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.

Citations

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Special Issue

Association between irregular working hours and work-related musculoskeletal pain: results from the 6th Korean Working Conditions Survey: Munyoung Yang, Jun-Pyo Myong, Jongin Lee, Min Young Park, Mo-Yeol Kang; Ann Occup Environ Med 2023;35:e21. Published online July 3, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e21

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Background

Recently, irregular working hours have become controversial issues in Korea. The health impact of irregular working hours on the work-related musculoskeletal pain (MSP) is scarcely researched before. We sought to investigate the association between irregular working hours and work-related MSP among South Korean workers.

Methods

This study used data from the sixth Korean Working Conditions Survey in 2020. The prevalence of work-related MSP was analyzed using the χ² test. A multiple logistic regression analysis was conducted to assess the association between irregular working hours and work-related MSP. We conducted stratified analysis by gender, weekly working hours, and workers’ control over their working hours. We calculated the adjusted odds ratios (ORs) of work-related MSP for irregular working hours combined with weekly working hours.

Results

The OR for work-related MSP was significantly higher in the population with irregular working hours than in the population with regular working hours (OR: 1.43, 95% confidence interval [CI]: 1.29–1.58). Irregular and long (> 52 hours/week) working hours have the highest risk of work-related MSP in both genders (in men, OR: 3.48 [95% CI: 2.53–4.78]; in women, OR: 2.41 [95% CI: 1.46–4.00]).

Conclusions

Irregular working hours were associated with work-related MSP in Korea. The association was magnified with long working hours. Reform of the Korean Labor Standards Act leading to increase irregular working hours may induce adverse health outcome.

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Effect of long working hours on psychological distress among young workers in different types of occupation
Seong-Uk Baek, Jin-Ha Yoon
Preventive Medicine.2024; 179: 107829. CrossRef
Special Series I: Working hours as a social determinant of workers’ health
Kyunghee Jung-Choi, Tae-Won Jang, Mo-Yeol Kang, Jungwon Kim, Eun-A Kim
Annals of Occupational and Environmental Medicine.2023;[Epub] CrossRef

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Research Article

The relationship between night work and breast cancer: Hye-Eun Lee, Jongin Lee, Tae-Won Jang, In-Ah Kim, Jungsun Park, Jaechul Song; Ann Occup Environ Med 2018;30:11. Published online February 6, 2018; DOI: https://doi.org/10.1186/s40557-018-0221-4

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Background

Since the International Agency for Research on Cancer classified shift work that involves circadian disruption as “probably carcinogenic to humans,” there has been growing concern on the relationship between night work and breast cancer. In Korea, about 10–15% of workers are engaged in night-shift work, and breast cancer is one of the most common cancers in women. The purpose of this study was to review epidemiologic evidence on the relationship between night work and breast cancer.

Methods

We reviewed 21 original articles and 5 meta analyses on relationship between nightwork and breast cancer, and investigated the compensation criteria of Denmark.

Results

The association between breast cancer and night work has been reported by numerous epidemiologic studies, including cohort studies, case-control studies, and meta-analysis. However, a dose-response relationship has not clearly emerged among workers exposed to less than 20 years of night work.

Conclusion

Although there are some limitations to the epidemiological studies so far, further consideration of breast cancer cases in patients with high exposure to night work is needed to assess breast cancer as a work-related disease.

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Research Article

Factors associated with suicide ideation among subway drivers in Korea: Junsu Byun, Hyoung-Ryoul Kim, Hye-Eun Lee, Se-Eun Kim, Jongin Lee; Ann Occup Environ Med 2016;28:31. Published online August 2, 2016; DOI: https://doi.org/10.1186/s40557-016-0120-5

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Background

There were several suicide events of subway drivers in Korea. The aim of this study is to explore work-related factors associated with suicide ideation among subway drivers.

Methods

We analyzed data from 980 male subway drivers. A section of the Korean version of the Composite International Diagnostic Interview (K-CIDI 2.1) was administered by trained interviewers to judge whether a driver has suicide ideation and to diagnose psychiatric disorders. A questionnaire was also administered to collect data on sociodemographic characteristics, work environments, occupational stress, person under train (PUT) experience, and work-related problems. Occupational stress was examined by using the Korean Occupational Stress Scale (KOSS). Logistic regression was applied to evaluate the association between work-related factors and suicide ideation among subway drivers.

Results

Regarding work-related problems, conflict with passengers and sudden stops due to the emergency bell were significantly associated with suicide ideation. MDD, PTSD, and panic disorder were strongly associated with suicide ideation. In the analysis of occupational stress, insufficient job control (OR 2.34) and lack of reward (OR 2.52) were associated with suicide ideation even after being adjusted for psychiatric disorders and other work-related factors.

Conclusions

Insufficient job control and lack of reward were associated with suicide ideation among subway drivers. Strategies for drivers to have autonomy while working and to achieve effort-reward balance should be implemented. Furthermore, drivers who have experienced negative work-related problems should be managed appropriately.

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Research Article

Risk factors associated with mortality from pneumonia among patients with pneumoconiosis: Bum Seak Jo, Jongin Lee, YounMo Cho, Junsu Byun, Hyoung Ryoul Kim, Jung Wan Koo, Jun Pyo Myong; Ann Occup Environ Med 2016;28:19. Published online April 7, 2016; DOI: https://doi.org/10.1186/s40557-016-0103-6

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Background

The aim of this study was to evaluate factors associated with increased risk of mortality from pneumonia among patients with pneumoconiosis.

Methods

Medical records of 103 pneumoconiosis patients hospitalized for pneumonia were investigated. Seven patients who had lung cancer or other malignancy and 13 patients with insufficient medical record were excluded. Two female patients were excluded due to small number to analyze. The subjects were divided into two groups by clinical outcome of pneumonia, the deceased group and the survival group. The two groups were compared in terms of age, smoking history, episode of recent pneumonia, concomitancy of interstitial fibrosis or fungal ball infection, extent of small opacities, grade of large opacities and results of spirometry. Multiple logistic regression was applied to determine the association between these variables and mortality from pneumonia.

Results

The deceased group showed more frequent history of recent pneumonia (p = 0.006), higher prevalence of interstitial fibrosis (p = 0.007) and longer hospitalization period (p = 0.044). The proportion of subjects who had decreased FVC, less than 70 % of predicted value, was higher in the deceased group (p < 0.001). In multiple logistic regression, after adjusting age, smoking history, recent pneumonia, fungal ball, large opacity, profusion and FVC (or FEV₁) less than 70 % of predicted value, history of recent pneumonia, concomitancy of interstitial fibrosis, type of pneumoconiosis and fungal ball presented statistically significant association with mortality from pneumonia.

Conclusions

The concomitancy of fungal ball or interstitial fibrosis, history of recent pneumonia within last 90 days, type of pneumoconiosis, FVC less than 70 % of predicted value, FEV₁ less than 70 % of predicted value presented statistically significant association with mortality from pneumonia. More attention should be given to patients who have such factors when treating pneumonia with pneumoconiosis.

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Research Article

The effects of individual, occupational, and supportive factors on successful return to work using a structural equation model: Jongin Lee, Min Choi, Sung Hye Park, Hyoung-Ryoul Kim, Hye-Eun Lee; Ann Occup Environ Med 2015;27:21. Published online August 28, 2015; DOI: https://doi.org/10.1186/s40557-015-0070-3

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Objectives

We aimed to ascertain the relationship between several factors and successful return to work using a structural equation model.

Methods

We used original data from the Panel Study of Worker’s Compensation Insurance, and defined four latent variables as occupational, individual, supportive, and successful return to work. Each latent variable was defined by its observed variables, including age, workplace size, and quality of the medical services. A theoretical model in which all latent variables had a relationship was suggested. After examining the model, we modified some pathways that were not significant or did not fit, and selected a final structural equation model that had the highest goodness of fit.

Results

All three latent variables (occupational, individual, and supportive) showed statistically significant relationships with successful return to work. The occupational and supportive factors had relationships with each other, but there was no relationship between individual and the other factors. Nearly all observed variables had significance with their latent variables. The correlation coefficients from the latent variables to successful return to work were statistically significant and the indices for goodness of fit were satisfactory. In particular, four observed variables—handicap level, duration of convalescence, working duration, and support from the company—showed construct validities with high correlation coefficients.

Conclusions

All factors that we examined are related to successful return to work. We should focus on the supportive factor the most because its variables are modifiable to promote a return to work by those injured in their workplace.

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Case Report

Work-related COPD after years of occupational exposure: YounMo Cho, JongIn Lee, Min Choi, WonSeon Choi, Jun-Pyo Myong, Hyoung-Ryoul Kim, Jung-Wan Koo; Ann Occup Environ Med 2015;27:6. Published online February 19, 2015; DOI: https://doi.org/10.1186/s40557-015-0056-1

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Background

Cigarette smoking is known as the most important risk factor of chronic obstructive pulmonary disease (COPD). However, occupational exposure to other substances can result in COPD.

Case report

A 76-year-old man with occupational exposures to mixtures of silica dust, gas, and fumes for 10 years and with a 25 pack-year smoking history was diagnosed with COPD. His computed tomogram scan revealed some hyperinflation with emphysematous change in both upper lobes. In the pulmonary function tests, his post-bronchodilator forced vital capacity (FVC), forced expiratory volume in one second (FEV₁), and FEV₁/FVC% were 2.20 L (67% of the predicted value), 1.12 L (52% of the predicted value), and 51%, respectively, indicating moderate COPD. This case of COPD was confirmed as a work-related disease by the Occupational Lung Disease Research Institute in Korea Workers’ Compensation & Welfare Service.

Conclusion

Exposure to various substances such as silica dust, gas, and fumes from furnace and boiler installation was likely the cause of COPD in this patient. Thus, occupational exposure should be considered an important risk factor of COPD.

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Research Article

The association between psychiatric disorders and work-related problems among subway drivers in Korea: Se-eun Kim, Hyoung-Ryoul Kim, Jong-Ik Park, Hae Woo Lee, Jongin Lee, Junsu Byun, Hyeon Woo Yim; Ann Occup Environ Med 2014;26:39. Published online November 1, 2014; DOI: https://doi.org/10.1186/s40557-014-0039-7

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Objectives

This study aimed to find the prevalence and occupational risk factors for major psychiatric disorders among subway drivers in South Korea.

Methods

Of all 998 current subway drivers, 995 participated in this study. The Korean version of the Composite International Diagnostic Interview (K-CIDI 2.1) was administered by trained interviewers to diagnose psychiatric disorders in all participants. The questions on socio-demographic characteristics and working conditions included some questions related to a person under train (PUT) experience and work-related problems. One-year prevalence and lifetime prevalence of major depressive disorder (MDD), post-traumatic stress disorder (PTSD), and panic disorder were diagnosed through the interview. The standardized prevalence ratios (SPRs) of these three disorders were calculated in the sample of subway drivers using the 2011 Korean National Epidemiologic Survey data as a basis. Multiple logistic regressions were performed to determine the association between work-related factors and the prevalence of the psychiatric disorders.

Results

The standardized prevalence ratios (SPRs) for a 1-year prevalence of MDD and PTSD among subway drivers were 1.1 (95% CI 0.7-1.7) and 5.6 (95% CI 3.1-8.8), respectively. Conflict with passengers was significantly associated with an increased risk for both MDD and PTSD in 1-year and in lifetime prevalence. Experiencing a sudden stop due to an emergency bell increased the risk of the lifetime prevalence of MDD (OR 2.61, 95% CI 1.14-6.97) and PTSD (OR 7.53, 95% CI 1.77-32.02). The risk of PTSD significantly increased among drivers who once experienced a near accident in terms of both the 1-year prevalence (OR 8.81, 95% CI 1.96-39.3) and the lifetime prevalence (OR 6.36, 95% CI 2.40-16.90).

Conclusions

PTSD and panic disorder were more prevalent among subway drivers than in the general population. We found that having a conflict with passengers, a near accident, and a breakdown while driving can be risk factors for psychiatric disorders among subway drivers. Therefore, a prompt and sensitive approach should be introduced for these high risk groups within the subway company.

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