Annals of Occupational and Environmental Medicine

Original Article

Are Cerebrovascular and Cardiovascular Diseases among Employees Work-related?: Jungsun Park; Korean Journal of Occupational and Environmental Medicine 2005;17(4):288-296. Published online December 31, 2005; DOI: https://doi.org/10.35371/kjoem.2005.17.4.288

Cerebrovascular and cardiovascular diseases (CVDs) are a major cause of deaths among workers as well as in general population in Korea. The term "Karoshi" in Japan represents work-related cerebrovascular and cardiovascular diseases (WR-CVD) due to excessive overwork. According to the Karasek's Demand-Control Model many prospective studies reported a significant association between working in jobs with high strain and increased likelihood of subsequent development of cardiovascular diseases. However, further understanding of the etiopathology of each different work-relatedness is needed to prevent WR-CVDs effectively. This review was planned to help the readers with knowledge on the etiopathology of the WR-CVDs. Based on the causal or triggering factors, work-relatedness in the literature can be classified into four types: 'accidental type (e.g. sudden cardiac deaths)', 'typical Karoshi type due to extreme overwork', 'maladaptation type due to dramatic change in job characteristics', and 'job stress type due to inherent characteristics'. Even though the outcome of each type is apparently similar, their causes and pathophysiologic mechanisms are quite different. In conclusion, the work-relatedness of CVDs among employees is very limited and usually works as a trigger rather than as the causal factors. A thorough understanding of the etiopathology of WR-CVDs can be very helpful in developing a prevention strategy.

Citations

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Original Article

A Study on Karoshi to Make Application for Industrial Accident Compensation in Busan: Yeon Nam, Cha Jae O, Jung Rae Park, Dong Jun Lee, Byung Mann Cho, Su Ill Lee; Korean Journal of Occupational and Environmental Medicine 2002;14(1):34-46. Published online March 31, 2002; DOI: https://doi.org/10.35371/kjoem.2002.14.1.34

Abstract PDF

OBJECTIVES
Karoshi is a word meaning death from work-overload. Work-related diseases due to continuous overwork are primarily cerebro- and cardio-vascular in nature. In Korea, despite an increase in the incidence of Karoshi, it is not easy to recognise by workmen's compensation in Korea. This study intended to establish basic information concerning the incidence of Karoshi.
METHODS
219 cases were collected based on workers' compensation records of three Busan Regional Centers of Labor Welfare Corporation from 1991 to 1999. The size of workplace, occupation, daily working time, type of working schedule, job tenures, characters of work-overload and duration of work-overload were investigated according of subgroups of general characteristics. Both univariate and multiple logistic regression analyses were used to estimate the relationship between risk factors and a recognition of Karoshi.
RESULTS
1. 61.6 % of total cases were recognized as Karoshi. 30.6 % occurred in a small workplace of less than 50 workers, 34.7 % were drivers or guards, and 48.8 % were more than 50 years old. Additionally, 29.6 % worked more than 12 hours, 37.5 % were irregular hours and shift workers and 21.5 % of the total had been on the job less than 6 months. 2. Of the causes of death, 49.8 % was cerebro-vascular diseases and it was more than cardio-vascular ones. And 80.4 % of total cases was belonged to the recognition-category of the Labour Ministry's Law. The previous disease history was found on 49.8 % of all cases. Of them, hypertension was most common as 21.9 %. 3. 53.9 % of patients were exposed to job hazards such as driving, monitoring, guarding, risky jobs and frequent long-term official trips. 64.7 % recorded a increased work-overload of job contents and working hours. Of the several types of work-overload, 42.5 % displayed long-term physical and psychotic work-overload and 22.2 % exhibited job characteristic work-overload. 4. In this study, work-overload was associated with the incidence of Karoshi in 76.3 % of cases. This rate was higher than the recognition of Workmen's compensation recorded by the Korea Labor Welfare Corporation. Of these, 43.6 % belonged to sufficient factors, 10.4 % partial factors, and 22.3 % were due to aggravating factors. 5. Logistic regression demonstrated that death due to cerebro- and cardio-vascular disease, shorttenure within 6 month was significantly associated with a recognition of Karoshi (p=0.034, OR=3.00, C I = 1 . 0 9~8.30/p=0.016, OR=6.76, CI=1.43~32.07 respectively) and that an increase of work-overload was also associated, but its statistical significance was slightly lower(p=0.081, OR=2.02, CI=0.91.~4.46 ) . However, no association was found between this recognition and overtime work, hazardous job, irregular work schedule, low-income, injury-onset place, or small size of workplace. The elderly group(>50years old) and those with a previous disease history were negatively associated with recognition although the statistical association was low.
CONCLUSIONS
Karoshi in Busan occurred frequently in a small workplace of less than 50 workers, especially drivers or guards. Additionally, these cases worked more than 12 hours, were irregular hours and shift workers. The death due to cerebro- and cardio-vascular disease, short-tenure within 6 month was significantly associated with a recognition of Karoshi. However Karoshi in this study occurred frequently in overtime work and high risk groups of work-overload. Therefore, for prevention of Karoshi, work-overload and overtime work need improved and controled.

Citations

Citations to this article as recorded by

Work-related Cerebro-Cardiovascular Diseases in Korea
Dae-Seong Kim, Seong-Kyu Kang
Journal of Korean Medical Science.2010; 25(Suppl): S105. CrossRef
Factors Affecting the Designation of Cerebrovascular Diseases as Work-Related in Administrative Litigation
Hyeongsu Kim, Jaewook Choi, Hwayoung Rim, Sounghoon Chang, Kunsei Lee
Journal of Korean Medical Science.2008; 23(2): 236. CrossRef

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