Annals of Occupational and Environmental Medicine

Original Article

Development of algorithm for work intensity evaluation using excess overwork index of construction workers with real-time heart rate measurement device: Jae-young Park, Jung Hwan Lee, Mo-Yeol Kang, Tae-Won Jang, Hyoung-Ryoul Kim, Se-Yeong Kim, Jongin Lee; Ann Occup Environ Med 2023;35:e24. Published online July 19, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e24

Abstract Abstract in Korean PDF Supplementary Material PubReader ePub

Background

The construction workers are vulnerable to fatigue due to high physical workload. This study aimed to investigate the relationship between overwork and heart rate in construction workers and propose a scheme to prevent overwork in advance.

Methods

We measured the heart rates of construction workers at a construction site of a residential and commercial complex in Seoul from August to October 2021 and develop an index that monitors overwork in real-time. A total of 66 Korean workers participated in the study, wearing real-time heart rate monitoring equipment. The relative heart rate (RHR) was calculated using the minimum and maximum heart rates, and the maximum acceptable working time (MAWT) was estimated using RHR to calculate the workload. The overwork index (OI) was defined as the cumulative workload evaluated with the MAWT. An appropriate scenario line (PSL) was set as an index that can be compared to the OI to evaluate the degree of overwork in real-time. The excess overwork index (EOI) was evaluated in real-time during work performance using the difference between the OI and the PSL. The EOI value was used to perform receiver operating characteristic (ROC) curve analysis to find the optimal cut-off value for classification of overwork state.

Results

Of the 60 participants analyzed, 28 (46.7%) were classified as the overwork group based on their RHR. ROC curve analysis showed that the EOI was a good predictor of overwork, with an area under the curve of 0.824. The optimal cut-off values ranged from 21.8% to 24.0% depending on the method used to determine the cut-off point.

Conclusion

The EOI showed promising results as a predictive tool to assess overwork in real-time using heart rate monitoring and calculation through MAWT. Further research is needed to assess physical workload accurately and determine cut-off values across industries.

실시간 심박수 측정 장치를 이용한 건설업 근로자 과로 예측 알고리즘
목적
건설업 근로자는 육체적 업무강도가 높아 이에 따른 피로와 그에 따른 사고 및 건강 악영향 우려가 높다. 이 연구에서는 일개 사업장 건설업 근로자를 대상으로 과로와 심박수 사이의 관계를 탐색하고 실시간 심박수 모니터링을 이용하여 과로를 방지하는 방법을 제안하였다.
방법
서울의 일개 건설업 현장에서 근무하는 근로자를 대상으로 2021.08.-2021.10.까지 근무 중 심박수를 측정하였다. 총 66명의 한국인 근로자가 손목시계 형 장치를 이용하여 심박수 측정에 참여하였다. 안정시 심박수와 최대 심박수 추정치를 바탕으로 상대심박수(RHR)를 산출하였고, 이를 바탕으로 피로 없이 근무할 수 있는 최대시간(MAWT)를 계산하여 이를 바탕으로 업무 부담(workload)를 추정하였다. 이를 통해 산출한 누적 업무량으로 과로 지수(Overwork index)를 산출한 후 적정 업무 부담(PSL)과의 차이인 초과 과로 지수(Excess overwork index)를 정의하였다. EOI 값을 이용해 일평균 상대심박수 30%값을 기준으로 정의한 과로군-비과로군을 예측할 수 있는 최적 절단값을 ROC 분석을 통해 산출하였다.
결과
근로자 60명의 심박수 측정값을 분석한 결과 28(46.7%)가 일평균 상대심박수를 기준으로 과로군으로 분류되었다. ROC 분석 결과 EOI값이 과로를 예측하는데 유용함을 확인하였고 AUC값은 0.824였다. 최적 절단 값은 최적화 방법에 따라 21.8%에서 24.0%로 나타났다.
결론
실시간 심박수 모니터링과 MAWT를 이용해 산출한 EOI값은 과로를 예측하는데 유용한 지표임을 확인하였다. 단, 건설업을 비롯하여 다른 육체적 부담이 큰 업종에서 최적 절단값을 찾기 위해서는 추가 연구가 필요하다.

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Research Article

Effect of long term high altitude exposure on cardiovascular autonomic adjustment during rest and post-exercise recovery: Prem Bhattarai, Bishnu H. Paudel, Dilip Thakur, Balkrishna Bhattarai, Bijay Subedi, Rita Khadka; Ann Occup Environ Med 2018;30:34. Published online May 11, 2018; DOI: https://doi.org/10.1186/s40557-018-0240-1

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Background

Despite the successful adaptation to high altitude, some differences do occur due to long term exposure to the hypoxic environment. The effect of long term high altitude exposure on cardiac autonomic adjustment during basal and post-exercise recovery is less known. Thus we aimed to study the differences in basal cardiac autonomic adjustment and its response to exercise in highlanders and to compare it with lowlanders.

Methods

The study was conducted on 29 healthy highlander males who were born and brought up at altitude of 3000 m and above from the sea level, their cardiac autonomic adjustment was compared with age, sex, physical activity and ethnicity-matched 29 healthy lowlanders using Heart Rate Variability (HRV) during rest and recovery from sub-maximal exercise (3 m step test). Intergroup comparison between the highlanders and lowlanders and intragroup comparison between the rest and the postexercise recovery conditions were done.

Results

Resting heart rate and HRV during rest was comparable between the groups. However, heart rate recovery after 3 min step test was faster in highlanders (p < 0.05) along with significantly higher LF power and total power during the recovery phase. Intragroup comparison of highlanders showed higher SDNN (p < 0.05) and lower LF/HF ratio (p < 0.05) during recovery phase compared to rest which was not significantly different in two phases in lowlanders. Further highlander showed complete recovery of RMSSD, NN50, pNN50 and HF power back to resting level within five minutes, whereas, these parameters failed to return back to resting level in lowlanders within the same time frame.

Conclusion

Highlanders completely recovered back to their resting state within five minutes from cessation of step test with parasympathetic reactivation; however, recovery in lowlanders was delayed.

Electronic supplementary material

The online version of this article (10.1186/s40557-018-0240-1) contains supplementary material, which is available to authorized users.

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Jie Feng, Weiwei Men, Xiao Yu, Wenjia Liu, Shiyu Zhang, Jie Liu, Lin Ma
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Research Article

The responses of subjective feeling, task performance ability, cortisol and HRV for the various types of floor impact sound: a pilot study: Seok Hyeon Yun, Sang Jin Park, Chang Sun Sim, Joo Hyun Sung, Ahra Kim, Jang Myeong Lee, Sang Hyun Lee, Jiho Lee; Ann Occup Environ Med 2017;29:13. Published online May 15, 2017; DOI: https://doi.org/10.1186/s40557-017-0168-x

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Background

Recently, noise coming from the neighborhood via floor wall has become a great social problem. The noise between the floors can be a cause of physical and psychological problems, and the different types of floor impact sound (FIS) may have the different effects on the human’s body and mind. The purpose of this study is to assess the responses of subjective feeling, task performance ability, cortisol and HRV for the various types of floor impact.

Methods

Ten men and 5 women were enrolled in our study, and the English listening test was performed under the twelve different types of FIS, which were made by the combinations of bang machine (B), tapping machine (T), impact ball (I) and sound-proof mattress (M). The 15 subjects were exposed to each FIS for about 3 min, and the subjective annoyance, performance ability (English listening test), cortisol level of urine/saliva and heart rate variability (HRV) were examined. The sound pressure level (SPL) and frequency of FIS were analyzed. Repeated-measures ANOVA, paired t-test, Wilcoxon signed rank test were performed for data analysis.

Results

The SPL of tapping machine (T) was reduced with the soundproof mattress (M) by 3.9–7.3 dBA. Impact ball (I) was higher than other FIS in low frequency (31.5–125 Hz) by 10 dBA, and tapping machine (T) was higher than other FIS in high frequency (2–4 k Hz) by 10 dBA. The subjective annoyance is highest in the combination of bang machine and tapping machine (BT), and next in the tapping machine (T). The English listening score was also lowest in the BT, and next in T. The difference of salivary cortisol levels between various types of FIS was significant (p = 0.003). The change of HRV parameters by the change of FIS types was significant in some parameters, which were total power (TP) (p = 0.004), low frequency (LF) (p = 0.002) and high frequency (HF) (p = 0.011).

Conclusions

These results suggest that the human’s subjective and objective responses were different according to FIS types and those combinations.

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Research Article

Ambulatory heart rate of professional taxi drivers while driving without their typical psychosocial work stressors: a pilot study: BongKyoo Choi, SangJun Choi, JeeYeon Jeong, JiWon Lee, Shi Shu, Nu Yu, SangBaek Ko, Yifang Zhu; Ann Occup Environ Med 2016;28:54. Published online October 6, 2016; DOI: https://doi.org/10.1186/s40557-016-0139-7

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Background

Few studies have examined ambulatory cardiovascular physiological parameters of taxi drivers while driving in relation to their occupational hazards. This study aims to investigate and quantify the impact of worksite physical hazards as a whole on ambulatory heart rate of professional taxi drivers while driving without their typical worksite psychosocial stressors.

Methods

Ambulatory heart rate (HR_driving) of 13 non-smoking male taxi drivers (24 to 67 years old) while driving was continuously assessed on their 6-hour experimental on-road driving in Los Angeles. Percent maximum HR range (PMHR_driving) of the drivers while driving was estimated based on the individual HR_driving values and US adult population resting HR (HR_rest) reference data. For analyses, the HR_driving and PMHR_driving data were split and averaged into 5-min segments. Five physical hazards inside taxi cabs were also monitored while driving. Work stress and work hours on typical work days were self-reported.

Results

The means of the ambulatory 5-min HR_driving and PMHR_driving values of the 13 drivers were 80.5 bpm (11.2 bpm higher than their mean HR_rest) and 10.7 % (range, 5.7 to 19.9 %), respectively. The means were lower than the upper limits of ambulatory HR and PMHR for a sustainable 8-hour work (35 bpm above HR_rest and 30 % PMHR), although 15–27 % of the 5-min HR_driving and PMHR_driving values of one driver were higher than the limits. The levels of the five physical hazards among the drivers were modest: temperature (26.4 ± 3.0 °C), relative humidity (40.7 ± 10.4 %), PM_2.5 (21.5 ± 7.9 μg/m³), CO₂ (1,267.1 ± 580.0 ppm) and noise (69.7 ± 3.0 dBA). The drivers worked, on average, 72 h per week and more than half of them reported that their job were often stressful.

Conclusions

The impact of physical worksite hazards alone on ambulatory HR of professional taxi drivers in Los Angeles generally appeared to be minor. Future ambulatory heart rate studies including both physical and psychosocial hazards of professional taxi drivers are warranted.

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Research Article

Factors related to heart rate variability among firefighters: Jae-Hong Shin, Jung-Youb Lee, Seon-Hee Yang, Mi-Young Lee, In-Sung Chung; Ann Occup Environ Med 2016;28:25. Published online June 13, 2016; DOI: https://doi.org/10.1186/s40557-016-0111-6

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Objectives

The aim of this study was to investigate factors associated with heart rate variability in firefighters working in a metropolitan city in South Korea.

Methods

Self-administered questionnaires including Korean Occupational Stress Scale (KOSS) as well as surveys collecting socio-demographic characteristics and work-related factors were given to 962 firefighters. After exclusion for missing data, 645 firefighters were included, and analysis of covaiance adjusted for the general risk factors and job characteristics were used to assess the relationship between heart rate variability and associated factors.

Results

SDNN and RMSSD and were decreased in the area of occupational climate of the group with high job stress (p = 0.027, p = 0.036). HF(ln) was decreased in the area of organizational system and occupational climate of the group with high stress that statistically significant level (p = 0.034, p = 0.043).

Conclusions

Occupational climate and organizational system are associated with reduction of heart rate variability. Preventive medical care plans for cardiovascular disease of firefighters through the analysis and evaluation of job stress factors are needed.

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Research Article

Effects of high occupational physical activity, aging, and exercise on heart rate variability among male workers: Dongmug Kang, Youngki Kim, Jongeun Kim, Yongsik Hwang, Byungmann Cho, Taekjong Hong, Byungmok Sung, Yonghwan Lee; Ann Occup Environ Med 2015;27:22. Published online September 25, 2015; DOI: https://doi.org/10.1186/s40557-015-0073-0

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Objectives

Effects of aging and leisure time physical activity (LPA) might influence the effect of occupational physical activity (OPA) on risk for cardiovascular disease (CVD). This study was conducted to determine whether OPA affects CVD after controlling the effects of LPA and other risk factors for CVD such as job stress.

Methods

Participants were 131 male Korean manual workers. Tests for heart rate variability (HRV) were conducted for five minutes in the morning at work. We defined OPA as the combined concept of relative heart rate ratio (RHR), evaluated using a heart rate monitor.

Results

Whereas high OPA was not related to any HRV items in the younger age group, high OPA was associated with an increased number of low-value cases among all HRV items in older workers. Exercise had beneficial effects only in the younger group. After controlling for exercise and other risk factors, the odds ratios of the root-mean square of the difference of successive normal R-R intervals (rMSSD) and high frequency band power (HF) among the older age and high OPA group compared with the younger age and low OPA group were 64.0 and 18.5, respectively. Social support and shift work were independent risk factors in HRV.

Conclusions

OPA in aging workers increases CVD risks. This study provides support for the need for protection of aging workers from physical work overload, and indicates the need for further study of optimal limits of OPA.

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Original Article

Effects of Volatile Organic Compounds, and Formaldehyde on Heart Rate Variability among Elderly People in Seoul: Jeong Cheol Seo, Mo Yeol Kang, Soo Hun Cho, Youn Hee Lim, Jin Hee Kim, Jong Ryeul Sohn, Yun Chul Hong; Korean Journal of Occupational and Environmental Medicine 2011;23(3):253-260. Published online September 30, 2011; DOI: https://doi.org/10.35371/kjoem.2011.23.3.253

Abstract PDF

OBJECTIVES
The purpose of the present study was to investigate the effects of volatile organic compounds, and formaldehyde on heart rate variability among elderly people who are vulnerable to ambient pollution.
METHODS
From May to August of 2009, 57 subjects older than 60 years were recruited in this study. Indoor air pollutants (volatile organic compounds and formaldehyde) were measured by a personal passive sampler. Heart rate variability (HRV) was measured in the sitting position for five minutes and assessed by time-domain and frequency-domain.
RESULTS
Multiple linear regression analysis showed significantly less low-frequency (LF) and high-frequency (HF) associated with elevated benzene levels. Exposure to toluene was associated with decreases in the Standard deviation of the NN intervals (SDNN) and LF. SDNN and LF were negatively associated with the increment of ethylbenzene levels.
CONCLUSIONS
An adverse effect on cardiovascular function caused by volatile organic compounds was observed among the elderly people of Seoul even though indoor air pollutant levels were lower than the yearly average guideline for indoor air quality in Korea.

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Original Article

Chronic and Acute Effects of Work-related Factors on Heart Rate Variability: Minjeong Son, Youngki Kim, Sangbum Ye, Jihyun Kim, Dongmug Kang, Jangseong Ham, Yonghwan Lee; Korean Journal of Occupational and Environmental Medicine 2008;20(4):314-325. Published online December 31, 2008; DOI: https://doi.org/10.35371/kjoem.2008.20.4.314

Abstract PDF

OBJECTIVES
Reduced heart rate variability (HRV) is one of the serious risk factors for heart diseases. We evaluated the acute and chronic effects of work-related factors on HRV.
METHODS
The five-minute HRV of 85 male workers from an automobile assembly factory were measured at 9 A.M. (before-work) and at 5 P.M. (after-work). The workplace noise, temperature and physical workload levels were measured as work-related factors. We postulated that the HRV measured at beforework represents the chronic effects and the HRV measured at after-work represents the acute effects of work-related factors. We used generalized linear regression analysis with adjusting for the general characteristics and/or the morning HRV.
RESULTS
The subjects exposed to noise or a hot environment showed increased HRV in the afternoon and decreased HRV in the morning. Machine oil and interpersonal conflict decreased the HRV in the morning, but other chemicals did not show any effect on the HRV. A physical workload decreased the HRV in both the morning and afternoon.
CONCLUSION
The physical and chemical environment, psychosocial stress and a physical workload may affect the autonomic nerve system.

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Original Article

The Health Effects of Mercury on the Cardiac Autonomic Activity According to the Heart Rate Variability: Sinye Lim, Min Cheol Choi, Kee Ock Joh, Domyung Paek; Korean Journal of Occupational and Environmental Medicine 2008;20(4):302-313. Published online December 31, 2008; DOI: https://doi.org/10.35371/kjoem.2008.20.4.302

Abstract PDF

OBJECTIVES
The effect of mercury on the cardiovascular system has recently been reported on, but the mechanisms as well as its nature of this effect still need to be confirmed. In this study, the mercury in the hair of a community population was analyzed in relation to the cardiac autonomic activity.
METHODS
A hair sample was obtained from the occiput area and the mercury in the hair was analyzed by using a Direct Mercury Analyzer. We measured the cardiovascular risk factors, including total cholesterol, triglyceride, blood pressure, and the body mass index (BMI). Heart rate variability was assessed for 5 minutes, in the time and frequency domain, by using SA-3000P from the Medi-core(R). company. The association between the mercury in the hair and heart rate variability was assessed after controlling for the other cardiovascular risk factors.
RESULTS
The mean age of the 671 total subjects was 36 years. The geometric mean of the hair mercury was 0.90 ppm. The hair mercury level was elevated in males, adults, smokers and drinkers. Hair mercury and age, the systolic and diastolic blood pressure, total cholesterol, triglyceride, LDL cholesterol and BMI were all positively correlated. However, hair mercury and heart rate, HDL cholesterol, standard deviation of the NN intervals (SDNN), total power (TP), low-frequency (LF), high- frequency (HF) were negatively correlated. In the higher mercury group, heart rate, SDNN, LF and HF indices were significantly lower compared with those of the lower mercury group. Heart rate was decreased 2.6 beats/min, Ln (HF) was decreased 0.131 msec2 and HF norm was decreased 2.550 with a 1 ppm increase of Ln (Hg), according to multiple linear regression analysis after controlling for age, gender and other cardiovascular risk factors.
CONCLUSION
This cross-sectional study showed that mercury may affect the cardiac autonomic activity through parasympathetic dysfunction.

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Su-Bin Park, Eun-Kyong Kim, Joon Sakong, Eun Young Park
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The association between mercury concentrations and lipid profiles in the Korean National Environmental Health Survey (KoNEHS) cycle 3
Soo Ho Sohn, Han Cheol Heo, Seongmin Jo, Chulyong Park, Joon Sakong
Annals of Occupational and Environmental Medicine.2020;[Epub] CrossRef
Mercury and metabolic syndrome: a review of experimental and clinical observations
Alexey A. Tinkov, Olga P. Ajsuvakova, Margarita G. Skalnaya, Elizaveta V. Popova, Anton I. Sinitskii, Olga N. Nemereshina, Evgenia R. Gatiatulina, Alexandr A. Nikonorov, Anatoly V. Skalny
BioMetals.2015; 28(2): 231. CrossRef

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Original Article

Heart Rate Variability of Carbon Disulfide Poisoned Subjects after Exposure Cessation: Sang Yoon Lee, Sung Il Cho, Do Myung Paek, Chang Bum Byeon, Mi Jeong Kim, Kyung Keun Park, Sang Hyeok Yim, Kil Seung Yang, Chang Kook Hwang, Hyung Joon Jhun; Korean Journal of Occupational and Environmental Medicine 2006;18(2):123-129. Published online June 30, 2006; DOI: https://doi.org/10.35371/kjoem.2006.18.2.123

Abstract PDF: OBJECTIVES
A previous study conducted in 2000 measuring the heart rate variability (HRV) of carbon disulfide (CS2)-poisoned subjects suggested that their HRV was reduced after exposure cessation. However, the study was limited by the following procedural limitations: (1) only 71 CS2-poisoned subjects participated, (2) no females participated, and (3) the CS2-poisoned subjects were older than the controls. This study was therefore conducted to overcome these limitations of the earlier study.
METHODS
The study subjects comprised 122 retired workers with CS2 poisoning and the same number of age- and sex-matched controls. Information on individual age, sex, height, weight, smoking history, alcohol drinking, regular exercise, medical and occupational history, chest x-ray, and ECG recording of the two groups was collected though a self-administered questionnaire and a medical examination. Standard Deviation of NN intervals (SDNN), Root-Mean-Square of Successive Differences (RMSSD), Total Power (TP), Low Frequency (LF), High Frequency (HF), and LF/HF ratio were measured as HRV indices for 5 minutes in the sitting position.
RESULTS
Univariate analysis revealed that all HRV indices of CS2-poisoned subjects were lower than those of the controls. Multiple linear regression analysis showed that CS2 poisoning had negative association with all HRV indices and that its association with RMSSD was statistically significant (P<0.05).
CONCLUSIONS
This study suggests that CS2-poisoned subjects continue to have reduced HRV, even though the exposure has ceased.

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Original Article

Sleep Patterns and Morning Heart Rate Variability Among Daytime Workers in Korea: Chang Ho sohn, Min Sook Kim, Hyunjoo Kim, Soo Young Kim, Ji Ho Lee, Hyung Joon Jhun, Jong Min Woo; Korean Journal of Occupational and Environmental Medicine 2005;17(3):208-215. Published online September 30, 2005; DOI: https://doi.org/10.35371/kjoem.2005.17.3.208

Abstract PDF

OBJECTIVES
This study was performed to evaluate the sleep patterns in a population of Korean labor workers and to assess the activity of the autonomic nervous system in relation to sleep habits.
METHODS
A sampler of 1238 daytime workers (male 911, female 327) completed questionnaires on sleep habits and their short term heart rate variability(HRV) was also examined. We used the SA-2000 (medi-core) instrument for 5 minutes for each participant in the morning and performed basic physical examinations including height, weight, and blood pressure.
RESULTS
Bed time and wake up time were negatively correlated with age, while the frequencies of waking up through the night and in the early morning showed positive correlation with age. We found that bed time and wake up time during weekdays, sleep latency during weekdays, frequency of waking up through the night, and the degree of sleepiness all varied significantly according to the average nightly amount of sleep within the last week. There was a positive correlation between wake up time at weekdays with mean heart rate. However, the other variables of sleep habits and pattern did not show significant correlation with HRV.
CONCLUSION
Among Korean daytime workers, sleep phases become advanced with aging. In spite of the aging processes, general sleep health seems to be maintained among the healthy worker group. However, short-term HRV was not useful parameter to measure the alternation of autonomic nervous system resulting from the difference of sleep habits and pattern.

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Eun-Jeong Hong
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Factors related with quality on sleep of daytime workers
Bu-il Kim, Seong-yong Yoon, Jin-seok Kim, Kuck-Hyeun Woo, Seong-yong Cho, Ho Lee, Jong-min An
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Temperament and Character Traits, Heart Rate Variability and Occupational Stress in New Nursing Employees
Min Soo Ko, Yong Lee Jang, Jin Sook Choi, Hyun Bo Shim, Hee Jung Nam, Mee Suk Wang, In Deok Lee, Hae Woo Lee
Journal of Korean Neuropsychiatric Association.2016; 55(3): 271. CrossRef

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Original Article

Relationship between Fatigue Severity and Heart Rate Variability in Middle-Aged Male Workers: Sang Wook Song, Jin Hee Shin, Thomas Findley; Korean Journal of Occupational and Environmental Medicine 2005;17(1):26-35. Published online March 31, 2005; DOI: https://doi.org/10.35371/kjoem.2005.17.1.26

Abstract PDF

OBJECTIVES
This study investigated the relationship between the severity of fatigue and the cardiac autonomic function by analyzing the heart rate variability on middle-aged male workers.
METHODS
The severity of fatigue and heart rate variability were assessed with the control measures of age, body mass index, blood pressure, alcohol consumption, smoking history, regular exercise on 82 healthy middle-aged male workers in an annual health checkup. The severity of fatigue was evaluated by the Fatigue Severity Scale (FSS), which was developed by Krupp. The 5-minute electrocardiographic recordings were analyzed as a function of the time and the frequency domain methods of the heart rate variability (HRV). Standard Deviation of the NN intervals (SDNN), Root-Mean-Square of Successive Differences (rMSSD), Total Power (TP), Low Frequency (LF: 0.04~0.15 Hz) power, High Frequency (HF: 0.15-0.4 Hz) power, LF/HF ratio were used as the indices of the HRV. For a comparison of autonomic nervous functions and other variables, the subjects were divided into three fatigue groups based on the FSS score as follows: low (N=31), moderate (N=33), high (N=18) fatigue groups.
RESULTS
There were no significant differences in age, blood pressure, heart rate, body mass index, alcohol consumption, or regular exercise except for the smoking history among the groups. In addition, there were no significant differences in the time domain analysis (SDNN, rMSSD) of HRV among the groups. Spectral analysis of the HRV showed that the mean amplitudes of the HF and LF component were lower in the high fatigue group, whereas there was no significant difference in the LF/HF ratio among the fatigue groups. There were no significant differences in the HRV indices between the smoking and non-smoking groups. No significant interacting effects between the severity of fatigue and smoking on the HRV were observed.
CONCLUSIONS
The association between severe fatigue and the reduced high and low frequency components of the HRV in middle-aged male workers reflects a dysregulation of the cardiac autonomous control. Although the pathophysiological mechanism of this association remains unclear, these results might explain their increased risk for cardiovascular disease. However, these effects need to be confirmed through a well-designed prospective study.

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Original Article

The Relationship between Heart Rate Variability and Metabolic Syndrome at a Rural Area: Kyoung Bok Min, Jin Young Min, Kyung Hee Jung-Choi, Hyung Joon Jhun, Sung Il Cho, Domyung Paek; Korean Journal of Occupational and Environmental Medicine 2004;16(4):459-466. Published online December 31, 2004; DOI: https://doi.org/10.35371/kjoem.2004.16.4.459

Abstract PDF: OBJECTIVES
The purpose of the present study was to estimate the prevalence of metabolic syndrome and to investigate the relation between metabolic syndrome and heart rate variability in a community population.
METHODS
The study design was cross-sectional, and 1028 subjects, aged 20~87 years, were recruited. Heart rate variability was measured in the sitting position for five minutes. The recorded data were assessed by time-domain (standard deviation of RR interval) and frequencydomain analysis. All subjects were examined for five components of metabolic syndrome.
RESULTS
The prevalence of metabolic syndrome in male and female subjects was 25.9% and 27.7%, respectively. The mean value of heart rate variability of the subjects was significantly different between healthy subjects and those with metabolic syndrome. The regression model showed that metabolic syndrome was negatively correlated with heart rate variability.
CONCLUSIONS
The results demonstrate that metabolic syndrome has potentially negative effects on the cardiovascular system, and that these effects could be detected by heart rate variability. Follow-up studies able to control the cohort effect are necessary to evaluate the relation between metabolic syndrome and heart rate variability.

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Original Article

Job Stress, Heart Rate Variability and Metabolic Syndrome: Sei Jin Chang, Sang Baek Koh, Hong Ryul Choi, Jong Min Woo, Bong Suk Cha, Jong Ku Park, Yong Hee Chen, Ho Keun Chung; Korean Journal of Occupational and Environmental Medicine 2004;16(1):70-81. Published online March 31, 2004; DOI: https://doi.org/10.35371/kjoem.2004.16.1.70

Abstract PDF

OBJECTIVE: A growing body of literature has documented that job stress is associated with the development of cardiovascular disease. Nevertheless, the pathophysiological mechanism of this association remains unclear. Therefore, we tried to elucidate the relationship between job stress, heart rate variability and metabolic syndrome.
METHOD
The study design was cross-sectional, and 169 industrial workers were recruited. A structured-questionnaire was used to assess the general characteristics and job characteristics (work demand, decision latitude). Heart rate variability (HRV) was recorded using SA-2000 (medi-core). HRV was assessed by time-domain and by frequency-domain analyses. Time domain analysis was performed for SDNN (Standard Deviation of NN interval), and spectral analysis for low-frequency (LF), high-frequency (HF) and total frequency power. Metabolic syndrome was defined on the basis of clustering of risk factors, when three or more of the following cardiovascular risk factors were included in the fifth quintile: glucose, systolic blood pressure, HDL-cholesterol (bottom quintile), triglyceride and waist-hip ratio.
RESULTS
The results showed that job characteristics were not associated with cardiovascular risk factors. The high strain group had a less favorable cardiovascular risk profile with higher levels of blood pressure, glucose, homocysteine, and clotting factor than the lower strain group (low strain+passive+active group), but the difference was not statistically significant. The SDNN of HRV was significantly lower in the high strain group than in the low strain group. The prevalence of metabolic syndrome in the low strain, passive, active and high strain groups was 9.7%, 13.9%, 14.9% and 23.8%, respectively. In the high strain group, the metabolic syndrome was significantly related to a decreased SDNN. However, we could not find a significant association in LF/HF ratio.
CONCLUSION
This result suggests that decreased HRV does not play a role in the development of disease; however, it can induce cardiovascular abnormalities or dysfunctions related to the onset of heart disease among high risk groups.

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Original Article

Effects of Physical Workload on Salivary Cortisol Level: Dong Mug Kang, Byung Min Son, Sang Baek Koh, Junho Jang, Mia Son, Jongwon Kim, Byung Mann Cho, Su Ill Lee; Korean Journal of Occupational and Environmental Medicine 2004;16(1):57-69. Published online March 31, 2004; DOI: https://doi.org/10.35371/kjoem.2004.16.1.57

Abstract PDF

OBJECTIVE: Workload is known to affect the hypothalamus-pituitary-adrenal axis. Although many studies had revealed that job stress related factors could affect the neuroendocrine system among blue-collar workers, these studies had limitations as they had not evaluated the workload by objective methods which took into consideration individual physiological differences. This study was conducted to evaluate the effects of physical workload adjusted job stress on cortisol regulation by using objective tools for workers having various job tasks.
METHODS
Among 110 foundry workers, shipyard workers, and fine machine assemblers for whom saliva samples were obtained, 102 without any past history of conditions that could affect hormonal regulation such as diabetes, and hypertension were included in this study. Among the 102 study participants, 15 workers whose saliva for morning or afternoon or heart rate monitoring data was not attained were excluded from the final analysis. Workload was evaluated by RHR (relative heart rate) using a heart rate monitor, and job stress was evaluated by Karasek's Job Content Questionnaire. Saliva samples were gathered during 8 - 9 am and 5 - 6 pm, and salivary cortisol levels were analysed by radioimmunoassay.
RESULTS
After adjusting several variables which could effect cortisol secretion including job stress, among the higher RHR group morning salivary cortisol level was increased (beta=60.32, S.E.=26.35, p=0.0266), afternoon salivary cortisol level was decreased (beta=-7.43, S.E.=29.73, p=0.8044), and salivary cortisol level difference between morning and afternoon was increased (beta=72.10, SE=35.50, p=0.0509).
CONCLUSIONS
As physical workload increases morning cortisol level, which is caused by the effect of arousal, and decreases afternoon cortisol level, which is caused by exhaustion, physical workload enlarges the width of diurnal cortisol variance. Therefore, physical exhaustion due to excessive workload could have adverse effects on the neuroendocrine system.

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Seon Soo Kim, Meiling Luo, Yeon Ju Oh, Yong Hee Lee
Journal of the Ergonomics Society of Korea.2013; 32(1): 47. CrossRef
Determination of Appropriate Sampling Time for Job Stress Assessment: the Salivary Chromogranin A and Cortisol in Adult Females
Ran-Hi Hong, Yun-Jung Yang, Sang-Yon Kim, Won-Young Lee, Yeon-Pyo Hong
Journal of Preventive Medicine and Public Health.2009; 42(4): 231. CrossRef
Distribution and determinants of maximal physical work capacity of Korean male metal workers
D. Kang, J.-H. Woo, Y.-C. Shin
Ergonomics.2007; 50(12): 2137. CrossRef

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Original Article

The Association of Carbon Disulfide Poisoning with Heart Rate Variability: Hyung Joon Jhun, Sang Hyuk Yim, Do Myung Paek; Korean Journal of Occupational and Environmental Medicine 2004;16(1):48-56. Published online March 31, 2004; DOI: https://doi.org/10.35371/kjoem.2004.16.1.48

Abstract PDF: OBJECTIVES
Mass poisoning by carbon disulfide (CS2) occurred in a viscose rayon factory in Korea. Up until 1998, 830 employees, including 38 who had died, were diagnosed with CS2 poisoning. Among the CS2 poisoned subjects, heart rate variability (HRV) was evaluated to investigate whether the toxic effect of CS2 persists after the exposure has ceased. The dose-response relationship between carbon disulfide exposure and HRV was also evaluated.
METHODS
The case group was comprised of 71 retired male workers diagnosed as being CS2 poisoned. The control group was comprised of 127 males of same age-range who had no history of CS2 exposure and cardiovascular diseases. Information on individual age, height, weight, cigarette smoking, alcohol drinking, regular exercise, medical and occupational history, chest x-ray, and ECG recording of the two groups were collected through a self-administered questionnaire and with a medical examination. Time (maximum, average, minimum RR interval) and frequency domain measures (low frequency - LF, high frequency - HF, total power spectrum TPS, and LF/HF ratio) of the two groups were analyzed. CS2 exposure indices of the case group (duration of employment, exposure level per work department, cumulative exposure index and duration of retirement) were investigated.
RESULTS
Using a univariate analysis, the frequency domain measures for the case group were significantly lower than those in the control group, except for HF. In the multivariate analysis, previous history of CS2 poisoning was inversely related to all frequency domain parameters and it significantly affected the LF (p<0.05) and the LF/HF ratio (p<0.05). There was no significant dose-response relationship between CS2 exposure indices and HRV parameters in the case group.
CONCLUSION
This study suggests that further studies are necessary to evaluate the residual effects of CS2 poisoning even after the CS2 exposure has ceased.

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Original Article

The Effects of Job Stress on the Autonomic Nerve Activity of Workers in Manufacturing Industry: Ki Jung Yoon, Mi Na Ha, Jai Young Kim, Sang Yun Lee, Hyoung June Im, Ae Sun Shin, Seung Sik Hwang, Jeong Soo Kim, Dae Hee Kang, Soo Hun Cho; Korean Journal of Occupational and Environmental Medicine 2002;14(3):280-287. Published online September 30, 2002; DOI: https://doi.org/10.35371/kjoem.2002.14.3.280

Abstract PDF: OBJECTIVE: A cross-sectional study was conducted to evaluate the relationships between autonomic nerve activity (i.e., heart rate variability and urinary catecholamines) and job stress.
METHODS
The study was conducted on 134 workers from a company producing consumer goods (i.e., diaper, paper towel) located in Cheonan, Korea. Job stress was assessed by Karasek's Job Content Questionnaire (JCQ). Autonomic function was assessed by heart rate variability (HRV) and urinary catecholamines (epinephrine, norepinephrine, and dopamine). Urine samplings, and measurings of HRV, were repeated three times for each shift. Information on demographic characteristics, previous job histories, past medical history, smoking and drinking were also collected.
RESULTS
No statistically significant differences were observed in any HRV and urinary catecholamines among the four groups, which were categorized by the Job Strain Model. When data were stratified by work duration, low field HRV was borderline significantly higher in the high strain group in individuals with a shorter work duration (<48.5 months, N=28, p-value of 0.92 by analysis of variance).
CONCLUSIONS
Neither HRV nor urinary catecholamines are significantly associated with job stress, as assessed by the Karasek's JCQ. However, HRV seems to be a potential physiological indicator of job stress only in the workers with a shorter work duration.

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Original Article

Influence of Shiftwork Duration on Blood Pressure and Heart Rate Variability in Short Rotating 8-hour Shiftworkers: Mi Na Ha, Jai Young Kim, Jung Sun Park, Ho Keun Chung; Korean Journal of Occupational and Environmental Medicine 2001;13(2):180-189. Published online June 30, 2001; DOI: https://doi.org/10.35371/kjoem.2001.13.2.180

Abstract PDF

OBJECTIVES
This study was performed to investigate the chronic health effect of shiftwork on cardiovascular system.
METHODS
We checked blood pressure(BP) and heart rate variability(HRV) at every shift on 134 male workers whose shift type was 8-hour and short rotating of 3 days shift interval. As confoundings, job stress was measured by Karasek's JCQ 49 items questionnaire and circardian type was assessed by morningness-eveningness questionnaire. Smoking and alcohol drinking habit, marital status and past medical history were also acquired. We used the method of repeated measured data analysis with mixed model to show the association between shiftwork duration and BP or HRV.
RESULTS
Average age of workers was 29 years olds(range 25~44). Among them, 77.9 % were current smokers, 50 % were the passive type of job strain in Karasek's model. Mean shiftwork duration was 5.21 years(range 5.4 months~10 years). In circadian type, no one was definitely morning type or definitely evening type. In multivariate analyses adjusted by age, job strain, shift, circadian rhythm and smoking, blood pressure were showed significantly increasing trends according to shiftwork duration in both systolic and diastolic(p<0.05). Heart rate variability were also showed significantly decreasing trends according to shiftwork duration in both parasympathetic and sympathetic functions(p<0.05).
CONCLUSIONS
The results of this studs suggests the chronic negative health effect of shiftwork on cardiovascular system.

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Original Article

Ambulatory Blood Pressure and Heart Rate of the Workers Exposed to Industrial Noise: Young Kee Kim, Tae Joon Cha, Joo Hyun Byun, Kwang Ook Koh, Yong Hwan Lee; Korean Journal of Occupational and Environmental Medicine 2000;12(1):99-110. Published online March 31, 2000; DOI: https://doi.org/10.35371/kjoem.2000.12.1.99

Abstract PDF: OBJECTIVES
This study was carried out to evaluate the effects of industrial noise on blood pressure and heart rate.
METHODS
Resting blood pressure, hearing loss, and general characteristics of the 102 subjects who were engaged in a factory in Pusan were measured from March to June for two years, in 1998 and 1999. With noise dosimeter, noise exposure level was measured from 8 A.M. to 4 P.M. Ambulatory blood pressure and heart rate were also measured every 30 minutes from 8 A.M. to 10 P. M.
RESULTS
Controlling for age, smoking, and Quetelet's index, in subjects of under 40 years old exposed to higher than 85dBA, noise exposure and systolic blood pressure had a statistically significant correlation, and the same result was obtained in all subjects. The daily variability of ambulatory blood pressure and heart rate were observed in older than 40 years old group, but only heart rate in under 40 years old.
CONCLUSIONS
The blood pressure and heart rate would be elevated when the workers exposed to noise. And in under 40 years old, the systolic blood pressure was elevated to the workers exposed to higher than 85dBA.

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