTW group than in the MTW group (OR, 3.112; 95% confidence interval, 1.285–7.535; p = 0.012).

Conclusions

In this study, the musculoskeletal pain ratio was significantly lower for MTWs when compared to NTWs. Chronotypes could play an important role in work-related musculoskeletal disorders. Further, larger-scale, follow-up studies on chronotypes are required to assist in the prevention of musculoskeletal disorders in future.

자동차 생산 남성 근로자에서 일주기성과 근골격계 통증과의 관련성
목적
사람의 심리적, 신체적 상태는 하루 주기에 따라 변화하며 일주기성에 따라 각 개인이 선호하는 최적의 활동시간대에 차이가 있다. 기존 연구들은 이러한 개인의 일주기성에 따라 통증에 대한 민감도의 차이를 보인다는 결과를 제시하고 있다. 본 연구에서는 근골격계 부담작업을 수행하는 생산직 남성 근로자를 대상으로 개인의 일주기성을 파악하고 근골격계 통증과의 관련성을 살펴보고자 하였다.
방법
자동차 제조 공장에서 근무하는 남성 근로자 119명을 대상으로 단면 연구를 시행하였다. 모든 대상자는 2교대 형태로 조립공정에서 근무하였다. 단축형 아침형-저녁형 척도, 불면증 심각성 척도, 스트레스 척도 및 근골격계 증상 여부를 포함한 설문을 실시하였으며 혈액검사를 통해 건강지표를 확보하였다. 단축형 아침형-저녁형 척도가 18점 이상인 경우를 아침형 근로자로, 18점 미만인 경우를 비아침형 근로자로 정의하였다.
결과
아침형 근로자와 비아침형 근로자는 각각 전체 대상자의 35.3%와 64.7%를 차지했다. 아침형 근로자 군과 비아침형 근로자 군의 비교에서 체질량지수, 흡연, 음주, 운동, 고혈압, 당뇨병, 지질, 신장 기능, 코티솔, C 반응성 단백질, 평균 수면 시간, 수면 및 스트레스 점수에는 유의한 차이를 보이지 않았다. 그러나 근골격계 증상 설문 중 최근 1년간 근골격계 통증 및 근골격계 치료 여부 비율에서 아침형 근로자 군과 비아침형 근로자 군 간의 유의한 차이가 관찰되었다(각각 35.7%대 62.3 %, p = 0.005 및 14.3%대 32.5%, p = 0.031). 변수를 보정한 후 근골격계 통증 발생의 오즈비는 아침형 근로자 군보다 비아침형 근로자 군에서 유의하게 높았다(오즈비 3.112, 95% 신뢰구간 1.285–7.535, p = 0.012).
결론
근골격계 질환은 업무상질병의 큰 비중을 차지하고 있으며 이를 예방하기위해 그 위험 요인에 대한 다각적 접근이 필요하다. 본 연구에서는 비아침형 근로자 군에서 상대적으로 높은 근골격계 통증 비율을 확인하였으며, 이는 일주기성이 업무 관련 근골격계 질환에서 의미 있는 인자일 가능성을 시사한다. 이를 토대로 근골격계 질환의 예방을 위해 개인의 일주기성에 대한 개입이나 일주기성에 맞춘 업무환경개선과 같은 새로운 접근 방법이 고려될 수 있다. 향후 근골격계 질환의 예방을 위해 근로자의 일주기성에 관한 추가적인 연구가 필요할 것이다.

Citations

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  • Influence of chronotype on pain incidence during early adolescence
    Rui Li, Cornelius Groenewald, See Wan Tham, Jennifer A. Rabbitts, Teresa M. Ward, Tonya M. Palermo
    Pain.2024;[Epub]     CrossRef
  • Medium- and Long-Term Effects of Insomnia Severity and Circadian Preference on Pain and Emotional Distress Among Individuals With Chronic Pain
    Chung Jung Mun, Nina Winsick, Stephen T. Wegener, Shawn D. Youngstedt, Claudia M. Campbell, Rachel V. Aaron
    The Journal of Pain.2023; 24(11): 1946.     CrossRef
  • Circadian Rhythm and Pain: a Review of Current Research and Future Implications
    Chung Jung Mun, Helen J. Burgess, Dorothy D. Sears, Sairam Parthasarathy, Dara James, Ulysses Altamirano, Surabhi Sajith, Ananya Lakhotia, Roger B. Fillingim, Shawn D. Youngstedt
    Current Sleep Medicine Reports.2022; 8(4): 114.     CrossRef
  • Physical hazards, musculoskeletal pain, and job control: Multilevel results from the European Social Survey
    Duygu Gulseren
    Safety Science.2022; 156: 105901.     CrossRef
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Original Article
Seroprevalence of measles, mumps, rubella, and varicella-zoster antibodies in new female nurses in the Republic of Korea
Yeongjae Yoo, Won-Ju Park, Seunghyeon Cho, Dae-Young Lim, Suwhan Kim, Wonyang Kang, Hyeonjun Kim, Jai-Dong Moon
Ann Occup Environ Med 2021;33:e19.   Published online June 15, 2021
DOI: https://doi.org/10.35371/aoem.2021.33.e19
AbstractAbstract AbstractAbstract in Korean PDFPubReaderePub
Background

For health care workers, immune management plays an important role in the protection against infectious diseases. This study investigated the seroprevalence of measles, mumps, rubella, and varicella-zoster in newly employed female nurses.

Methods

We conducted a survey on the seroprevalence of measles, mumps, rubella, and varicella-zoster in newly employed female nurses at a university hospital from 2011 to 2019, before the nurses were given their department placements and duty start. Enzyme-linked immunosorbent and chemiluminescence immunoassays were used to detect immunoglobulin G antibodies. We analyzed whether there was a significant difference in seroprevalence depending on the age, birth year, birth season, and region of residence (metropolitan residency: yes or no).

Results

The arithmetic mean ages of the participants were 28.6 ± 4.8, 23.5 ± 3.2, 23.6 ± 3.0, and 26.1 ± 4.5 years for measles, mumps, rubella, and varicella-zoster, respectively. The seropositivity rates were 93.9% (551/587), 60.2% (50/83), 83.3% (3,093/3,711), and 89.5% (978/1,093) for measles, mumps, rubella, and varicella-zoster, respectively. Significant differences in the seroprevalence when assessed according to the age and birth year were noted with measles, while significant differences in the seroprevalence were only noted with rubella and varicella-zoster when assessed according to birth year and age, respectively.

Conclusions

In this study, we identified the levels of antibody prevalence in new female nurses. Considering the seropositivity levels, cost-effectiveness, and convenience for the participants, we recommend that the measles-mumps-rubella vaccination be provided without serologic testing for all new female nurses and the varicella-zoster vaccination only be performed for persons who are negative after serologic testing. And it would be useful if the vaccinations were combined with compulsory worker health examinations, such as the pre-placement health examinations.

신규 여성 간호사의 부서 배치 전 홍역, 유행성 이하선염, 풍진, 수두 항체의 혈청 유병율
목적
간호사는 다양한 환자와 직간접적인 접촉이 수시로 이루어지는 직종으로 감염병에 대한 면역 및 백신 예방접종이 매우 중요하다. 하지만 현재 신규 의료종사자 예방접종에 대한 명확한 규정은 없는 상태로 각 의료기관의 감염관리 정책에 따라 상이하게 수행되고 있다. 본 연구는 의료 종사자 중 신규 간호사를 대상으로 근무를 시작하기 전 상태에서 홍역, 유행성이하선염, 풍진 및 수두의 항체 혈청 유병률을 조사하였다. 향후 의료종사자에 대한 예방접종 정책 수립의 자료로 활용하고자 한다.
방법
2011년부터 2019년까지 일개 대학 병원에 신규 채용된 21~39세 여성 간호사를 대상으로 부서 배치 전 홍역, 유행성이하선염, 풍진, 수두에 대한 면역글로불린 항체를 발광면역측정법과 효소결합면역흡착측정법으로 측정하였다. 각 항체 유병률을 구하고 유병률에 유의한 영향을 미치는 인자가 있는지 카이제곱 검정 또는 선형 대 선형 결합법을 사용하여 분석하였다.
결과
연구대상자의 평균연령 및 표준편차는 홍역 28.6 ± 4.8세, 유행성 이하선염 23.5 ± 3.2세, 풍진 23.6 ± 3.0세, 수두 26.1 ± 4.5세였다. 신규 여성 간호사의 항체 유병률은 홍역 93.9% (551/587), 유행성이하선염 60.2% (50/83), 풍진 83.3% (3,093/3,711) 및 수두 89.5% (978/1,093)로 확인되었다. 홍역은 출생연도와 나이에 따라 항체 유병율에 유의한 차이가 있었다. 풍진은 출생연도에 따라 혈청 항체 유병률에 유의한 차이가 있었으며, 수두의 항체 유병률은 나이에 따라 차이가 있었다. 출생 계절 및 대도시 거주에 따른 각 항체의 유병률에는 유의한 차이는 없었다.
결론
의료기관 내에서 감염병에 대한 관리는 매우 중요하며 병원 내 감염 발생 시 큰 보건학적 문제가 발생하게 된다. 따라서 향후 의료기관 종사자에 대한 국가적인 예방접종 정책이 수립되어야 할 것이다. 항체 유병률, 항체검사 분석 비용, 채혈의 부작용 등을 고려할 때 신규 여성 간호사의 경우 채용되어 업무 시작 전 항체검사 없이 홍역/유행성이하선염/풍진(MMR) 예방접종 실시를, 수두는 항체검사 후 항체 음성인 사람에게 예방접종을 실시하는 것을 고려해 볼 수 있겠으며, 향후 이에 대한 정책연구가 필요할 것으로 판단된다. 또한 이러한 예방접종은 산업안전보건법 상의 배치 전 건강진단과 같은 근로자 건강진단과 병행한다면, 더 효과적으로 진행될 수 있을 것이다.

Citations

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  • Seroprevalence for Measles, Varicella, Mumps and Rubella in the Trainee Obstetric Population: A Survey in Southern Italy
    Brunella Perfetto, Giovanna Paduano, Elena Grimaldi, Vincenza Sansone, Giovanna Donnarumma, Gabriella Di Giuseppe
    Vaccines.2024; 12(3): 335.     CrossRef
  • The third dose of measles-containing vaccine induces robust immune responses against measles in young seronegative healthcare workers who had previous two-dose measles vaccination
    Yong Chan Kim, Heejin Nam, Jun Yong Choi, Eui-Cheol Shin, Young Hwa Choi
    Journal of Infection and Public Health.2023; 16(10): 1643.     CrossRef
  • Antibody Positivity Rates of Vaccine-preventable Diseases among New Healthcare Workers in a Teaching Hospital and Affecting Factors, 2019-2023
    Eunjung Kim, Se Ju Lee, Jae Hyoung Im, Jin-Soo Lee, Jihyeon Baek
    Korean Journal of Healthcare-Associated Infection Control and Prevention.2023; 28(2): 216.     CrossRef
  • Strategies for Minimizing Mealses Transmission in Korean Healthcare Facilities
    Yong Chan Kim
    Korean Journal of Healthcare-Associated Infection Control and Prevention.2022; 27(2): 125.     CrossRef
  • Susceptibility towards Chickenpox, Measles and Rubella among Healthcare Workers at a Teaching Hospital in Rome
    Giuseppe La Torre, Mattia Marte, Valentin Imeshtari, Corrado Colaprico, Eleonora Ricci, David Shaholli, Vanessa India Barletta, Pasquale Serruto, Aurelia Gaeta, Guido Antonelli
    Vaccines.2022; 10(10): 1573.     CrossRef
  • Seroprevalence of Varicella-Zoster Virus and Measles among Healthcare Workers in a Tertiary Medical Center in Korea
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    Vaccines.2022; 10(11): 1956.     CrossRef
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Research Article
Relationship between fatigue severity scale and occupational injury in Korean workers
Hyeonwoo Ju, Hwan-Cheol Kim, Sung Wook Jang, Youna Won, Shin-Goo Park, Jong-Han Leem
Ann Occup Environ Med 2021;33:e15.   Published online May 4, 2021
DOI: https://doi.org/10.35371/aoem.2021.33.e15
AbstractAbstract PDFPubReaderePub
Background

The aim of this study is to investigate the relationship between fatigue and occupational injury.

Methods

This study was conducted at a university hospital in 2014 and 2015. In 2014, the fatigue severity scale (FSS) was used to evaluate workers' fatigue levels. Later, when the same workers were examined in 2015, a questionnaire survey was conducted to determine whether they had experienced absences or treatment for work-related accidents. The χ2 test was used to analyse the relationship between demographic characteristics, fatigue levels, and occupational injuries. After controlling for confounders, a logistic regression analysis was performed to calculate the odds ratios (ORs).

Results

In 2014, 19,218 workers were screened during health examination and their fatigue level were evaluated using FSS questionnaires. in 2015, workers' occupational injury was evaluated. In result, men in the moderate- and high-fatigue groups, after adjusting for age, smoking and drinking habits, chronic diseases, and occupational factors such as size of company industrial classification and type of work (shift or non-shift), adjusted ORs for hospital treatment due to occupational injury were 1.76 (95% confidence interval [CI]: 1.39–2.24) and 2.61 (95% CI:1.68–4.06), respectively. Among men in the medium- and high-fatigue groups, the adjusted ORs for absence due to occupational injury were 2.06 (95% CI: 1.52–2.80) and 3.65 (95% CI: 2.20–6.05), respectively. No significant association was observed between fatigue and occupational injury in women.

Conclusions

Male workers with high fatigue levels have a higher risk of experiencing work injuries. This study suggests that active intervention be considered to prevent injuries in workers with high scores on workplace fatigue evaluation scales.


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  • The study on workload analysis of construction workers operating at elevated jobsite using wearable physiological monitor
    Wei-Cheng Chen, Chi Ming Chia, H. Ping Tserng, Chyi Herng Teh
    Journal of the Chinese Institute of Engineers.2024; 47(4): 369.     CrossRef
  • Efficacy and safety of herbal medicine Gongjin-Dan and Ssanghwa-Tang in patients with chronic fatigue: A randomized, double-blind, placebo-controlled, clinical trial
    Jun-Yong Choi, Bom Choi, Ojin Kwon, Chang-Seob Seo, Ae-Ran Kim, Hyeun-kyoo Shin, Kibong Kim
    Integrative Medicine Research.2024; 13(1): 101025.     CrossRef
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Research Article
Association between prenatal polycyclic aromatic hydrocarbons and infantile allergic diseases modified by maternal glutathione S-transferase polymorphisms: results from the MOCEH birth cohort
Tai Kyung Koh, Hyesook Park, Yun-Chul Hong, Mina Ha, Yangho Kim, Bo-Eun Lee, Surabhi Shah, Eunhee Ha
Ann Occup Environ Med 2021;33:e12.   Published online April 23, 2021
DOI: https://doi.org/10.35371/aoem.2021.33.e12
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background

Prenatal exposure to polycyclic aromatic hydrocarbons (PAH) has been linked to allergic disease onset. Variations in the glutathione S-transferase (GST) gene family can impact the progression of allergic diseases. We sought to examine the association between prenatal PAH exposure and infantile allergic diseases in 6-month-old infants, and how maternal glutathione S-transferase M1 (GSTM1) or T1 (GSTT1) polymorphism affects the association between prenatal PAH exposure and allergic diseases in the Mothers and Children's Environmental Health (MOCEH) study.

Methods

The study sample comprised 349 infants and their mothers from the MOCEH study, for whom 1-hydroxypyrene (1-OHP) and 2-naphthol were measured in both the early period of pregnancy and late period of pregnancy. An infant was deemed to be affected by an allergic disease if diagnosed with or if developed at least one of the allergic diseases. A logistic regression analysis was performed to study the association between urinary 1-OHP and 2-naphthol levels during pregnancy and allergic diseases in 6-month-old infants. Furthermore, analyses stratified by maternal GSTM1 or GSTT1 present/null polymorphisms were performed.

Results

The risk of allergic diseases in 6-month-old infants was significantly increased in accordance with an increase in urinary 1-OHP during the early period of pregnancy (odds ratio [OR]: 1.84; 95% confidence interval [CI]: 1.05, 3.23; by one log-transformed unit of 1-OHP μg/g creatinine). The increased risk of infantile allergic diseases associated with urinary 1-OHP during the early period of pregnancy was limited to the maternal GSTT1 null type (OR: 2.69; 95% CI: 1.17, 6.21, by one log-transformed unit of 1-OHP μg/g creatinine); however, the Relative Excess Risk due to Interaction was not statistically significant.

Conclusions

The present study found that infantile allergic diseases could be affected by intrauterine PAH exposure, particularly in the early prenatal period and the risk was limited to the maternal GSTT1 null type.


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  • Infantile allergic diseases: a cohort study prenatal fish intake and mercury exposure context
    Surabhi Shah, Hae Soon Kim, Yun-Chul Hong, Hyesook Park, Mina Ha, Yangho Kim, Ji Hyen Lee, Eun-Hee Ha
    BMC Public Health.2024;[Epub]     CrossRef
  • Prenatal dietary exposure to mixtures of chemicals is associated with allergy or respiratory diseases in children in the ELFE nationwide cohort
    Manel Ghozal, Manik Kadawathagedara, Rosalie Delvert, Amandine Divaret-Chauveau, Chantal Raherison, Raphaëlle Varraso, Annabelle Bédard, Amélie Crépet, Véronique Sirot, Marie Aline Charles, Karine Adel-Patient, Blandine de Lauzon-Guillain
    Environmental Health.2024;[Epub]     CrossRef
  • Prenatal dietary exposure to chemicals and allergy or respiratory diseases in children in the EDEN mother–child cohort
    Manel Ghozal, Manik Kadawathagedara, Rosalie Delvert, Karine Adel-Patient, Muriel Tafflet, Isabella Annesi-Maesano, Amélie Crépet, Véronique Sirot, Marie Aline Charles, Barbara Heude, Blandine de Lauzon-Guillain
    Environment International.2023; 180: 108195.     CrossRef
  • Gene-environment interactions related to maternal exposure to environmental and lifestyle-related chemicals during pregnancy and the resulting adverse fetal growth: a review
    Sumitaka Kobayashi, Fumihiro Sata, Reiko Kishi
    Environmental Health and Preventive Medicine.2022; 27: 24.     CrossRef
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    Rebecca Levy, Thu H. Le
    Kidney360.2022; 3(12): 2153.     CrossRef
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Case Report
Parkinson's disease in a worker exposed to insecticides at a greenhouse
Yangwoo Kim, Inah Kim, Jung-Min Sung, Jaechul Song
Ann Occup Environ Med 2021;33:e6.   Published online February 5, 2021
DOI: https://doi.org/10.35371/aoem.2021.33.e6
AbstractAbstract PDFPubReaderePub
Background

Parkinson's disease (PD) is a rare, neurodegenerative disease with various occupational and environmental risk factors. Exposure to specific pesticides contributes significantly to the incidence of PD. However, it is difficult to measure the level of pesticide exposure in workers. This study presents the first case recognized the work-relatedness between PD and pesticide exposure.

Case presentation

A 68-year-old male was diagnosed with PD after working with pesticides at a tomato greenhouse for 12 years and 5 months. From the results of a field study, it was reasonable to assume that the patient had been exposed to a significant level of various insecticides. In the present report, we described the first accepted case of work-relatedness between PD and exposure to pesticides. The evaluation was conducted using the following steps: we ruled out other possible risk factors including additional occupational history and personal risk factors, we assessed the work environment, surveyed possible exposures, found proper epidemiological evidence, and calculated the probability of causation. The work-relatedness was determined through the review of epidemiological evidence and estimation of exposure situation and level, and biological plausibility. We also decided work-relatedness based on the exposure of PD related pesticides with identified biologically plausible and the presumption that the exposure level would be high due to the working process.

Conclusions

In this case, the field study and epidemiological results supported the work-relatedness of PD and exposure to pesticides. Moreover, the results of previous studies have confirmed a causal relationship between exposure to pesticides and PD.


Citations

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  • Rotenone-Induced Model of Parkinson’s Disease: Beyond Mitochondrial Complex I Inhibition
    María Teresa Ibarra-Gutiérrez, Norma Serrano-García, Marisol Orozco-Ibarra
    Molecular Neurobiology.2023; 60(4): 1929.     CrossRef
  • Food Contamination: An Unexplored Possible Link between Dietary Habits and Parkinson’s Disease
    Giulia Caioni, Annamaria Cimini, Elisabetta Benedetti
    Nutrients.2022; 14(7): 1467.     CrossRef
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Research Article
Association between the prevalence of allergic reactions to skin prick tests and workplace types among agricultural workers in South Korea
Jiyoung Han, Yangwoo Kim, Sooyeon Lee, Soo-Jin Lee
Ann Occup Environ Med 2020;32:e36.   Published online November 11, 2020
DOI: https://doi.org/10.35371/aoem.2020.32.e36
AbstractAbstract PDFPubReaderePub
Background

Farmers are often exposed to dust, molds, pollen, animal products, insects, and chemicals. Accordingly, they have a high prevalence of respiratory and allergic diseases. Some studies have shown that farmers have a high prevalence of respiratory diseases and symptoms depending on where farmers work. The objective of the present study was to investigate whether certain types of agricultural workplaces are associated with the prevalence of allergic reactions in skin prick tests (SPTs) in South Korea.

Method

A total of 149 farmers, grouped according to their workplaces in greenhouses, poultry houses, or outdoors, answered a self-reported questionnaire about the prevalence of respiratory diseases and symptoms. They were skin-tested using 12 allergens. The questionnaire and the prevalence of positive skin tests were determined for each of the participant groups, and the results were analyzed by multivariate logistic regression.

Results

There were significant differences in the prevalence of allergic reactions to the SPT, chronic obstructive pulmonary diseases (COPDs) and asthma symptoms (wheezing) among the subgroups. The allergic reaction to SPT was the highest in greenhouse workers (30.9%), followed by poultry house workers (15.9%), and outdoor workers (8.1%). The prevalence of COPD was 6.8% in poultry house workers alone and not in other groups. The prevalence of wheezing was the highest at 9.1% in poultry house workers. According to the results of the logistic analysis, the prevalence of allergic reactions to SPT had positive correlations with the types of workplaces. Greenhouse workers had higher risk of SPT sensitization compared to outdoor workers (adjusted odds ratio [OR]: 5.55, 95% confidence interval [CI]: 1.32–32.24). The prevalence of SPT positivity also had an association with the symptoms of sneezing, rhinorrhea, or nasal congestion (adjusted OR: 6.64, 95% CI: 2.06–23.63).

Conclusions

These data demonstrate that the types of workplaces were associated with the prevalence of allergic sensitization. This could be explained by the difference in the type or level of airborne exposures in each workplace. It is also likely that this was caused by differences between groups of individual factors such as age and BMI that influence SPT sensitization.


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  • New Developments in Climate Change, Air Pollution, Pollen Allergy, and Interaction with SARS-CoV-2
    Gennaro D’Amato, Isabella Annesi-Maesano, Benedetta Biagioni, Andrea Lancia, Lorenzo Cecchi, Maria Concetta D’Ovidio, Maria D’Amato
    Atmosphere.2023; 14(5): 848.     CrossRef
  • Comparison of Overall Immunity Levels among Workers at Grape Orchard, Rose Greenhouse, and Open-Field Onion Farm
    Anju Maharjan, Ravi Gautam, JiHun Jo, Manju Acharya, DaEun Lee, Pramod Bahadur K C, Jin Gim, Sojung Sin, Hyocher Kim, ChangYul Kim, SooYeon Lee, SooJin Lee, Yong Heo, HyoungAh Kim
    Safety and Health at Work.2022; 13(2): 248.     CrossRef
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Research Article
Asbestos exposure and autoantibody titers
Eunsoo Lee, Youngki Kim, Se Yeong Kim, Dongmug Kang
Ann Occup Environ Med 2020;32:e32.   Published online September 1, 2020
DOI: https://doi.org/10.35371/aoem.2020.32.e32
AbstractAbstract PDFPubReaderePub
Background

Asbestos is a well-known hazardous substance that causes occupational and environmental diseases including asbestosis (lung fibrosis). Silica exposure which causes silicosis (another type of lung fibrosis) has long been linked to the development of autoimmune diseases; however, there are few studies on the relationship between asbestos exposure and autoimmune diseases.

Methods

A total of 54 individuals who had worked in a former asbestos textile factory underwent autoantibody-related blood tests, chest X-ray imaging, and pulmonary function tests. Based on the job exposure matrix (JEM), the estimated asbestos exposure concentrations were determined, and the presence of asbestosis was determined by chest radiography.

Results

Scleroderma (Scl-70) and ribonucleoprotein (RNP) antibodies were significantly lowered in the pleural plaque present group than in the absent group. Additionally, Scl-70, RNP, and Sjögren's syndrome type B (SS-B) antibodies were significantly lowered in the asbestosis present group. When stratifying variables with or without asbestosis, Scl-70, Smith, SS-B, and RNP antibodies decreased in female, crocidolite handling group, and higher estimated asbestos exposure level group.

Conclusions

Contrary to our expectations that autoantibody titers would be higher in groups with high asbestos exposure or in the asbestosis group, those with asbestosis showed lower titers. But as our research has some methodological limitations, the lowered titer of autoimmune antibody in our asbestos exposed subjects could not be simply interpreted as a lowered risk of autoimmune diseases. So careful interpreting should be taken when examine autoantibodies to screening or diagnose autoimmune diseases in people with asbestos exposure. In addition, it is necessary to establish relevance of asbestosis and autoantibodies through further studies of larger scale and higher confidence levels.


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  • Amphibole asbestos as an environmental trigger for systemic autoimmune diseases
    Jean C. Pfau, Brett McLaurin, Brenda J. Buck, Frederick W. Miller
    Autoimmunity Reviews.2024; 23(7-8): 103603.     CrossRef
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Research Article
Association of discrimination and presenteeism with cardiovascular disease: the Fourth Korean Working Conditions Survey
Kyusung Kim, Sung-il Cho, Domyung Paek
Ann Occup Environ Med 2019;31:e28.   Published online October 11, 2019
DOI: https://doi.org/10.35371/aoem.2019.31.e28
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background

Discrimination is a representative social determinant of health. Presenteeism is defined as presenting to work despite of illness and is an indicator of group health. We investigated the association of discrimination and presenteeism with cardiovascular disease using Korean data.

Methods

This study used the fourth Korea Working Conditions Survey (2014) data of 27,662 wage workers (employees). Presenteeism and discrimination related to age, sex, education, birth region, and employment type were ascertained. Self-reported cardiovascular disease was also assessed using the survey questionnaire. General and occupational characteristics found to be significant in univariate analyses were entered into a multivariate logistic regression analysis of the association of discrimination and presenteeism with cardiovascular disease. We also calculated the odds ratios of multiple discriminations and/or presenteeism for cardiovascular disease.

Results

In the univariate analyses, sex, age, education, monthly income, employment type, occupation, hours worked per week, workplace scale, and shift work were significantly associated with cardiovascular disease. A multivariate logistic regression analysis adjusted for general and occupational characteristics showed that discrimination and presenteeism were significantly associated with cardiovascular disease. Finally, the association with cardiovascular disease was strongest when both multiple discriminations and presenteeism were present.

Conclusions

Discrimination and presenteeism are associated with cardiovascular disease, and this association was stronger in the presence of multiple types of discrimination and presenteeism.


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  • The effect of occupational coping self-efficacy on presenteeism among ICU nurses in Chinese public hospitals: a cross-sectional study
    Jijun Wu, Yuxin Li, Qin Lin, Jiquan Zhang, Zhenfan Liu, Xiaoli Liu, Xian Rong, Xiaoli Zhong
    Frontiers in Psychology.2024;[Epub]     CrossRef
  • Sickness Presenteeism in Shift and Non-Shift Nurses: Using the Fifth Korean Working Conditions Survey
    Ari Min, Minkyung Kang, Hye Chong Hong
    International Journal of Environmental Research and Public Health.2021; 18(6): 3236.     CrossRef
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Research Article
Association between depression and cardiovascular disease risk in general population of Korea: results from the Korea National Health and Nutrition Examination Survey, 2016
Jinho Song, Tae Hwan Koh, One Park, Daeil Kwon, Seonghoon Kang, Kyeongmin Kwak, Jong-Tae Park
Ann Occup Environ Med 2019;31:e10.   Published online June 20, 2019
DOI: https://doi.org/10.35371/aoem.2019.31.e10
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background

Depression is considered as a risk factor for cardiovascular disease (CVD) and associated with changes in individuals' health status that might influence CVD risk. However, most studies have scrutinized this relationship on a rather narrower and specific study population. By focusing on general population of Korea, we sought to inspect the association of depression with CVD risk and cardiovascular risk factors.

Methods

The data from the first year (2016) of the 7th Korea National Health and Nutrition Examination Survey was used. Participants were classified by the Patient Health Questionnaire-9 (PHQ-9) score as such: normal group (PHQ-9 score 0–4), mild depression (MD) group (PHQ-9 score 5–9) and moderate and severe depression (MSD) group (PHQ-9 score 10–27). General linear model was used to analyze differences and the trend of mean CVD risk according to depression level. Adjusted odds ratios (AORs) were calculated by logistic regression to identify the association between depression and cardiovascular risk factors after adjusting for age.

Results

Mean CVD risk of MSD group was higher than that of normal group (p < 0.05). There was a tendency of CVD risk to increase as depression worsened (p < 0.01). Among men, MSD group was associated with current smoking (AOR, 2.97; 95% confidence interval [CI], 1.78–4.97), taking antihypertensive medications (AOR, 2.42; 95% CI, 1.26–4.66), increased fasting blood sugar (> 125 mg/dL; AOR, 2.37; 95% CI, 1.25–4.50) and taking diabetes medications (AOR, 3.08; 95% CI, 1.65–5.72). MD group was associated with current smoking (AOR, 1.60; 95% CI, 1.18–2.17). Among women, MSD group was associated with high body mass index (≥ 25 kg/m2; AOR, 1.61; 95% CI, 1.11–2.32), large waist circumference (≥ 85 cm; AOR, 1.63; 95% CI, 1.12–2.37), current smoking (AOR, 5.11; 95% CI, 3.07–8.52) and taking diabetes medications (AOR, 2.62; 95% CI, 1.68–4.08). MD group was associated with current smoking (AOR, 1.86; 95% CI, 1.18–2.93).

Conclusions

We suggest that depression is associated with increased risk for CVD occurrence in general population of Korea.


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    Priyanka Banerjee, Khanh Chau, Sivareddy Kotla, Eleanor L. Davis, Estefani Berrios Turcios, Shengyu Li, Zhang Pengzhi, Guangyu Wang, Gopi Krishna Kolluru, Abhishek Jain, John P. Cooke, Junichi Abe, Nhat-Tu Le
    Current Atherosclerosis Reports.2024; 26(9): 463.     CrossRef
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    Jiyoung Song, Eunwon Lee
    BMJ Open.2023; 13(7): e068282.     CrossRef
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    Stephanie A. Hooker, Patrick J. O'Connor, JoAnn M. Sperl-Hillen, A. Lauren Crain, Kris Ohnsorg, Sheryl Kane, Rebecca Rossom
    Journal of Psychosomatic Research.2022; 158: 110920.     CrossRef
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    Shinuk Kim
    BMC Geriatrics.2022;[Epub]     CrossRef
  • Self-Esteem as a Mediator between Life Satisfaction and Depression among Cardiovascular Disease Patients
    Zeying Qin, Songli Mei, Tingting Gao, Leilei Liang, Chuanen Li, Yueyang Hu, Xinmeng Guo, Cuicui Meng, Jianping Lv, Tongshuang Yuan, Junsong Fei, Qian Tong, Yang Yang
    Clinical Nursing Research.2022; 31(1): 115.     CrossRef
  • Muscle Strength Moderates the Relationship between Nutritional Health Risk and Depression in Korean Older Adults
    Jeonghyeon Kim, Seamon Kang, Haeryun Hong, Hyunsik Kang, Ju-Hyoung Kim, Sang-Koo Woo
    Nutrients.2022; 14(3): 665.     CrossRef
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    Zain I Warriach, Sruti Patel, Fatima Khan, Gerardo F Ferrer
    Cureus.2022;[Epub]     CrossRef
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    姗姗 郭
    Nursing Science.2019; 08(06): 436.     CrossRef
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