Annals of Occupational and Environmental Medicine

Original Article

Increased breast cancer incidence among nurses in a tertiary university hospital in South Korea: Juho Choi, Dong-Wook Lee, Baek-Yong Choi, Seung-Woo Ryoo, Taeshik Kim, Yun-Chul Hong; Ann Occup Environ Med 2023;35:e44. Published online November 4, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e44

Abstract Abstract in Korean PDF PubReader ePub: Background
A series of breast cancer cases were recently reported in a tertiary university hospital in South Korea. Nurses are generally exposed to risk factors for breast cancer such as night shift work, antineoplastic agents, and job strain. However, the epidemiological evidence of excess incidence among nurses remains lacking. This study aims to investigate the excess incidence of breast cancer among nurses in a tertiary university hospital and provide epidemiological evidence of occupational risk factors.
Methods
A retrospective cohort was developed using personnel records of female workers in the nursing department who worked from January 2011 to June 2021 in a tertiary university hospital in South Korea. Sick leave records were used to identify cases of breast cancer. The standardized incidence ratio of breast cancer among nurses was compared to the general population.
Results
A total of 5,509 nurses were followed up for 30,404 person-years, and 26 breast cancer cases were identified. This study revealed a significantly increased breast cancer incidence among all included nurses, with a standardized incidence ratio of 1.65 (95% confidence interval [CI]: 1.08–2.41), compared to the general population. Workers, who handle antineoplastic agents in their representative department and current and/or former department, had significantly elevated breast cancer standardized incidence ratios of 2.73 (95% CI: 1.008–5.94) and 3.39 (95% CI: 1.46–6.68), respectively.
Conclusions
This study provides significant evidence of increased breast cancer risk among nursing staff in a hospital setting, particularly those who handle antineoplastic drugs. Measures that reduce exposure to risk factors should be implemented, especially anticancer drugs, to protect healthcare professionals. Further research at a national level that focuses on healthcare workers is necessary to validate breast cancer incidence and its contributing factors.; 국내 모 대학병원 내 간호노동자에서의 유방암 발병률 증가
목적
최근 서울에 위치한 모 대학병원에서 항암제를 취급하는 근무지 내 간호사 중에서 여러 건의 유방암이 진단되었다. 간호사들에 대한 직업적 위험인자로 야간 근무, 항암제 노출, 직무 스트레스 등이 파악되었다. 그러나 간호사를 포함한 의료종사자들 사이에서 유방암 발병률 증가에 대한 연구 결과는 부족하다. 본 연구는 해당 대학병원의 간호부문 근로자에서의 유방암 발병률을 일반인과 비교하여 확인함으로써, 이들의 직업적 위험요인에 대한 역학적 증거를 제공하고자 하였다.
방법
해당 대학병원의 인사기록을 활용하여 후향적 코호트 연구를 수행하였으며, 2011년 1월부터 2021년 6월까지 간호부문에서 근무한 여성 근로자를 연구대상으로 하였다. 유방암 환자들을 식별하기 위해 병가 기록이 활용되었으며, 대표적인 근무지는 근로자가 가장 오래 근무한 곳을 기준으로 결정되었다. 간호부문 근로자에서의 연령 표준화 유방암 발병률을 산출하여 일반인구와 비교하였다.
결과
본 연구에서는 간호부문 근로자 5,509명을 대상으로 코호트 연구를 수행하였다. 관찰기간은 총 30,404인년이었고, 추적 기간 동안 신규 유방암 환자 26명을 확인하였다. 전체 간호부문 근로자들에서의 일반인구 대비 유방암 표준화발생률(Standardized Incidence ratio, SIR)은 1.65 (95% CI : 1.08-2.41)로 유의한 증가를 보였다. 항암제 취급 부서가 그들의 대표부서이거나 이전에 근무했던 경험이 있는 경우, 각각 2.73배(95% CI :1.00-5.94), 3.39배(95% CI : 1.46-6.68) 높은 유방암 발병위험이 확인되었다.
결론
본 연구는 병원 내 간호부문 종사자, 특히 항암제 취급 종사자에서의 유방암 발병 위험이 일반인구 대비 유의하게 증가함을 확인하였다. 의료종사자들을 직업적 위험요인으로부터 보호하기 위해 항암제 노출 차단, 야간 근무 감소, 개인 맞춤형 건강검진이 도입되어야 할 것이다. 추후 의료종사자를 대상으로 국가 수준의 연구를 통해 이들의 유방암 발병위험과 그 기여요인에 대해 확인해야 할 것이다.

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Research Article

Mental disorders among workers in the healthcare industry: 2014 national health insurance data: Min-Seok Kim, Taeshik Kim, Dongwook Lee, Ji-hoo Yook, Yun-Chul Hong, Seung-Yup Lee, Jin-Ha Yoon, Mo-Yeol Kang; Ann Occup Environ Med 2018;30:31. Published online May 3, 2018; DOI: https://doi.org/10.1186/s40557-018-0244-x

Abstract PDF PubReader ePub

Background

Numerous studies have shown that healthcare professionals are exposed to psychological distress. However, since most of these studies assessed psychological distress using self-reporting questionnaires, the magnitude of the problem is largely unknown. We evaluated the risks of mood disorders, anxiety disorders, sleep disorders, and any psychiatric disorders in workers in healthcare industry using Korea National Health Insurance (NHI) claims data from 2014, which are based on actual diagnoses instead of self-evaluation.

Methods

We used Korea 2014 NHI claims data and classified employees as workers in the healthcare industry, based on companies in the NHI database that were registered with hospitals, clinics, public healthcare, and other medical services. To estimate the standardized prevalence of the selected mental health disorders, we calculated the prevalence of diseases in each age group and sex using the age distribution of the Korea population. To compare the risk of selected mental disorders among workers in the healthcare industry with those in other industries, we considered age, sex, and income quartile characteristics and conducted propensity scored matching.

Results

In the matching study, workers in healthcare industry had higher odds ratios for mood disorders (1.13, 95% CI: 1.11–1.15), anxiety disorders (1.15, 95% CI: 1.13–1.17), sleep disorders (2.21, 95% CI: 2.18–2.24), and any psychiatric disorders (1.44, 95% CI: 1.43–1.46) than the reference group did. Among workers in healthcare industry, females had higher prevalence of psychiatric disorders than males, but the odds ratios for psychiatric disorders, compared to the reference group, were higher in male workers in healthcare industry than in females.

Conclusions

The prevalence of mood disorders, anxiety disorders, sleep disorders, and all psychiatric disorders for workers in the healthcare industry was higher than that of other Korean workers. The strikingly high prevalence of sleep disorders could be related to the frequent night-shifts in these professions. The high prevalence of mental health problems among workers in healthcare industry is alarming and requires prompt action to protect the health of the “protectors.”

Citations

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Research Article

Computer use at work is associated with self-reported depressive and anxiety disorder: Taeshik Kim, Mo-Yeol Kang, Min-sang Yoo, Dongwook Lee, Yun-Chul Hong; Ann Occup Environ Med 2016;28:57. Published online October 13, 2016; DOI: https://doi.org/10.1186/s40557-016-0146-8

Abstract PDF PubReader ePub

Background

With the development of technology, extensive use of computers in the workplace is prevalent and increases efficiency. However, computer users are facing new harmful working conditions with high workloads and longer hours. This study aimed to investigate the association between computer use at work and self-reported depressive and anxiety disorder (DAD) in a nationally representative sample of South Korean workers.

Methods

This cross-sectional study was based on the third Korean Working Conditions Survey (2011), and 48,850 workers were analyzed. Information about computer use and DAD was obtained from a self-administered questionnaire. We investigated the relation between computer use at work and DAD using logistic regression.

Results

The 12-month prevalence of DAD in computer-using workers was 1.46 %. After adjustment for socio-demographic factors, the odds ratio for DAD was higher in workers using computers more than 75 % of their workday (OR 1.69, 95 % CI 1.30−2.20) than in workers using computers less than 50 % of their shift. After stratifying by working hours, computer use for over 75 % of the work time was significantly associated with increased odds of DAD in 20–39, 41–50, 51–60, and over 60 working hours per week. After stratifying by occupation, education, and job status, computer use for more than 75 % of the work time was related with higher odds of DAD in sales and service workers, those with high school and college education, and those who were self-employed and employers.

Conclusions

A high proportion of computer use at work may be associated with depressive and anxiety disorder. This finding suggests the necessity of a work guideline to help the workers suffering from high computer use at work.

Electronic supplementary material

The online version of this article (doi:10.1186/s40557-016-0146-8) contains supplementary material, which is available to authorized users.

Citations

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Research Article

Association between urinary 3-phenoxybenzoic acid and body mass index in Korean adults: 1^st Korean National Environmental Health Survey: Minsang Yoo, Youn-Hee Lim, Taeshik Kim, Dongwook Lee, Yun-Chul Hong; Ann Occup Environ Med 2016;28:2. Published online January 13, 2016; DOI: https://doi.org/10.1186/s40557-015-0079-7

Abstract PDF PubReader ePub

Background

According to US-EPA report, the use of pyrethrins and pyrethroids has increased during the past decade, and their area of use included not only in agricultural settings, but in commerce, and individual household. It is known that urinary 3-PBA, major metabolite of pyrethroid, have some associations with health effect in nervous and endocrine system, however, there’s no known evidence that urinary 3-PBA have associations with obesity.

Method

We used data of 3671 participants aged above 19 from the Korean National Environmental Health Survey in 2009–2011. In our analysis, multivariate piece-wise regression and logistic regression analysis were used to investigate the association between urinary 3-PBA (3-Phenoxybenzoic Acid) and BMI.

Result

Log-transformed level of urinary 3-PBA had significantly positive association with BMI at the low-level range of exposure (p < 0.0001), and opposite associations were observed at the high level exposure (p = 0.04) after adjusting covariates. In piece-wise regression analysis, the flexion point that changes direction of the associations was at around 4 ug/g creatinine of urinary 3-PBA. As quintiles based on concentration of urinary 3-PBA increased to Q4, the ORs for prevalence of overweight (BMI ≥ 23 kg/m²) were increased, and the OR of Q5 was lower than that of Q4 (OR = 1.810 for Q4; OR = 1.483 for Q5). In the analysis using obesity (BMI ≥ 25 kg/m²) as outcome variable, significant associations were observed between obesity and quintiles of 3-PBA, however, there were no differences between the OR of Q5 and that of Q4 (OR = 1.659 for Q4; OR = 1.666 for Q5).

Conclusion

Our analysis suggested that low-level of pyrethroid exposure has positive association with BMI, however, there is an inverse relationship above the urinary 3-PBA level at 4 ug/g creatinine.

Electronic supplementary material

The online version of this article (doi:10.1186/s40557-015-0079-7) contains supplementary material, which is available to authorized users.

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