Annals of Occupational and Environmental Medicine

Original Article

Relationship between workplace violence and work-related depression/anxiety, separating the types of perpetrators: a cross-sectional study using data from the fourth and fifth Korean Working Conditions Surveys (KWCS): Na-Rae Lee, Sang-Woo Kim, Jae-Han Joo, Jae-Han Lee, June-Hee Lee, Kyung-Jae Lee; Ann Occup Environ Med 2022;34:e13. Published online June 10, 2022; DOI: https://doi.org/10.35371/aoem.2022.34.e13

Abstract Abstract in Korean PDF Supplementary Material PubReader ePub

Background

Work is an inseparable element of a person’s life, and violence in the workplace has various effects on individual workers and companies. While most studies have focused on specific industries, very few studies have investigated the influence of workplace violence by co-workers. Therefore, this study aimed to evaluate the association between workplace violence and work-related depression/anxiety in various occupations by differentiating the perpetrators of violence as co-workers and clients.

Methods

This study was conducted based on data from the 4th and 5th Korean Working Conditions Surveys (KWCS). The experience of workplace violence was classified in terms of the perpetrator: workplace violence by co-workers and that by clients. Work-related depression and anxiety were assessed using questions about health problems related to depression and anxiety and whether the problems were related to work. Descriptive statistics, χ² tests, and multiple logistic regression analyses were performed using the SPSS 26.0.

Results

After adjusting for sociodemographic characteristics (age, education, income, subjective health status) and occupational characteristics (occupation, weekly working hours, type of employment, size of workplace, and shift work), male workers with experience of workplace violence by co-workers were found to be at a higher risk of work-related depression/anxiety (odds ratio [OR], 11.52; 95% confidence interval [CI], 8.65–15.36). The same was confirmed for female workers (OR, 10.89; 95% CI, 7.90–15.02).

Conclusions

Employees who experienced workplace violence from co-workers were found to be more vulnerable to work-related depression/anxiety. Continuous contact between the victim and the perpetrator may occur, and the possibility of a secondary assault can frighten the victim. Appropriate prevention and intervention measures that focus on the perpetrators of violence are needed.

가해자 유형별 작업장 폭력과 업무 관련 우울/불안의 연관성
목적
작업장 폭력은 근로환경에서 타인에게 의도적으로 상해, 사망, 정신적 손상, 발달장애 또는 결핍을 일으키는 행위나 위협을 가하는 것으로, 근로자의 신체적·정신적 건강에 부정적 영향을 미치며 기업의 생산성을 저해한다. 작업장 폭력에 대한 대다수의 연구는 특정 직종에 초점을 맞추고 있어 직장 동료에 의해 내부에서 발생하는 작업장 폭력의 영향이 잘 반영되지 않을 수 있다. 본 연구를 통해 가해자 유형별 업무 관련 우울/불안의 연관성을 비교‧확인하고자 한다.
방법
제 4차 및 제 5차 근로환경조사를 바탕으로, 만 18세 이상 피고용자 55,201 명에서 작업장 폭력에 대한 경험과 그 가해자 및 업무 관련 우울/불안 유무를 분석하였다. SPSS 26.0을 통해 기술통계, 카이제곱검정 및 다중로짓회귀분석을 시행했고, 직장 동료 혹은 고객에 의해 작업장 폭력을 경험한 근로자에서 작업장 폭력을 경험하지 않은 근로자에 비해 업무 관련 우울/불안이 있을 위험에 대한 Odds ratio [OR]를 구하였다.
결과
성별을 막론하여 직장 동료 혹은 고객에 의해 작업장 폭력을 경험한 근로자의 경우 작업장 폭력을 경험하지 않은 근로자에 비해 업무 관련 우울/불안의 빈도가 유의하게 높았다. 작업장 폭력을 경험한 남성 근로자에서 업무 관련 우울/불안에 대한 OR은 가해자가 직장 동료일 경우 11.52 (95% Confidence interval [CI] 8.65-15.36), 고객일 경우 5.06 (95% CI 3.73-6.88)으로 나타났으며, 여성 근로자의 경우에도 마찬가지로 가해자가 직장 동료일 경우 OR 10.89 (95% CI 7.90-15.02), 고객일 경우 OR 4.94 (95% CI 3.77-6.47)로 나타났다.
결론
작업장 폭력을 경험한 근로자는 작업장 폭력 경험이 없는 근로자에 비해 업무 관련 우울/불안의 위험이 더 크다. 작업장 폭력의 가해자가 직장 동료일 경우, 피해자와 가해자가 동일 작업장 내에서 지속적으로 접촉하여 폭력에 대한 반복적인 회상 또는 2차 가해 등이 이루어지기 쉬운 환경이 조성되기 때문에 고객에 의한 작업장 폭력에 비해 업무 관련 우울/불안의 위험이 더 크게 나타날 수 있다. 작업장 폭력의 가해자를 고려한 적절한 예방 및 중재 조치가 필요하며, 해당 분야에 대해 후속 연구가 이루어져야 할 것으로 생각된다.

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Original Article

Radiotechnologists and Radiation Exposure from PET and PET/CT Systems: Hoon Hee Park, Jeongbae Rhie, Pilkyun Jung, Jong Doo Lee, Jong Uk Won, Jaehoon Roh; Korean Journal of Occupational and Environmental Medicine 2012;24(1):86-95. Published online March 31, 2012; DOI: https://doi.org/10.35371/kjoem.2012.24.1.86

Abstract PDF

OBJECTIVES
In this study, radiotechnologists who work performing PET and PET/CT methodologies were analyzed in order to find the cause for the differences in radiation exposure as they applied to general characteristics, work characteristics, knowledge, and exposure recognition or conduct.
METHODS
From April 15th, 2010 to May 14th, 2010, we conducted a retrospective analysis on 80 radiotechnologists using data garnered from their individual general characteristics, work characteristics, knowledge, and exposure recognition or conduct. Their average annual radiation exposure dosages were measured using a thermoluminescence dosimeter. A multiple regression analysis was performed as a statistical tool.
RESULTS
Regarding the general PET and PET/CT characteristics, when the work experience was short, the exposure dose was higher. The factors of age, marriage, work experience in nuclear medicine, PET, PET/CT, and sex were found to have statistically significant effects. The knowledge, recognition, and conduct factors for the radiotechnologists were affected by unsecure radiation exposure at the moment of carrying, unsecure radiation exposure at the moment of injection, the application of protection at the moment of injection, and the use of auto distributor. It was found that, the use of an auto distributor, efforts in reducing the radiation exposure, unsecure exposure when with a patient, and the application of protective procedures at the moment of injection affected the overall factor of radiotechnologists radiation exposure dose.
CONCLUSIONS
We believe that if radiotechnologists would reduce their radiation exposure by using auto distributors, make efforts to reduce the chance of exposure, and be conscious of radiation, they would be able to reduce the radiation exposure dose even during unavoidable circumstances.

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A Comparative Study on the Radiation Awareness of University Students Gender in Chungbuk Area
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Original Article

The PTSD Symptom and Related Factors among the Residents after Samsung-Hebei Spirits Oil Spill: Seongsik Cho, Tae Kyung Lee, Jeong Min Kim, Ye Won Bang, Narae Hong, Hyoung June Im, Young Jun Kwon, Yong Cho, Jae Yong Moon, Young Su Ju; Korean Journal of Occupational and Environmental Medicine 2009;21(3):235-245. Published online September 30, 2009; DOI: https://doi.org/10.35371/kjoem.2009.21.3.235

Abstract PDF

BACKGROUND
The purpose of the study was to estimate the mental health problems and other related factors in residents that experienced the Samsung-Hebei spirits oil spill by surveying PTSD symptoms.
METHOD
Trained interviewers performed direct interviews of the residents approximately 70 days after the oil spill. We investigated PTSD symptoms through PTSD Symptom Scale Interview Version (PSS-I). To determine those factors related to PTSD symptoms, the following factors were determined as part of the survey: gender, age, occupation, duration of cleanup activity, monthly income and amount of debt. Logistic regression analysis was used to analyze all factors.
RESULTS
Of the 318 residents investigated, 56.6% of the subjects had PTSD symptoms related to the spirits oil spill (about 70 days post spill). With regard to occupation, those subjects answering fishery (POR:3.05) and commerce (POR:4.24) as their occupations experienced higher PTSD symptoms than residents answering farming as their occupation. Residents who answered that they had debt over 10 million KRW (POR:2.61) were more vulnerable to PTSD symptoms compared to residents without debt; residents with acute physical symptoms were vulnerable (POR:5.11) to PTSD symptom compared to residents without acute physical symptoms. The results of multiple logistic analysis, including the cleanup activity, age, gender, occupation, acute physical symptoms and amount of debt in the model suggest that only cleanup activity increased PTSD symptoms. The subjects who had engaged in cleanup activities for longer periods of time had more PTSD symptoms and an additional dose-response relationship.
CONCLUSION
Many residents in Samsung-Hebei spirits oil spill area had PTSD symptoms. This suggests that there were serious mental health problems among the residents, who might require specific social supports and psychiatric interventions as a result of the oil spill.

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Original Article

Change of Urinary Trans, Trans-Muconic Acid before and after Turnaround Process in a Petrochemical Plant: Seung Hyun Kim, Ji Ung Park, Jai Dong Moon; Korean Journal of Occupational and Environmental Medicine 2008;20(4):335-342. Published online December 31, 2008; DOI: https://doi.org/10.35371/kjoem.2008.20.4.335

Abstract PDF

OBJECTIVES
This study was performed to estimate the exposure to benzene, one of the most serious health hazards, in four phases of a turnaround in a petrochemical company, and to evaluate the suitability of trans,trans-muconic acid (tt-MA) to act as a biomarker of exposure to low benzene levels.
METHODS
tt-MA was determined in 152 urine samples collected in 4 phases ('before daily work', 'after daily work', 'purge', and 'inspection' of turnaround work) from 19 exposed workers involved in turnaround work and 19 clerical workers. The ambient benzene levels were monitored simultaneously during the 'purge' process of turnaround work in the exposed group.
RESULTS
The median urinary tt-MA for the 4 phases was 0.046 mg/L, 0.082 mg/L, 0.507 mg/L, and 0.468 mg/L in the exposed group and 0.050 mg/L, 0.065 mg/L, 0.269 mg/L, and 0.331 mg/L in the clerical workers, respectively. The median urinary tt-MA for the exposed group was significantly higher than that of the clerical workers during the purge process (P<0.05). In the exposed group, median urinary tt-MA for the 'before daily work' phase was significantly lower than that of the other three phases (P<0.05). Even in the clerical workers, the urinary tt-MA level for the 'before daily work' phase was significantly lower than that of the turnaround (P<0.05). There was a very significant correlation between urinary tt-MA levels and ambient benzene levels (r(s) = 0.795, P<0.01).
CONCLUSION
The turnaround process increased the benzene exposure for all workers, even the clerical workers, in a petrochemical company handling benzene. Urinary tt-MA was found to be suitable as a biomarker for the exposure to low-level benzene.

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Original Article

A Case of Cubital Tunnel Syndrome Due To Repetitive Work: Jung Il Kim, Young Il Lee; Korean Journal of Occupational and Environmental Medicine 2006;18(2):156-162. Published online June 30, 2006; DOI: https://doi.org/10.35371/kjoem.2006.18.2.156

Abstract PDF: OBJECTIVE: To report one case of cubital tunnel syndrome due to repetitive work METHOD: The authors examined a worker who complained of severe muscle atrophy between the right thumb and index finger, claw deformity and numbness of the 5th finger. We evaluated him with physical examination, neurophysiologic studies (nerve conduction study, NCV; electromygraphy, EMG), plain Xray and magnetic resonance image(MRI) at the right elbow. We also investigated his occupational history, and analyzed his work motions, using rapid upper limb assessment (RULA) of the work cycle at his previous work site.
RESULT
The patient had been a ship welder for 17 years, followed by 6 years of dismantling boxes and loading/unloading materials. The latter job required inappropriate elbow posture such as repetitive flexion and extension. The NCV study revealed slow conduction velocity of the right ulnar motor and sensory nerve, decreased action potential of the right hand intrinsic muscles and flexor carpi ulnaris. The simple X-ray film showed normal finding, but MRI showed a finding compatible with cubital tunnel syndrome combined with enlargement of the right ulnar nerve at right elbow, 0.6cm intraarticular loose body and medial aspect of the medial epicondyle of the right distal humerus.
CONCLUSION
We confirmed the diagnosis of cubital tunnel syndrome that was related to his packing job which had demanded repetitive flexion and extension of elbow joint. At the time of writing, surgery was being considered as appropriate treatment.

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Case Report

A Case of Work-Related Cubital Tunnel Syndrome Due To Repetitive Motions: Jung Won Kim, Insun Park, Youngjoon Lee, Yu Chang Kim, Pilja Kim, Dongmug Kang, Chae Un Lee; Korean Journal of Occupational and Environmental Medicine 2000;12(2):310-318. Published online June 30, 2000; DOI: https://doi.org/10.35371/kjoem.2000.12.2.310

Abstract PDF: OBJECTIVES
To report cubital tunnel syndrome due to repetitive motions.
METHODS
A worker complaining muscle weakness and atrophy of the right hand intrinsic muscles admitted to a hospital. We evaluated him with blood tests, neurophysiologic studies (NCV & EMG), plain X-ray and US at the both elbows. We investigated his occupational history, and videotaped his work motions based on the work cycle at his previous work site. Finally, an ergonomics expert analyzed the motions using rapid upper limb assessment (RULA).
RESULTS
NCV & EMG studies reveals slow conduction velocity on both ulnar nerve across the elbow, more severely in the right side. US shows us compatible finding with diffuse neuritis of both ulnar nerves at both elbows. RULA score is 7.
CONCLUSION
We confirmed that the workers symptoms were related to his previous jobs demanding repetitive motions using the elbow joints. It is necessary that we should prepare appropriate measures to evaluate, prevent, rehabilitate, and help injured workers to return to work.

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Original Article

Usefulness of Power Spectral Analysis for Measurement of Local Muscle Fatigue during Keyboard Task: Soon Young Kwon, Chung Yill Park, Jung Wan Koo, Hyeon Woo Yim, Kang Sook Lee; Korean Journal of Occupational and Environmental Medicine 1999;11(4):449-459. Published online December 31, 1999; DOI: https://doi.org/10.35371/kjoem.1999.11.4.449

Abstract PDF: OBJECTIVES
Work-related upper extremity disorders of the tendons, nerves, and musdes associated with. repetitive motion represent an increasing proportion of occupational illnesses, medical services, and workers' compensation costs. Severe local muscle fatigue may be a precursor of repetition strain injuries. The demand for objective and quantitative assessment of local muscle fatigue is now increasing. The purpose of this study is to determine the usefulness of power spectral analysis of individual muscle as one of the objective spectral parameters in quantification of local muscle fatigue.
METHODS
From 10 normal male without neuromuscular dysfuction, motor unit action potentials (MUAPs) of three muscles (upper trapezius, infraspinatus, and anterior deltoid) of left shoulder girdle were obtained. The surface electrodes were used and the changes of power spectrum according to frequency components were calculated per minute during the keyboard task for 30-minute period by power spectral analysis of MUAPs signal.
RESULTS
There was a linear relationship between median frequency (MF) and time flow in the upper trapezius muscle, however the same was not observed in other muscles. The MF slope of the upper trapezius muscle showed a decline of the MF over time and reflected the fatigue rate. Other spectral parameters, such as mean frequency and total power were not significantly correlated to time flow during the keyboard task in all three muscles. And no significant correlation was observed between keying rate and slope of median frequency of upper trapezius muscle.
CONCLUSIONS
Above results suggested that the power spectral analysis on median frequency in upper trapezius muscle would be useful in quantification of local muscle fatigue during the keyboard task and local muscle fatigue of shoulder was affected by static posture, not by keying rate.

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Case Report

Aplastic Anemia in a Petrochemical Plant Worker: Young Mann Baak, Yong Hyu Choi, Seong Kyu Kang, Ji Hong Kim, Kyoung Ah Kim, Young Lim, Joung Wook Lee; Korean Journal of Occupational and Environmental Medicine 1999;11(2):287-292. Published online June 30, 1999; DOI: https://doi.org/10.35371/kjoem.1999.11.2.287

Abstract PDF: Aplastic anemia is characterized by pancytopenia with hypocellular bone marrow. Fifty percent of the cases are idiopathic and the rest are caused by various agents including drugs, chemicals, radiation and viruses. It is difficult to link specific etiologic agents, especially chemicals to the development of aplastic anemia because multiple or unknown exposures may be involved in. Benzene, a common industrial chemical and a component of gasoline, may lead progressively to pancytopenia, aplastic anemia and leukemia when exposed. A petrochemical worker with aplastic anemia was referred to our hospital to evaluate a relationship between the job history and the disease. He worked in the petrochemical plant for .21 years and was exposed to low-level benzene. There was not any other etiologic agent except benzene and this is the case report of aplastic anemia which possibly due to benzene exposure.

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Original Article

Assessment of Genotoxic Hazard in Petrochemical Workers: Jai Dong Moon, Soon Phal Suh, Jung Sun Park, Jin Hyung Cho, Ki Won Ahn; Korean Journal of Occupational and Environmental Medicine 1998;10(1):53-60. Published online February 28, 1998; DOI: https://doi.org/10.35371/kjoem.1998.10.1.53

Abstract PDF

In order to evaluate the genotoxic hazard among workers potentially exposed to low level petrochemical substances, the analyses of micronuclei (MN) and sister chromatid exchanges (SCEs) in lymphocytes were performed in 46 male workers (as exposed group) and 46 nonexposed subjects (as control group). Mean frequencies of MN and SCEs (respectively, 12.9/1000 cells and 6.5/cell) in exposed group were very significantly higher than those (10.2/1000 cells and 5.4/cell) in control group. And there were also significant differences in mean frequencies of MN and SCEs adjusted for age, employment duration, smoking, and drinking between two groups. Median frequencies of MN and SCEs in exposed group were very significantly higher than those in control group. Frequencies of SCEs were higher in smokers than in non-smoker. Frequencies of MN in smokers, however, were similiar to those of non-smoker. Interaction between exposure and smoking on MN and SCEs induction was not observed. The results suggest that there is genotoxic hazard in high risk group like workers handling carcinogens in petrochemical plants and the analyses of MN and SCEs are useful biomarkers for the exposure to hazard substances even at the level below the exposure limit.

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Original Article

Biological Indices for Early Detection of Cadmium Poisoning: Significance of Urinary Metallothionein: Jung Duck Park, Yeon Pyo Hong, Im Won Chang; Korean Journal of Occupational and Environmental Medicine 1997;9(2):230-243. Published online June 30, 1997; DOI: https://doi.org/10.35371/kjoem.1997.9.2.230

Abstract PDF: Metallothionein(MT) is a low molecular weight protein that is induced as a defence mechanism for cadmium (Cd) toxicity. In present study, urinary MT was determined using a competitive ELISA in Cd-exposed rats. In addition, measures the urinary, blood and renal Cd concentration and the urinary excretion of total protein, beta 2-microglobulin (MG) and N-acetyl-beta-D-glucosaminidase(NAG) at 1, 3, 7, 14, 28 days after Cd injection in Cd-exposed rats with dosers of 0.8 and 1.6 mg Cd/kg body weight respectively. The urinary, blood and renal Cd were specific for Cd-exposure, that increased in proportional to dose of Cd. The urinary and blood Cd tended to slightly decrease, while renal Cd tended to increase by lapse of time after Cd exposure. this finding indicates that renal Cd is more specific than urinary and blood Cd for Cd exposure. The urinary excretion of MT showed a statistically significant increase in Cd exposed rats(0.8 and 1.6 no Cd/kg body weight). The increase of urinary excretion of MT was more evident at 7, 14, 28 lays after Cd exposure than the changes of urinary excretion of total protein, beta-MG and NAG. The Pearson's correlation coefficients between urinary Cd and urinary MT, beta-MG, NAG and total protein were 0.4344, 0.3727, 0.3307 and 0.2099, respectively. These findings indicate that the urinary MT is more sensitive and specific than total protein, beta-MG and NAG for Cd exposure. The present results suggest that the urinary MT, using a simple and rapid competitive ELISA, is a valuable index as screening test in epidemiologic study for Cd exposed group.

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Original Article

Biological Index for Cadmium Exposure: Assay of Metallothionein by Competitive ELISA: Jung Duck Park, Woo Suk Lee, Yoon Kong, Yeon Pyo Hong, Im Won Chang; Korean Journal of Occupational and Environmental Medicine 1996;8(2):258-271. Published online September 30, 1996; DOI: https://doi.org/10.35371/kjoem.1996.8.2.258

Abstract PDF

Metallothionein (MT) is a cadmium binding protein that played major' roles in protective mechanism for cadmium toxicity. In the present study, competitive ELISA was established to assay the MT expression utilizing monospecific antibody which was generated against MT-L A total of 10 Sprague-Dawley rats was injected with CdCl2 for two weeks to induce MT. The cytosolic fraction of rat liver was obtained by differential centrifugation. Two major MT isozymes (MT-I & MT-II) at ca. 10 kDa were purified by Sephadex G-75 gel filtration followed by DEAE-Trisacryl-M anion exchange column chromatogra-phy, respectively. Two rabbits were immunized 4 times consecutively with the conjugate of purified MT-L The sera were collected by heart puncture. When immunoblot was carried out, the immunized rabbit sera (anti-MT-I) exhibited specific immunoreactive band at MT-I while showed any cross reactions neither with MT-II nor with other cytosolic proteins.. By chequerboard titration using the monospecific antibody, the competitive ELISA was established. The dose-dependent relationship was observed between anti-MT-I antibody and the amount of MT in biological samples (r(2)=O.9980). These results suggested strongly that competitive ELISA is a simple, rapid and reproducible method for screening cadmium exposure.

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