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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
AbstractAbstract AbstractAbstract 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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Original Article
Relationship between long-term PM2.5 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
AbstractAbstract AbstractAbstract in Korean PDFSupplementary Material
Background
PM2.5 (particulate matter less than 2.5 μm) causes various health problems. Recent studies suggest that long-term exposure to PM2.5 may have a negative impact on vision. This study examined the effects of long-term exposure to concentrations of PM2.5 exceeding Korean standards on myopia prevalence.
Methods
This study was conducted on adults aged 40–69 years. The PM2.5 concentrations were calculated as the 1–5-year moving averages based on the participants' residential areas. The relationships between the PM2.5 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
PM2.5 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 PM2.5 levels exceeded the Korean standards. These findings suggest that long-term exposure to PM2.5 may have a detrimental effect on vision.
Conclusions
This study revealed the impact of long-term PM2.5 exposure on the prevalence of myopia, highlighting the importance of managing PM2.5 levels. Nevertheless, further cohort studies focusing on adults and in-depth research into the effects of long-term exposure will be necessary.
장기 PM2.5 노출과 근시 유병률 간의 관계: 국민건강영양조사-대기오염 연계자료, 2020
목적
초미세먼지(PM2.5)는 다양한 건강 문제를 유발하며, 특히 장기 노출이 시력에 부정적인 영향을 미칠 수 있다는 연구가 제기되고 있다. PM2.5는 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 PM2.5 노출이 근시 유병률에 영향을 미칠 가능성이 제시되었다. 한국의 PM2.5 연간 기준은 15㎍/㎥로, WHO 기준보다 3배 높으나 이에 기반한 연구는 드물다. 본 연구는 한국의 PM2.5 기준을 바탕으로 성인의 근시 유병률과의 관계를 장기적으로 분석하였다.
방법
연구는 2020년 국민건강영양조사-대기오염 연계자료를 활용해 진행되었으며, 대상은 40-69세 성인이다. 연구 참여자의 거주지에서 PM2.5 농도의 1년-5년 이동평균을 계산하고, 이를 한국 연간 기준인 15㎍/㎥를 기준으로 나누어 분석했다. 근시는 자동굴절검사를 통해 정의되었으며, 이분형 로지스틱 회귀분석으로 근시 유병률과 PM2.5 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
PM2.5의 1년-3년 이동평균은 근시 유병률과 유의미한 관계를 보이지 않았으나, 4년-5년 이동평균이 기준치를 초과한 지역에서는 근시 유병률이 유의미하게 증가했다. 5년 이동평균 PM2.5 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 PM2.5 노출이 근시 유병률에 미치는 누적 손상 효과를 규명하며, 특히 4년-5년 이상의 노출이 중요한 요인임을 밝혔다. 이는 기존 연구와 달리 한국의 PM2.5 기준을 적용하여 현실적이고 특화된 결과를 도출한 점에서 의미가 있다. PM2.5 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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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
AbstractAbstract AbstractAbstract in Korean PDFSupplementary 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.

Citations

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  • Sex Differences in the Association Between the Korean Healthy Eating Index and Liver Enzymes Among Korean Adults
    Seong-Uk Baek, Jin-Ha Yoon
    Nutrients.2025; 17(14): 2372.     CrossRef
  • Temporary Employment Is Associated with Poor Dietary Quality in Middle-Aged Workers in Korea: A Nationwide Study Based on the Korean Healthy Eating Index, 2013–2021
    Seong-Uk Baek, Myeong-Hun Lim, Yu-Min Lee, Jong-Uk Won, Jin-Ha Yoon
    Nutrients.2024; 16(10): 1482.     CrossRef
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Research Article
Public-health impact of outdoor air pollution for 2nd air pollution management policy in Seoul metropolitan area, Korea
Jong Han Leem, Soon Tae Kim, Hwan Cheol Kim
Ann Occup Environ Med 2015;27:7.   Published online February 27, 2015
DOI: https://doi.org/10.1186/s40557-015-0058-z
AbstractAbstract PDF
Objectives

Air pollution contributes to mortality and morbidity. We estimated the impact of outdoor air pollution on public health in Seoul metropolitan area, Korea. Attributable cases of morbidity and mortality were estimated.

Methods

Epidemiology-based exposure-response functions for a 10 μg/m3 increase in particulate matter (PM2.5 and PM10) were used to quantify the effects of air pollution. Cases attributable to air pollution were estimated for mortality (adults ≥ 30 years), respiratory and cardiovascular hospital admissions (all ages), chronic bronchitis (all ages), and acute bronchitis episodes (≤18 years). Environmental exposure (PM2.5 and PM10) was modeled for each 3 km × 3 km.

Results

In 2010, air pollution caused 15.9% of total mortality or approximately 15,346 attributable cases per year. Particulate air pollution also accounted for: 12,511 hospitalized cases of respiratory disease; 20,490 new cases of chronic bronchitis (adults); 278,346 episodes of acute bronchitis (children). After performing the 2nd Seoul metropolitan air pollution management plan, the reducible death number associated with air pollution is 14,915 cases per year in 2024. We can reduce 57.9% of death associated with air pollution.

Conclusion

This assessment estimates the public-health impacts of current patterns of air pollution. Although individual health risks of air pollution are relatively small, the public-health consequences are remarkable. Particulate air pollution remains a key target for public-health action in the Seoul metropolitan area. Our results, which have also been used for economic valuation, should guide decisions on the assessment of environmental health-policy options.


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