Annals of Occupational and Environmental Medicine

Original Article

Association of weight and dietary habits with high blood mercury levels in Korean adolescents: data from the KoNEHS cycle 4, 2018-2020: Ji Hoon Kim, Minju Jung, Jaewon Mun, Dong-Jae Seo, Jong-Han Leem, Shin-Goo Park, Dong-Wook Lee, Hyung Doo Kim, Hwan-Cheol Kim; Ann Occup Environ Med 2025;37:e5. Published online February 21, 2025; DOI: https://doi.org/10.35371/aoem.2025.37.e5

Abstract Abstract in Korean PDF Supplementary Material PubReader: Background
Humans are exposed to mercury primarily in its highly toxic form, methyl mercury, which is known to have adverse effects on various organs and systems. The negative impact of mercury exposure on the growth, development, and mental health of children, from infancy to adolescence, is well-documented. However, there are no internationally standardized safe limits for mercury exposure. This study investigated the impact of dietary habits and higher body mass index (BMI) on blood mercury levels in adolescents.
Methods
This study analyzed the data from the 4th Korean National Environmental Health Survey (KoNEHS) 2018–2020. The focus was on 825 middle and high school students aged 13–18 years, whose blood mercury levels were measured. A survey on dietary and lifestyle habits was also conducted. Blood mercury levels were categorized by geometric median values, and associations with overweight status and seafood consumption were examined using a generalized linear model.
Results
The geometric mean blood mercury level for the entire sample was 1.37 μg/L, with levels of 1.31 μg/L in normal-weight individuals and 1.43 μg/L in overweight individuals, showing a statistically significant difference between the two groups. After adjusting for other variables, blood mercury levels were significantly associated with overweight status (estimate: 0.084; p = 0.018; 95% confidence interval [CI]: 0.015–0.153), consumption of large fish and tuna more than once a week (estimate: 0.18; p = 0.001; 95% CI: 0.077–0.284), and consumption of fish once a week or more (estimate: 0.147; p = 0.004; 95% CI: 0.043–0.250).
Conclusions
In adolescents, a higher BMI and an increased consumption of large fish, tuna, and fish were associated with higher blood mercury levels. Notably, a stronger association was found between large fish consumption and blood mercury levels in the overweight group. These findings suggest the need to moderate seafood consumption and establish more proactive mercury exposure standards for adolescents.; 한국 청소년에서 체중 및 식습관과 높은 혈중 수은 농도의 연관: KNHANES 제4기 데이터, 2018-2020
목적
수은은 독성이 강한 형태인 메틸 수은의 상태로 인간에게 주로 노출된다. 메틸 수은은 발달 및 정신건강측면을 포함한 인체 전반에 독성 영향이 있지만 현재 국제적으로 표준화된 수은 노출 기준이 없다. 특히나 영유아나 청소년은 발달이 아직 이루어지지 않아 성인에 비해 더 수은 노출의 위험도가 높다. 본 연구에서는 청소년의 식습관이나 과체중 여부가 혈중 수은 노출에 미치는 영향을 조사하였다.
방법
본 연구는 국립환경과학원에서 발간하는 제4기 국민환경보건 기초조사(2018-2020)를 활용하였다. 제4기 대상 중 혈중 수은 농도가 측정된 13-18세의 중, 고등학생 825명을 대상으로 하였고 식습관이나 생활 습관에 대한 개인 설문을 활용하였다. 혈중 수은 농도 중위값을 기준으로 구분하여 과체중 여부를 구분하여 각종 해산물 식습관과 혈중 수은 농도와의 연관성을 로지스틱 회귀 모델을 사용하여 조사였고 이 후 전체 연구 대상자를 대상으로 연관성을 조사하였다.
결과
전체 표본의 기하평균 혈중 수은 농도는 1.37 µg/L로, 정상체중 군은 1.31 µg/L, 과체중 군은 1.43 µg/L로 나타났으며, 두 군 간에 통계적으로 유의미한 차이가 있었습니다. 다른 변수들을 조정한 후, 혈중 수은 농도는 과체중 상태(추정값: 0.084; p-value: 0.018; 95% 신뢰구간[CI]: 0.015-0.153), 주 1회 이상 대형어류와 참치 섭취(추정값: 0.18; p-value: 0.001; 95% CI: 0.077-0.284), 주 1회 이상 어류 섭취(추정값: 0.147; p-value: 0.004; 95% CI: 0.043-0.250)와 유의미한 관계가 있었습니다.
결론
청소년에서 높은 BMI와 대형어류, 참치, 어류 섭취가 높은 혈중 수은 농도와 관련이 있었습니다. 특히, 과체중 그룹에서는 대형어류 섭취와 혈중 수은 농도 간의 강한 연관성이 발견되었습니다. 이 결과는 청소년을 위한 해산물 섭취 절제와 더 적극적인 수은 노출 기준 설정이 필요함을 시사합니다.

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Original Article

Exploring the impact of age and socioeconomic factors on health-related unemployment using propensity score matching: results from Korea National Health and Nutrition Examination Survey (2015–2017): Ye-Seo Lee, Dong-Wook Lee, Mo-Yeol Kang; Ann Occup Environ Med 2024;36:e16. Published online July 1, 2024; DOI: https://doi.org/10.35371/aoem.2024.36.e16

Abstract Abstract in Korean PDF Supplementary Material PubReader ePub: Background
Previous reports showed that age and socioeconomic factors mediated health-related unemployment. However, those studies had limitations controlling for confounding factors. This study examines age and socioeconomic factors contributing to health-related unemployment using propensity score matching (PSM) to control for various confounding variables.
Methods
Data were obtained from the Korean National Health and Nutrition Examination Survey (KNHANES) from 2015–2017. We applied a 1:1 PSM to align health factors, and examined the association between health-related unemployment and age or socioeconomic factors through conditional logistic regression. The health-related unemployment group was compared with the employment group.
Results
Among the 9,917 participants (5,817 women, 4,100 men), 1,182 (853 women, 329 men) were in the health-related unemployment group. Total 911 pairs (629 women pairs and 282 men pairs) were retained after PSM for health factors. The results of conditional logistic regression showed that older age, low individual and household income levels, low education level, receipt of the Basic Livelihood Security Program benefits and longest-held job characteristics were linked to health-related unemployment, despite having similar health levels.
Conclusions
Older age and low socioeconomic status can increase the risk of health-related unemployment, highlighting the presence of age discrimination and socioeconomic inequality. These findings underscore the importance of proactive management strategies aimed at addressing these disparities, which are crucial for reducing the heightened risk of health-related unemployment.; 연령과 사회경제적 요인이 건강 관련 실업에 미치는 영향: 성향점수매칭을 활용한 한국 국민건강영양조사(2015-2017)자료 분석 결과
목적
이전 연구들에서 연령 및 사회경제적 요인들이 건강 관련 실업을 연관되어 있다는 것을 보여주었으나, 이러한 연구들은 교란 요인을 통제하는 데 한계가 있었다. 본 연구는 다양한 교란 변수를 통제하기 위해 성향점수매칭을 사용하여 건강 관련 실업에 기여하는 요인들을 분석하고자 하였다.
방법
2015년부터 2017년까지 조사된 국민건강영양조사 자료를 활용하였으며, 건강 관련 실업군을 취업군과 비교하였다. 우리는 1:1 성향점수매칭을 적용하여 두 군 간의 건강관련 요인을 통제하였으며, 조건부 로지스틱 회귀 분석을 통해 건강 관련 실업과 연령 및 사회경제적 요인 간의 관련성을 조사하였다.
결과
9,917명의 참가자(5,817명의 여성, 4,100명의 남성) 가운데 건강 관련 실업군은 1,182명(853명의 여성, 329명의 남성), 취업군은 5,777명(2,894명의 여성, 2,883명의 남성)이었다. 성향점수매칭 후 조건부 로지스틱 회귀의 결과, 고령, 낮은 개인 및 가구 소득, 낮은 교육 수준, 기초생활수급상태, 최장일자리의 성격이 건강 관련 실업과 연관되었다.
결론
고령과 낮은 사회경제적 지위는 건강 관련 실업의 위험을 증가시킬 수 있으며, 이는 연령 차별 및 사회경제적 불평등을 시사한다. 따라서 건강 관련 실업 위험을 완화하기 위해서는 이러한 차별을 해소하기 위한 적극적인 관리 방안이 필요하다.

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Original Article

Increased breast cancer incidence among nurses in a tertiary university hospital in South Korea: Juho Choi, Dong-Wook Lee, Baek-Yong Choi, Seung-Woo Ryoo, Taeshik Kim, Yun-Chul Hong; Ann Occup Environ Med 2023;35:e44. Published online November 4, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e44

Abstract Abstract in Korean PDF PubReader ePub: Background
A series of breast cancer cases were recently reported in a tertiary university hospital in South Korea. Nurses are generally exposed to risk factors for breast cancer such as night shift work, antineoplastic agents, and job strain. However, the epidemiological evidence of excess incidence among nurses remains lacking. This study aims to investigate the excess incidence of breast cancer among nurses in a tertiary university hospital and provide epidemiological evidence of occupational risk factors.
Methods
A retrospective cohort was developed using personnel records of female workers in the nursing department who worked from January 2011 to June 2021 in a tertiary university hospital in South Korea. Sick leave records were used to identify cases of breast cancer. The standardized incidence ratio of breast cancer among nurses was compared to the general population.
Results
A total of 5,509 nurses were followed up for 30,404 person-years, and 26 breast cancer cases were identified. This study revealed a significantly increased breast cancer incidence among all included nurses, with a standardized incidence ratio of 1.65 (95% confidence interval [CI]: 1.08–2.41), compared to the general population. Workers, who handle antineoplastic agents in their representative department and current and/or former department, had significantly elevated breast cancer standardized incidence ratios of 2.73 (95% CI: 1.008–5.94) and 3.39 (95% CI: 1.46–6.68), respectively.
Conclusions
This study provides significant evidence of increased breast cancer risk among nursing staff in a hospital setting, particularly those who handle antineoplastic drugs. Measures that reduce exposure to risk factors should be implemented, especially anticancer drugs, to protect healthcare professionals. Further research at a national level that focuses on healthcare workers is necessary to validate breast cancer incidence and its contributing factors.; 국내 모 대학병원 내 간호노동자에서의 유방암 발병률 증가
목적
최근 서울에 위치한 모 대학병원에서 항암제를 취급하는 근무지 내 간호사 중에서 여러 건의 유방암이 진단되었다. 간호사들에 대한 직업적 위험인자로 야간 근무, 항암제 노출, 직무 스트레스 등이 파악되었다. 그러나 간호사를 포함한 의료종사자들 사이에서 유방암 발병률 증가에 대한 연구 결과는 부족하다. 본 연구는 해당 대학병원의 간호부문 근로자에서의 유방암 발병률을 일반인과 비교하여 확인함으로써, 이들의 직업적 위험요인에 대한 역학적 증거를 제공하고자 하였다.
방법
해당 대학병원의 인사기록을 활용하여 후향적 코호트 연구를 수행하였으며, 2011년 1월부터 2021년 6월까지 간호부문에서 근무한 여성 근로자를 연구대상으로 하였다. 유방암 환자들을 식별하기 위해 병가 기록이 활용되었으며, 대표적인 근무지는 근로자가 가장 오래 근무한 곳을 기준으로 결정되었다. 간호부문 근로자에서의 연령 표준화 유방암 발병률을 산출하여 일반인구와 비교하였다.
결과
본 연구에서는 간호부문 근로자 5,509명을 대상으로 코호트 연구를 수행하였다. 관찰기간은 총 30,404인년이었고, 추적 기간 동안 신규 유방암 환자 26명을 확인하였다. 전체 간호부문 근로자들에서의 일반인구 대비 유방암 표준화발생률(Standardized Incidence ratio, SIR)은 1.65 (95% CI : 1.08-2.41)로 유의한 증가를 보였다. 항암제 취급 부서가 그들의 대표부서이거나 이전에 근무했던 경험이 있는 경우, 각각 2.73배(95% CI :1.00-5.94), 3.39배(95% CI : 1.46-6.68) 높은 유방암 발병위험이 확인되었다.
결론
본 연구는 병원 내 간호부문 종사자, 특히 항암제 취급 종사자에서의 유방암 발병 위험이 일반인구 대비 유의하게 증가함을 확인하였다. 의료종사자들을 직업적 위험요인으로부터 보호하기 위해 항암제 노출 차단, 야간 근무 감소, 개인 맞춤형 건강검진이 도입되어야 할 것이다. 추후 의료종사자를 대상으로 국가 수준의 연구를 통해 이들의 유방암 발병위험과 그 기여요인에 대해 확인해야 할 것이다.

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Original Article

Occupational stress changes and new-onset depression among male Korean manufacturing workers: Jiho Kim, Hwan-Cheol Kim, Minsun Kim, Seong-Cheol Yang, Shin-Goo Park, Jong-Han Leem, Dong-Wook Lee; Ann Occup Environ Med 2023;35:e33. Published online August 17, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e33

Abstract Abstract in Korean PDF PubReader ePub: Background
Studies on the association between occupational stress and depression have been frequently reported. However, the cross-sectional designs of studies limited insight into causal associations. In this study, we investigated the longitudinal association between occupational stress and new-onset depression among employees in a single manufacturing plant.
Methods
The annual health checkup data of employees at a manufacturing plant in Korea were collected. A total of 1,837 male employees without depression who completed a health checkup during two consecutive years were included. Occupational stress was measured using a short form of the Korea Occupational Stress Scale (KOSS-SF), and depression was assessed using a Patient Health Questionnaire-2. The association between occupational stress change over the two years and newly developed depression was investigated using two logistic regression models.
Results
Across all sub-factors of KOSS-SF, employees who reported increased occupational stress had a higher risk of new-onset depression. Newly developed depression was significantly associated with job demand (odds ratio [OR]: 4.34; 95% confidence interval [CI]: 2.37–7.96), job insecurity (OR: 3.21; 95% CI: 1.89–5.48), occupational climate (OR: 3.18; 95% CI: 1.91–5.31), lack of reward (OR: 2.28; 95% CI: 1.26–4.12), interpersonal conflict (OR: 2.14; 95% CI: 1.18–3.86), insufficient job control (OR: 1.93; 95% CI: 1.05–3.56), and the organizational system (OR: 1.84; 95% CI: 1.01–3.36).
Conclusions
For every sub-factor of the KOSS-SF, occupational stress increase and persistent high stress were associated with the risk of developing new-onset depression. Among the seven sub-factors, job demand had the most significant effect. Our results show that occupational stress should be managed to promote employee mental healthcare.; 한국 남성 제조업 근로자의 직무 스트레스 변화와 우울증 발생의 관계
목적
직무 스트레스와 우울증의 연관성에 대한 연구는 지속적으로 보고되고 있다. 그러나 국내 연구는 부족한 실정이며 주로 단면적 분석 설계에 국한되고 있다. 이 연구에서 우리는 단일 제조업 공장의 근로자들에서 직무 스트레스와 새롭게 발병하는 우울증 사이의 종단적 연관성을 조사하였다.
방법
국내 한 제조업 공장 근로자들의 연간 건강검진 자료를 수집하였다. 2년 연속 건강검진을 완료한 이들 중 우울증이 없는 남성은 총 1837명이었다. 직무 스트레스는 Korea Occupational Stress Scale KOSS Short Form (KOSS-SF)으로 측정하였고, 우울증은 Patient Health Questionnaire-2(PHQ-2)로 평가하였다. 1년 간의 직무 스트레스 변화와 새로 발생한 우울증과의 연관성을 로지스틱 회귀 모델을 사용하여 분석했다.
결과
KOSS-SF의 모든 하위 영역에서 직무 스트레스가 증가했다고 보고한 근로자는 새로운 우울증 발병 위험이 더 높았다. 새로 발생한 우울증의 위험은 각각 직무 요구[교차비(OR)=4.34, 95% 신뢰 구간(CI)= 2.37–7.96], 직무 불안정(OR=3.21, 95%CI=1.89–5.48), 직장문화(OR=3.18, 95%CI=1.91–5.31), 보상 부적절(OR=2.28, 95%CI=1.26–4.12), 관계 갈등(OR=2.14, 95%CI=1.18–3.86), 직무 자율성 결여(OR=1.93, 95%CI=1.05–3.56) 및 조직체계(OR=1.84, 95%CI=1.01–3.36) 순이었다.
결론
KOSS-SF의 모든 하위 영역에서 직무 스트레스 증가와 높은 스트레스 상태의 지속은 새로운 우울증 발병 위험과 관련이 있었다. 7가지 하위 영역 중 직무 요구가 가장 큰 영향을 미쳤다. 우리의 결과는 근로자 정신 건강을 증진하기 위해 직무 스트레스를 관리해야 함을 시사한다

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Original Article

The relationship between fatigue and sickness absence from work: Minsun Kim, Jiho Kim, SeongCheol Yang, Dong-Wook Lee, Shin-Goo Park, Jong-Han Leem, Hwan-Cheol Kim; Ann Occup Environ Med 2023;35:e32. Published online August 10, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e32

Abstract Abstract in Korean PDF PubReader ePub

Background

Although many studies have been conducted on worker fatigue and sickness absence, the association between fatigue and sickness absence is unclear in Korean workers. This study was conducted to investigate the effect of worker fatigue on future sickness absence.

Methods

The study was conducted on workers who received medical check-ups at a university hospital for two consecutive years (2014–2015). During check-ups in the first year, the Fatigue Severity Scale (FSS) was used to assess fatigue levels, and during check-ups in the second year, sickness absence was surveyed to determine whether they had been absent from work due to physical or mental illness during previous 12 months. The χ² test was used to analyze relationships between sociodemographic and occupational characteristics, fatigue levels, and sickness absence. Odds ratios (ORs) were calculated by logistic regression analysis controlled for confounding factors.

Results

A total of 12,250 workers were included in the study, and 396 (3.2%) workers experienced more than one day of sickness absence during the study period. Adjusted ORs for sickness absence were 3.35 (95% confidence interval [CI]: 2.64–4.28) in the moderate-fatigue group and 6.87 (95% CI: 4.93–9.57) in the high-fatigue group versus the low-fatigue group. For men in the moderate- and high-fatigue groups, adjusted ORs for sickness absence were 3.40 (95% CI: 2.58–4.48) and 8.94 (95% CI: 6.12–13.07), and for women in the moderate- and high-fatigue groups, adjusted ORs for sickness absence were 2.93 (95% CI: 1.68–5.10) and 3.71 (95% CI: 1.84–7.49), respectively.

Conclusions

Worker fatigue is associated with sickness absence during the following 12 months, and this association appears to be stronger for men than women. These results support the notion that sickness absence can be reduced by evaluating and managing work-related fatigue.

근로자의 피로와 질병 결근의 연관성
목적
근로자의 피로와 질병 결근에 관한 많은 연구가 이루어졌으나, 한국 근로자의 피로와 질병 결근의 연관성은 불분명합니다. 본 연구는 근로자의 피로가 미래의 질병 결근에 미치는 영향을 조사하기 위해 수행되었습니다.
방법
본 연구는 2년 연속(2014년-2015년) 대학병원에서 건강검진을 받은 근로자들을 대상으로 실시되었습니다. 첫번째 2014년 건강검진에서는 피로 심각도 척도를 이용하여 피로도를 평가했고, 다음해인 2015년 건강검진에서는 같은 근로자를 대상으로 지난 12개월 간 신체적 질환 또는 정신적 질환으로 인한 결근한 적이 있는지를 조사했습니다. χ2 분석으로 사회인구학적 특성과 직업적 특성, 피로도와 질병 결근의 연관성을 분석하였습니다. 오즈비는 교란 요인들을 통제 후 로지스틱 회귀 분석을 통해 측정되었습니다.
결과
연구 대상에는 총 12,250명의 근로자가 포함되었으며, 12개월 동안 396명(3.2%)의 근로자가 하루 이상의 질병 결근을 하였습니다. 질병 결근에 대한 조정된 오즈비는 낮은 피로 그룹에 비해 중간 피로 그룹에서 3.35 (95% CI: 2.64-4.28), 고피로 그룹에서 6.87 (95% CI: 4.93-9.57)였습니다. 남성의 질병 결근에 대한 조정된 오즈비는 중간 피로 그룹에서 3.40 (95% CI: 2.58-4.48), 고피로 그룹에서 8.94 (95% CI: 6.12-13.07)였으며, 여성의 질병 결근에 대한 조정된 오즈비는 중간 피로 그룹에서 2.93 (95% CI: 1.68-5.10), 고피로 그룹에서 3.71 (95% CI: 1.84-7.49)이었습니다.
결론
근로자의 피로는 이후 12개월 동안의 질병 결근과 관련이 있으며, 이 연관성은 여성보다 남성에게 더 강한 것으로 보입니다. 이러한 결과는 업무 관련 피로를 평가하고 관리함으로써 질병 결근을 줄일 수 있다는 개념을 뒷받침합니다.

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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

Abstract PDF Supplementary Material PubReader ePub

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.

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Original Article

Association between long working hours and liver enzymes: evidence from the Korea National Health and Nutrition Examination Survey, 2007–2017: Ji-Hun Song, Hyoung-Ryoul Kim, Dong-Wook Lee, Jeehee Min, Yu Min Lee, Mo-Yeol Kang; Ann Occup Environ Med 2022;34:e9. Published online May 13, 2022; DOI: https://doi.org/10.35371/aoem.2022.34.e9

Abstract Abstract in Korean PDF Supplementary Material PubReader ePub

Background

Long working hours causes several health risks, but little is known about its effects on the liver. This study aimed to examine the correlation between working hours and abnormal liver enzyme levels.

Methods

We used data from the Korea National Health and Nutrition Examination Survey IV–VII. For the final 15,316 study participant, the information on working hours was obtained through questionnaires, and liver enzyme levels, consisting of serum levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT), through blood tests. The relationship between weekly working hours and abnormal levels of liver enzymes was analyzed using multiple logistic regression, and a trend test was also conducted.

Results

In male, working ≥ 61 hours per week was significantly associated with elevated AST and ALT levels compared with working 35–52 hours per week. Even after adjusting for covariates, the odds ratios (ORs) of abnormal AST and ALT increased by 1.51 (95% confidence interval: 1.20–2.05) and 1.25 (1.03–1.52), respectively, and a dose-response relationship was observed. This association was more prominent among the high-risk group, such as those aged > 40 years, obese individuals, worker on non-standard work schedule, pink-collar workers, or temporary worker. No correlation was observed in female.

Conclusions

Long working hours are associated with abnormal liver function test results in male. Strict adherence to statutory working hours is necessary to protect workers’ liver health.

장시간 노동과 간기능 이상의 상관성: 2007-2017 국민건강영양조사 자료를 이용하여
목적
장시간 노동은 여러 가지 건강상의 위험을 초래하지만 간에 미치는 영향에 대해서는 아직까지 알려진 바가 거의 없다. 본 연구는 근로시간과 간기능 이상과의 상관관계를 알아보는 것을 목적으로 하였다.
방법
본 연구를 위해 4-7차 국민건강영양조사 자료를 사용하였다. 최종 연구참여자 15,316명을 대상으로 설문지를 통해 근무시간 정보를 얻었고 혈액검사를 통해 혈청 아스파르테이트아미노트랜스퍼라제(AST)와 알라닌아미노트랜스퍼라제(ALT)로 구성된 간효소치 정보를 얻었다. 다중 로지스틱 회귀 분석을 통해 주당 근무 시간과 간효소 이상 수치와의 관계를 분석하고 추세 검정도 함께 진행하였다.
결과
남성의 경우 주당 35-52시간 일하는 것에 비해, 법정 최대 근로시간을 초과한 주당 53-60시간을 근무하여도 AST 및 ALT 수치의 유의한 상승이 관찰되진 않았으나, 주당 60시간을 초과하여 일하는 경우 유의하게 상승하였다. 공변량을 보정한 후에도 AST와 ALT이상수치의 교차비(ORs)가 각각 1.51 (95% 신뢰 구간: 1.20-2.05) 및 1.25 (1.03-1.52) 증가하여 용량-반응 관계가 관찰되었다. 이 연관성은 40세 이상, 비만인, 비정규시간 근로자, 핑크 칼라 노동자, 임시직 노동자와 같은 고위험군에서 더 두드러졌다. 여성에서는 상관관계가 관찰되지 않았다.
결론
남성의 경우 장시간 노동은 간기능 검사 결과 이상과 관련이 있다. 근로자의 간 건강을 보호하기 위해서는 법정 근로시간을 철저히 준수하는 것이 필요하다.

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Original Article

Poor worker’s long working hours paradox: evidence from the Korea National Health and Nutrition Examination Survey, 2013-2018: Min Young Park, Jaeyoung Park, Jun-Pyo Myong, Hyoung-Ryoul Kim, Dong-Wook Lee, Mo-Yeol Kang; Ann Occup Environ Med 2022;34:e2. Published online February 14, 2022; DOI: https://doi.org/10.35371/aoem.2022.34.e2

Abstract Abstract in Korean PDF PubReader ePub

Background

Because income and working hours are closely related, the health impact of working hours can vary according to economic status. This study aimed to investigate the relationship between working hours and the risk of poor self-rated health according to household income level.

Methods

We used the data from the Korea National Health and Nutrition Examination Survey VI and VII. The information on working hours and self-rated health was obtained from the questionnaire. After stratifying by household income level, the risk of poor self-rated health for long working hour group (≥ 52 hours a week), compared to the 35–51 working hour group as a reference, were calculated using multiple logistic regression.

Results

Long working hours increased the risk of poor self-rated health in the group with the highest income, but not in the group with the lowest income. On the other hand, the overall weighted prevalence of poor self-rated health was higher in the low-income group.

Conclusions

The relationship between long working hours and the risk of poor self-rated health varied by household income level. This phenomenon, in which the health effects of long working hours appear to diminish in low-income households can be referred to as the ‘poor worker’s long working hours paradox’. Our findings suggest that the recent working hour restriction policy implemented by the Korean government should be promoted, together with a basic wage preservation to improve workers’ general health and well-being.

저소득 근로자의 장시간근무 역설: 2013-2018 국민건강영양조사 자료를 이용하여
목적
소득과 근로시간은 서로 밀접한 관계에 있으며, 이로 인해 근로시간이 건강 상태에 미치는 영향은 경제적 상황에 따라 달라질 수 있다. 본 연구는 가구소득수준에 따른 근로시간과 자가 건강 평가(self-rated health) 악화 위험의 연관성에 대하여 조사하였다.
방법
국민건강영양조사 제 6기 및 제 7기 자료를 이용하여 연구를 수행하였다. 근로시간 및 자가 건강 평가에 대한 정보는 설문조사를 통해 조사되었다. 주당 근로시간 35-51시간 군과 비교하여 주당 근로시간 52시간 이상인 장시간 근로 군의 자가 건강 평가 악화 위험을 가구 소득 수준으로 층화하여 다중 로지스틱 회귀분석을 통해 계산하였다.
결과
소득이 가장 높은 군에서는 근로시간이 길수록 자가 건강 평가 악화의 위험이 증가했으나 소득이 낮은 군에서는 유의한 결과를 보이지 않았다. 반면에 소득이 낮은 군에서는 근로시간에 관계 없이 전체적인 자가 건강 평가 수준이 낮은 것으로 관찰되었다.
결론
장시간 근로와 자가 건강 평가 악화 위험 간의 연관성은 가구소득수준에 따라 다른 것으로 나타났다. 저소득층에서 장시간 근로의 건강 영향이 약화되어 나타나는 이러한 현상을 ‘저소득 근로자 장시간 근로의 역설’이라고 부를 수 있다. 본 연구 결과는 최근 한국 정부가 시행하고 있는 근로시간 제한 정책을 추진할 때 전체 근로자의 건강과 복지를 향상시키기 위해서는 기본 임금 보전이 함께 추진되어야 함을 시사한다.

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Research Article

Cardiovascular disease risk differences between bus company employees and general workers according to the Korean National Health Insurance Data: Ji-Hoo Yook, Dong-Wook Lee, Min-Seok Kim, Yun-Chul Hong; Ann Occup Environ Med 2018;30:32. Published online May 8, 2018; DOI: https://doi.org/10.1186/s40557-018-0242-z

Abstract PDF PubReader ePub

Background

Bus drivers are known to be highly at risk of cardiovascular diseases. In this study, we assessed the cardiovascular disease prevalence of bus company employees in Seoul, South Korea, and compared the results to those of general workers.

Methods

We analyzed the 2014 Korean National Health Insurance (NHI) data and defined hypertension, diabetes, dyslipidemia, ischemic heart disease, and cerebrovascular disease based on the KCD-6 medical diagnoses. We used bus company employees as surrogate participants of bus drivers due to the characteristics of Korean NHI data. We identified bus company employees in Seoul based on one’s workplace which the insurance is registered. The prevalence of five diseases was compared between the bus company employees and general workers. We also calculated the odds ratios (OR) of five diseases between the bus company employees and general workers. To compensate the vast demographical differences between the two groups, we performed propensity score matching.

Results

Bus company employees have higher OR for having hypertension (OR 1.33, 95% CI: 1.28–1.39), diabetes mellitus (1.14, 95% CI: 1.08–1.22), and dyslipidemia (1.23, 95% CI: 1.17–1.29) than the general workers or propensity score matched controls. However, the OR of having ischemic heart disease were not significant. The OR of cerebrovascular disease were lower in bus company employees than in the general workers after adjusting the covariates, but similar in the propensity score matched model.

Conclusion

This study showed that the ORs of cardiovascular disease risk factors are high in bus company employees when compared to the general working population. Further studies with the longitudinal design should be conducted to confirm the causal association.

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Research Article

The effect of long working hours on 10-year risk of coronary heart disease and stroke in the Korean population: the Korea National Health and Nutrition Examination Survey (KNHANES), 2007 to 2013: Dong-Wook Lee, Yun-Chul Hong, Kyoung-Bok Min, Tae-Shik Kim, Min-Seok Kim, Mo-Yeol Kang; Ann Occup Environ Med 2016;28:64. Published online November 15, 2016; DOI: https://doi.org/10.1186/s40557-016-0149-5

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Background

Recently, the emergence of long working hours and the associated conditions such as coronary heart disease (CHD) and stroke have gained attention. The aim of this study was to investigate the association between long working hours and the 10-year-risk of CHD and stroke, estimated by Jee’s health risk-appraisal model for ischemic heart disease.

Methods

We analyzed data from Koreans who randomly enrolled in Korean National Health and Nutrition Examination Survey 2008–2012 and finally included 13,799 participants. The participants were classified as per their working hours: 0–30 h/week, 31–39 h/week, 40 h/week, 41–50 h/week, 51–60 h/week, 61–70 h/week, 71–80 h/week, and >80 h/week. The risks for CHD and stroke were determined using Jee’s health risk-appraisal model. Multiple logistic regression was used to analyze the association between working hours and 10-year risk for CHD.

Results

The 10-year risks for CHD and stroke were significantly and positively associated with working hours in both men and women. Furthermore, higher risks for CHD and stroke were associated with longer working hours in women.

Conclusion

Long working hours are significantly associated with the risks of CHD and stroke, estimated by Jee’s health risk-appraisal model. This study suggests the need for proper management of working hours to reduce CHD risk and stroke risk in the Korean population.

Electronic supplementary material

The online version of this article (doi:10.1186/s40557-016-0149-5) contains supplementary material, which is available to authorized users.

Citations

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