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

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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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Special Issue

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; Ann Occup Environ Med 2023;35:e16. Published online July 6, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e16

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Special Issue

Working hours and the regulations for night shift workers: Tae-Won Jang; Ann Occup Environ Med 2023;35:e19. Published online July 5, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e19

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There are several types of shift work in Korea: rotating shift, 24-hour shift, day-night shift, fixed night work, and.so on. As a result of analyzing the 8th Korea National Health and Nutrition Examination Survey and the 6th Korean Working Condition Survey, Korean shift workers accounted for 11.6%–13.9% of wage workers. Weekly working hours of shift workers were 57.69 ± 1.73 (24-hours shift) and 49.97 ± 0.67 (fixed night shift), which were significantly longer than day workers. To prevent health consequences of night work, many countries regulate the working hours of night work not to exceed 7–9 hours a day. However, Korea does not regulate working hours for night work, and some occupations may work more hours than the prescribed overtime hours. To prevent health consequences and reduce working hours for Korean night shift workers, it is necessary to regulate the working hours of night shift workers by law.

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The association of shift work and TyG index among male workers in a chemical plant of Korea: a cross-sectional study
Gwangin Baek, Yong-Jin Lee, Soon-Chan Kwon, Young-Sun Min, Jisuk Yun, Tae Jin Ahn, Eun-Chul Jang
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Association between long working hours and diet quality and patterns: A latent profile analysis of a nationally representative sample of Korean workers
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Annals of Occupational and Environmental Medicine.2023;[Epub] CrossRef

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Original Article

Association between sleep quality and type of shift work in Korean firefighters: Hyun-Jeong Oh, Chang Sun Sim, Tae-Won Jang, Yeon Soon Ahn, Kyoung Sook Jeong; Ann Occup Environ Med 2022;34:e27. Published online October 11, 2022; DOI: https://doi.org/10.35371/aoem.2022.34.e27

Abstract Abstract in Korean PDF PubReader ePub

Background

Shift work that interferes with normal sleep patterns, is known to be a cause of sleep disturbance and has been studied through various occupational groups. However, it is not known which shift type is better for sleep health.

Methods

This study included 568 firefighters. Sleep quality was evaluated using Pittsburgh Sleep Quality Index. Sleep quality was categorized into 2 groups; good quality (≤ 5 points) and poor quality (≥ 6 points). Demographic variables, depression, anxiety, type of shift, and job were collected by self-reported questionnaires. The χ² test, t-test, and multiple logistic regression analysis were used to evaluate the effect of shift type on the sleep quality of firefighters.

Results

Three hundred thirty-seven firefighters (59.3%) have poor sleep quality. Compared to day workers, the odds ratios (ORs) of poor sleep quality were 2.169 (95% confidence interval: 1.137–4.134) in 6-day cycle, 2.161 (1.150–4.062) in 9-day cycle, 1.805 (1.087–2.997) in 21-day cycle, and 1.485 (0.718–3.069) in 3-day cycle. The ORs of poor sleep quality were 1.697(1.021–2.823) in fire suppression and 2.325 (1.213–4.455) in emergency medical service compared to administration.

Conclusions

All shift work type except for the 3-day cycle was associated with poor sleep quality compared to day work.

한국 소방관에서 수면의 질과 교대근무 유형의 연관성
목적
소방관의 수면의 질에 어떤 교대근무 유형이 적합한지 결정하는 것이다.
방법
이 연구는 568명의 소방관을 포함하여 피츠버그 수면의 질 지수를 사용하여 수면의 질을 평가하였고, 다른 교란 요인은 자기보고형태의 설문지를 통해 수집하였다. 소방관의 수면의 질에 대한 교대근무 유형의 영향을 평가하기 위하여 카이제곱 검정, t-검정, 다중 로지스틱 회귀 분석을 사용하였다.
결과
337명(59.3%)은 나쁜 수면의 질을 가졌다. 주간 근무자와 비교했을 때, 나쁜 수면의 질에 대한 오즈비는 6주기에서 2.161 (95% 신뢰구간 1.137-4.134), 9주기에서 2.161 (1.150-4.062), 21주기에서 1.805 (1.087-2.997), 3주기에서 1.485 (0.718-3.069). 직무별로는 행정에 비해 화재진압 소방관의 수면의 질이 나쁠 오즈비는 1.697 (1.021-2.823)이었고, 구급업무 소방관은 2.325 (1.213-4.455)이었다.
결론
3주기를 제외하고 다른 형태의 교대근무에서 수면의 질은 주간근무에 비해 에서 나쁜 것으로 나타났다.

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Association of age and night flight duration with sleep disorders among Chinese airline pilots
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Working hours and the regulations for night shift workers
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Annals of Occupational and Environmental Medicine.2023;[Epub] CrossRef

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Research Article

Descriptive analysis of prevalence and medical expenses of cancer, cardio-cerebrovascular disease, psychiatric disease, and musculoskeletal disease in Korean firefighters: Jeehee Min, Yangwoo Kim, Hye Sim Kim, Jiyoung Han, Inah Kim, Jaechul Song, Sang-Baek Koh, Tae-Won Jang; Ann Occup Environ Med 2020;32:e7. Published online January 30, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e7

Abstract PDF Supplementary Material PubReader ePub

Background

Firefighters are exposed to many dangerous working conditions. Many studies have identified the risk of disease for firefighters, but only a few studies have addressed the medical expenses of firefighters, which represents a concrete scale of disease. Our purpose in this study was to determine the medical expenditures of firefighters to assess the overall scale of disease in Korea. We focused on cancer, mental disorders, cardio-cerebrovascular disease, and musculoskeletal disease, the prevalence of which was expected to be high in firefighters.

Methods

This study utilized National Health Insurance Service data. We targeted firefighters, police officers, and government officials. We classified disease based on the 10th revision of the International Statistical Classification of Diseases and Related Health Problems codes. We compared prevalence by the age-standardized prevalence rate, considering standard distribution of the population. Medical expenditure of disease was defined as outpatient fees, hospitalization fees, and drug costs. Total medical expenditures were calculated by the sum of those 3 categories.

Results

The age-standardized prevalence of cancer, mental disorders, and cardiovascular disease in firefighters was slightly higher than or similar to that of government officials and police officers (no significant difference). However, medical expenditures for stomach cancer, mental disorders, and most cardio-cerebrovascular diseases were higher in firefighters than in others. In particular, firefighters spent 12 times more money for ischemic heart disease than did government officials. Of musculoskeletal diseases, lumbar disc disorder had the highest expenditures among firefighters.

Conclusions

The age-standardized prevalence of most of diseases of firefighters was not as high as in the other groups, but the medical expenses of firefighters were much higher than those of government officials and police officers.

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The global prevalence of musculoskeletal disorders among firefighters: a systematic review and meta-analysis
Amir Hossein Khoshakhlagh, Saeid Yazdanirad, Saleh Al Sulaie, Abdollah Mohammadian-Hafshejani, Robin Marc Orr
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Review

The standards for recognition of occupational cancers related with polycyclic aromatic hydrocarbons (PAHs) in Korea: Tae-Won Jang, Yangho Kim, Jong-Uk Won, Jong-Seong Lee, Jaechul Song; Ann Occup Environ Med 2018;30:13. Published online February 26, 2018; DOI: https://doi.org/10.1186/s40557-018-0224-1

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Polycyclic aromatic hydrocarbons (PAHs) are organic compounds containing carbon and hydrogen. PAHs have carcinogenicity in human. Cancers related with PAHs include cancers of lung, skin, bladder, and others. International Agency for Research on Cancer (IARC) has determined several occupations that can be exposure to PAHs were probable carcinogens to human. National Toxicology Program (NTP) classified coal tars and coal tar pitches, and coke oven emissions as known to human carcinogens, and US Environmental Protection Agency (EPA) classified coke oven emissions as human carcinogen.

PAHs can be produced both naturally and artificially. Sources of occupational exposure include coal gasification, coke production, coal tar distillation, aluminium production, and so on. Diesel exhaust emission contains large amount of PAHs. Cigarette smoking also contains many PAHs, which is the important source of environmental source of PAHs.

The evaluation for work-relatedness and standards for recognition of occupational cancers should focus on occupations that can be exposed to PAHs. In Korea, standards for recognition of occupational cancers related with PAHs are following: lung cancers related with more than 10 years exposure to coal tar pitch, lung and skin cancers related with soot exposure, and skin cancers related with more than 10 years exposure to coal tar. When applying these standards, occupations that can be exposed to PAHs should be focused on. In addition, latent period for solid cancer should be considered. In addition to these occupations, diesel engine combustion and firefighters can be exposed to PAHs.

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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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Review

Evaluation of mercury exposure level, clinical diagnosis and treatment for mercury intoxication: Byeong-Jin Ye, Byoung-Gwon Kim, Man-Joong Jeon, Se-Yeong Kim, Hawn-Cheol Kim, Tae-Won Jang, Hong-Jae Chae, Won-Jun Choi, Mi-Na Ha, Young-Seoub Hong; Ann Occup Environ Med 2016;28:5. Published online January 22, 2016; DOI: https://doi.org/10.1186/s40557-015-0086-8

Abstract PDF PubReader ePub

Mercury occurs in various chemical forms, and it is different to health effects according to chemical forms. In consideration of the point, the evaluation of the mercury exposure to human distinguished from occupational and environmental exposure.

With strict to manage occupational exposure in factory, it is declined mercury intoxication cases by metallic and inorganic mercury inhalation to occupational exposure. It is increasing to importance in environmental exposure and public health.

The focus on the health impact of exposure to mercury is more on chronic, low or moderate grade exposure—albeit a topic of great controversy—, not high concentration exposure by methylmercury, which caused Minamata disease.

Recently, the issue of mercury toxicity according to the mercury exposure level, health effects as well as the determination of what mercury levels affect health are in the spotlight and under active discussion. Evaluating the health effects and Biomarker of mercury exposure and establishing diagnosis and treatment standards are very difficult.

It can implement that evaluating mercury exposure level for diagnosis by a provocation test uses chelating agent and conducting to appropriate therapy according to the result. but, indications for the therapy of chelating agents with mercury exposure have not yet been fully established.

The therapy to symptomatic patients with mercury poisoning is chelating agents, combination therapy with chelating agents, plasma exchange, hemodialysis, plasmapheresis. But the further evaluations are necessary for the effects and side effects with each therapy.

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Review

Evaluation and management of lead exposure: Hwan-Cheol Kim, Tae-Won Jang, Hong-Jae Chae, Won-Jun Choi, Mi-Na Ha, Byeong-Jin Ye, Byoung-Gwon Kim, Man-Joong Jeon, Se-Yeong Kim, Young-Seoub Hong; Ann Occup Environ Med 2015;27:30. Published online December 15, 2015; DOI: https://doi.org/10.1186/s40557-015-0085-9

Abstract PDF PubReader ePub

Lead, which is widely used in industry, is a common element found in low concentrations in the Earth’s crust. Implementations to reduce environmental lead concentrations have resulted in a considerable reduction of lead levels in the environment (air) and a sustained reduction in the blood lead levels of the average citizen. However, people are still being exposed to lead through a variety of routes in everyday commodities.

Lead causes health problems such as toxicity of the liver, kidneys, hematopoietic system, and nervous system. Having a carcinogenic risk as well, the IARC classifies inorganic lead compounds as probably carcinogenic to humans (Group 2A). Occupational lead poisonings have decreased due to the efforts to reduce the lead concentrations in the working environment. In contrast, health hazards associated with long-term environmental exposure to low concentrations of lead have been reported steadily. In particular, chronic exposure to low concentrations of lead has been reported to induce cognitive behavioral disturbances in children.

It is almost impossible to remove lead completely from the human body, and it is not easy to treat health hazards due to lead exposure. Therefore, reduction and prevention of lead exposure are very important. We reviewed the toxicity and health hazards, monitoring and evaluation, and management of lead exposure.

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