Annals of Occupational and Environmental Medicine

Original Article

Association between outdoor clothing use and serum perfluoroalkyl substances (PFAS): Korean National Environmental Health Survey cycle 4: Keon Woo Kim, Jisoo Kang, Seong-yong Cho, Seongyong Yoon, Daehwan Kim, Hyun Woo Park; Ann Occup Environ Med 2026;38:e4. Published online January 8, 2026; DOI: https://doi.org/10.35371/aoem.2026.38.e4

Abstract Abstract in Korean PDF Supplementary Material: Background
Perfluoroalkyl substances (PFAS) are used in various products, and PFAS have been detected in outdoor clothing. PFAS can be absorbed into the human body via oral ingestion, inhalation, and dermal contact. In this study, we examined the association between the frequency of using outdoor clothing and serum PFAS concentrations in the Korean population using data from cycle 4 (2018–2020) of the Korean National Environmental Health Survey.
Methods
Data from 2,993 adult participants were analyzed. The participants were classified into low-concentration and high-concentration groups based on the 75th percentile concentration of serum PFAS. The use of outdoor clothing was categorized into three groups: non-use, <4 times a week, and ≥4 times a week. The odds ratio (OR) for serum PFAS levels associated with use of outdoor clothing was determined through logistic regression analysis, adjusted for demographic characteristics, health-related factors, PFAS-treated items, dietary factors, and ventilation time.
Results
ORs for high serum PFAS were higher in groups using outdoor clothing compared to the non-user group. In males, the adjusted ORs for the < 4 times a week and ≥ 4 times a week outdoor clothing usage group were as follows: perfluorooctanoic acid (PFOA), 1.26 (95% confidence interval [CI]: 1.10–1.44) and 1.70 (1.40–2.07); perfluorohexanesulfonic acid (PFHxS), 1.49 (1.16–1.92) and 1.70 (1.22–2.37); and perfluorononanoic acid (PFNA), 1.34 (1.19–1.51) and 1.68 (1.38–2.05), respectively. In females, the respective ORs were as follows: PFOA 1.32 (95% CI: 1.19–1.46) and 1.53 (1.01–2.32); PFHxS, 1.46 (1.08–1.96) and 2.63 (2.10–3.29); PFNA, 1.38 (1.22–1.55) and 1.45 (1.07–1.96).
Conclusions
In adults, elevated serum PFAS levels were associated with increased frequency of using outdoor clothing.; 제4기(2018-2020) 국민환경보건 기초조사 자료를 이용한 아웃도어 의류 착용과 혈청 과불화화합물과의 관계
목적
과불화화합물(PFAS)은 방수 및 방유 효과를 가지고 있어 아웃도어 의류를 포함한 일회용 식품 포장, 조리 기구, 가구 등 다양한 제품에 사용된다. 선행 연구에 따르면 PFAS가 아웃도어 의류에서 검출되었다. PFAS는 경구섭취, 흡입, 피부접촉 등의 경로를 통해 인체에 흡수되며 체내에 장기간 잔류하면서 간기능, 신기능, 생식기능 등의 저하 증상을 유발할 수 있다. 본 연구에서는 한국 국민환경보건 기초조사(KoNEHS) 4주기(2018-2020)의 데이터를 사용하여 한국 인구의 아웃도어 의류 사용 빈도와 혈청 PFAS농도와의 연관성을 확인하고자 한다.
방법
KoNEHS 4주기의 데이터를 이용하여 2,993명의 성인 참가자를 분석하였다. 혈청 PFAS의 75 번째 백분위 수 농도를 기준으로 저농도군과 고농도군으로 나누었다. 아웃도어 의류 사용은 미사용, 주 당 4회 미만, 주 당 4회 이상으로 세 군으로 분류하였다. 아웃도어 의류 사용에 관한 혈청 PFAS의 오즈비는 인구통계학적 특성, 건강 관련 특성, PFAS 사용 물품, 식이요인 그리고 환기 시간을 보정한 후 로지스틱 회귀분석을 사용하여 구하였다
결과
본 연구에서는 아웃도어 의류를 사용하지 않는 군에 비해 주 4회 미만 사용군 및 주4회 이상 사용군에서 혈청 PFAS 고농도군에 속할 OR 값이 높게 나왔다. 남성에서 주 4회미만 사용군 및 주 4회이상 사용군에서 PFOA의 고농도군에 해당될 adjusted OR는 1.26(95% CI; 1.10-1.44) 및 1.70(95% CI; 1.40-2.07)이었다PFHxS는 1.49(95%CI; 1.16-1.92) 및 1.70(95%CI; 1.22-2.37), PFNA는 1.34(95% CI; 1.19-1.51) 및 1.68(95% CI; 1.38-2.05), 이었다. 여성의 경우 주 4회미만 사용군 및 주 4회이상 사용군에서 PFOA의 고농도군에 해당될 adjusted OR는 1.32(95% CI; 1.19-1.46) 및 1.53(95% CI; 1.01-2.32)이었다. PFHxS는 1.46(95%CI; 1.08-1.96) 및 2.63(95%CI; 2.10-3.29), PFNA는 1.38(95% CI; 1.22-1.55) 및 1.45(95% CI; 1.07-1.96) 이었다.
결론
성인에서 아웃도어 의류 착용 횟수가 많을수록 혈청 PFAS(PFOA, PFOS, PFHxS, PFNA, PFDeA) 농도가 증가하였다.

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Review

Impacts of heat on sleep quality among heat-exposed workers: a systematic review: Maarthi Raja, Vidhya Venugopal, D. C. Mathangi, Suvarna Jyothi Kantipudi, K. Mahesh Kumar, Somnath Panda, Latha Perumal Kamalakkannan; Ann Occup Environ Med 2026;38:e3. Published online January 8, 2026; DOI: https://doi.org/10.35371/aoem.2026.38.e3

Abstract PDF Supplementary Material: Climate change is intensifying occupational heat exposure, posing risks not only for heat-related illness but also for sleep, which is essential for recovery, safety, and productivity. Heat-exposed workers are highly vulnerable due to prolonged exposure, limited access to cooling, and poor housing. This systematic review aimed to synthesise global evidence on how occupational heat exposure affects sleep quality among workers across different occupations and settings. A systematic review was conducted following Synthesis without Meta-Analysis (SWiM) guidelines. PubMed, Scopus, and Google Scholar were searched (2000–2025) for studies involving adult workers (≥18 years) reporting both heat exposure and sleep outcomes. The review was registered with PROSPERO (ID: CRD420251125735). Of 7,108 records screened, 11 studies met the inclusion criteria. Studies spanned Asia, Australia, North America, and global cohorts. Heat exposure consistently impaired sleep quality and duration. Using Pittsburgh Sleep Quality Index, Actigraphy, and self-reports, common complaints included difficulty falling asleep (64%), restlessness (54%), non-restorative sleep (54%), night sweats (36%), and reduced total sleep time (45%). Night-time temperatures above 25°C and high workplace wet bulb globe temperature values were strongly linked with reduced sleep efficiency and delayed sleep onset. Vulnerable groups included shift workers, petrochemical and steel labourers, women, older adults, and low-income workers in urban heat islands and poorly ventilated housing. Occupational heat exposure disrupts sleep, compounding daytime strain and creating a dual burden for workers. Integrating sleep into heat stress management through cooling interventions, better housing, and revised work–rest schedules is critical for workers well-being in a warming climate.

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Original Article

Development of criteria for health examination of high-risk occupational groups and application to female fishers: Delphi study: Hye-min Kim, Jungwon Kim, Kunhyung Kim, Hansoo Song; Ann Occup Environ Med 2026;38:e2. Published online January 8, 2026; DOI: https://doi.org/10.35371/aoem.2026.38.e2

Abstract Abstract in Korean PDF Supplementary Material: Background
The objective of this study was to establish criteria for designing health examination programs and selecting appropriate examination items for high-risk occupational groups and to apply these criteria specifically to female fishers.
Methods
The first Delphi survey comprised five domains and 15 specific criteria for identifying relevant health screening items for high-risk occupations. The second survey included open-ended questions addressing inconsistencies identified in the first survey and sought suggestions for additional items. In the third Delphi survey, specific health screening items were proposed for female fishers, and experts directly evaluated these items according to the finalized selection criteria.
Results
Twenty-eight experts participated in this study. The first and second Delphi rounds facilitated the finalization of selection criteria for health screening items, consisting of five domains: Domain 1, Priority of target disease; Domain 2, Applicability of early detection and intervention; Domain 3, Scientific evidence of medical test method; Domain 4, Acceptability of medical test method; and Domain 5, Effectiveness of examination. Content validity ratios for these criteria ranged between 0.429 and 1.000. Based on the established criteria, experts evaluated eight proposed screening items for female fishers in the third round of the Delphi survey. Bone density, bioelectrical impedance analysis, cardiovascular disease risk factors, and fundoscopy were evaluated as appropriate; however, no agreement was reached on the early detection and intervention areas for degenerative lumbar disease, knee osteoarthritis, and upper extremity disease, as well as on the effectiveness for upper extremity disease and chronic obstructive pulmonary disease.
Conclusion
This study successfully established comprehensive criteria for selecting diseases targeted by health examinations in high-risk occupational groups. The practical application of these criteria proved effective in assessing the appropriateness of specific health screening items.; 고위험 직업군 건강검진 기준 개발 및 여성 어업종사자에의 적용: 델파이 조사
배경
본 연구의 목적은 고위험 직업군을 위한 건강검진 프로그램 설계 기준과 적절한 검사 항목을 선정하는 기준을 수립하고, 이를 여성 어업종사자에게 구체적으로 적용하는 것이었다.
방법
첫 번째 델파이 조사에서는 고위험 직업군의 건강검진 항목을 선정하기 위한 5개 영역과 15개의 기준을 설정하였다. 두 번째 조사에서는 첫 번째 조사에서 발견된 불일치를 해소하고 추가 항목에 대한 제안을 받기 위해 개방형 질문을 포함하였다. 세 번째 델파이 조사에서는 여성 어업종사자에게 적용할 건강검진 항목을 제안하고, 전문가들이 최종 선정 기준에 따라 해당 항목을 평가하였다.
결과
본 연구에는 28명의 전문가가 참여하였다. 첫 번째와 두 번째 델파이 조사에서는 건강검진 항목 선정 기준이 확정되었으며, 이 기준은 다음의 5개 영역으로 구성되었다: <영역 1: 대상 질병의 우선순위>, <영역 2: 조기 발견 및 개입의 적용 가능성>, <영역 3: 의학적 검사 방법에 대한 과학적 근거>, <영역 4: 의학적 검사 방법의 수용 가능성>, <영역 5: 검사의 효과성>. 각 기준의 내용 타당도 비율은 0.429에서 1.000 사이였다. 확립된 기준에 따라, 세 번째 델파이 조사에서 여성 어업종사자를 위한 8개 건강검진 항목이 평가되었으며, 골밀도, 생체 전기 저항 분석, 심혈관 질환 위험 인자, 안저 검사는 적절한 항목으로 평가되었으나, 퇴행성 요추 질환, 무릎 골관절염, 상지 질환 및 만성 폐쇄성 폐질환의 조기 발견 및 개입 영역과 상지 질환과 만성 폐쇄성 폐질환의 효과성에 대해서는 전문가들 간의 합의가 이루어지지 않았다.
결론
본 연구는 고위험 직업군의 건강검진을 위한 질병 선정 기준을 성공적으로 확립하였다. 이 기준을 실제로 적용함으로써 특정 건강검진 항목의 적절성을 평가하는 데 효과적임을 확인하였다.

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Original Article

Health effects of weekend work on Korean workers: based on the 6th Korean Working Conditions Survey: Ji-Hyeon Lee, Jin-Young Min, Seok-Yoon Son, Seung-Woo Ryoo, Kyoung-Bok Min; Ann Occup Environ Med 2025;37:e31. Published online September 3, 2025; DOI: https://doi.org/10.35371/aoem.2025.37.e31

Abstract Abstract in Korean PDF Supplementary Material: Background
Although weekend work makes up a significant part of work patterns in modern society, research on the health effects of weekend work is relatively limited compared to other types of nonstandard work. This study was conducted to examine the impact of weekend work on the health of Korean workers, aiming to provide evidence to support the development of welfare policies that promote workers’ health.
Methods
This study was conducted using data from the 6th Korean Working Conditions Survey, targeting 35,957 Korean workers who met the research criteria. Based on the survey responses, information was collected on weekend work status and health outcomes, including general health, musculoskeletal pain, headaches or eye pain, fatigue, sleep disorders, depression, anxiety, absenteeism and presenteeism. To examine the association between weekend work and health outcome variables, logistic regression analysis was performed adjusting for sociodemographic and occupational characteristics, with additional stratified analyses conducted according to employment status.
Results
Among the final study population, 11,255 workers, accounting for 30.5% of the total, were weekend workers. After adjusting for sociodemographic and occupational characteristics, weekend work was found to be significantly associated with depression (odds ratio [OR]: 1.08; 95% confidence interval [CI]: 1.00–1.18), anxiety (OR: 1.35; 95% CI: 1.16–1.58), musculoskeletal pain (OR: 1.45; 95% CI: 1.34–1.58), fatigue (OR: 1.49; 95% CI: 1.36–1.62), absenteeism (OR: 1.70; 95% CI: 1.43–2.03), and presenteeism (OR: 1.82; 95% CI: 1.62–2.04). The health effects of weekend work differed between the self-employed and employees, as shown in the results of the stratified analysis.
Conclusions
Weekend work was found to increase the risk of both physical and mental health problems of Korean workers, and the effect varied according to employment status. There is a need to design a comprehensive occupational health policy that reflects the characteristics of different employment statuses.; 한국인 근로자에서 주말근무가 건강에 미치는 영향 : 제6차 근로환경조사 데이터를 활용하여
목적
주말근무는 서비스업 중심의 현대 노동시장에서 상당한 비중을 차지하고 있는 근무 형태이다. 한국에서도 상당수의 근로자들이 주말근무에 종사하고 있지만, 주말근무가 건강에 미치는 영향에 대한 연구는 다른 비표준 근무에 대한 연구에 비해 드물다. 본 연구는 주말근무가 한국인 근로자의 건강에 미치는 영향을 파악하여 근로자 건강 증진을 위한 복지 정책 수립의 근거 자료를 제공하는 것을 목적으로 수행되었다.
방법
본 연구는 제6차 근로환경조사 데이터를 활용하여 연구 기준에 부합하는 한국인 근로자 36,381명을 대상으로 실시되었다. 설문 응답을 바탕으로 주말 근무 여부와 주관적 건강상태, 근골격계 통증, 두통 및 눈의 피로, 전신 피로, 수면 장애, 우울, 불안, 결근 및 프리젠티즘 등의 건강상태에 대한 정보를 수집하였다. 주말근무와 건강변수 간의 연관성을 분석하기 위해 사회인구학적 및 직업적 특성을 보정한 로지스틱 회귀분석을 실시하였으며, 종사상 지위에 따른 층화 분석을 추가로 수행하였다.
결과
최종 선정된 연구 대상자 중 주말근무자는 11,383명(30.46%)이었다. 사회인구학적 및 직업적 특성을 보정한 결과, 주말 근무는 우울(OR 1.09, 95% CI 1.01–1.18), 불안(OR 1.39, 95% CI 1.18–1.63), 근골격계 통증(OR 1.46, 95% CI 1.35–1.58), 피로(OR 1.48, 95% CI 1.36–1.61), 결근(OR 1.72, 95% CI 1.45–2.05), 프리젠티즘(OR 1.84, 95% CI 1.64–2.06)과 유의하게 연관이 있었다. 층화 분석 결과, 주말 근무의 건강영향은 자영업자와 임금근로자 간에 서로 다르게 나타났다.
결론
본 연구는 주말근무와 신체적 및 정신적 건강 상태를 나타내는 다양한 지표 간에 유의한 연관성을 관찰하였다. 주말근무는 한국 노동자의 신체적 및 정신적 건강 문제 위험을 증가시키며, 그 영향은 종사상 지위에 따라 차이가 있었다. 이에 따라 각 종사상 지위의 특성과 위험 요인을 반영한 종합적인 산업보건 정책 설계의 필요성이 대두된다.

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Original Article

Factors affecting heat-related illness symptoms among school food service workers: a cross-sectional study in Korea: Nahyun Kim, Dongwhan Suh, Jia Ryu, Woo Chul Jeong, Yun-Keun Lee, Jinwoo Lee, Hyunjoo Kim; Ann Occup Environ Med 2025;37:e30. Published online September 2, 2025; DOI: https://doi.org/10.35371/aoem.2025.37.e30

Abstract Abstract in Korean PDF Supplementary Material: Background
School food service workers are highly likely to develop heat-related illnesses because of their work environment. However, studies that have examined the risk of heat-related illnesses among them are limited. The purpose of this study was to investigate the status of heat exposure, implementation of heat wave countermeasures, and prevalence of heat-related illness symptoms among school food service workers in Korea, and to explore the relationship between them.
Methods
A cross-sectional study was conducted through an online survey of school food service workers from May 25 to June 12, 2023, via three labor unions. We analyzed 6,244 valid responses. We assessed general characteristics, heat-related illness symptoms (heat rash, heat cramps, heat edema, heat exhaustion, heat syncope), duration of heat exposure during heat waves, and heat wave preventive measures. Multiple logistic regression analyses were performed, with adjustments for age, occupation, hypertension, diabetes, and school type.
Results
More than one-third of school food service workers reported heat exposure between May and September exceeding 4 hours daily, and 94.6% experienced at least one heat-related illness symptom during the last year. A dose-response relationship was observed between heat exposure duration and heat-related illness symptoms (p for trend < 0.001). School food service workers who did not have increased rest periods or did not reduce high-heat prepared foods showed significantly higher odds ratios for heat-related illness symptoms.
Conclusions
School food service workers experience substantial heat exposure and a high prevalence of heat-related illness symptoms. The risk of heat-related illness symptoms was associated with extended duration of heat exposure. Increasing rest periods and reducing high-heat food preparation were effective preventive measures. These findings underscore the need for improved heat exposure management and implementation of effective preventive measures to protect the health of school food service workers, with particular attention to appropriate rest periods.; 학교 급식 종사자의 온열질환 증상 위험요인
목적
학교 급식 종사자는 다수의 열원이 존재하는 협소한 공간에서 근무하기 때문에 온열질환 발생 가능성이 높다. 학교 급식 종사자의 작업 중 열 노출 현황, 폭염 대응책 시행, 온열질환 증상 유병률을 조사하고 이들의 관계를 탐구하고자 하였다.
방법
2023. 5. 25- 6. 12까지 학교 급식 관련 3개 노동조합을 통해 온라인 설문조사를 실시해 6,244개의 유효한 응답을 얻었다. 일반적 특성과 온열질환 증상 경험, 폭염 시 근무 중 고온노출 시간, 폭염피해 예방 조치 경험을 조사했다. 온열질환 증상 경험에 관련된 요인을 확인하기 위해 연령, 직종, 고혈압, 당뇨병, 학교 유형을 보정한 다중 로지스틱 회귀분석을 수행했다.
결과
학교 급식 종사자의 3분의 1 이상이 5월부터 9월 사이 일일 4시간을 초과하는 열 노출을 보고했으며, 94.6%가 지난 1년 동안 적어도 하나의 온열질환 질환 증상을 경험했다. 하루 중 고온 노출 시간에 따라 온열질환 증상 경험의 위험은 양반응 관계로 증가했다(P for trend<0.001). 폭염 피해 예방 조치를 경험한 것에 비해 그렇지 않은 경우 온열질환 증상 경험의 위험은 휴게시간 증가(OR=1.86), 고열 제조 반찬 줄임(OR=1.59)에서 통계적으로 유의하게 증가했다.
결론
학교 급식 종사자들은 상당한 열 노출과 높은 온열질환 증상 유병률을 보였다. 온열질환 증상의 위험은 고온 노출이 심할수록 증가하는 것으로 확인되었다. 휴식시간 증가와 고열 제조 음식 조리 감소가 효과적인 예방 조치였다. 이러한 결과는 학교 급식 종사자들의 건강을 보호하기 위한 개선된 열 노출 관리와 효과적인 예방 조치 시행의 필요성을 강조하며, 특히 적절한 휴식시간에 특별한 주의를 기울여야 함을 시사한다.

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[Special Collection] Paid Sick Leave and Sickness Benefits: Toward the Right to Rest When Sick

Opinion

A sickness benefit for all, leaving no one behind: Daseul Moon, Hongjo Choi; Ann Occup Environ Med 2025;37:e25. Published online July 28, 2025; DOI: https://doi.org/10.35371/aoem.2025.37.e25

Abstract Abstract in Korean PDF: South Korea’s pilot sickness benefit program, launched in 2022 across six regions and currently operating in 14 regions as of 2025, represents a critical juncture in the country’s social protection development. While ostensibly designed with inclusive eligibility criteria, the program reveals fundamental paradoxes that illuminate deeper structural inequalities within Korea's dualized labor market. This opinion piece examines how current design choices risk undermining universal health coverage goals by systematically excluding the most precarious workers. The program’s design features—including low replacement rates (60% of the minimum wage) and extended waiting periods—created perverse incentives where the most vulnerable workers accepted the least favorable conditions. This pattern exemplifies what Korpi and Palme termed the “paradox of redistribution,” where targeted approaches ultimately prove less effective than universal ones, with the second phase’s restriction to the bottom 50% income bracket threatening to exacerbate this paradox. Successful implementation will depend on integrating equity, people-centered design, and gender-transformative perspectives into every phase—design, operation, evaluation, and reform. In doing so, South Korea has the opportunity to offer a model of sickness protection that does not simply patch gaps, but actively reshapes the structures that produce health and economic inequalities in the first place.; 모두를 위한 상병수당의 과제
2022년 6개 지역에서 시작되어 2025년 현재 14개 지역에서 시행되고 있는 한국형 상병수당 시범사업은 한국 사회보장의 제도적 발전에 있어 중요한 전환점을 나타낸다. 시범사업은 기존 제도와 비교해 보다 포용적인 자격 기준으로 설계되었지만, 한국의 이중화된 노동시장과 결합한 구조적 불평등을 드러내는 근본적 역설들을 보여주고 있다. 본 논문은 현재의 제도적 설계가 한국의 불안정한 노동자들을 체계적으로 배제하며, 이것이 보편적 건강보장 목표 달성에 장벽으로 작동한다는 점을 분석한다. 1차 시범사업 신청 현황 분석 결과, 낮은 소득대체율(최저임금의 60%)과 긴 대기기간을 포함한 프로그램의 설계 특징들은 가장 취약한 노동자들이 가장 불리한 조건을 받아들이는 역설적 유인을 만들어냈다. 이러한 패턴은 재분배의 역설을 반영하며, 2단계에서 소득 하위 50%로 대상을 제한한 것은 이러한 역설을 심화할 것으로 예상된다. 상병수당 제도의 성공적인 실행은 설계, 운영, 평가, 개혁의 모든 단계에서 형평성, 사람 중심 설계, 젠더 변혁적 관점을 통합하는 데 달려 있다. 이를 통해 건강과 경제적 불평등을 생산하는 구조를 재편하는 제도로서 상병수당을 기대할 수 있을 것이다.

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[Special Collection] Paid Sick Leave and Sickness Benefits: Toward the Right to Rest When Sick

Review

Medical certification in sickness benefit schemes (I): theoretical perspectives and return-to-work: Yangwoo Kim, Inah Kim; Ann Occup Environ Med 2025;37:e23. Published online July 28, 2025; DOI: https://doi.org/10.35371/aoem.2025.37.e23

Abstract Abstract in Korean PDF Supplementary Material

This study explores the theoretical foundations and practical applications of medical certification within the sickness benefit systems, particularly in the context of Korea’s pilot program and its planned national rollout. While sickness benefit systems have long existed in many Organization for Economic Cooperation and Development (OECD) countries, Korea has only recently initiated pilot projects, largely prompted by the coronavirus disease 2019 pandemic. These systems aim to compensate for income loss due to illness or injury, and medical certification plays a central role in determining eligibility and work ability. This study defines medical certification as a two-stage process: clinical diagnosis and formal assessment of a worker’s ability to return-to-work. The dual nature highlights the distinct objectives of the medical treatment and social security policies. Drawing on international practices, this study reviews the International Classification of Functioning, Disability, and Health (ICF) as a key global framework for assessing disability and work ability, although it acknowledges the limitations of its application to sickness benefits. The research emphasizes a shift in global trends toward return-to-work–oriented certification models, such as the UK’s “fit note” system, which focuses on evaluating fitness-for-work rather than merely documenting illness. Sweden and Japan also offer models that integrate rehabilitation with flexible work accommodations. Three key issues were identified in Korea’s system: the role of medical certification and concerns about moral hazard, the burden of proof and workload on physicians, and public perceptions of the program’s purpose. We believe that medical certification should not only verify illness but also support early intervention and a healthy workforce. Ultimately, this study advocates for a balanced and efficient medical certification system tailored to Korea’s healthcare context closely aligning with labor market policies to ensure long-term sustenance and integration of the sickness benefit program.

상병수당 제도에서의 의료인증체계(1): 이론적 배경과 직장복귀
본 연구는 한국의 시범사업과 향후 전국적 시행을 앞둔 상황에서 상병수당 제도에서 의료인증의 이론적 기반과 실제적 적용을 살펴보고자 하였다. 상병수당 제도는 많은 OECD 국가에서 오래전부터 시행되어 왔으나, 한국에서는 COVID-19 팬데믹을 계기로 최근에야 시범사업이 시작되었다. 이 제도는 질병이나 부상으로 인한 소득 상실을 보상하는 것을 목적으로 하며, 의료증명은 수급 자격 및 업무 수행 능력을 판단하는 핵심적 요소이다.
의료인증은 진단이라는 1단계와, 업무복귀 가능성을 공식적으로 평가하는 2단계로 구성되며, 이는 의료적 목적과 사회보장 정책 목적의 차이를 드러낸다. 국제적 관행을 참고하여, 본 연구는 장애 및 업무능력 평가의 세계적 기준인 ‘기능장애건강국제분류(ICF)’를 검토하되, 이를 상병수당에 적용하는 데 있어 한계점도 지적한다. 연구는 세계적으로 ‘복귀 중심(return-to-work)’ 의료증명 체계로의 전환이 이루어지고 있음을 강조한다. 예를 들어, 영국의 ‘핏 노트(fit note)’ 제도는 단순한 질병 증명에서 벗어나 업무수행 가능성을 평가하는 방식이다. 스웨덴과 일본은 재활과 유연한 업무조정을 포함한 모델을 운영 중이다.
한국 제도 설계에서 중요한 세 가지 이슈는 의료인증의 역할과 도덕적 해이 우려, 의료진의 입증 책임 및 행정 부담, 그리고 제도 목적에 대한 대중의 오해이다. 본 연구는 의료적 증명이 단순한 질병 확인을 넘어 조기 개입과 건강한 노동력 유지로 이어져야 한다고 주장한다.
궁극적으로 본 연구는 한국의 의료이용 환경에 적합하고 노동시장 정책과 조화를 이루는, 균형 있고 효율적인 의료증명 체계의 구축을 제안한다. 이는 상병수당 제도의 지속 가능성과 신뢰성을 확보하는 데 핵심적인 요소다.

Citations

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Medical certification in sickness benefit scheme (II): practical approaches for evaluating work disability
Yangwoo Kim, Inah Kim
Annals of Occupational and Environmental Medicine.2025; 37: e24. CrossRef

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Original Article

Educational disparities in labor market participation among middle-aged Koreans with chronic diseases: evidence from the Korean Longitudinal Study of Elderly Employment: Seung Yeon Jeon, Dong-Wook Lee, Jaesung Choi, Mo-Yeol Kang; Ann Occup Environ Med 2025;37:e19. Published online July 17, 2025; DOI: https://doi.org/10.35371/aoem.2025.37.e19

Abstract Abstract in Korean PDF Supplementary Material: Background
As South Korea experiences rapid population aging, preventing early retirement has become a critical concern. Ill health contributes to early retirement, and educational level moderates this relationship. Although well-studied in Europe, it remains less explored in Northeast Asia, where labor markets and educational attainment differ significantly. This study investigated the moderating role of education in the relationship between chronic diseases and labor force non-participation in South Korea, considering disease severity, type, and employment status.
Methods
Using data from the Korean Longitudinal Study of Elderly Employment, this study analyzed 5,758 individuals born between 1964 and 1976. Chronic diseases were categorized by severity and type. Labor force participation and retirement from lifetime primary occupation were measured. Education was categorized as low (≤high school) or high (≥college). Logistic regression analyses were conducted, adjusting for sociodemographic and lifestyle covariates, with stratification by education level, employment status, severity, and disease characteristics.
Results
Chronic diseases were significantly associated with labor market non-participation and early retirement, with stronger associations among individuals with lower educational levels. Educational disparities were particularly evident for severe and psychiatric disorders. Among wage workers, those with lower education were more likely to exit the labor market due to chronic diseases, whereas those with higher education generally maintained employment, except in cases of musculoskeletal diseases. Low-educated individuals with chronic diseases were also more likely to retire early from their lifetime primary occupations.
Conclusions
Education moderates the relationship between chronic diseases and labor non-participation, with greater disparities in severe or psychiatric illnesses and among wage workers. Low-educated workers are more vulnerable to early retirement due to ill health, highlighting the need for targeted policy interventions to support this group and prevent early exit from the workforce.; 교육 수준에 따른 한국 만성 질환 중년층의 노동시장 참여 격차: 고령화고용패널을 중심으로
목적
한국은 빠른 고령화를 겪고 있으며, 이에 따라 조기 퇴직을 예방하는 것이 중요한 과제로 대두되고 있다. 건강 악화는 조기 퇴직의 주요 원인 중 하나로, 교육 수준은 이 관계에 영향을 미치는 조절 변수로 작용한다. 본 연구는 만성질환과 경제활동 미참여 간의 관계에서 교육 수준이 어떤 역할을 하는지, 질병의 중증도, 유형, 고용 형태를 고려하여 분석하였다.
방법
고령화고용패널 자료를 활용하여 1964년부터 1976년 사이에 출생한 5,758명을 분석하였다. 만성질환은 중증도와 유형에 따라 분류되었으며, 경제활동 참여 여부 및 주된 생애 일자리에서의 퇴직 여부를 측정하였다. 교육 수준은 고졸 이하(저학력)와 전문대 이상(고학력)으로 구분하였다. 연령, 성별, 결혼 여부, 가계 소득, 건강 관련 생활습관(흡연, 운동, 음주)를 통제하고, 교육 수준과 질병의 중증도 및 유형에 따라 층화된 로지스틱 회귀 분석을 수행하였다.
결과
만성질환은 경제활동 미참여 및 생애 주된 일자리 퇴직과 유의한 관련성을 보였으며, 특히 교육 수준이 낮은 집단에서 이러한 경향이 더욱 뚜렷하게 나타났다. 교육 수준에 따른 격차는 중증 질환과 정신질환에서 더욱 두드러지게 나타났다. 임금 근로자의 경우, 저학력자는 만성질환이 있을 경우, 노동 시장에서 이탈하는 경향을 보였으나 고학력자는 근골격계 질환을 제외하면 대체로 이탈하지 않았다. 또한 저학력자의 경우, 만성질환이 있을 때 생애 주된 일자리에서 퇴직하는 경향을 더욱 보였다.
결론
교육 수준은 만성질환과 경제활동 미참여 및 생애 주된 일자리에서의 퇴직 간의 관계를 조절하며, 중증 또는 정신질환 및 임금근로자 집단에서 그 격차가 더욱 뚜렷하게 나타난다.

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Original Article

Sex difference in musculoskeletal disabilities among Korean fishers: a cross-sectional study: Hye-min Kim, Soo Hyeong Park, Bong Gyun Joo, Ki-Soo Park, Jeong Ho Kim, Hansoo Song; Ann Occup Environ Med 2025;37:e18. Published online July 7, 2025; DOI: https://doi.org/10.35371/aoem.2025.37.e18

Abstract Abstract in Korean PDF

Background
Fishing is a physically demanding occupation with a high risk of musculoskeletal disabilities (MSDs). Although previous studies have focused on ergonomic risk factors, little attention has been paid to sex differences in the prevalence of MSDs among fishers. This study aimed to assess whether female fishers experience a higher prevalence of MSDs than male fishers and to examine whether this difference persists after adjusting for socioeconomic and occupational factors.
Methods
We analyzed cross-sectional data from 898 Korean fishers (513 men and 385 women) who participated in the 2021–2022 Fisher Health Survey. MSDs in the upper extremities, lower back, and knees were defined as scores in the top 25% of the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), Oswestry Disability Index, and Western Ontario and McMaster Universities Arthritis Index Short Form (WOMAC-SF), respectively. Modified Poisson regression was used to calculate the prevalence ratios (PRs) by sex, with stepwise adjustments for age, socioeconomic factors, and occupational factors.
Results
Female fishers had significantly higher MSD risk than male fishers across all body regions (fully adjusted PRs: upper extremity, 1.59; lower back, 1.63; knee, 1.44). Sex disparities were most pronounced among those under 60 years of age and remained significant even in older age groups.
Conclusions
The elevated MSD risk among female fishers persisted despite adjusting for conventional risk factors, suggesting the influence of additional factors such as biological susceptibility, domestic labor, and gendered health reporting. Therefore, MSD prevention strategies should include sex-sensitive multidimensional approaches beyond ergonomic interventions.

한국 어업인에서의 근골격계 장애의 성별 차이: 단면 연구
목적
어업은 육체적으로 힘든 직업으로 근골격계 장애의 위험이 높다. 기존 연구들은 주로 인간공학적 위험요인에 집중해 왔으나, 어업인의 근골격계 장애 유병률에 대한 성별 차이는 상대적으로 덜 주목 받아 왔다. 본 연구는 여성 어업인이 남성 어업인보다 근골격계 장애 유병률이 더 높은지를 평가하고, 이러한 차이가 사회경제적 및 직업적 요인을 보정한 후에도 지속되는지를 살펴보았다.
방법
2021–2022년 어업인 건강조사에 참여한 한국 어업인 898명(남성 513명, 여성 385명)의 단면 자료를 분석하였다. 상지, 요추, 무릎의 근골격계 장애는 각각 QuickDASH, ODI, WOMAC-SF 점수 상위 25%에 해당할 경우로 정의하였다. 수정된 포아송 회귀(modified Poisson regression)를 사용하여 성별에 따른 유병비를 산출하였으며, 연령, 사회경제적 요인, 직업적 요인 순으로 단계적으로 보정하였다.
결과
여성 어업인은 남성 어업인보다 모든 신체 부위에서 근골격계 장애의 위험이 유의하게 높았다(보정 유병비: 상지 1.59, 요추 1.63, 무릎 1.44). 성별 격차는 60세 미만 집단에서 가장 두드러졌으며, 고령 집단에서도 유의한 차이가 지속되었다.
결론
여성 어업인의 높은 근골격계 장애의 위험은 잘 알려진 위험요인을 보정한 후에도 유지되었으며, 이는 생물학적 취약성, 가사노동, 성별에 따른 건강보고 차이 등의 추가적인 요인이 작용했을 가능성을 시사한다. 따라서 근골격계 장애 예방 전략은 인간공학적 개입을 넘어 성 감수성을 가져야 하며, 다차원적으로 접근해야 한다.

Citations

Citations to this article as recorded by

Development of criteria for health examination of high-risk occupational groups and application to female fishers: Delphi study
Hye-min Kim, Jungwon Kim, Kunhyung Kim, Hansoo Song
Annals of Occupational and Environmental Medicine.2026; 38: e2. CrossRef

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Original Article

Relationship between long-term PM_2.5 exposure and myopia prevalence in adults: analysis of the Korea National Health and Nutrition Examination Survey–Air Pollution Linked Data, 2020: Minju Jung, Hyungdoo Kim, Ji Hoon Kim, Dong-Jae Seo, Jong-Han Leem, Shin-Goo Park, Dong-Wook Lee, Hwan-Cheol Kim; Ann Occup Environ Med 2025;37:e8. Published online April 16, 2025; DOI: https://doi.org/10.35371/aoem.2025.37.e8

Abstract Abstract in Korean PDF Supplementary Material: Background
PM_2.5 (particulate matter less than 2.5 μm) causes various health problems. Recent studies suggest that long-term exposure to PM_2.5 may have a negative impact on vision. This study examined the effects of long-term exposure to concentrations of PM_2.5 exceeding Korean standards on myopia prevalence.
Methods
This study was conducted on adults aged 40–69 years. The PM_2.5 concentrations were calculated as the 1–5-year moving averages based on the participants' residential areas. The relationships between the PM_2.5 levels, categorized by the annual average concentration standard in Korea, and the prevalence of myopia were analyzed using binary logistic regression. The results were evaluated using the 95% confidence interval.
Results
PM_2.5 concentrations averaged over 1–3 years were not significantly associated with the prevalence of myopia. On the other hand, the prevalence of myopia was significantly higher in areas where the 4–5-year moving average PM_2.5 levels exceeded the Korean standards. These findings suggest that long-term exposure to PM_2.5 may have a detrimental effect on vision.
Conclusions
This study revealed the impact of long-term PM_2.5 exposure on the prevalence of myopia, highlighting the importance of managing PM_2.5 levels. Nevertheless, further cohort studies focusing on adults and in-depth research into the effects of long-term exposure will be necessary.; 장기 PM_2.5 노출과 근시 유병률 간의 관계: 국민건강영양조사-대기오염 연계자료, 2020
목적
초미세먼지(PM_2.5)는 다양한 건강 문제를 유발하며, 특히 장기 노출이 시력에 부정적인 영향을 미칠 수 있다는 연구가 제기되고 있다. PM_2.5는 염증 반응과 산화 스트레스를 유발하여 눈 조직에 손상을 줄 수 있으며, 이는 근시를 포함한 다양한 안구 질환과 관련이 있다. 기존 연구는 주로 학령기 아동을 대상으로 했으나, 최근 연구에서는 40세 이상의 성인에서도 PM_2.5 노출이 근시 유병률에 영향을 미칠 가능성이 제시되었다. 한국의 PM_2.5 연간 기준은 15㎍/㎥로, WHO 기준보다 3배 높으나 이에 기반한 연구는 드물다. 본 연구는 한국의 PM_2.5 기준을 바탕으로 성인의 근시 유병률과의 관계를 장기적으로 분석하였다.
방법
연구는 2020년 국민건강영양조사-대기오염 연계자료를 활용해 진행되었으며, 대상은 40-69세 성인이다. 연구 참여자의 거주지에서 PM_2.5 농도의 1년-5년 이동평균을 계산하고, 이를 한국 연간 기준인 15㎍/㎥를 기준으로 나누어 분석했다. 근시는 자동굴절검사를 통해 정의되었으며, 이분형 로지스틱 회귀분석으로 근시 유병률과 PM_2.5 농도의 관계를 평가했다. 혼란 변수로 성별, 연령, 교육 수준, 음주 및 흡연 여부 등이 포함되었으며, SPSS를 사용해 통계 분석을 진행했다. 분석 결과는 오즈비(odds ratio)와 95% 신뢰구간으로 제시되었다.
결과
PM_2.5의 1년-3년 이동평균은 근시 유병률과 유의미한 관계를 보이지 않았으나, 4년-5년 이동평균이 기준치를 초과한 지역에서는 근시 유병률이 유의미하게 증가했다. 5년 이동평균 PM_2.5 농도의 오즈비는 4.038(95% CI: 1.295-12.595)로 나타나, 장기 노출이 근시 발생 위험을 크게 높이는 것으로 확인되었다.
결론
본 연구는 장기간 PM_2.5 노출이 근시 유병률에 미치는 누적 손상 효과를 규명하며, 특히 4년-5년 이상의 노출이 중요한 요인임을 밝혔다. 이는 기존 연구와 달리 한국의 PM_2.5 기준을 적용하여 현실적이고 특화된 결과를 도출한 점에서 의미가 있다. PM_2.5 노출은 염증 반응과 산화 스트레스를 통해 안구 건강에 악영향을 미치며, 이는 성인뿐만 아니라 다양한 연령층에서도 고려해야 할 문제다. 단면 연구로 인과관계를 확정할 수는 없지만, 대기 오염 관리와 장기 코호트 연구의 필요성을 강조한다. 후속 연구에서는 다양한 대기오염 물질의 복합적인 영향을 분석해야 할 필요가 있다.

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Data Profile

Data profile: Korean Work, Sleep, and Health Study (KWSHS): Seong-Sik Cho, Jeehee Min, Heejoo Ko, Mo-Yeol Kang; Ann Occup Environ Med 2025;37:e3. Published online February 19, 2025; DOI: https://doi.org/10.35371/aoem.2025.37.e3

Abstract Abstract in Korean PDF

The Korean Work, Sleep, and Health Study (KWSHS) was launched in 2022 as a longitudinal panel study to examine the interactions between work conditions, sleep health, and labour market performance among the Korean workforce. Baseline data were collected from 5,517 participants aged 19 to 70, encompassing diverse occupations. Follow-up surveys occur biannually, accommodating seasonal variations in sleep and health dynamics. To ensure stability, refreshment samples were integrated in later waves, maintaining a cohort size of 5,783 participants in wave 5. Key data include socio-demographics, employment characteristics, sleep patterns, health outcomes, and workplace performance. Early findings highlight critical associations, such as the adverse effects of occupational physical activity on productivity, the impact of emotional labour on health-related productivity loss, and the significance of sleep disruptions on mental health. The cohort’s design enables detailed analyses of longitudinal and cross-sectional trends, offering insights into how changing work environments influence health and productivity. The KWSHS could serve as a vital resource for evidence-based interventions aimed at improving occupational health and productivity in Korea's evolving labour landscape. Data access is available through the study’s principal investigator upon request.

한국 직업, 수면 및 건강 연구(KWSHS)
한국 직업, 수면 및 건강 연구(KWSHS)는 한국 노동자의 근로 조건, 수면 건강, 노동 시장 성과 간 상호작용을 조사하기 위해 2022년에 시작된 종단적 패널 연구이다. 기초 자료는 다양한 직업군을 포함하여 19세에서 70세까지의 5,517명을 대상으로 수집하였다. 후속 설문조사는 수면 및 건강 역학의 계절적 변동성을 고려하여 2년마다 실시하며, 코호트의 안정성을 유지하기 위해 후속 조사에서는 보충 표본을 추가하여 5차 웨이브에서는 총 5,783명의 코호트 규모를 유지하였다. 주요 자료에는 사회인구학적 정보, 고용 특성, 수면 패턴, 건강 결과 및 직장 성과 등이 포함된다. 초기 연구 결과는 직업적 신체활동이 생산성에 미치는 부정적 영향, 감정 노동이 건강 관련 생산성 손실에 미치는 영향, 그리고 수면 장애가 정신 건강에 미치는 중요성을 포함한 주요 연관성을 강조하고 있다. 본 코호트의 설계는 종단적 및 횡단적 추세에 대한 세부적인 분석을 가능하게 하여 변화하는 근로 환경이 건강 및 생산성에 미치는 영향을 심층적으로 이해할 수 있게 한다. KWSHS는 한국의 변화하는 노동 환경 속에서 직업 건강 및 생산성을 향상시키기 위한 근거 기반 개입을 위한 중요한 자원이 될 수 있다. 데이터 접근은 연구 책임자에게 요청을 통해 가능하다.

Citations

Citations to this article as recorded by

The Impact of Comorbid Insomnia and Sleep Apnea (COMISA) on Work Ability: Results From Population‐Based Panel Data in Korea
Heejoo Ko, Seong‐Sik Cho, Dong‐Wook Lee, Jaesung Choi, Min‐Seok Kim, Mo‐Yeol Kang
Journal of Sleep Research.2026;[Epub] CrossRef
Association of Working Time Control With Health-Related Productivity Loss and Work Engagement
Jae Rim Jeon, Seong-Sik Cho, Hyoung-Ryoul Kim, Sangjun Choi, Hye-Eun Lee, Mo-Yeol Kang
Journal of Occupational & Environmental Medicine.2026; 68(2): 115. CrossRef
Unmanaged “Managed Heart”
Heejoo Ko, Seong-Sik Cho, Dong-Wook Lee, Jaesung Choi, Mo-Yeol Kang
Journal of Occupational & Environmental Medicine.2026; 68(2): 155. CrossRef
Work ability and health-related productivity loss by chronotype: Results from population-based panel study
Heejoo Ko, Seong-Sik Cho, Mo-Yeol Kang
Sleep Health.2025; 11(5): 731. CrossRef
Work-related risk factors of sleep apnea: evidence from the Korean work, sleep, and health study
Heejoo Ko, Seong-Sik Cho, Hye-Eun Lee, Jeehee Min, Mo-Yeol Kang
International Archives of Occupational and Environmental Health.2025; 98(9-10): 797. CrossRef
Association between work stress and sleep disturbances: the mediating role of pre-sleep arousal symptoms
Jeehee MIN, Hoje RYU, Seong-Sik CHO, Mo-Yeol KANG
Industrial Health.2025; 63(5): 478. CrossRef
Associations of self-rated health, depression, and work ability with employee control over working time
Heejoo Ko, Seong-Sik Cho, Jaesung Choi, Mo-Yeol Kang
Epidemiology and Health.2025; 47: e2025036. CrossRef
Workplace Psychosocial Safety Climate and Sleep Health: Association With Sleep Quality and Insomnia Symptoms
Jiwon Kim, Seong‐Sik Cho, Maureen F. Dollard, May Young Loh, Mo‐Yeol Kang
Journal of Sleep Research.2025;[Epub] CrossRef
Association between psychosocial safety climate and depression risk among Korean workers
Soo Kyung Cho, Seong-Sik Cho, Maureen F. Dollard, May Young Loh, Mo-Yeol Kang
Epidemiology and Health.2025; 47: e2025044. CrossRef
Associations of sleep duration and sleep quality with lifestyle inflammation score in a nationwide Korean survey
Jaegeun Cho, Eunvin Kang, Se Eun Kim, Young-Joo Won
Scientific Reports.2025;[Epub] CrossRef
Altered cortical myelination based on gray-to-white matter signal intensity contrast in shift workers
Jonghun Lee, Youjin Kim, Junbeom Lee, Joon Yul Choi, Wanhyung Lee
Brain Structure and Function.2025;[Epub] CrossRef

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Opinion

Perspectives from the new president of the Korean Society of Occupational and Environmental Medicine: future strategies for occupational and environmental medicine: Sang Baek Ko; Ann Occup Environ Med 2025;37:e1. Published online February 19, 2025; DOI: https://doi.org/10.35371/aoem.2025.37.e1

Abstract Abstract in Korean PDF: Modern Korean society is experiencing fundamental transformations in industrial structures and working environments driven by complex factors, including demographic shifts, the Fourth Industrial Revolution, the coronavirus disease 2019 pandemic, and digital transformation. The evolving dynamics between the manufacturing and service industries, the emergence of technology-driven sectors, and the proliferation of new occupational categories are reshaping traditional employment models. This has directed the labor market toward nonstandard employment forms, including temporary, contract-based, and platform labor. Consequently, issues such as employment instability and reduced accessibility to workplace health programs, including occupational safety training, health examinations, and workplace health management, have become increasingly prominent. Although occupational and environmental medicine has subsequently gained significance, the current occupational health and safety framework inadequately addresses the nuances of emerging labor forms. Legal gaps persist, leaving vulnerable groups such as nonregular workers, platform laborers, and older workers insufficiently protected under existing systems. Furthermore, systemic issues are evident in the inadequate follow-up care during occupational health examinations, lacking continued adherence to hazard-centric approaches, and insufficient attention to chronic diseases and mental health challenges. This study proposes strategies that occupational and environmental medicine can address these issues. First, legal and institutional reforms must encompass new labor forms, accompanied by modernized safety and health guidelines. Second, state-of-the-art technologies should be leveraged to enhance predictive disease management and personalized healthcare for workers. Third, a preventive approach integrating chronic disease management, mental healthcare, and psychosocial risk factors must be established. Fourth, fostering interdisciplinary research collaboration across medicine, engineering, and psychology is essential for developing practical solutions to emerging challenges. In conclusion, occupational and environmental medicine in Korea must adapt to effectively address the evolving labor landscape. Through systematic innovation, integrated health-management approaches, technological advancements, and interdisciplinary cooperation, the health and safety of all workers in the rapidly changing world can be ensured.; 대한직업환경의학회 신임회장의 제언: 직업환경의학의 미래 전략
현대 한국 사회는 인구구조 변화, 4차 산업혁명, 팬데믹, 디지털 전환 등 복합적인 요인에 의해 산업 구조와 근로 환경에서 근본적인 변화를 경험하고 있다. 제조업과 서비스업 간의 역학 변화, 기술 중심 산업의 부상, 새로운 직업군의 확산은 전통적인 고용 모델을 재편하고 있다. 이에 따라 노동 시장은 비정규직, 계약직, 플랫폼 노동과 같은 비표준 고용 형태로 이동하고 있다. 그 결과, 고용 불안정과 직업 안전 교육, 건강검진, 작업장 건강관리 등 직업 건강 프로그램에 대한 접근성 저하 문제가 점점 더 부각되고 있다.
이러한 변화로 직업환경의학의 중요성이 증대되었으나, 현재의 직업 건강 및 안전 체계는 새로운 노동 형태의 특성을 충분히 반영하지 못하고 있다. 법적 공백이 여전히 존재하며, 비정규직 근로자, 플랫폼 노동자, 고령 노동자 등 취약 계층은 기존 제도 아래에서 충분히 보호받지 못하고 있다. 또한, 건강검진 후 사후관리의 미비, 유해 요인 중심 접근의 지속적 적용 부족, 만성 질환 및 정신 건강 문제에 대한 관심 부족 등 체계적 문제가 드러나고 있다.
본 연구는 직업환경의학이 이러한 문제를 해결하기 위한 전략을 제안한다. 첫째, 새로운 노동 형태를 포괄하는 법적·제도적 개혁과 현대화된 안전 및 건강 지침의 도입이 필요하다. 둘째, 최첨단 기술을 활용하여 예측적 질병 관리와 근로자 맞춤형 건강관리를 강화해야 한다. 셋째, 만성 질환 관리, 정신 건강 관리, 심리사회적 위험 요인을 통합하는 예방적 접근을 확립해야 한다. 넷째, 의학, 공학, 심리학 등 학제 간 연구 협력을 통해 새로운 과제에 대한 실질적 해결책을 모색해야 한다. 결론적으로, 한국의 직업환경의학은 변화하는 노동 환경에 효과적으로 대응하기 위해 적응해야 한다. 체계적 혁신, 통합적 건강 관리 접근법, 기술적 발전, 학제 간 협력을 통해 빠르게 변화하는 세계에서 모든 근로자의 건강과 안전을 보장할 수 있을 것이다.

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Original Article

Burnout, stress, and their correlates among bank employees of South India: a cross-sectional study: Guruprasad Vinod, Srikant Ambatipudi; Ann Occup Environ Med 2024;36:e22. Published online August 28, 2024; DOI: https://doi.org/10.35371/aoem.2024.36.e22

Abstract PDF Supplementary Material

Background
The banking sector is one of the job sectors that experience high stress, workload, complex interpersonal relationships, and job burnout as it involves interaction with the public and financial responsibilities, which leads to high burnout and stress. The present study was conducted to assess the prevalence of burnout and stress among bank employees and to find the associated factors.
Methods
This cross-sectional survey was conducted among 282 bank employees of Kollam district, Kerala, India. Data was collected using a self-administered questionnaire related to the socio-demographic and professional details. We used the Oldenburg Burnout Inventory (OLBI) to screen for burnout levels. Depression Anxiety Stress Scale (DASS 21) to screen for the levels of depression, anxiety, and stress among study participants. Descriptive statistics were used to summarize the data, and logistic regression was used to identify the factors associated with the levels of burnout and stress.
Results
Of 282 study participants, moderate to high levels of burnout were observed in 232 participants (82.2%), and 74 participants (26.2%) had mild to extremely severe levels of stress. Daily average working duration showed an association with higher levels of burnout (adjusted odds ratio [ORAdj]: 2.391; 95% confidence interval [CI]: 1.12–5.10) and stress (ORAdj: 3.37; 95% CI: 1.58–7.16).
Conclusions
A high prevalence of burnout and stress was observed in the present study. The duration of working hours was associated with both burnout and stress. Therefore, regulating the working hours may help adequately manage stress and burnout, thereby improving the mental health of bank employees.

Citations

Citations to this article as recorded by

Riesgos psicosociales en el sector bancario: evidencia científica y propuestas de intervención organizacional frente al estrés laboral
Pablo Santana Briones, Erick Manuel Cantos Santana
Revista Científica Multidisciplinaria SAPIENTIAE.2026; : 368. CrossRef
Associations of long working hours with the use of combustible cigarettes, electronic cigarettes, and heated tobacco products among young adults: a population-based study of South Korea
Seong-Uk Baek, Jin-Ha Yoon
Postgraduate Medical Journal.2025;[Epub] CrossRef

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Original Article

Association between multiple jobs and physical and psychological symptoms among the Korean working population: Seok-Yoon Son, Jin-Young Min, Seung-Woo Ryoo, Baek-Yong Choi, Kyoung-Bok Min; Ann Occup Environ Med 2024;36:e21. Published online August 6, 2024; DOI: https://doi.org/10.35371/aoem.2024.36.e21

Abstract Abstract in Korean PDF Supplementary Material

Background

The prevalence of multiple job-holding (MJH) is expected to show an upward trend among Korean workers, yet its potential impact on workers’ health remains poorly discussed. This study aimed to explore the association between MJH and experience of physical and psychological symptoms in various aspects among active Korean workers and to identify its differences depending on workers’ gender.

Methods

We conducted a population-based cross-sectional study among South Korean workers aged 15–59 using data from the 6th Korean Working Conditions Survey. The final study sample comprised 34,175 participants. MJH status and symptoms, such as musculoskeletal pain, headache or eyestrain, fatigue, insomnia, and anxiety, were measured by self-reported data. Logistic regression analyses were performed on the total sample and gender-stratified groups, with adjustments for the sociodemographic and occupational characteristics of the participants.

Results

One hundred thirty-five men and 103 women were defined as multiple job-holders (MJHers) among the study sample. When adjusted for sociodemographic and occupational characteristics, MJHers suffered more events of headache or eyestrain (odds ratio [OR]: 1.85, 95% confidence interval [CI]: 1.23–2.78) and anxiety (OR: 1.99, 95% CI: 1.05–3.79). Gender-stratified analyses with adjustment showed that among women workers, MJH was associated with musculoskeletal pain (OR: 1.85, 95% CI: 1.02–3.34), headache or eyestrain (OR: 2.53, 95% CI: 1.37–4.67), fatigue (OR: 2.38, 95% CI: 1.29–4.40), insomnia (OR: 1.92, 95% CI: 1.04–3.57), and anxiety (OR: 2.83, 95% CI: 1.11–7.20).

Conclusions

We found a significant association between MJH and various symptoms. Women MJHers were revealed to be a more vulnerable population than their men counterparts. Further research should account for the social context of MJH, and appropriate monitoring and intervention for maintaining the well-being of MJHers are needed.

한국인 근로자 집단에서의 다중직업종사와 육체적, 정신적 증상 간 연관성
목적
한 근로자가 동시에 두 개 이상의 직업을 가지는 행위인 ‘다중직업종사’ 현상은 한국인 근로자들 간 그 비중이 점차 증가할 것으로 전망된다. 그러나, 다중직업종사가 근로자의 다양한 육체적, 정신적 증상에 미칠 수 있는 영향에 대한 논의는 부족한 실정이다. 이에, 본 연구에서는 한국인 근로자 집단을 대상으로 하여 다중직업종사와 근로자의 건강 간 연관성을 다양한 관점에서 탐구하였다. 나아가 이러한 연관성이 근로자의 성별에 따라 관찰되는 차이에 대하여 확인하였다.
방법
본 연구는 제6차 근로환경조사 자료를 활용한 단면 연구로, 만 15세 이상 59세 이하인 한국인 근로자 34,175명을 대상으로 수행되었다. 다중직업종사 상태 및 육체적, 정신적 증상으로서 근골격계 통증, 두통 및 눈의 피로, 전신피로, 불면 및 불안의 유무는 자가 보고된 자료로 확인하였다. 연구대상 집단 전체 및 각 성별 집단을 대상으로, 근로자들의 인구사회학적 특성 및 직업 특성을 보정한 로지스틱 회귀분석을 시행하였다.
결과
연구대상 집단 중 135명의 남성과 103명의 여성이 다중직업종사자로 정의되었다. 인구사회학적 특성 및 직업 특성을 보정한 분석 결과 다중직업종사자에서 두통 및 눈의 피로 (OR 1.85, 95% CI 1.23-2.78)와 불안 (OR 1.99, 95% CI 1.05-3.79)의 위험이 더 큰 것으로 나타났다. 성별을 통한 층화 후 분석 결과 여성 근로자 집단에서 다중직업종사는 근골격계 통증 (OR 1.85, 95% CI 1.02-3.34), 두통 및 눈의 피로 (OR 2.53, 95% CI 1.37-4.67), 전신피로 (OR 2.38, 95% CI 1.29-4.40)와 불안 (OR 2.83, 95% CI 1.11-7.20) 간 유의한 연관성을 보였다.
결론
본 연구에서 다중직업종사와 근로자의 다양한 증상 간 유의한 연관성이 있음을 확인하였다. 다중직업종사의 건강 영향은 여성 근로자 집단에서 보다 저명한 것으로 나타났다. 후속 연구는 다중직업종사 현상에 대한 사회적 맥락을 보다 고려해야 할 것이다. 또한 다중직업종사자들의 건강 유지를 위한 모니터링 및 중재가 적절히 수행되어야 함을 제안한다.

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Original Article

Relationship between the use of hair products and urine benzophenone-3: the Korean National Environmental Health Survey (KoNEHS) cycle 4: Siyoung Kim, Seong-yong Cho, Seongyong Yoon, Daehwan Kim, Hyun Woo Park, Jisoo Kang, Sung Woo Huh; Ann Occup Environ Med 2024;36:e20. Published online August 6, 2024; DOI: https://doi.org/10.35371/aoem.2024.36.e20

Abstract Abstract in Korean PDF Supplementary Material

Background

Benzophenone-3 is a type of ketone with 2 benzene rings attached to a carbonyl group (C=O) and one benzene ring attached to a hydroxyl group (-OH). As an endocrine-disrupting chemical, benzophenone-3 is known to be associated with reproductive, developmental, thyroid, and endocrine toxicities. Benzophenone-3 is commonly used in hair products, cosmetics, and ultraviolet (UV) filters because of its characteristic property to absorb UV light. This study aims to investigate the association between the use of hair products and urine benzophenone-3 using the data from the Korean National Environmental Health Survey (KoNEHS) cycle 4 (2018–2020), which represents the Korean population.

Methods

Using the KoNEHS cycle 4 survey, the data of 3,796 adults aged ≥ 19 years were analyzed. Based on the 75th percentile concentration of urine benzophenone-3, the participants were divided into the low- and high-concentration groups. Chi-square test was conducted to analyze the association of urine benzophenone-3 with distribution of general characteristics, use of personal care products, consumption of marine foods, and use of plastic products as the variable. Logistic regression analysis was conducted to calculate odds ratios (ORs) for the high-concentration group of urine benzophenone-3 based on the use of hair products.

Results

Women with < 6 times or ≥ 6 times of hair product usage had significantly higher adjusted ORs compared to those who did not use hair products. The calculated ORs were 1.24 (95% confidence interval [CI]: 1.12–1.38) for women with < 6 times of usage and 1.54 (95% CI: 1.33–1.79) for women with ≥ 6 times of usage.

Conclusions

This study revealed the association between the use of hair products and the concentration of urine benzophenone-3 in the general Korean population.

제4기 (2018-2020) 국민환경보건 기초조사를 이용한 헤어제품사용과 요중 벤조페논-3(benzophenone-3)과의 관계
목적
벤조페논-3은 2개의 벤젠고리가 카르보닐기(C=O)에 결합된 케톤 형태로 이루어져 있으며, 한개의 벤젠고리에 히드록시기(-OH)가 결합된 형태를 가지고 있다. 벤조페논-3은 내분비계교란화합물(Endocrine disrupting chemical)로서 생식독성, 발달독성, 갑상선 및 내분비계 독성 등을 가지고 있는 것으로 알려져 있다. 벤조페논-3은 자외선을 흡수하는 특성이 있어, 헤어제품(hair product), 화장품, 자외선차단제 등에 사용된다. 본 연구에서는 대한민국 인구집단를 대표하는 국민환경보건기초조사(KoNEHS) 4주기(2018-2020)의 데이터를 이용하여 헤어제품 사용과 요중 벤조페논-3과의 연관성을 확인하고자 한다.
방법
KoNEHS 4주기의 데이터에서 19세 이상 성인 3,796명의 참가자를 분석하였다. 요중 벤조페논-의 75번째 백분위 수 농도를 기준으로 저농도군과 고농도군으로 나누었다. 연구대상의 요중 벤조페논- 3농도와 일반적 특성, 개인 및 위생용품사용, 해양생물 섭취, 플라스틱용품사용 간의 분포 및 평균을 비교하기 위하여 독립 t-검정과 χ2 테스트를 실시하였다. 헤어제품에 대한 요중 벤조페논-3 대한 승산비(ORs)는 일반적 특성, 개인 및 위생용품사용, 해양생물 섭취, 그리고 플라스틱용품 사용을 보정한 후 로지스틱 회귀분석을 사용하여 계산하였다.
결과
본 연구에서는 여성에서 헤어제품 ‘주 6회 미만 사용군’과 ‘주 6회 이상 사용군’은 ‘사용안함군’에 비해 요중 벤조페논-3 고농도군에 속할 OR 값이 증가하였다. 계산된 OR값은 ‘주 6회 미만 사용군’ 1.24(95% CI: 1.12-1.38), ‘주 6회 이상 사용군’ 1.54 (95% CI: 1.33-1.79)이었다.
결론
본 연구를 통해서 헤어제품 사용과 요중 벤죠페논-3과의 연관성을 확인할 수 있었다.

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Environmental disease monitoring by regional Environmental Health Centers in Korea: a narrative review
Myung-Sook Park, Hwan-Cheol Kim, Woo Jin Kim, Yun-Chul Hong, Won-Jun Choi, Seock-Yeon Hwang, Jiho Lee, Young-Seoub Hong, Yong-Dae Kim, Seong-Chul Hong, Joo Hyun Sung, Inchul Jeong, Kwan Lee, Won-Ju Park, Hyun-Joo Bae, Seong-Yong Yoon, Cheolmin Lee, Kyoung
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Association between exposure to VOCs mixture and impaired renal function in Korean adults
Seong-Uk Baek, Jin-Ha Yoon
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Sooyeon Hong, Ok-Jin Kim, Sun Kyoung Jung, Hye Li Jeon, Suejin Kim, Jihyon Kil
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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

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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Relationship between breakfast skipping and hyperuricemia in Korean adults: results from KNHANES 2016–2023
Hyungyoon Jin, Seung-Yeon Lee, Wanhyung Lee
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Seong-Uk Baek, Jin-Ha Yoon
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Original Article

Rotating shift and BMI increase among healthcare workers in a military hospital: pre- and post-pandemic analysis in Taiwan: Zong-Ming Chen, Ro-Ting Lin; Ann Occup Environ Med 2024;36:e15. Published online June 21, 2024; DOI: https://doi.org/10.35371/aoem.2024.36.e15

Abstract PDF

Background

The increasing prevalence of high body mass index (BMI) emphasizes the need for action. Understanding of BMI factors among military hospital healthcare workers remains limited. This study aims to address this gap by analyzing BMI risk factors and changes pre- and post-coronavirus 2019 pandemic among military hospital healthcare workers in central Taiwan from 2019 to 2021.

Methods

Conducted at a military hospital in central Taiwan, this study analyzed anonymized health examination data from 2019 to 2021 for 483 healthcare workers. We performed generalized estimating equations to investigate trends in BMI and its association with various factors, including age, sex, job titles, military status, job tenure, work shifts, and lifestyle habits.

Results

The risk of increased BMI was higher in 2021 compared to 2019 (risk ratio [RR]: 1.008, 95% confidence interval [CI]: 1.001–1.014). Individuals on rotating shifts had a higher risk of increased BMI compared to day shift workers (RR: 1.021; 95% CI: 1.008–1.035) and higher odds of obesity (odds ratio: 1.546; 95% CI: 1.099–2.175). Among obese individuals, BMI in soldiers was approximately 4.9% lower than in non-soldiers (RR: 0.951; 95% CI: 0.915–0.988).

Conclusions

This study identified a significant post-pandemic increase in BMI among healthcare workers in a Taiwanese military hospital, with rotating shifts being a key risk factor for both increased BMI and obesity. Work-related factors influenced BMI changes among obese individuals, while non-work-related factors were significant for non-obese individuals. These findings highlight the broader effects of the pandemic and the specific impact of work-related factors on obese healthcare workers.

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Original Article

Telecommuting during the COVID-19: the role of job demand and control on health outcomes: Seung-Woo Ryoo, Jin-Young Min, Seok-Yoon Son, Baek-Yong Choi, Juho Choi, Kyoung-Bok Min; Ann Occup Environ Med 2024;36:e14. Published online June 14, 2024; DOI: https://doi.org/10.35371/aoem.2024.36.e14

Abstract Abstract in Korean PDF Supplementary Material

Background

The coronavirus disease 2019 (COVID-19) pandemic drastically modified the occupational system wherein telecommuting has risen as the major form of work. Few studies have incorporated Karasek’s job demand-control (JDC) model into explaining the health effects of telecommuting. This study aimed to investigate the health risk in South Korean telecommuters during the pandemic, and its distribution according to the job stress-related factors.

Methods

A nationwide population-based cross-sectional study of South Korean laborers was conducted, utilizing the 6th Korean Working Conditions Survey (2020–2021). Following the previously described concept of telecommuting, 14,478 white-collar employees were eligible study participants. Telecommuting, job demand, job control, and various health indicators were measured by the responses to the survey. Participants were stratified into 4 job profiles classified by the JDC model. We conducted multiple logistic regression analyses between telecommuting and health-related outcomes to estimate the odds ratio (OR) with a 95% confidence interval (CI).

Results

One hundred forty-six low-strain, 223 active, 69 passive, and 148 high-strain workers were screened as telecommuters. Compared to office workers, telecommuters had a higher proportion in high job control groups. Subgroup analysis demonstrated different relationships between telecommuting and health, where only active telecommuters showed a higher prevalence of depression (OR: 1.980, 95% CI: 1.126–3.481), and high-strain telecommuters were affected in most outcomes including insomnia (OR: 2.555, 95% CI: 1.473–4.433), musculoskeletal pain (OR: 2.786, 95% CI: 1.719–4.517), headache/eye strain (OR: 3.074, 95% CI: 1.992–4.745) and presenteeism (OR: 1.932, 95% CI: 1.193–3.131).

Conclusions

This study revealed significantly increased odds of multiple health outcomes among South Korean telecommuters during the COVID-19 pandemic era. High-strain job holders were prominently susceptible to the negative health impacts of telecommuting. Occupational health management towards telecommuters should approach mitigating high job demand and low job control.

코로나19 시기 재택근무: 건강 결과에 대한 직무 요구와 직무 재량의 역할
목적
코로나19 팬데믹으로 인해 재택근무는 직무 체계에서 주요한 업무 형태로 떠올랐다. 재택근무가 노동자의 건강에 미치는 영향을 설명하는데 있어 직무 요구-재량 모델을 도입한 연구가 부족하다. 본 연구는 팬데믹 기간 동안 한국 재택근무자들의 건강 위험과 상기 직무 스트레스 관련 요인에 따른 분포를 조사하는 것을 목표로 했다.
방법
본 연구는 제6차 근로환경조사(2020~2021년)를 활용하여 한국 노동자에 대한 전국 인구 기반 횡단면 연구를 실시했다. 이전 연구에서 확립한 재택근무 개념에 따라 14,478명의 화이트 칼라 피고용인 노동자들을 적격집단으로 선정했다. 설문조사 응답 결과를 토대로 재택근무, 직무 요구, 직무 재량 및 다양한 건강 지표를 측정했다. 연구대상자들을 직무 요구-재량 모델에 따라 분류된 네 가지 직무 유형으로 구분하였고, 다중 로지스틱 회귀분석을 시행하여 재택근무 여부에 따른 건강 변수의 오즈비(OR)와 95% 신뢰구간(CI)을 측정하였다.
결과
저-긴장 노동자 146명, 능동적 노동자 223명, 수동적 노동자 69명, 고-긴장 노동자148명이 재택근무자로 분류되었다. 통근근무자와 비교했을 때, 재택근무자들은 직무 재량이 높은 군에서 그 비중이 높았다. 층화분석 결과 재택근무와 건강 사이의 연관성은 군별로 상이하였는데, 오직 능동적 재택근무자들만이 통근근무자들보다 높은 우울증 유병률을 보였고 (OR 1.980, 95% CI 1.126-3.481) 고-긴장 재택근무자들이 가장 많은 결과 변수에서 유의한 오즈비를 보였다; 불면증 (OR 2.555, 95% CI 1.473-4.433), 근골격계 통증 (OR 2.786, 95% CI 1.719-4.517), 두통/안구 피로 (OR 3.074, 95% CI 1.992-4.745), 상병 시 근무 (OR 1.932, 95% CI 1.193-3.131).
결론
본 연구에 따르면 코로나19 팬데믹 기간 동안 한국 재택근무자들에서 다수의 건강 문제가 발생할 오즈가 유의하게 증가하였다. 그중 고-긴장 업무에 종사하는 노동자들은 재택근무가 건강에 미치는 부정적인 영향에 가장 취약하였다. 따라서 재택근무자들에 대한 산업보건 관리는 높은 직무 요구와 낮은 직무 재량을 완화하는 방향으로 접근해야 할 것이다.

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Annals of Occupational and Environmental Medicine.2025; 37: e12. CrossRef

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Original Article

Relationship between crustacean consumption and serum perfluoroalkyl substances (PFAS): the Korean National Environmental Health Survey (KoNEHS) cycle 4: Sung Woo Huh, Seong-yong Cho, Seongyong Yoon, Daehwan Kim, Hyun Woo Park, Jisoo Kang, Keon Woo Kim; Ann Occup Environ Med 2024;36:e12. Published online April 19, 2024; DOI: https://doi.org/10.35371/aoem.2024.36.e12

Abstract Abstract in Korean PDF

Background

Perfluoroalkyl substances (PFASs) are non-aromatic organic compounds, whose hydrogen atoms in the carbon chain substituted by fluorine atoms. PFASs exhibit developmental toxicity, carcinogenicity, hepatotoxicity, reproductive toxicity, immunotoxicity, and hormone toxicity. PFASs are used in the production of disposable food packages, aircraft and automobile devices, cooking utensils, outdoor gear, furniture and carpets, aqueous film forming foam (AFFF), cables and wires, electronics, and semiconductors. This study aimed to determine the association between crustacean consumption and serum PFASs.

Methods

Adult participants (2,993) aged ≥ 19 years were extracted from the 4th cycle data of the Korean National Environmental Health Survey (KoNEHS). Based on the 50th percentile concentrations of serum PFASs, participants were divided into the low-concentration group (LC) and the high-concentration group (HC). General characteristics, dietary factors, coated product usage, and personal care product usage, an independent t-test and χ² test were analyzed. The odds ratio (OR) of serum PFAS concentration against crustacean consumption was estimated via logistic regression analysis adjusting for general characteristics, dietary factors, coated product usage, and personal care product usage.

Results

The OR for the HC of serum PFASs was higher in individuals with ≥once a week crustacean consumption than in those with < once a week crustacean consumption. Estimated ORs were perfluorohexanesulfonic acid 2.15 (95% confidence interval [CI]: 1.53–3.02), perfluorononanoic acid (PFNA) 1.23 (95% CI: 1.07–1.41), and perfluorodecanoic acid (PFDeA) 1.42 (95% CI: 1.17–1.74) in males, and perfluorooctanoic acid 1.48 (95% CI: 1.19–1.84), perfluorooctanesulfonic acid 1.39 (95% CI: 1.27–1.52), PFNA 1.70 (95% CI: 1.29–2.26) and PFDeA 1.43 (95% CI: 1.32–1.54) in females.

Conclusions

This study revealed the association between the crustacean consumption and concentrations of serum PFASs in general Korean population.

제4기(2018-2020) 국민환경보건 기초조사 자료를 이용한 갑각률 섭취와 혈청 괍불화화합물(PFAS)과의 관계
목적
과불화화합물은 탄소 사슬에 결합 되어 있는 수소 원자가 불소 원자로 대체된 비방향족 유기 화합물이다. PFAS 는 발달 독성, 발암성, 간 독성, 생식 독성, 면역 독성, 신경 독성 및 호르몬 독성 등을 가진다. PFAS는 일회용 식품 포장, 항공, 자동차, 조리기구, 아웃도어 용품, 가구 및 카펫, 수성막포, 케이블 및 배선, 전자 및 반도체 생산에 사용된다. 본 연구에서는 국가를 대표하는 조사인 한국 국민환경보건 기초조사(KoNEHS) 4주기의 데이터를 사용하여 갑각류 섭취와 혈청 PFAS노출과의 연관성을 확인하려고 한다.
방법
KoNEHS 4주기의 데이터에서 19세 이상 성인 2,993명의 참가자를 분석하였다. 혈청 PFAS 의 50번째 백분위 수 농도를 기준으로 저농도군과 고농도군으로 나누었다. 연구대상의 혈청 PFAS 농도와 일반적 특성, 식이요인, 코팅용품 사용, 미용제품 사용간의 분포 및 평균을 비교하기 위하여 독립 t-검정과 χ2 테스트를 실시하였다. 갑각류 섭취에 대한 혈청 PFAS의 승산비는 일반적 특성, 식이요인, 코팅용품 사용, 미용제품 사용을 보정한 후 로지스틱 회귀분석을 사용하여 계산하였다.
결과
본 연구에서는 갑각류 주1회이상 섭취군은 주1회미만 섭취군에 비해 혈청 PFAS 고농도군에 속할 OR 값이 증가하였다. 남성에서는 PFHxS 2.15(95% confidence interval [CI]; 1.53-3.02), PFNA 1.23(95% CI; 1.07-1.41), PFDeA 1.42(95% CI; 1.17-1.74), 여성에서는 PFOA 1.48(95% CI; 1.19-1.84), PFOS 1.39(95% CI; 1.27-1.52), PFNA 1.70(95% CI; 1.29-2.26), PFDeA 1.43(95% CI; 1.32-1.54) 이었다.
결론
갑각류 섭취 횟수가 많을수록 혈청 PFAS (PFOA, PFOS, PFHxS, PFNA, PFDeA) 농도가 증가하였다.

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Original Article

The impact of long working hours on daily sodium intake: Kyungho Ju, Yangwoo Kim, Seung Hee Woo, Juhyeong Kim, Inah Kim, Jaechul Song, Soo-Jin Lee, Jeehee Min; Ann Occup Environ Med 2024;36:e9. Published online April 1, 2024; DOI: https://doi.org/10.35371/aoem.2024.36.e9

Abstract Abstract in Korean PDF

Background

Long working hours are associated with an increased risk of cardiovascular disease, yet the underlying mechanism(s) remain unclear. The study examines how occupational factors like working hours, shift work, and employment status correlate with dietary choices and sodium intake, impacting hypertension risk.

Methods

This study used data from the Korea National Health and Nutrition Examination Survey conducted between 2013 and 2020. The dataset included 8,471 respondents, all of whom were wage workers aged 20 or older and reported working at least 36 hours per week. Individuals who have been previously diagnosed with or are currently diagnosed with hypertension, diabetes, or dyslipidemia were excluded. The average daily sodium intake was assessed via a 24-hour dietary recall method. Average weekly working hours were categorized into 3 groups: 36–40 hours, 41–52 hours, and over 52 hours. Multiple logistic regression models were used.

Results

Study findings revealed that 83.7% of participants exceeded the recommended daily sodium intake of 2 g set by the World Health Organization. After adjusting for confounding factors, a positive correlation was observed between average working hours and daily sodium intake. Among males, statistical significance was found in the group with average weekly working hours of 41–52 hours (prevalence ratio [PR]: 1.17; 95% confidence interval [CI]: 1.05–1.30) and the group exceeding 52 hours (PR: 1.22; 95% CI: 1.09–1.38) when comparing the fourth quartile of daily sodium intake to the combined quartiles of Q1, Q2, and Q3. Among females, no significance was noted.

Conclusions

Long working hours were associated with increased sodium intake, primarily among male workers. This connection is likely attributed to having less time for home-cooked meals, resulting in higher fast food consumption and dining out. A workplace intervention promoting healthy eating and reducing stress is essential to lower sodium consumption and mitigate hypertension risk.

장시간 근무가 일일 소듐 섭취량에 미치는 영향
목적
장시간 근무는 심혈관 질환의 증가와 관련이 있다고 알려져 있지만, 그 메커니즘은 명확히 알려져 있지 않다. 본 연구는 주당 평균 근로시간, 교대근무 및 고용 형태 등의 직업적 요인과 식습관 변화 간의 관계를 확인하고, 특히 고혈압의 알려진 위험 요인인 과다한 소듐 섭취와의 관련성을 조사하였다.
방법
본 연구는 2013년부터 2020년까지 실시된 대한민국 국민건강영양조사의 데이터를 사용하였다. 연구대상자는 20세 이상의 임금 근로자, 주당 최소 36시간 이상 근무하는 자로 선정하였다. 이 외에도 다양한 인구학적, 직업 변수가 설문 조사를 통해 수집되었으며, 평균 일일 소듐 섭취량은 24시간 회상법을 통해 조사되었다. 주당 평균 근무 시간은 36-40시간, 41-52시간 및 52시간 이상의 세 집단으로 분류되었다. 다중 로지스틱 회귀 모델이 분석에 사용되었다.
결과
연구대상자 중 83.7%가 세계보건기구(WHO)에서 권장한 일일 나트륨 섭취량인 2g을 초과한 것이 확인되었다. 교란변수 보정 후에도 주당 평균 근로시간과 일일 소듐 섭취 간의 통계적 유의성이 확인되었다. 남성에 대하여, 주당 평균 근무 시간이 41-52시간인 그룹 (PR: 1.17, 95% CI: 1.05-1.30)과 52시간을 초과한 그룹 (PR: 1.22, 95% CI: 1.09-1.38)이 일일 소듐 섭취량 4분위에서 1, 2, 3분위를 포함한 그룹과와 비교하여 통계적으로 유의미한 관련이 있었다. 여성에 대하여는 통계적으로 유의미하지 않았다.
결론
장시간 근무는 주로 남성 근로자에서 소듐 섭취 증가와 관련이 있었다. 이는 가정에서 조리하는 시간이 줄어들어 패스트 푸드 및 외식 소비가 증가하는 것에 기인한 것으로 생각된다. 과량의 소듐 섭취는 고혈압의 알려진 위험 요인이므로, 직장에서의 적극적인 개입을 통해, 더 건강한 식습관과 개선된 근무 환경을 통해 소듐 섭취를 줄이는 것이 필요하다.

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Original Article

Differences of nutritional intake habits and Dietary Inflammatory Index score between occupational classifications in the Korean working population: Seung Hee Woo, Yangwoo Kim, Kyungho Ju, Juhyeong Kim, Jaechul Song, Soo-Jin Lee, Jeehee Min; Ann Occup Environ Med 2024;36:e5. Published online March 18, 2024; DOI: https://doi.org/10.35371/aoem.2024.36.e5

Abstract Abstract in Korean PDF Supplementary Material

Background

Human nutrient intake is closely related to the conditions of their workplace.

Methods

This study used data from the Korean National Health and Nutritional Examination Survey (KNHANES) conducted between 2016 and 2020. The study population comprised individuals aged 19 to 65 years who were engaged in paid work, excluding soldiers (total = 12,201, male = 5,872, female = 6,329). The primary outcome of interest was the Dietary Inflammatory Index (DII) score, which was calculated using dietary intake data. Generalized linear models were used for statistical analyses.

Results

Pink-collar workers had higher DII scores, indicating a potentially higher inflammatory diet than white-collar workers (mean: 2.18 vs. 1.89, p < 0.001). Green and blue-collar workers displayed lower levels of dietary inflammation (green: 1.64 vs. 1.89, p = 0.019, blue: 1.79 vs. 1.89, p = 0.022). After adjusting for sex, age, income, education, and energy intake, the sole trend that persisted was the comparison between white-collar and pink-collar workers.

Conclusions

DII scores and dietary patterns differed among occupational groups and genders.

한국 직장 인구의 직업 분류별 영양 섭취 습관과 식이 염증 지수 차이
목적
직장인의 영양 섭취는 그들의 직장 환경과 밀접한 관련이 있다.
방법
본 연구는 2016년부터 2020년까지 실시된 대한민국 국립건강영양조사(KNHANES) 자료를 사용하였다. 연구 대상은 19세에서 65세까지의 직장인으로, 군인은 제외되었다.(전체 = 12,201명, 남성 = 5,872명, 여성 = 6,329명) 주요 관심 대상은 식이 염증 지수(DII)로, 식품 섭취 정보를 사용하여 계산하였다. 통계 분석에는 일반화된 선형 모델을 사용하였다.
결과
핑크 칼라 직종 근로자들은 DII 점수가 더 높았으며, 이는 화이트 칼라 직종 근로자들보다 잠재적으로 염증성 식습관이 높을 수 있음을 나타낸다.(평균: 2.18 대 1.89, p < 0.001) 그린과 블루 칼라 직종 근로자들은 DII 점수가 낮았다.(그린: 1.64 대 1.89, p = 0.019, 블루: 1.79 대 1.89, p = 0.022) 핑크 칼라와 화이트 칼라 직종 근로자에서 DII 점수의 차이는 성별, 연령, 소득, 교육 및 에너지 섭취량에 대한 보정 후에도 지속되었다.
결론
DII 점수와 식습관은 직업군과 성별에 따라 다르게 나타났다.

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Original Article

Relationship between the use of plastics in refrigerator food storage and urine phthalate metabolites: the Korean National Environmental Health Survey (KoNEHS) cycle 3: Jisoo Kang, Seong-yong Cho, Seongyong Yoon; Ann Occup Environ Med 2023;35:e53. Published online December 27, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e53

Abstract Abstract in Korean PDF

Background

Plastics are high-molecular-weight materials composed of long carbon chains. They are prevalent in daily life, present in various items such as food containers and microwavable packaging. Phthalates, an additive used to enhance their flexibility, are endocrine-disrupting chemicals. We utilized the data from the Korean National Environmental Health Survey (KoNEHS) cycle 3, representing the general South Korean population, to investigate the relationship between the use of plastics in refrigerator food storage and phthalate exposure.

Methods

We assessed 3,333 adult participants (aged ≥ 19 years) including 1,526 men and 1,807 women, using data from KoNEHS cycle 3. Using the 75th percentile concentration, urine phthalate metabolites were categorized into high and low-concentration groups. χ² test was conducted to analyze variations in the distribution of each variable, considering sociodemographic factors, health-related factors, food intake, the use of plastics, and the concentration of urine phthalate metabolites as the variables. To calculate odds ratios (ORs) for the high-concentration group of urine phthalate metabolites based on the use of plastics in refrigerator food storage, logistic regression analysis was conducted.

Results

In men, the use of plastics in refrigerator food storage had significantly higher adjusted ORs compared to those using the others. The adjusted ORs were calculated as follows: mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) had an OR of 1.35 (95% confidence interval [CI]: 1.05–1.72), mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP) had an OR of 1.48 (95% CI: 1.16–1.88), mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP) had an OR of 1.32 (95% CI: 1.04–1.66), ∑di(2-ethylhexyl) phthalate (∑DEHP) had an OR of 1.37 (95% CI: 1.08–1.74) and mono-n-butyl phthalate (MnBP) had an OR of 1.44 (95% CI: 1.13–1.84).

Conclusion

The concentrations of urine phthalate metabolites (MEHHP, MEOHP, MECPP, ∑DEHP, and MnBP) were significantly higher in men who used plastics in refrigerator food storage compared to those using the others.

제3기(2015-2017) 국민환경보건 기초조사 자료를 이용한 냉장고 식품보관 시 플라스틱을 사용하는 경우와 요중 프탈레이트 대사체간의 관계
목적
플라스틱은 긴 탄소 사슬로 구성된 고분자 물질로 일상생활에서 식품용기, 전자레인지용 포장용기 등 다양한 곳에서 사용되고 있다. 프탈레이트는 플라스틱의 유연성을 증가시키는 가소제로 사용되는데, 이는 내분비계 장애물질로 알려져있다. 본 연구에서는 우리나라 인구를 대표하는 자료인 국민환경보건 기초조사 3기를 이용하여 가정내 냉장고 식품보관 시 플라스틱을 사용하는 경우와 요중 프탈레이트 대사체와의 연관성을 조사하였다.
방법
본 연구는 국민환경보건 기초조사 3기에서 3,333명의 19세 이상 성인을 연구 대상자로 선정하였다. (남자: 1,526명 여자: 1,807명) 요중 프탈레이트 대사체는 75th percentile값을 기준으로 요중 프탈레이트 대사체 고농도군과 저농도군으로 정의하였다. 사회인구학적 요인, 건강행태 요인, 식이요인과 플라스틱 사용, 요중 프탈레이트 대사체 농도간의 분포를 분석하기위해 χ2-test를 사용하였다. 또한 로지스틱 회귀분석을 사용하여 가정내 냉장고 식품보관 시 플라스틱을 사용하는 경우와 요중 프탈레이트 대사체 고농도군에 속할 OR값을 계산하였다.
결과
남성에서 가정내 냉장고 식품보관시 플라스틱을 사용하는 경우 플라스틱을 사용하지 않는 경우보다 요중 프탈레이트 대사체 농도가 높았다. 플라스틱을 사용하는 경우 MEHHP의 고농도군에 해당될 adjusted ORs은 1.35(95%CI: 1.05-1.72), MEOHP 1.48(95%CI: 1.16-1.88), MECPP 1.32(95%CI: 1.04-1.66), ∑DEHP 1.37(95%CI: 1.08-1.74), MnBP 1.44(95%CI: 1.13-1.84)으로 조사되었다.
결론
남성에서 가정내 냉장고 식품 보관 시 플라스틱을 사용하는 경우는 플라스틱을 사용하지 않는 경우보다 요중 프탈레이트 대사체(MEHHP, MEOHP, MECPP, ∑DEHP, MnBP) 농도가 높았다.

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Data Profile

Data resource profile: the Korean Working Conditions Survey (KWCS): Yoonho Cho; Ann Occup Environ Med 2023;35:e49. Published online November 23, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e49

Abstract Abstract in Korean PDF

The Korean Working Conditions Survey (KWCS) is a state-approved statistical survey that has been conducted by the Occupational Safety and Health Research Institute (OSHRI) every 3 years since 2006 to monitor changes in the working conditions of Koreans. This cross-sectional national survey involves a sample of 50,000 employed people aged 15 or older. KWCS measures various working conditions through > 130 survey questions, including questions regarding working hours, labor intensity, work–life balance, degree of exposure to risk factors, and subjective health status. Professional survey interviewers visit households and conduct face to face interviews. KWCS provides data and statistics for occupational safety and health polices and research in Korea. Furthermore, OSHRI holds academic conferences every year, awards high-quality academic papers, and supports researchers using data. Microdata is publicly available through the OSHRI website (https://oshri.kosha.or.kr).

자료원 프로파일: 근로환경조사
KWCS는 국가승인통계로 대한민국에 거주하는 만15세 이상 취업자 5만명을 표본으로 매 3년마다 실시하는 단면적 조사로, 2006년부터 산업안전보건연구원에서 실시하고 있다. KWCS는 전문조사원에 의해 가구를 방문하여 1:1 면접 조사로 이루어지며, 근무시간, 노동강도, 일과 삶의 균형, 유해위험요인에 대한 노출 정도, 주관적 건강상태 등 다양한 근로환경에 대해 130여개 이상의 문항에 대해 조사한다. 조사 결과는 정책 수립과 연구자를 위한 기초 자료로 제공하고 있으며, 마이크로데이터는 산업안전보건연구원 홈페이지(OSHRI.OR.KR)를 통해 공개하고 있다.

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Original Article

Effects of a supportive workplace environment on the success rate for smoking cessation camp: Woojin Kim, A Ram Kim, Minsu Ock, Young-Jee Jeon, Heun Lee, Daehwan Kim, Minjun Kim, Cheolin Yoo; Ann Occup Environ Med 2023;35:e48. Published online November 22, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e48

Abstract Abstract in Korean PDF

Background

This study was conducted to identify the success rate for smoking cessation over time after participation in a therapeutic smoking cessation camp, and to identify how participant characteristics, including a supportive workplace environment for smoking cessation (SWESC), affect the success rate for smoking cessation.

Methods

In all, 296 participants at smoking cessation camps in Ulsan between 2015 and 2020 were investigated. The success rates of smoking cessation after weeks 4, 6, 12, and 24 at camp were investigated. The participants were grouped as workers with an SWESC, and workers without an SWESC, and variables (age, education, household income, marital status, drinking, exercise, body mass index, morbidity, job, number of counseling sessions, cigarettes smoked per day and smoking initiation age) were investigated. Multiple logistic regression analysis was conducted at each time point. In addition, Cox regression analysis was performed to evaluate the variables affecting the success rate for smoking cessation over time.

Results

The smoking cessation success rate of workers with an SWESC at week 24 (90.7%) was higher than that for workers without an SWESC (60.5%). Multiple logistic regression was performed to determine the relationship between each variable and the success rates for smoking cessation at week 6, 12, and 24. SWESC was confirmed as significant (p < 0.05) variables for increased success rate for smoking cessation at all 3 time points. After adjusting for all variables, the Cox proportional hazards survival analysis showed a hazard ratio of 6.17 for SWESC (p < 0.001,; 95% confidence interval: 3.08–12.38).

Conclusions

At a professional treatment smoking cessation camp, participants with an SWESC showed a significantly higher success rate for smoking cessation. Supportive workplace environment for workers’ health is expected to be an important factor for smoking cessation projects as well as other health promotion projects at workplace.

직장의 금연에 대한 지지적 환경이 전문 치료형 금연 캠프의 금연성공률에 미치는 영향
목적
본 연구는 울산에서 진행된 전문 치료형 금연 캠프에 참가한 후 시간 경과에 따른 금연 성공률을 알아보고, 직장의 금연에 대한 지지적 환경 (SWESC: supportive workplace environment for smoking cessation)을 포함한 각 참가자의 특성이 금연 성공률에 어떤 영향을 미치는지 알아보기 위해 실시되었다.
방법
2015-2020년 울산 지역 금연 캠프 참가자 455명을 대상으로 자가 보고, 호기 일산화탄소, 소변 코티닌 수치를 이용하여 캠프 후 4주, 6주, 12주, 24주차 금연 성공률을 조사하였다. 캠프 참가자를 SWESC가 있는 근로자 및 SWESC가 없는 근로자로 분류하여 각 집단에서 변수 (연령, 교육 수준, 가계 소득, 배우자 유무, 음주, 운동, 체질량지수, 현병력, 직업, 상담 횟수, 하루 흡연량, 흡연 시작 연령)들의 비율을 알아보았고, 시점별 금연 성공률을 집계하였다. 변수와 금연 성공의 관계를 알아보기 위해 각 시점에서 다중 로지스틱 회귀 분석을 실시하였다. 또한 시간 경과에 따른 금연 성공률에 영향을 미치는 변수를 평가하기 위해 Cox 생존 분석을 시행하였다.
결과
SWESC가 있는 근로자의 24주 금연 성공률 (90.7%)은 SWE가 없는 근로자 (60.5%)보다 높았다. 캠프 후 6주, 12주, 24주째 금연성공률과 변수에 대하여 다중 로지스틱 회귀 분석을 실시한 결과, 세 시점에서 모두 금연에 유의한 (p < 0.05) 변수는 SWESC로 나타났다. 모든 변수를 조정하여 Cox 비례 위험 생존 분석을 실시한 결과 SWESC의 위험비는 6.17 ( 95% 신뢰구간: 3.08-12.38)였다.
결론
금연 캠프 참가자 중 SWESC가 있는 참가자는 금연 성공률이 유의하게 높았다. 근로자의 건강에 대한 지지적인 직장 환경은 금연 사업 등 보건 사업의 성공에 중요한 요인이 될 것으로 예상된다.

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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: 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

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

Abstract Abstract in Korean PDF

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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Association Between Food Insecurity and Poor Cardiovascular Health Assessed by the Life’s Essential 8 Metric: A Population-Based Study of Korean Adults
Seong-Uk Baek, Jin-Ha Yoon
Nutrients.2025; 17(13): 2148. CrossRef

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Original Article

Particulate matter concentration effects on attention to environmental issues: a cross-sectional study among residents in Korea’s Pohang Industrial Complex: Hye-seung Ryu, Jea Chul Ha, Insung Chung, Seonhee Yang, Hyunjoo Kim, Sung-Deuk Choi; Ann Occup Environ Med 2023;35:e31. Published online August 10, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e31

Abstract Abstract in Korean PDF Supplementary Material

Background

With modernization, air pollution has become increasingly serious, and its effects on health have been revealed. As a result, public interest in environmental pollution has become critical for regulating air pollution. In our study, we aim to evaluate the impact of air pollution levels on public attention to environmental issues and examine whether awareness of the residential environment’s impact on health acts as a mediator in this relationship.

Methods

We conducted an analysis on 400 individuals surveyed in the preliminary feasibility study on adverse health effects in the Pohang Industrial Complex, to examine the relationship between particulate matter 2.5 (PM2.5) and attention to environmental issues. Logistic regression analysis was performed, and mediation analysis was used to determine whether awareness of the residential environment’s impact on health mediated the relationship.

Results

The logistic regression analysis results showed that PM2.5 levels were associated with attention to environmental issues (adjusted odds ratio [AOR]: 2.1; 95% confidence interval [CI]: 1.3–3.5; p = 0.003) and awareness of health impacts (AOR: 3.4; 95% CI: 1.6–7.1; p = 0.001). The PM2.5 levels showed 9.9% (95% CI: 5.4–14.0) increase in the prevalence of high attention to environmental issues, of which, only 1.0% (95% CI: 0.2–2.3) were mediated by health impact awareness. In the overall analysis, 10% of the total effect of PM2.5 on attention to environmental issues was mediated by health impact awareness.

Conclusions

According to this study’s results, there was a correlation between air pollution levels and attention to environmental issues. Awareness of the health impacts of air pollution partially mediated the effect of air pollution levels on attention to environmental issues. In future studies, it is recommended to identify other mediators to further understand this structure.

미세먼지(Particular matter)농도가 환경문제에 대한 관심에 미치는 영향 : 포항시 거주민을 대상으로 한 단면연구
목적
근현대화가 진행되어오면서 대기오염은 심각해지고 대기오염에 의한 건강영향이 밝혀지면서 대기오염을 규제하기위해 환경오염에 대한 대중의 관심도가 중요해졌다. 이번 연구에서는 대기오염 수치가 환경오염에 대한 관심도에 미치는 영향을 평가하고 그 구조로써 건강영향에 대한 인식이 매개체로써 작용하는지 탐구하고자 하였다.
방법
포항 산업단지 건강피해 예비타당성 위해소통 설문조사에서 파악된 400명에 대하여 분석을 시행하였다. PM2.5와 환경오염에 대한 관심의 관계에 대해서 보기위해 로지스틱 회귀분석을 시행하였고, 그 구조를 파악하기 위해 매개분석을 사용하여 건강영향에 대한 인식이 매개체로써 작용하는지 확인하였다.
결과
로지스틱 분석 결과 PM2.5 수치는 환경에 대한 관심과 관련이 있었고([AOR]: 2.1, 95% CI: 1.3, 3.5, P = 0.003), 건강영향에 대한 인식도와도 관련이 있었다(AOR: 3.4, 95% CI: 1.6, 7.1, P = 0.001). PM2.5수치는 전체 환경에 대한 관심도에 비교위험(%)이 9.9 (95 % CI: 5.4, 14.0)인데 전체에서 1.0 (95 % CI: 0.2, 2.3) 만이 건강영향 인식도에 의해 매개되는 비교위험이다. 전체 분석 결과에서 PM2.5가 환경에 대한 관심에 미치는 전체 영향의 10%가 건강영향 인식에 매개되었다.
결론
연구결과에 따르면 대기오염 수준은 환경오염에 대한 관심도와 관련이 있었다. 건강영향에 대한 인식은 대기오염수준이 환경오염에 대한 관심도에 미치는 영향의 일부를 매개하였다.

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Toward the 3rd Generation of Smart Farming: Materials, Devices, and Systems for E‐Plant Technologies
Daegun Kim, Jonghyun Won, Hyeongmin Park, Jun‐Gyu Choi, Sungjun Park, Giwon Lee
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Original Article

Association between lone work and self-rated health status: using the 5th Korean Working Conditions Survey: Eunseun Han, Ui-Jin Kim, Yongho Lee, Sanghyuk Lee, Seunghon Ham, Wanhyung Lee, Won-Jun Choi, Seong-Kyu Kang; Ann Occup Environ Med 2023;35:e29. Published online July 31, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e29

Abstract PDF Supplementary Material

Background

Lone workers are generally defined as individuals who work alone without supervision, including self-employed people. While lone workers are considered a vulnerable group in some countries, there is a lack of research on their health status in domestic studies. Globally, the number of lone workers has been increasing, and this trend has been further accelerated since the coronavirus disease 2019 (COVID-19) pandemic with the rise of remote work.

Methods

The study analyzed data from 44,281 participants, excluding unpaid family workers, soldiers, and those with missing data. Lone workers were defined as individuals who reported having no colleagues with the same job at their current workplace. Self-rated health status was categorized as “good” or “poor.”

Results

This study found a statistically significant higher number of lone workers among women compare to men. The largest occupational category for lone workers was service and sales workers, followed by agriculture and fisheries workers. A majority of non-lone workers reported working 40 hours or less per week, while the majority of lone workers reported working 53 hours or more per week. In addition, lone workers had significantly poorer health status evaluations compared to non-lone workers (odds ratio: 1.297; 95% confidence interval: 1.165–1.444).

Conclusions

Further research is needed to investigate the causal relationship between lone work and health, using data collected after the COVID-19 pandemic.

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Original Article

Association between discrimination in the workplace and insomnia symptoms: Suhwan Ju, Seong-Sik Cho, Jung Il Kim, Hoje Ryu, Hyunjun Kim; Ann Occup Environ Med 2023;35:e25. Published online July 23, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e25

Abstract Abstract in Korean PDF

Background

In Korea, little research has focused on the relationship between discrimination in the workplace and sleep health. Thus, this study aims to investigate the association between such discriminatory experiences and insomnia, a common sleep disorder, using Korean employees’ data.

Methods

This study used data from the 6th Korea Working Conditions Survey. Discrimination experiences due to age, ethnic background, nationality, race, sex, religion, disability, sexual orientation, educational level, hometown, and employment status were investigated. The Minimal Insomnia Symptom Scale estimated insomnia symptoms. The association between discrimination experience and insomnia symptoms were analyzed using survey-weighted logistic regression analysis.

Results

Based on experiences of discrimination over the past 12 months, insomnia symptoms were associated with discrimination experience due to religion (odds ratio [OR]: 3.70; 95% confidential interval [CI]: 1.58–8.69), sex (OR: 2.51; 95% CI: 1.87–3.37), age (OR: 2.30; 95% CI: 1.88–2.81), hometown (OR: 2.07; 95% CI: 1.44–2.97), employment status (OR: 1.69; 95% CI: 1.37–2.10), and educational level (OR: 1.67; 95% CI: 1.31–2.14). Furthermore, the prevalence of insomnia symptoms increased with the number of discrimination experiences.

Conclusions

In this study, discrimination experiences due to religion, sex, age, hometown, employment status, and educational level were significantly associated with insomnia symptoms. Furthermore, as the number of discrimination experiences increased, so did the prevalence of insomnia. Preventing workplace discrimination may improve workers’ sleep health.

직장에서의 차별 경험과 불면증 증상 간의 연관성
목적
한국에서 차별 경험과 수면 장애 간의 연관성에 대한 연구가 거의 없었다. 따라서, 이 연구의 목적은 직장에서의 차별 경험과 불면증 증상의 연관성을 조사하는 것이다.
방법
이 연구는 제6차 근로환경조사의 자료를 활용하였다. 나이, 출신민족, 국적, 인종, 성, 종교, 장애, 성적 지향성, 학벌, 출신 지역, 고용 형태 등 총 11개 종류의 차별에 대한 경험 유무를 조사하였다. 수면 장애는 minimal insomnia symptom scale (MISS)을 사용하여 불면증 증상의 유무를 조사하였다. 둘 사이의 연관성을 평가하기 위해 가중치를 이용한 로지스틱 회귀분석을 사용하였다.
결과
종교(odds ratio [OR], 3.70; 95% confidential interval [CI], 1.58–8.69), 성 (OR, 2.51 ; 95% CI, 1.87–3.37), 나이 (OR, 2.30 ; 95% CI, 1.88–2.81), 출신 지역 (OR, 2.07 ; 95% CI, 1.44–2.97), 고용 형태 (OR, 1.69 ; 95% CI, 1.37–2.10), 학벌 (OR, 1.67 ; 95% CI, 1.31–2.14)에 대한 차별 경험과 불면증 증상 간의 연관성이 확인되었다. 또한, 경험한 차별의 종류가 많을수록 불면증 증상의 유병률이 증가하는 경향이 확인되었다.
결론
이 연구에서 직장에서의 종교, 성별, 나이, 고향, 고용상태, 교육수준에 대한 차별 경험과 불면증 증상 간의 연관성이 확인되었다. 직장에서의 차별을 예방함으로써 근로자들의 수면 건강을 향상시킬 수 있을 것이다.

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[Special Collection] Working hours as a social determinants of workers' health

Brief Communication

The impacts of working time flexibilization on occupational safety and health: an expert survey: Daseul Moon, Hyunjoo Kim; Ann Occup Environ Med 2023;35:e20. Published online July 20, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e20

Abstract PDF Supplementary Material

The policy proposal by the current Korean government that proposes flexible overtime rules is causing social controversy. This study has explored the 612 experts’ opinions on the occupational safety and health impacts of the policy using an online self-report survey. They expected short-term overwork (87.25%), overwork inequality (86.44%), irregular working hours (84.31%), chronic overwork (84.15%), long working hours (83.66%), and unpredictability of working hours (81.86%) as a result of the policy change. They also responded that the policy change would increase industrial accident deaths (87.25%), mental illnesses (87.09%), deaths due to overwork or cardiovascular diseases (83.84%), and accidents (83.33%). They disagreed that the government’s flexibilization policy, while agreeing that the necessity of policies on regulating night work (94.77%), guaranteeing wages to eliminate overtime (90.36%), establishing working time regulations for the bogus self-employed (82.84%), and applying the 52-hour workweek system to all workplaces (76.47%). These expert opinions are consistent with previous research on the health effects of working hours.

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[Special Collection] Working hours as a social determinants of workers' health

Opinion

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

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

Correlation of commute time with the risk of subjective mental health problems: 6^th Korean Working Conditions Survey (KWCS): Hyo Choon Lee, Eun Hye Yang, Soonsu Shin, Seoung Ho Moon, Nan Song, Jae-Hong Ryoo; Ann Occup Environ Med 2023;35:e9. Published online May 11, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e9

Abstract Abstract in Korean PDF

Background

Studies conducted so far on the link between commute time and mental health among Koreans remain insufficient. In this study, we attempted to identify the relationship between commute time and subjective mental health using the 6^th Korean Working Conditions Survey (KWCS).

Methods

Self-reported commute time was divided into four groups: ≤ 30 (group 1), 30–60 (group 2), 60–120 (group 3), and > 120 minutes (group 4). Subjective depression was defined as a score of 50 points or less on the WHO-5 well-being index. Subjective anxiety and fatigue were defined as answering ‘yes’ to the questionnaire on whether they had experienced it over the past year. The analysis of variance, t-test, and χ² test was used to analyze the differences among the characteristics of the study participants according to commute time, depression, anxiety, and fatigue. Odds ratios (ORs) and 95% confidence intervals (CIs) for depression, anxiety, and fatigue according to commute time were calculated using multivariate logistic regression models adjusted for sex, age, monthly income, occupation, company size, weekly working hours, and shift work status.

Results

Long commute times showed increased ORs and graded increasing trends for depression, anxiety, and fatigue. The ORs for depression increased significantly in group 2 (1.06 [1.01–1.11]), group 3 (1.23 [1.13–1.33]), and group 4 (1.31 [1.09–1.57]) compared to group 1 (reference). The ORs for anxiety increased significantly in group 2 (1.17 [1.06–1.29]), group 3 (1.43 [1.23–1.65]) and group 4 (1.89 [1.42–2.53]). The ORs for fatigue increased significantly in group 2 (1.09 [1.04–1.15]), group 3 (1.32 [1.21–1.43]), and group 4 (1.51 [1.25–1.82]).

Conclusions

This study highlights that the risk of depression, anxiety, and fatigue increases with commute time.

통근 시간과 주관적 정신건강문제 위험의 상관관계 : 제6차 한국근로환경조사
목적
한국인들의 통근 시간과 정신 건강의 관계에 대해 지금까지 수행된 연구는 매우 부족하다. 본 연구에서는 제6차 한국근로환경조사 자료를 이용하여 통근 시간과 주관적 정신건강의 관계를 규명하고자 하였다.
방법
자가 보고된 통근 시간은 30분 이하(1군), 30분-60분(2군), 60분-120분(3군), 120분 초과(4군)의 4개 그룹으로 분류하였다. 주관적 우울은 WHO-5 웰빙 지수 50점 이하인 경우로 정의하였다. 주관적 불안과 피로는 지난 1년간 이러한 증상을 경험한 적이 있는지에 대한 설문지에 '그렇다'고 대답한 경우로 정의하였다. 분산분석, T-검정 및 카이-제곱 검정을 사용하여 출퇴근 시간, 우울, 불안, 피로에 따른 연구 참여자들의 특성 차이를 분석하였다. 성별, 연령, 월 소득, 직업, 회사 규모, 주당 근로 시간, 교대근무 상태를 보정한 다변량 로지스틱 회귀모형을 이용하여, 통근 시간에 따른 우울, 불안, 피로에 대한 오즈비와 95% 신뢰구간을 산출하였다.
결과
긴 통근 시간은 우울, 불안, 피로에 대한 오즈비 증가 및 점진적인 상승 추세를 보여주었다. 우울에 대한 오즈비는 2군(1.06[1.01-1.11]), 3군(1.23[1.13-1.33])과 4군(1.31[1.09-1.57])에서 1군(참조군)에 비해 유의하게 증가하였다. 불안에 대한 오즈비는 2군(1.17[1.06-1.29]), 3군(1.43[1.23-1.65])과 4군(1.89[1.42-2.53])에서 유의하게 증가했다. 피로에 대한 오즈비는 2군(1.09[1.04-1.15]), 3군(1.32[1.21-1.43])과 4군(1.51[1.25-1.82])에서 유의하게 증가했다.
결론
본 연구는 출퇴근 시간이 증가함에 따라 우울증, 불안, 피로의 위험이 증가한다는 것을 강조한다.

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[Special Collection] Working hours as a social determinants of workers' health

Special Article

Problems and suggested improvement plans for occupational health service in Korea: Dongmug Kang; Ann Occup Environ Med 2023;35:e10. Published online May 11, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e10

Abstract Abstract in Korean PDF Supplementary Material

The purpose of this paper was to review the problems relating to Korea’s occupational health services and suggest ways to improve them. Korea can be classified as a welfare state type of conservative corporatism partially interwoven with liberalism. While experiencing compressed economic growth, the economic sectors of developed (excess areas) and developing (deficient areas) countries are interwoven. Therefore, it is necessary to perfect conservative corporatism along with a complementary reinforcement of liberal contents and to apply a multilayered approach focusing on complementing the deficient areas. It is essential to form a national representative indicator related to occupational health, and a strategy for selection and concentration is needed. The proposed central indicator is the occupational health coverage rate (OHCR), which is the number of workers who have applied for mandatory occupational health services under the Occupational Safety and Health Act in the numerator with the total working population in the denominator. This paper proposes ways to raise the OHCR, which is currently at the level of 25%–40%, to 70%–80%, which is the level of Japan, Germany, and France. To achieve this target, it is necessary to focus on small businesses and vulnerable workers. This is an area of market failure and requires the active input of community-oriented public resources. For access to larger workplaces, the marketability of services should be strengthened and personal intervention using digital health resources should be actively attempted. Taking a national perspective, work environment improvement committees with tripartite (labor, management, and government) participation for improvement of the working environment need to be established at the center and in the regions. Through this, prevention funds linked to industrial accident compensation and prevention could be used efficiently. A national chemical substance management system must be established to monitor the health of workers and the general public.

한국의 직업보건서비스의 문제점과 개선 방안
한국의 직업보건서비스의 문제점을 살펴보고 개선 방안을 제시하고자 하였다. 발간된 논문과 보고서 및 2022년의 산업보건환경 변화에 따른 대응방안 연구(정책포럼)1의 결과를 중심으로 조사하였다. 한국은 보수적조합주의를 근간으로 한 자유주의가 가미된 형태의 복지국가유형으로 분류할 수 있고, 압축적 경제성장을 경험하면서 선진국과 개발도상국의 영역이 섞여 있어 과잉과 결핍이 혼재되어 있다. 따라서 한국의 직업보건서비스의 발전을 위해서는 보수조합주의적 완성도를 높이면서 부수적으로 자유주의적 내용을 보완하여야 하며, 동일한 발전단계에 대한 단일한 접근법 보다는 결핍영역에 대한 보완을 중심으로 한 중층적 접근법이 필요하다. 직업보건관련 중심적 지표를 형성하고 이에 대한 선택과 집중전략이 필요하며, 중심지표로는 현재 25~40% 수준에 머물러 있는 직업보건 적용율을 독일, 프랑스, 일본 수준인 70~80% 수준으로 제고하는 것을 목표로 삼기를 제안한다. 이렇게 하기 위해서는 소규모 사업장과 취약한 노동자에 대해 집중하여야 하며, 이 영역은 시장실패영역으로서 지역중심의 공공자원의 적극적 투입이 필요한데, 전국 보건소 숫자인 256개 정도의 지역에 지역 직업보건 지원센터를 건립할 것을 제안한다. 중규모 이상의 사업장에 대한 접근으로는 서비스의 수요에 기반한 시장성을 강화하고 디지털헬스를 이용한 개인영역의 중재를 적극 시도하여야 한다. 전국적차원에서 사업장 작업환경개선과 중재를 위한 노사정이 참여하는 작업환경개선위원회를 중앙과 지역에 설치하고, 이를 통해 산재보상과 예방을 연계한 예방기금을 효율적으로 사용하도록 한다. 국가 차원의 화학물질 관리체계를 구축하고, 근로자와 일반국민의 건강을 모니터링할 수 있어야 한다

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Original Article

Relationship between shellfish consumption and urinary phthalate metabolites: Korean National Environmental Health Survey (KoNEHS) cycle 3 (2015-2017): Jisoo Kang, Seong-yong Cho, Jinseok Kim, Seongyong Yoon, Jong-min An, Gayoung Kim, Si young Kim; Ann Occup Environ Med 2023;35:e2. Published online February 6, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e2

Abstract Abstract in Korean PDF

Background

Phthalates are endocrine disrupting chemicals that are widely used in the production of items of daily life such as in polyvinylchloride plastics, insecticides, and medical devices. This study aimed to determine the association between phthalate exposure and shellfish consumption using data from the Korean National Environmental Health Survey (KoNEHS) cycle 3 (2015–2017), which is a nationally representative survey.

Methods

In this study, we analyzed the KoNEHS cycle 3 data of 3,333 (1,526 men and 1,807 women) adults aged more than 19 years. Data related to the variables of sociodemographic factors, health-related behaviors, dietary factors, seafood consumption frequency, and urinary phthalate metabolites concentrations were collected. The concentrations of urinary phthalate metabolites of all the participants were divided into quartiles to define high and low concentration groups based on the 75th percentile concentration. A χ² test was conducted to analyze the distribution of independent variables. To analyze the relationship between shellfish consumption and phthalate exposure, the odds ratios (ORs) were calculated using logistic regression analysis.

Results

Total adults with shellfish consumption frequency of over once a week showed the following adjusted ORs for high concentrations of the following metabolites compared with the group that consumed shellfish once a week or less: 1.43 (95% confidence interval [CI]: 1.01–2.06) for mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP), 1.43 (95% CI: 1.01–2.03) for mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP), 1.57 (95% CI: 1.10–2.24) for ∑di-2-ethylhexyl phthalate (∑DEHP), 2.01 (95% CI: 1.46–2.77) for mono-carboxyoctyl phthalate (MCOP), 1.56 (95% CI: 1.11–2.18) for mono-carboxy-isononly phthalate (MCNP), and 2.57 (95% CI: 1.85–3.56) for mono (3-carboxypropyl) phthalate (MCPP).

Conclusions

The concentrations of urinary phthalate metabolites (MEOHP, MECPP, ∑DEHP, MCOP, MCNP, and MCPP) were higher in adults with a higher frequency of shellfish consumption.

국민환경보건 기초조사 제3기(2015-2017) 자료를 이용한 조개류 섭취와 요중 프탈레이트 대사체간의 관계
목적
프탈레이트(phthalate)는 내분비계 장애물질(endocrine disrupting chemicals, EDCs)로서, 일상생활에서 가소제, 살충제, 의료기기 등으로 광범위하게 사용되고 있다. 프탈레이트는 해양 생태계에서 널리 발견되며, 조개류는 해양생태계오염의 대표적인 지표로 사용된다. 현재까지 해양 생태계의 프탈레이트의 오염에 대한 다양한 연구가 수행되고 있으나 국내에서 프탈레이트 노출과 조개류 섭취와 관련된 연구는 아직 이루어진 바가 없다. 따라서 본 연구에서는 우리나라 인구를 대표하는 자료인 국민환경보건 기초조사 제3기(2015-2017) 자료를 이용하여 요중 프탈레이트 대사체와 조개류 섭취와의 연관성을 분석하고자 했다.
방법
본 연구는 국민환경보건 기초조사 제3기(2015-2017) 자료를 이용하여 만 19세 이상 성인 3,333명(남자1,526명과 여자1,807명)을 대상으로 진행하였다. 사회인구학적 변수 및 건강행태 관련 변수 및 식이 요인과 해산물의 섭취 빈도, 요중 프탈레이트 대사체 농도를 변수로 두어 각 변수 간의 분포 차이를 분석하였다. 로지스틱 회귀분석을 사용하여 조개류 섭취빈도에 따라 요중 프탈레이트 대사체 고농도군에 속할 OR값을 계산하였다.
결과
조개류 섭취의 경우 주 1회 초과군에서 MEOHP의 고농도군에 해당될 adjusted ORs은 1.43(95%CI: 1.01-2.06), MECPP 1.43(95%CI: 1.01-2.03), ∑DEHP 1.57(95%CI: 1.10-2.24), MCOP 2.01(95%CI: 1.46-2.77), MCNP 1.56(95%CI: 1.11-2.18), MCPP 2.57(95%CI: 1.85-3.56)으로 조사되었다.
결론
성인에서 조개류 섭취 빈도가 많을수록 요중 프탈레이트 대사체(MEOHP, MECPP, ∑DEHP, MCOP, MCNP, MCPP) 농도가 높았다.

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Filling gaps in population estimates of phthalate exposure globally: A systematic review and meta-analysis of international biomonitoring data
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International Journal of Hygiene and Environmental Health.2025; 265: 114539. CrossRef
Urinary phthalate metabolites and heart rate variability: A panel study
Ziqian Zhang, Miao Liu, Lei Zhao, Linlin Liu, Wenting Guo, Jie Yu, Huihua Yang, Xuefeng Lai, Xiaomin Zhang, Liangle Yang
Environmental Pollution.2023; 330: 121760. CrossRef
Microplastics induced inflammation and apoptosis via ferroptosis and the NF-κB pathway in carp
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Annals of Occupational and Environmental Medicine.2023;[Epub] CrossRef

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Original Article

Association between presenteeism and mental health among logistic center workers: Hyoungseob Yoo, Ji-hun Song, Hyoung-Ryoul Kim; Ann Occup Environ Med 2022;34:e39. Published online November 17, 2022; DOI: https://doi.org/10.35371/aoem.2022.34.e39

Abstract Abstract in Korean PDF Supplementary Material

Background

Workers in logistics centers are always pressed for time to collect and pack products. They also participate in high-intensity manual labor in which various musculoskeletal hazards exist. In the case of logistic center labor, it is estimated that there is a high risk of presenteeism due to the above characteristics which can cause deterioration of workers’ mental health. However, there is insufficient research on this topic.

Methods

Workers in a logistic center were surveyed using an Internet questionnaire. The survey items included demographic characteristics, labor intensity and work-related factors, and mental health aspects such as depression and anxiety. The survey was conducted for about a month from July 26, 2021 and a total of 353 people were analyzed. Through the χ² test and t-test, the characteristics of workers who experienced presenteeism were examined and the prevalence ratios (PRs) of depression and anxiety experiences were calculated by multivariable Poisson regression. Afterwards, stratification analysis considering gender, the type of contract, and labor intensity was implemented.

Results

In the group that experienced presenteeism, the number of working days per week was higher and fixed-term workers, high labor intensity, and sleep deprivation were more common. In the multi-Poisson regression analysis conducted by adjusting the demographic characteristics, working hours, and work-related factors, the PRs of depression and anxiety were 1.98 (95% confidence interval: 1.24–3.18) and 1.81 (1.22–2.68), respectively. In particular, the p-value for interactions was significant when stratified with the type of contract.

Conclusions

As a result of the study, presenteeism and mental health were associated in logistic center workers. To prevent mental health issues of logistic center workers, management of presenteeism is necessary and a prospective study is needed.

일개 물류센터 노동자에서 프리젠티즘과 정신건강 사이의 상관성
목적
코로나19 이후 물류 산업 전반의 수요가 증가하기 시작하였다. 물류센터 노동은 상품을 입고하고 주문된 상품을 제한 시간 내에 집품, 포장해야하는 업무로 항상 시간에 쫓기며, 다양한 근골격계 유해인자들이 상존하는 고강도의 육체 노동이 특징적이다. 물류센터 노동의 경우 위와 같은 특징으로 프리젠티즘이 발생할 위험이 높을 것으로 추정되며, 이후 근로자의 정신건강의 악화를 가져올 것으로 추정이 되나, 이에 대한 연구는 드물다. 이에 물류산업 노동자에서의 프리젠티즘과 정신건강 사이의 상관성을 보고자 본 연구를 시행하였다.
방법
일개 물류센터 종사자들을 대상으로 온라인 설문조사 링크를 통해 2021.7.26-2021.8.27. 동안 설문조사를 실시하였다. 중복을 제외하여 총 353명의 물류센터 종사자들이 최종 연구대상자로 선정되었다. 인구학적 특징, 고용 형태 및 업무 내용, 노동 시간 및 강도, 교대 근무, 질병 경험, 수면장애, 우울 등 건강 실태 등에 대해 조사하였다. Chi-square test, T-test를 통해 프리젠티즘 여부에 따른 근로 관련 특징을 살펴보았고, multivariable Poisson regression을 통해 프리젠티즘 유무에 따른 우울, 불안의 Prevalence ratio(PR)을 산출하였고, 성별, 근무 시간, 노동 강도에 따른 층화 분석을 시행하였다. 통계 프로그램은 SAS 9.4(SAS Institute, Cary, NC, USA)를 사용하였다.
결과
프리젠티즘이 확인되는 군에서 주당 근로일수가 길고, 계약직이 많으며, 노동 강도가 높고, 수면시간이 적은 것으로 확인된다. 나이, 성별, 계약조건, 주당 근로시간, 근무 형태, 노동 강도를 보정하여 multivariable Poission regression을 통해 분석한 결과 프리젠티즘이 있는 군에서 우울과 불안이 발생할 PR 값이 1.98(95%CI 1.24-3.18), 불안이 발생할 PR 값이 1.81(95%CI 1.22-2.68)로 나타났다. 층화 분석 시 고용 형태가 프리젠티즘과 우울과의 관계에서 유의한 상호작용이 확인되었다.
결론
본 연구 결과 물류센터 노동자에서 프리젠티즘과 정신건강 사이의 상관관계가 확인되었다. 물류센터 노동자의 정신건강을 예방하기 위해 프리젠티즘을 유발할 노동 강도 및 노동 환경을 개선해야하며, 아파도 일을 쉴 수 있도록 상병수당, 유급휴가 등의 정책 등이 마련되어야 할 것을 보여준다.

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Antecedents and outcomes of presenteeism in the service industry
Mohammad Soliman, Neveen A. Kohaf, Islam Elgammal, Francesca Dal Mas, Ali Mohsin Salim BaAwain
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Original Article

Association between working evening shifts and mental health among Korean employees: data from the 5th Korean Working Conditions Survey: Seongchan Heo, Yunrae Cho, Man-Joong Jeon; Ann Occup Environ Med 2022;34:e36. Published online November 8, 2022; DOI: https://doi.org/10.35371/aoem.2022.34.e36

Abstract Abstract in Korean PDF

Background

Many studies have been conducted to investigate the harmful effect of shift work on physical and mental health. Although, by definition, “working evening shift” is included in the scope of shift work, most related studies conducted thus far have focused on working night shifts, overtime work, or different types of shift work, with little research effort dedicated to “working evening shifts.” Therefore, to fill this research gap, we investigated the effect of working evening shifts on workers’ mental health.

Methods

The participants of this study were 16,692 employees of the 50,205 that participated in the 5^th wave of the Korean Working Conditions Survey. We performed χ² test and logistic regression analysis to analyze the effects of independent variables on health problems and calculated odds ratios and 95% confidence intervals (CIs).

Results

In the logistic regression analysis adjusted for sociodemographic characteristics, health-related factors, and work-related characteristics, employees who worked evening shifts showed higher levels of depression and anxiety compared to those that did not. In particular, the adjusted odds ratios of the group working evening shifts between one and nine times a month were the highest with 2.723 (95% CI: 2.014–3.682) for depression, 3.294 (95% CI: 2.547–4.259) for anxiety.

Conclusions

The results of our study suggest that working evening shifts has a negative effect on employees’ mental health. This trend decreased with an increase in the monthly frequency of evening work.

한국 근로자의 저녁 근무와 정신건강과의 관련성: 제 5차 한국 근로환경조사를 이용하여
목적
교대근무가 신체 및 정신건강에 미치는 유해한 영향에 대해서는 많은 연구가 이루어져왔다. 하지만 정의 상 저녁근무 또한 교대근무에 포함됨에도 불구하고 기존의 연구는 주로 야간근무 및 장시간 근무 또는 교대근무의 형태에 대해서 다뤘을 뿐 저녁시간 근무에 대한 검토는 거의 없었다. 따라서 본 연구에서는 저녁시간 근무가 근로자의 정신건강에 미치는 영향에 대해 알아보고자 하였다.
방법
이 연구는 제 5차 한국 근로환경조사에 포함된 50,205명의 참가자 중 임금 근로자 16,692명을 대상으로 진행되었다. 카이제곱 검정을 사용하여 대상자들의 각 특성과 건강문제와의 관련성을 파악하고, 이러한 결과를 기반으로 로지스틱 회귀분석을 시행하여 건강문제에 대한 독립변인의 영향력을 파악하고 교차비 (OR)와 95% 신뢰 구간 (CI)을 산출하였다.
결과
사회인구학적 특성, 건강관련 요인, 직업별 특성에 따라 조정된 로지스틱 회귀 분석에서 저녁 근무를 수행하는 근로자는 그렇지 않은 근로자에 비해 높은 수준의 우울, 불안, 피로감을 보였다. 특히 저녁 근무를 한 달에 1회이상 9회 이하 수행하는 군의 조정된 교차비는 우울 2.723 (95% confidence interval (CI): 2.014-3.682), 불안 3.294 (95% CI:2.547-4.259)으로 가장 높은 수치를 나타냈다.
결론
우리 연구의 결과는 저녁시간 근무가 근로자의 정신건강에 부정적 영향을 미침을 나타낸다. 이러한 경향은 한 달에 수행하는 저녁근무 횟수가 증가할수록 감소하는 결과를 보였다.

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Original Article

Hotel housekeepers and occupational health: experiences and perceived risks: Xènia Chela-Alvarez, Oana Bulilete, Encarna Garcia-Illan, MClara Vidal-Thomàs, Joan Llobera; Ann Occup Environ Med 2022;34:e29. Published online October 25, 2022; DOI: https://doi.org/10.35371/aoem.2022.34.e29

Abstract PDF

Background

Hotel housekeepers are one of the most important occupational group within tourism hotel sector; various health problems related to their job have been described, above all musculoskeletal disorders. The objective of this study is to understand the experiences and perceptions of hotel housekeepers and key informants from the Balearic Islands (Spain) regarding occupational health conditions and the strategies employed to mitigate them.

Methods

A qualitative study was carried out. Six focus groups with hotel housekeepers and 10 semi-structured interviews with key informants were conducted. Next, we carried out a content analysis.

Results

Hotel housekeepers reported musculoskeletal disorders, anxiety and stress as main occupational health problems; health professionals underscored the physical problems. Hotel housekeepers perceived that their work (physically demanding and with repetitive movements) caused their health conditions. To solve health issues, they used medication (anti-inflammatory agents, painkillers, sedatives and anxiolytics), which allowed them to continue working; health public services, generally rated as satisfactory; individual protective equipment; ergonomics (with difficulties due to high work pace and hotel facilities) and physical activity. Two contrasting attitudes were identified regarding sick leave: HHs who refused to accept a doctor-prescribed sick leave (due to fear of being fired, sense of responsibility, ...), and those who accepted it (because they could not continue working, they prioritised health before work).

Conclusions

Our results might contribute to plan improvement strategies and programs to address health problems among hotel housekeepers. These programs should include interventions, such as coping strategies for the work-related risk factors (i.e., stress) and strategies to reduce medicine consumption. Additionally, hotel facilities should adopt policies focused on making workplaces more ergonomic (i.e., furniture) and to diminish the work pace.

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Working conditions, health status and musculoskeletal disorders among hotel employees: A cross-sectional study in Türkiye
İrem Medeni, Özge Tonbuloğlu Altıner, Volkan Medeni, Mustafa Necmi İlhan
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Original Article

Transnational ties with the home country matters: the moderation effect of the relationship between perceived discrimination and self-reported health among foreign workers in Korea: Yaena Song, Sou Hyun Jang; Ann Occup Environ Med 2022;34:e18. Published online July 19, 2022; DOI: https://doi.org/10.35371/aoem.2022.34.e18

Abstract Abstract in Korean PDF

Background

Little attention has been paid to the relationship between perceived discrimination and self-rated health (SRH) among foreign workers in Korea. Transnational ties with the home country are known to be critical among immigrants, as they allow the maintenance of social networks and support. Nonetheless, as far as we know, no studies have examined the impact of transnational ties on SRH itself and the relationship between perceived discrimination and SRH, which the current study tries to examine.

Methods

Logistic regression analyses were conducted using the 2013 Survey on Living Conditions of Foreign Workers in Korea. Adult foreign workers from different Asian countries (n = 1,370) participated in this study. The dependent variable was good SRH and the independent variable was perceived discrimination. Transnational ties with the home country, as a moderating variable, was categorized into broad (i.e., contacting family members in the home country) vs. narrow types (i.e., visiting the home country).

Results

Foreign workers who perceived discrimination had a lower rate of good SRH than those who did not perceive discrimination. Broad social transnational ties moderated the relationship between perceived discrimination and SRH; narrow social transnational ties did not.

Conclusions

In line with previous studies, an association was found between perceived discrimination and SRH. Broad social transnational ties can be a good source of social support and buffer against the distress of perceived discrimination.

한국거주 외국인 노동자의 차별인식과 주관적 건강과의 관계: 모국과의 초국가적 연계의 조절효과를 중심으로
목적
1990년대 이후 외국인노동자의 숫자는 한국 사회에서 점차 증가하고 있다. 여러 선행연구들에서 연구자들은 차별인식과 주관적 건강이 부(-)의 관계가 있음을 밝혔으나, 한국적 맥락에서 외국인 노동자들의 차별인식과 주관적 건강과의 상관관계를 본 연구는 드물다. 최근 기술의 발전에 따라 이주민들의 모국과의 초국가적 연계(transnational ties with the home country)가 증가하고 있다. 그러나 이러한 초국가적 연계가 차별인식과 주관적 건강과의 상관관계를 조절하는지에 대한 연구는 부재하여, 본 연구에서 고찰해 보고자 한다.
방법
본 연구는 2013년 체류외국인실태조사를 이용하여 1) 차별인식과 주관적 건강과의 상관관계와 2) 모국과의 초국가적 연계의 조절 효과를 로지스틱 회귀분석을 통해 알아본다 (N=1,370). 종속변수는 양호한 주관적 건강(good self-rated health)이었으며, 독립변수는 한국에 거주하는 동안 인식한 차별(perceived discrimination) 여부이다. 조절변수로는 넓은 모국과의 초국가적 연계(모국에 있는 가족이나 친구와 연락하는 빈도)와 좁은 연계(모국 방문 빈도)로 측정되었다.
결과
한국 내에서의 차별인식과 주관적 건강은 부의 관계가 있었다. 모국에 있는 가족이나 친구와의 연락을 통한 넓은 의미의 초국가적 연계는 이 관계를 조절하였으나 모국을 방문하는 좁은 의미의 초국가적 연계는 조절 효과가 없었다.
결론
한국 내에 외국인 노동자에 대한 차별을 줄이는 노력과 더불어 외국인 노동자들이 모국에 있는 가족, 친구들과 초국가적으로 긴밀히 연결되어 이를 통해 사회적 지지를 받을 수 있도록 돕는 정책과 지원이 필요하다.

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Original Article

A proposal of spirometry reference equations for Korean workers: Yonglim Won, Hwa-Yeon Lee; Ann Occup Environ Med 2022;34:e14. Published online June 21, 2022; DOI: https://doi.org/10.35371/aoem.2022.34.e14

Abstract Abstract in Korean PDF

Background

Although spirometry results can be interpreted differently depending on the reference equation used, there are no established criteria for selecting reference equations as part of the special health examinations for Korean workers. Thus, it is essential to examine the current use of reference equations in Korea, quantify their impact on result interpretation, and propose reference equations suitable for Korean workers, while also considering the environmental conditions of special health examination facilities.

Methods

The 213,640 results from the special health examination database were analyzed to identify changes in the ratio of measured values to reference values of lung capacity in Korean workers with changes in age or height, and changes in the agreement of interpretations with the reference equation used. Data from 238 organizations that participated in the 2018–2019 quality control assessment by the Korea Occupational Safety and Health Agency were used to identify the spirometer model and reference equations used in each special health examination facility.

Results

Korean special health examination facilities used six reference equations, and the rate of normal or abnormal ventilatory diagnoses varied with the reference equation used. The prediction curve of the Global Lung Function Initiative 2012-Northeast Asian (GLI2012) equation most resembled that of the normal group, but the spirometry model most commonly used by examination facilities was not compliant with the GLI2012 equation. With a scaling factor of 0.95 applied to the Dr. Choi equation, the agreement with the GLI2012 equation was > 0.81 for men and women.

Conclusions

We propose the GLI2012 equation as reference equation for spirometry in Korean workers. The GLI2012 equation exhibited the most suitable prediction curve against the normal lung function group. For devices that cannot use the GLI2012 equation, we recommend applying a scaling factor of 0.95 to the Dr. Choi equation.

한국인 근로자의 특수건강진단 폐활량검사 결과 해석을 위한 예측식 제안
목적
폐활량검사 결과의 해석은 적용 예측식에 따라 달라질 수 있으나 현재 한국에는 특수건강진단 폐활량검사의 해석을 위한 예측식 선택 기준이 없다. 따라서 한국 특수건강진단기관 전체의 예측식 사용 실태를 파악하여 그것들이 결과 해석에 어느 정도 영향을 주었는지 정량적으로 확인하고, 한국인 근로자에게 적합하며 특수건강진단기관의 현실을 고려한 예측식을 제안할 필요가 있다.
방법
특수건강진단 데이터베이스로부터 추출한 213,640건의 폐활량검사 결과를 분석하여 한국인 근로자의 나이 또는 키의 변화에 따른 폐활량 예측치 대비 측정치의 변화와 예측식 변경에 따른 판정일치도의 변화를 확인하였다. 2018-2019년에 한국산업안전보건공단의 정도관리에 참여했던 238개 기관의 평가자료로부터 각 특수건강진단기관의 폐활량검사기 모델과 예측식 적용실태를 확인하였다.
결과
한국의 특수건강진단기관에서는 6종류의 예측식을 사용하고있었으며, 예측식에 따라 폐활량검사의 정상 또는 이상 판정률에 차이가 있었다. Global Lung Function Initiative 2012-동북아시안식의 예측곡선이 정상선별집단의 분포와 가장 일치하였으나 특수건강진단기관에서 가장 많이 사용하고 있는 검사기 모델에는 GLI 2012식을 적용할 수 없었다. 최정근식에 보정계수 0.95 적용 시 남성과 여성 모두에서 GLI 2012식과의 판정일치도는 0.81이상이었다.
결론
한국인 근로자의 폐활량검사 예측식으로 GLI 2012식을 제안한다. GLI 2012식은 정상 선별집단의 폐활량분포와 가장 일치하는 예측곡선을 그렸다. GLI 2012식을 적용할 수 없는 검사기에는 최정근식에 보정계수 0.95의 적용을 제안한다.

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Merve Nur Uygun, Myeong-Min Ju, Jun-Young Song, Yong-Ki Son, Dae-Sung Park
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Spirometry Reference Equations for Asian Migrant Workers in Korea: A Proposal
Hwa-Yeon LEE, Yonglim WON
Korean Journal of Clinical Laboratory Science.2023; 55(1): 29. CrossRef

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Original Article

Distribution of Korean safety and health professionals from the perspective of gender equality: Jeongim Park, Sohyeon Choi, Yeji Sung, Jinjoo Chung, Sangjun Choi; Ann Occup Environ Med 2022;34:e12. Published online June 9, 2022; DOI: https://doi.org/10.35371/aoem.2022.34.e12

Abstract Abstract in Korean PDF: Background
Gender equality in the workplace remains a challenge. This study aimed to investigate the gender gap of human resources in the field of occupational safety and health (OSH) in Korea.
Methods
Several national statistical data that can confirm the gender distribution of personnel in the OSH sector were reviewed. The gender distribution of industrial technical manpower statistics, professional certificate holders in the OSH field, and the status of the appointment of safety and health managers by industry was analyzed.
Results
The distribution of professionals in the OSH sector in Korea had a large gender gap with a small number of women. In particular, the proportion of women in the safety field was lower than that in the health field. In the younger age group, while the proportion of women is increasing, the gender gap tends to decrease.
Conclusions
Few data are available to understand the gender-related aspects of OSH professions. Nevertheless, our results provide basic information for initiating a discussion on the necessity of establishing gender-sensitive culture and policies in the OSH sector.; 성평등의 관점에서 본 한국 안전보건 전문인력 분포 특성
목적
이 연구는 한국의 산업안전보건 분야 인적 자원의 성별 격차를 조사함으로써 양성 평등의 관점에서 안전보건 인력의 분포 특성을 평가하고자 하였다.
방법
한국내 가용한 안전보건 인력에 대한 성별 분포 특성을 파악할 수 있는 자료를 수집하여 성별 특성을 비교 분석하였다. 산업기술인력 통계, 안전보건 분야 국가 자격증 취득자 분포 및 업종별 안전보건관리자 선임 특성 등을 분석하였다.
결과
국내 안전보건 분야 전문인력 분포는 2019년 산업기술인력 통계 분석 결과 여성이 4.5% 밖에 되지 않아 성별 차이가 컸다. 관리자 직급의 경우 보건의료 서비스 분야가 23.8%로 여성 비율이 가장 높았고, 나머지 직군에서는 4% 미만으로 성별 차이가 컸다. 보건 분야에 비해 안전 분야의 여성비율이 낮았으며, 30세 이하 젊은 연령층에서는 여성 비율이 증가하며 성별 격차가 줄어드는 경향을 보였다.
결론
국내 안전보건 분야 성별 특성을 파악할 수 있는 자료 자체가 매우 적었다. 그럼에도 불구하고, 본 연구 결과 안전보건 분야 전문인력의 여성 비율이 매우 낮음을 확인할 수 있었다. 본 연구 결과는 안전보건 분야 인력에 대한 성별 격차를 줄이고, 성별 특성을 고려한 안전보건정책 수립의 필요성에 대한 논의를 시작하기 위한 기초정보를 제공할 것이다.

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Original Article

Analysis of self-reported mental health problems among the self-employed compared with paid workers in the Republic of Korea: Yongho Lee, Junhyeong Lee, Ui-Jin Kim, Eunseun Han, Seunghon Ham, Won-Jun Choi, Seong-Kyu Kang, Wanhyung Lee; Ann Occup Environ Med 2022;34:e8. Published online April 8, 2022; DOI: https://doi.org/10.35371/aoem.2022.34.e8

Abstract Abstract in Korean PDF

Background

As self-employed workers are vulnerable to health problems, this study aimed to analyze mental health problems and sleep disturbances among self-employed workers compared with paid workers in Korea.

Methods

A total of 34,750 workers (23,938 paid workers and 10,812 self-employed workers) were analyzed from the fifth Korean Working Condition Survey, which included 50,205 households collected by stratified sampling in 2017. To compare mental health problems and sleep disturbance among self-employed workers and paid workers, multivariate logistic regression analyses were performed.

Results

The odds ratio in self-employed workers compared with paid workers was 1.25 (95% confidence interval [CI]: 1.09–1.42) for anxiety, 1.11 (95% CI: 1.04–1.17) for overall fatigue, 1.11 (95% CI: 1.04–1.20) for difficulty falling asleep, 1.10 (95% CI: 1.02–1.18) for difficulty maintaining sleep and 1.24 (95% CI: 1.16–1.32) for extreme fatigue after waking up.

Conclusions

Self-employed workers in Korea have a higher risk of self-reported mental health problems and sleep disturbances than paid workers. Further studies with a longitudinal design and structured evaluation are required to investigate the causal relationship between health problems and self-employment.

한국 자영업자의 주관적 정신건강 문제 : 제 5차 근로환경조사를 이용하여
목적
자영업자는 고용, 사업체 운영 등에 대한 스트레스를 받고 있으며 자신들의 건강관리에 취약한 것으로 여겨지고 있다. 이 연구는 자영업자들에게 초점을 맞춰 유급근로자들과 비교하여 정신건강 문제와 수면 장애를 분석하는 것을 목표로 하였다.
방법
이 연구는 한국의 5차 근로환경조사 데이터를 바탕으로 23,938명의 유급근로자와 10,812명의 자영업자들을 선택하여 분석을 수행하였다. 정신건강 문제는 ‘우울감’, ‘불안감’, ‘전신 피로’에 대한 설문과 수면 장애는 ‘잠들기가 어려움’, ‘자는 동안 반복적으로 깨어남’, ‘기진맥진함 또는 극도의 피곤함을 느끼며 깨어남’ 설문의 답변을 이용하였다. 자영업자의 정신건강 문제와 수면 장애를 분석하기 위해 다변량 로지스틱 회귀 분석을 시행하였다.
결과
자영업자에서의 ‘불안감’에 대한 보정된 오즈비는 1.25 (95% CI=1.09-1.42), ‘전신피로’는 1.11 (95% CI=1.04-1.17), ‘잠들기가 어려움’은 1.11 (95% CI=1.04-1.20), ‘자는 동안 반복적으로 깨어남’은 1.10 (95% CI=1.02-1.18) 그리고 ‘기진맥진함 또는 극도의 피곤함을 느끼며 깨어남’은 1.24 (95% CI=1.16-1.32)이었다.
결론
본 연구는 유급근로자에 비해 자영업자들의 정신건강 문제와 수면 장애의 위험성이 높은 것을 확인할 수 있었다. 자영업자들의 건강 보호와 증진을 위해 구조화된 설문, 전향적 연구 등의 추가적인 연구와 사회의 관심이 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

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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Kazuhiro Watanabe, Kazuhito Yokoyama, Akizumi Tsutsumi
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Effect of long working hours on psychological distress among young workers in different types of occupation
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Multi-Dimensional Comparison of the Impact Mechanism of the Self-Rated Health Status of Urban and Rural Residents in Chinese Social Environments
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Original Article

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

Abstract Abstract in Korean PDF Supplementary Material

Background

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

Methods

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

Results

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

Conclusions

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

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

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Seong-Uk Baek, Minseo Choi, Yu-Min Lee, Jin-Ha Yoon
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Distribution of volatile organic compounds by distance from industrial complexes and potential health impact on the residents
A Ram Kim, Jin-Hee Bang, Sunghee Lee, Chang Sun Sim, Yangho Kim, Jiho Lee
International Journal of Environmental Health Research.2024; 34(12): 4202. CrossRef
Association of Urinary Benzene Metabolite and the Ratio of Triglycerides to High-Density Lipoprotein Cholesterol: A Cross-Sectional Study Using the Korean National Environmental Health Survey (2018–2020)
Seungju Baek, Eunjung Park, Eun Young Park
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Journal of Environmental Health Sciences.2023; 49(6): 344. CrossRef
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Soon Su Shin, Eun Hye Yang, Hyo Choon Lee, Seong Ho Moon, Jae-Hong Ryoo
BMC Public Health.2022;[Epub] CrossRef

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Original Article

Association between physical hazardous agent exposure and mental health in the Korean working population: the 5th Korean Working Conditions Survey: Daeil Kwon, Kyeongmin Kwak, Kiook Baek, Youngchan Chi, Sewhan Na, Jong-Tae Park; Ann Occup Environ Med 2021;33:e33. Published online November 8, 2021; DOI: https://doi.org/10.35371/aoem.2021.33.e33

Abstract Abstract in Korean PDF Supplementary Material

Background

Mental health problems are emerging issues in occupational safety and health, whereas the findings on the relationship between physical hazards and mental health are not consistent. The aim of our study was to investigate the association between physical hazard exposure and mental health outcomes including depression and anxiety.

Methods

We included 48,476 participants from the fifth Korean Working Conditions Survey (KWCS) in this study. The χ² test and logistic regression analyses were conducted to assess the association between physical hazard exposures and mental health. All statistical analyses were performed sex-specifically.

Results

In logistic regression analysis, the odds ratios (ORs) of depression were significantly increased in male workers who were exposed to vibration (severe OR: 1.54, 95% confidence interval [CI]: 1.21–1.95) and noise (severe OR: 1.93, 95% CI: 1.49–2.48) whereas the ORs of depression were not significant in female workers from vibration (severe OR: 0.86, 95% CI: 0.50–1.38) or noise exposure (severe OR: 1.39, 95% CI: 0.84–2.17). The ORs of anxiety were significantly increased in male workers with vibration (severe OR: 1.76, 95% CI: 1.43–2.15) and noise exposure (severe OR: 2.12, 95% CI: 1.69–2.63) whereas the OR between vibration and anxiety (severe OR: 1.45, 95% CI: 0.91–2.21) was not significant in female workers. High or low temperature exposure had significant associations with depression and anxiety in both male and female subjects.

Conclusions

Results of our study suggest that physical hazard exposures may be associated with increased risk of mental health problems including depression and anxiety. These associations are more prominent in male workers in comparison with female workers.

한국 노동인구에서 물리적 위험요인 노출과 정신건강의 연관: 제5차 근로환경조사 자료
목적
산업보건에서 정신건강 문제가 새롭게 대두되고 있으나 물리적 위험요인과 정신건강의 관련성에 대한 일치된 결과는 없었다. 본 연구는 물리적 위험요인 노출과 우울 및 불안의 상관관계를 밝히는 데에 목적을 두고 있다.
방법
본 연구는 제5차 근로환경조사에서 추출한 48,476명을 대상으로 수행하였다. 카이제곱 검정과 로지스틱 회귀분석을 수행하여 물리적 유해인자 노출과 정신건강의 상관관계를 평가하였다. 모든 통계 분석은 성별에 따라 각각 이루어졌다.
결과
로지스틱 회귀분석에서 우울의 오즈비(odds ratio; OR)는 진동(심한 노출 OR: 1.54, 95% 신뢰구간 [confidence interval; CI]: 1.21, 1.95) 및 소음(심한 노출 OR: 1.93, 95% CI: 1.49, 2.48) 노출이 있는 남성 근로자에서 통계적으로 유의하게 증가한 반면 여성 근로자에서는 진동(심한 노출 OR: 0.86, 95% CI: 0.50, 1.38) 및 소음(심한 노출 OR: 1.39, 95% CI: 0.84, 2.17) 모두 통계적 유의성이 나타나지 않았다. 불안의 오즈비는 남성 근로자에서 진동(심한 노출 OR: 1.76, 95% CI: 1.43, 2.15) 및 소음(심한 노출 OR: 2.12, 95% CI: 1.69, 2.63)이 있는 경우 통계적으로 유의한 상승을 보였으나 여성 근로자에서 진동과 불안 간의 오즈비(심한 노출 OR: 1.45, 95% CI: 0.91, 2.21)는 유의하지 않았다. 고온 및 저온 노출의 경우 남녀 모두에서 우울, 불안과 유의한 상관관계가 확인되었다.
결론
본 연구의 결과는 물리적 유해인자 노출이 우울, 불안 등의 정신건강 문제 위험의 증가와 관련이 될 수 있음을 시사한다. 이러한 관계는 여성 근로자보다 남성 근로자에서 더 두드러지게 나타났다.

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Original Article

Need for individual-based evaluation to determine the association between humidifier disinfectants and health injuries: Hyeong-Cheol Kim, Hyunil Kim, Eun-Chan Mun, Yesung Lee, Soyoung Park; Ann Occup Environ Med 2021;33:e21. Published online June 18, 2021; DOI: https://doi.org/10.35371/aoem.2021.33.e21

Abstract PDF Supplementary Material

Background

Injuries caused by humidifier disinfectants (HDs) can no longer be grouped under the concept of HD lung injury. Focusing on individual cases, we were able to evaluate the relevance not only of diseases for which epidemiological correlation is recognized but also all diseases and symptoms that the victims complain of.

Methods

In-depth interviews and reassessment of 113 HD-exposed patients who had not been acknowledged as victims by the government were conducted, and their medical records were reviewed. Based on these processes, an assessment questionnaire for the injuries related to HDs was completed and the involvement of HDs was assessed either as “strong association,” “association,” or “no association.”

Results

In this study, of the 113 patients included who claimed damages, 78 (69.0%) had HD-related injuries. Among the cases of 22 patients who applied for injury acknowledgment due to upper respiratory inflammation that was not included among the acknowledged diseases, 17 (77.3%) were judged to be HD-related injuries (strong association vs. association: 10 [45.5%] vs. 7 [31.8%]). When the cases of 12 rhinitis patients were reassessed, 9 were HD-related injuries (strong association vs. association: 4 [33.3%] vs. 5 [41.7%]). When the cases of 18 asthma patients unacknowledged as a victim were reassessed, 17 (94.4%) were humidifier-related injuries (strong association vs. association: 12 [66.6%] vs. 5 [27.8%]). Among 4 interstitial lung disease patients unacknowledged as a victim, 2 (50.0%) were HD-related injuries.

Conclusions

HD-related health injuries should be assessed through both individual interviews and detailed chart reviews for more accurate injury acknowledgment. In the future, efforts should go beyond existing methods based on the adherence to acknowledgment criteria to directly listen to the victims.

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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

Abstract Abstract in Korean PDF

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.

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Review

Tuberculosis infection status and risk factors among health workers: an updated systematic review: Sanga Lee, Wanhyung Lee, Seong-Kyu Kang; Ann Occup Environ Med 2021;33:e17. Published online May 28, 2021; DOI: https://doi.org/10.35371/aoem.2021.33.e17

Abstract PDF

Tuberculosis (TB) infection is a common occupational risk for health workers (HWs) and poses a threat to the patients under their care and to other HWs. Hence, the development of a prevention strategy is crucial. We conducted a study to understand the status and risk factors of TB infection among HWs. The existing literature was searched for all published reports from 1 August 2010 to 31 December 2018, related to TB among HWs according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The inclusion criteria were: (1) study participants working in a health care facility; (2) TB cases diagnosed by medical professionals; (3) original research articles; and (4) English reports in a peer-reviewed journal. We finally included 61 studies from 642 articles searched initially. The TB infection rate in HWs was higher than that of the general population. Based on 39 studies, the prevalence of TB in HWs (tuberculin skin test positive) was 29.94%. In contrast, the global burden of latent TB infection was 23.0% (95% uncertainty interval: 20.4%–26.4%) in 2014. The risk factors of TB among HWs were aging, long duration of employment, nursing professionals, lack of Bacillus Calmette-Guerin vaccination, and low body mass index. HWs have an increased risk for TB infection, which can cause secondary infections in patients or other HWs. An effective prevention strategy must be developed to enable early diagnosis and prompt treatment.

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Research Article

Association between sleep duration and impaired fasting glucose according to work type in non-regular workers: data from the first and second year (2016, 2017) of the 7th Korean National Health and Nutrition Examination (KNHANE) (a cross-sectional study): JaeHan Joo, Jae-Gwang Lee, SangWoo Kim, JaeHan Lee, June-Hee Lee, Kyung-Jae Lee; Ann Occup Environ Med 2020;32:e29. Published online July 30, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e29

Abstract PDF

Background

We aimed to find the relationship between sleep duration and impaired fasting glucose according to working type in non-regular workers using the 2016 and 2017 Korean National Health And Nutrition Examination (KNHANE, 7th revision).

Method

In the 1st and 2nd year (2016, 2017) of the 7th KNHANE, 16,277 people participated. Minors were excluded because this study was intended for individuals aged 19 years and older. As this study was based on wage workers, unemployment, self-employed workers, employers, unpaid family workers, and those who have insufficient answers such as unknown or no response were excluded. Regular workers were excluded because this study was intended for non-regular workers. Finally, a total of 2,168 people were included in the survey, except those who had been diagnosed with diabetes, had a fasting blood glucose level of 126 mg/dL or higher, or taking hypoglycemic agents or receiving insulin injections. To find the relationship between sleep duration and impaired fasting glucose according to work type in non-regular workers, multiple logistic regression analysis was performed by adjusting the general and occupational characteristics after stratification according to work type. All statistical analyses were performed using the SPSS software (version 26.0; SPSS Inc., Chicago, IL, USA).

Results

In the case of insufficient sleep duration in irregular female workers, the odds ratio (OR) of impaired fasting glucose was statistically insignificant, but in the case of insufficient sleep duration in irregular male workers who have shift work, the odds ratio (OR) of impaired fasting glucose was significantly higher than that of sufficient sleep duration (Model 1, OR: 3.05, 95% confidence interval [CI]: 1.18–7.90; Model 2, OR: 2.81, 95% CI: 1.08–7.29).

Conclusions

Our findings demonstrate that insufficient sleep duration was associated with an increase in fasting blood glucose levels in non-regular male workers working shifts. This means that non-regular workers are in desperate need for adequate sleep and health care. We hope that our study will help improve the health of non-regular workers and more systematic and prospective follow-up studies will be conducted to further improve the health of non-regular workers.

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Case Report

Mental health impact on a humidifier disinfectant disaster victim: a case report: Ye-Sung Lee, Min-Woo Nam, Hyun-Il Kim, Hyeong-Cheol Kim, Eun-Chan Mun, So-Young Park; Ann Occup Environ Med 2020;32:e15. Published online June 1, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e15

Abstract PDF

In Korea, the cause of lung disease of unknown origin was identified as humidifier disinfectants in November 2011. In February 2017, the ‘Special Act on Remedy for Damage Caused by Humidifier Disinfectants’ was promulgated. Even though emotional and mental injuries caused by humidifier disinfectants have been reported, the focus of the special act has been on physical injury only, and criteria for recognizing mental health impact have not been considered. This case considers emotional and mental injury caused by humidifier disinfectants. After a humidifier disinfectant was used from January 2005 to April 2006, the patient's son aged 20 months was hospitalized with respiratory symptoms, and he died within two weeks. Also, the patient was hospitalized for a month with the same symptoms, and then she led a normal life with no symptoms. After both mother and son were diagnosed with definite (level 1) humidifier disinfectant lung injury (HDLI) in 2017, she took to drinking alcohol because of extreme guilt over her son's death. In March 2018 she died from acute liver failure due to alcohol use disorder. The patient's death was caused by continuous alcoholism, due to emotional and mental trauma caused by her son's death after HDLI was revealed as the cause. The government did not acknowledge her death was due to humidifier disinfectants, but the company that sold the humidifier disinfectants recognized her as a victim and compensated the family of the victim. There are still lots of psychological responses among humidifier disinfectant disaster victims. Mental health impact on humidifier disinfectant victims should be considered more carefully, and institutional improvements should be made into establish psychological interventions and measures.

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Research Article

Relationship between seafood consumption and bisphenol A exposure: the Second Korean National Environmental Health Survey (KoNEHS 2012–2014): Yeji Kim, Minkyu Park, Do Jin Nam, Eun Hye Yang, Jae-Hong Ryoo; Ann Occup Environ Med 2020;32:e10. Published online March 5, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e10

Abstract PDF

Background

This study aimed to identify the relationship between exposure to bisphenol A (BPA) and seafood consumption using a nationally representative data of the general Korean population.

Methods

This study was conducted on 5,402 adults aged 19 years and older (2,488 men, 2,914 women) based on the second Korean National Environmental Health Survey (2012–2014). We stratified the data according to gender and analyzed urinary BPA concentrations in terms of sociodemographic characteristics, health behavior, dietary factor, and seafood consumption. In the high and low BPA exposure groups, the odds ratios (ORs) were calculated using logistic regression analysis according to the top 75th percentile concentration.

Results

In men, large fish and tuna and other seafood categories had significantly higher ORs before and after adjustment in the group who consumed seafood more than once a week than in the group who rarely consumed seafood, with an adjusted value of 1.97 (95% confidence interval [CI]: 1.12–3.48) and 1.74 (95% CI: 1.10–2.75), respectively. In the shellfish category, the unadjusted OR was 1.61 (95% CI: 1.00–2.59), which was significantly higher in the group who consumed seafood more than once a week than in the group who rarely consumed seafood. However, the OR after adjusting for the variables was not statistically significant. In women, the frequency of seafood consumption and the concentration of urinary BPA were not significantly associated.

Conclusions

BPA concentration was higher in men who frequently consumed large fish and tuna, shellfish and other seafood in this study.

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