Annals of Occupational and Environmental Medicine

Review

A work-relatedness assessment in epidemiological case investigation of occupational cancers: I. Principles: Kihun Kim, Jungwon Kim; Ann Occup Environ Med 2020;32:e30. Published online September 1, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e30

It is important to identify the causal relationship between occupational exposure and the disease in the area of compensation because most cancers have long latent period. This review presents the principles that should be considered when evaluating the work-relatedness. We reviewed reports on occupational cancers published by the International Agency for Research on Cancer, American Conference of Governmental Industrial Hygienists, National Toxicology Program, Environmental Protection Agency, European Union, which are the world's most prestigious organizations. In addition, we reviewed relevant papers and books published in Korea. The process is conducted in the order of cancer diagnosis, exposure assessment for carcinogens, and work-relatedness assessment. The probability of causation is determined stochastically rather than deterministically. There is no absolute standard for accreditation criteria and results may vary according to expert opinions and in each country or organization. Revealing the causal relationship of occupational cancers is a difficult process owing to inconsistency in relevant epidemiological studies, lack of well-established biological mechanisms, loss of objective occupational historical data, and other complexity of individual cases. Causation is unclear in many cases. Nevertheless, the data should be reviewed in detail for each case suspected of work-related cancers, and an assessment should be made through valid and plausible logic and literature evidences.

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Technetium-99m hand perfusion scintigraphy (Raynaud’s scan) as a method of verification in hand arm vibration syndrome: a review
Taewoong Ha, Hyeoncheol Oh, Jungwon Kim
Annals of Occupational and Environmental Medicine.2022;[Epub] CrossRef

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Case Report

Gastric and rectal cancers in workers exposed to asbestos: a case series: Byeong Ju Choi, Saerom Lee, Iu Jin Lee, Soon Woo Park, Sanggil Lee; Ann Occup Environ Med 2020;32:e4. Published online January 2, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e4

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Background

The Occupational Safety and Health Research Institute (OSHRI) of the Korea had not recognized gastrointestinal cancer as work-related disease during their evaluation. However, in 2018 OSHRI recognized gastric and rectal cancers as work-related disease in asbestos-exposed workers. We present 2 such cases along supportive evidence of causation.

Case presentation

Patient A: A 57-year-old man had worked for about 40 years since 1978 as an oxygen cutter at workplaces that dismantle ships, buildings, boilers, and thermal power plants. In November 2016, endoscopy and biopsy confirmed the diagnosis of advanced gastric cancer, for which he underwent subtotal gastrectomy and chemotherapy; however, he later died of the cancer. Patient B: A 71-year-old man had worked in shipbuilding and repair workplaces for approximately 49 years, being employed in pipe laying, asbestos insulation installation, grinding, and other ship repair work. In 2003, he was diagnosed of rectal cancer by abdominal computed tomography. He accordingly underwent surgical removal of the cancer. Based on the occupational history of the 2 patients and our review of the relevant literature addressing the occupational environment, we concluded that both patients had continuous exposure to high levels of asbestos while performing their jobs for 40 and 49 years, respectively.

Conclusion

Both patients had a history of smoking and drinking (non-occupational personal risk factors). However, the possibility of an increased risk of gastric and rectal cancers from asbestos exposure cannot be excluded. Therefore, we considered that occupational exposure to asbestos had contributed to the cancer diagnosis in these cases. Workers exposed to asbestos should be made aware of the possibility of gastric or rectal cancer, and should undergo monitoring and medical examinations. Appropriate compensation for gastric and rectal cancers that occur in workers exposed to asbestos are anticipated in future.

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Sustainable management of hazardous asbestos-containing materials: Containment, stabilization and inertization
Shiv Bolan, Leela Kempton, Timothy McCarthy, Hasintha Wijesekara, Udara Piyathilake, Tahereh Jasemizad, Lokesh P. Padhye, Tao Zhang, Jörg Rinklebe, Hailong Wang, M.B. Kirkham, Kadambot H.M. Siddique, Nanthi Bolan
Science of The Total Environment.2023; 881: 163456. CrossRef
Parkinson's disease in a worker exposed to insecticides at a greenhouse
Yangwoo Kim, Inah Kim, Jung-Min Sung, Jaechul Song
Annals of Occupational and Environmental Medicine.2021;[Epub] CrossRef
Increased Risk of Gastric Cancer in Asbestos-Exposed Workers: A Retrospective Cohort Study Based on Taiwan Cancer Registry 1980–2015
Yi-Jen Fang, Hung-Yi Chuang, Chih-Hong Pan, Yu-Yin Chang, Yawen Cheng, Lukas Jyuhn-Hsiarn Lee, Jung-Der Wang
International Journal of Environmental Research and Public Health.2021; 18(14): 7521. CrossRef
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Environments.2020; 7(5): 35. CrossRef

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Case Report

Work-related olfactory disorder: a case series and review: Soon Woo Park, Young Joong Kang, Huisu Eom, Hyun-Jin Cho, Jungho Ahn, Sang-Gil Lee; Ann Occup Environ Med 2018;30:18. Published online March 12, 2018; DOI: https://doi.org/10.1186/s40557-018-0230-3

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Background

The olfactory bulb is anatomically exposed and thus can be directly damaged by external stimulation. This can occur as an occupational injury owing to contact with organic solvents or other causes. We present cases of eight patients who sustained occupation-related exposure to potentially toxic substances and later presented with signs and symptoms of anosmia. We examined the occupational and medical characteristics of the patients and evaluated their work-relatedness.

Case presentation

Case 1: A 50-year-old man performed high-frequency heat treatments for approximately 11 years. He experienced decreased senses for olfaction and taste during the later years culminating in the diagnosis of anosmia after 3 years (high work-relatedness). Case 2: A 54-year-old man whose work involved exposure to various organic solvents, such as spray painting and application of paint and thinners for approximately 4 years, was subsequently diagnosed with anosmia based on rhinorrhea, headache, and loss of olfaction (high work-relatedness). Case 3: A 44-year-old-man who performed spray painting for approximately 17 years developed anosmia (high work-relatedness). Case 4: A 44-year-old man was involved in ship engine cleaning once a month, for approximately 7 h per cleaning session; he was diagnosed with anosmia based on loss of olfaction (low work-relatedness). Case 5: A 41-year-old man worked in ship building block construction for approximately 13 years; anosmia diagnosis was based on loss of olfaction (low work-relatedness). Case 6: A 47-year-old woman performed product inspection and labeling at a plant manufacturing automobile parts; anosmia diagnosis was based on decreased olfaction and taste (low work-relatedness). Case 7: A 50-year-old woman performed epoxy coating in a plant manufacturing automobile parts; anosmia diagnosis was based on diminishing olfaction (low work-relatedness). Case 8: A 57-year-old woman performed cleaning of the area where mobile phone parts were manufactured; anosmia diagnosis was based on diminishing olfaction (low work-relatedness).

Conclusion

The study results confirmed work-relatedness when the subject was young, and the duration of exposure was long without any other cause of anosmia. Regarding compensation for occupational diseases, work-relatedness can be recognized as a relative concept.

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Predictors of Olfactory Decline in Aging: A Longitudinal Population-Based Study
Ingrid Ekström, Maria Larsson, Debora Rizzuto, Johan Fastbom, Lars Bäckman, Erika J Laukka, Anne B Newman
The Journals of Gerontology: Series A.2020; 75(12): 2441. CrossRef

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Review

Overview of occupational cancer in painters in Korea: Jun-Pyo Myong, Younmo Cho, Min Choi, Hyoung-Ryoul Kim; Ann Occup Environ Med 2018;30:10. Published online February 6, 2018; DOI: https://doi.org/10.1186/s40557-018-0222-3

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Comprehensive consideration is necessary for setting guidelines to evaluate evidence of occupational cancer in painters due to work-related exposure to carcinogens in paint (a phenomenon termed herein as “work-relatedness”). The aim of the present research is to perform a comprehensive review and to suggest criteria for the provision of compensation for occupational neoplasm among painters in Korea. In order to perform a comprehensive review, this study assessed and evaluated scientific reports of carcinogenicities from the International Agency for Research on Cancer (IARC) and the Industrial Injuries Advisory Council (IIAC), as well as reviewed the existing literature about occupational exposure among painters in Korea and the epidemiologic investigations of claimed cases of cancer among painters in Korea. The IARC declares that occupational exposures in commercial painting are classified as Group 1 carcinogens for lung cancer and bladder cancer among painters. The epidemiologic studies show consistent causal relationships between occupational exposure in painters and cancers such as lung cancer [meta relative risk: 1.34 (95% confidence intervals (CIs): 1.23-1.41)] and bladder cancer [meta relative risk: 1.24 (95% CIs: 1.16-1.33)]. In reviewing occupational cancer risks for commercial painters, the Industrial Injuries Advisory Council (IIAC) confirms occupational cancer risks for lung and bladder cancer among commercial painters. According to the IIAC, however, the elevated cancer risks reported in existing literature are not doubled in either lung or bladder cancer in commercial painters relative to the risks of these cancers in the general population. Based on our review of existing Korean articles on the topic, painters are exposed to potential carcinogens including polycyclic aromatic hydrocarbons (PAHs), benzene, hexavalent chrome, crystalized silica, asbestos, and other agents, and relative levels are estimated within commercial painting processes. However, the cancer risks of occupational exposure to Group 1 carcinogens for lung and bladder cancer in painters per se are not fully assessed in existing Korean articles. Total work duration, potential carcinogens in paint, mixed exposure to paints across various industries such as construction and shipbuilding, exposure periods, latent periods, and other factors should be considered on an individual basis in investigating the work-relatedness of certain types of cancer in commercial painters.

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The Predictive Effect of Protection Motivation Theory Structures on the Protective Behaviors of Painting Workers: An Analysis of Threat Appraisal and Coping Appraisal Processes
Mohsen Rezaeian, Mostafa Nasirzadeh, Mahmood Mahbobirad, Hassan Ahmadinia, Mahdi Abdolkarimi, Alireza Taheri Fard
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Efectos adversos por el uso de sustancias químicas en la salud de los trabajadores de la industria de la construcción. Artículo de revisión
Solaindy Andrea Zapata-Alvarez, Dayanis Bautista-Avila, Carla Patricia Laguna-Acosta, Pier Paolo Rojas-Valderrama, Yessica Alejandra Rincón-Rojas, Fabiola Contreras-Pacheco
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Establishment and operation of a cooperative program to identify work-related acute myeloid leukemia in a general hospital
Jiyoun Jung, Hye-ran Choi, Byung-Sik Cho, Silvia Park, Jun-Pyo Myong, Mo-Yeol Kang, Hee-Je Kim
Annals of Occupational and Environmental Medicine.2019;[Epub] CrossRef

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Research Article

Work-relatedness of lung cancer by smoking and histologic type in Korea: Young-Il Lee, Sang-Gil Lee, Dong-Mug Kang, Jong-Eun Kim, Young-Ki Kim, Jong-Han Leem, Hwan-Cheol Kim; Ann Occup Environ Med 2014;26:43. Published online December 1, 2014; DOI: https://doi.org/10.1186/s40557-014-0043-y

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Objectives

This study investigated the distribution of causative agents related to occupational lung cancer, their relationships with work, and associations between work-relatedness and the histologic type of lung cancer.

Methods

We used data from the occupational surveillance system in Korea in 2013. In addition, data from 1,404 participants diagnosed with lung cancer were collected through interviews. We included the patients’ longest-held job in the analysis. Work-relatedness was categorized as “definite,” “probable,” “possible,” “suspicious,” “none,” or “undetermined.”

Results

Among the subjects, 69.3% were men and 30.7% were women. Regarding smoking status, current smokers were the most prevalent (35.5%), followed by non-smokers (32.3%), ex-smokers (32.2%). Regarding the causative agents of lung cancer, asbestos (1.0%) and crystalline silica (0.9%) were the most common in definite work-related cases, while non-arsenical insecticide (2.8%) was the most common in probable cases followed by diesel engine exhaust (1.9%) and asbestos (1.0%). Regarding histologic type, adenocarcinoma was the most common (41.7%), followed by squamous cell carcinoma (21.2%). Among current smokers, squamous cell carcinoma was the most common among definite and probable cases (13.4%), while non-small cell lung cancer was the least common (7.1%). Among non-smokers, squamous cell carcinoma was the most common (21.4%), while the least common was adenocarcinoma (1.6%).

Conclusions

Approximately, 9.5% of all lung cancer cases in Korea are occupational-related lung cancer. Well-known substances associated with lung cancer, such as crystalline silica, asbestos, and diesel engine exhaust, are of particular concern. However, the histologic types of lung cancer related to smoking were inconsistent with previous studies when work-relatedness was taken into account. Future studies are required to clarify the incidence of occupational lung cancer in agricultural workers exposed to non-arsenical insecticides and the associations between work-relatedness and the histologic type of lung cancer.

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Young Ju Jung, Evaldas Katilius, Rachel M. Ostroff, Youndong Kim, Minkyoung Seok, Sujin Lee, Seongsoo Jang, Woo Sung Kim, Chang-Min Choi
Clinical Lung Cancer.2017; 18(2): e99. CrossRef
Smoking habits and nicotine dependence of North Korean male defectors
Sei Won Kim, Jong Min Lee, Woo Ho Ban, Chan Kwon Park, Hyoung Kyu Yoon, Sang Haak Lee
The Korean Journal of Internal Medicine.2016; 31(4): 685. CrossRef

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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

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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.

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Original Article

The Work-Related Cases among Bronchial Asthma Diagnosed at a University Hospital in Incheon: Chang Ho Chae, Seung Won Choi, Youg Hyu Choi, Young Woo Jin, Eun A Kim, Seong Kyu Kang; Korean Journal of Occupational and Environmental Medicine 1999;11(2):174-180. Published online June 30, 1999; DOI: https://doi.org/10.35371/kjoem.1999.11.2.174

Abstract PDF

Bronchial Asthma could be developed by occupational origin. 4-16% of bronchial asthmas are known to be related to occupational exposure. However, occupational asthma has not been reported from the periodic occupational health examination, but reported through case report from clinicians. The authors analysed hospital records to find out work-related bronchial asthma and their occupational characteristics at a university hospital in Jnchon. All records which were confirmed as bronchial asthma in adult by an allergist from June, 1996 to May, 1998 were selected. Through record reviewing, any suspected work related asthma was selected and the interview was done by phone or at the out-patient clinic. The possible cases were confirmed by additional tests including specific bronchial provocation test. Sixteen(3. 9%) out of 411 bronchial asthma were confirmed as work-related asthma. Eight cases out of 16 worked at furniture industry, three worked at dye manufacturing and two worked at musical instrument manufacturing industry. Others worked at farm and machinary industry. The confirmed asthmogen were toluene diisocyante(8), reactive dye(3), and grain dust(1). None of the cases was detected as work-related asthma in the periodic health examination. Twelve out of sixteen occupational asthma patients discontinued their work. The results suggested that many patients with occupational asthma were not reported and the periodic health examination was not an effective system for detecting the workrelated asthma. Thus, setting up the surveillance system involving allergist or pulmonologist would be important to detect and prevent occupational asthma.

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Clinical Importance of Work-Exacerbated Asthma: Findings From a Prospective Asthma Cohort in a Highly Industrialized City in Korea
Woori Jo, Kwang Won Seo, Hwa Sik Jung, Chui Yong Park, Byung Ju Kang, Hyeon Hui Kang, Seung Won Ra, Yangjin Jegal, Jong Joon Ahn, Soon Eun Park, Moon Sik Jung, Ju Ik Park, Eun Ji Park, Chang Sun Sim, Tae-Bum Kim, Taehoon Lee
Allergy, Asthma & Immunology Research.2021; 13(2): 256. CrossRef
Work-Related Asthma in Korea - Findings from the Korea Work-Related Asthma Surveillance (KOWAS) program, 2004-2009
Soon-Chan Kwon, Jaechul Song, Yong-kyu Kim, Geoffrey M. Calvert
Allergy, Asthma & Immunology Research.2015; 7(1): 51. CrossRef
Occupational Asthma in Korea
Sung Soo Oh, Kyoo Sang Kim
Journal of Korean Medical Science.2010; 25(Suppl): S20. CrossRef
Occupational Diseases in Korea
Seong-Kyu Kang, Eun A Kim
Journal of Korean Medical Science.2010; 25(Suppl): S4. CrossRef

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