Annals of Occupational and Environmental Medicine

Original Article

The effect of long working hours on developing type 2 diabetes in adults with prediabetes: The Kangbuk Samsung Cohort Study: Eunhye Seo, Yesung Lee, Eunchan Mun, Dae Hoon Kim, Youshik Jeong, Jaehong Lee, Jinsook Jeong, Woncheol Lee; Ann Occup Environ Med 2022;34:e4. Published online March 14, 2022; DOI: https://doi.org/10.35371/aoem.2022.34.e4

Abstract Abstract in Korean PDF Supplementary Material PubReader ePub

Background

Long working hours are known to account for approximately one-third of the total expected work-related diseases, and much interest and research on long working hours have recently been conducted. Additionally, as the prevalence of prediabetes and the high-risk group for diabetes are increasing worldwide, interest in prediabetes is also rising. However, few studies have addressed the development of type 2 diabetes and long working hours in prediabetes. Therefore, the aim of this longitudinal study was to evaluate the relationship between long working hours and the development of diabetes in prediabetes.

Methods

We included 14,258 prediabetes participants with hemoglobinA1c (HbA1c) level of 5.7 to 6.4 in the Kangbuk Samsung Cohort Study. According to a self-reported questionnaire, we evaluated weekly working hours, which were categorized into 35–40, 41–52, and > 52 hours. Development of diabetes was defined as an HbA1c level ≥ 6.5%. Hazard ratios (HRs) and 95% confidence intervals (CIs) for the development of diabetes were estimated using Cox proportional hazards analyses with weekly working 35–40 hours as the reference.

Results

During a median follow-up of 3.0 years, 776 participants developed diabetes (incidence density, 1.66 per 100 person-years). Multivariable-adjusted HRs of development of diabetes for weekly working > 52 hours compared with working 35–40 hours were 2.00 (95% CI: 1.50–2.67). In subgroup analyses by age (< 40 years old, ≥ 40 years old), sex (men, women), and household income (< 6 million KRW, ≥ 6 million KRW), consistent and significant positive associations were observed in all groups.

Conclusions

In our large-scale longitudinal study, long working hours increases the risk of developing diabetes in prediabetes patients.

당뇨전단계 성인의 제 2형 당뇨로 진행에 대한 장시간 근무의 영향: 강북삼성 코호트 연구
목적
이 연구의 목적은 당뇨전단계라는 고위험그룹에서 장시간 노동과 당뇨로의 진행 사이의 관계를 종단적 연구로 평가하는 것이다.
방법
연구는 강북 삼성 종합 건진 센터에서 2012년 1월 1일부터 2018년 12월 31 일 사이에 최소 두번의 건강검진을 받은 수검자 중, HbA1c 수치가 5.7~6.4인 당뇨전단계 기준을 만족하는 14,258명을 포함했다. 참가자들은 자체 보고된 설문지를 사용하여 3개 그룹 (35-40시간, 41-52시간 및 >52시간)으로 나뉘었고 당뇨로의 진행은 HbA1c 수치 ≥6.5%로 정의되었다. 당뇨 발병에 대한 위험 비율(HR) 및 95% 신뢰 구간(CI)은 주당 35-40시간 근무하는 그룹을 기준으로 Cox 비례 위험 분석을 사용하여 추정되었다.
결과
중앙값 3.0년의 추적 기간 동안 776명의 참가자가 당뇨(발병률, 100인년당 1.66)로 발전했습니다. 주당 근무시간이 35-40시간인 그룹과 비교하여 52시간 초과 근무한 그룹의 다 변수 조정 당뇨 발생 위험비율은 2.00(95% 신뢰구간 [1.50–2.67])이었다. 연령(40세 미만, 40세 이상), 성별(남성, 여성) 및 가계 소득(600만원, 600만원)에 따른 하위 그룹 분석에서 모든 그룹에서 일관되고 유의한 연관성이 관찰되었다.
결론
이 대규모 종단 연구는 당뇨전단계에서 긴 근무 시간이 당뇨 발병과 관련이 있음을 보여주었다.

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Research Article

Effects of high occupational physical activity, aging, and exercise on heart rate variability among male workers: Dongmug Kang, Youngki Kim, Jongeun Kim, Yongsik Hwang, Byungmann Cho, Taekjong Hong, Byungmok Sung, Yonghwan Lee; Ann Occup Environ Med 2015;27:22. Published online September 25, 2015; DOI: https://doi.org/10.1186/s40557-015-0073-0

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Objectives

Effects of aging and leisure time physical activity (LPA) might influence the effect of occupational physical activity (OPA) on risk for cardiovascular disease (CVD). This study was conducted to determine whether OPA affects CVD after controlling the effects of LPA and other risk factors for CVD such as job stress.

Methods

Participants were 131 male Korean manual workers. Tests for heart rate variability (HRV) were conducted for five minutes in the morning at work. We defined OPA as the combined concept of relative heart rate ratio (RHR), evaluated using a heart rate monitor.

Results

Whereas high OPA was not related to any HRV items in the younger age group, high OPA was associated with an increased number of low-value cases among all HRV items in older workers. Exercise had beneficial effects only in the younger group. After controlling for exercise and other risk factors, the odds ratios of the root-mean square of the difference of successive normal R-R intervals (rMSSD) and high frequency band power (HF) among the older age and high OPA group compared with the younger age and low OPA group were 64.0 and 18.5, respectively. Social support and shift work were independent risk factors in HRV.

Conclusions

OPA in aging workers increases CVD risks. This study provides support for the need for protection of aging workers from physical work overload, and indicates the need for further study of optimal limits of OPA.

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Original Article

Association between Physical Workload and Work-related Back Pain: A Nationwide Study: Jae Il Oh, Dong Hyun Yoo, Do Myung Paek, Jung Sun Park, Sung Il Cho; Korean Journal of Occupational and Environmental Medicine 2011;23(3):298-308. Published online September 30, 2011; DOI: https://doi.org/10.35371/kjoem.2011.23.3.298

Abstract PDF

OBJECTIVES
To date, no population-based epidemiological studies have estimated the association between physical workload (standing or walking, carrying heavy loads, carrying people, repetitive hand or arm movements, wearing protective equipment) and work-related back pain in Korea. The purpose of this study was to evaluate the relationship between physical workload and work-related back pain using a nationwide survey.
METHODS
We analyzed data obtained from working men and women age 15 to 64 (n=10,043) who participated in the 2006 national working condition survey of random sample workers in Korea. Using both simple and multiple logistic regression analysis, the association between physical workload and work-related back pain was evaluated.
RESULTS
Carrying heavy loads, repetitive hand or arm movements, and wearing protective equipment were associated with an increased risk of work-related back pain.
CONCLUSIONS
This study identifies that an increased risk of work-related back pain related to the nature and intensity of the physical workload of the general working population in Korea. We also found a strong association between repetitive hand or arm movements and back pain.

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Original Article

Chronic and Acute Effects of Work-related Factors on Heart Rate Variability: Minjeong Son, Youngki Kim, Sangbum Ye, Jihyun Kim, Dongmug Kang, Jangseong Ham, Yonghwan Lee; Korean Journal of Occupational and Environmental Medicine 2008;20(4):314-325. Published online December 31, 2008; DOI: https://doi.org/10.35371/kjoem.2008.20.4.314

Abstract PDF

OBJECTIVES
Reduced heart rate variability (HRV) is one of the serious risk factors for heart diseases. We evaluated the acute and chronic effects of work-related factors on HRV.
METHODS
The five-minute HRV of 85 male workers from an automobile assembly factory were measured at 9 A.M. (before-work) and at 5 P.M. (after-work). The workplace noise, temperature and physical workload levels were measured as work-related factors. We postulated that the HRV measured at beforework represents the chronic effects and the HRV measured at after-work represents the acute effects of work-related factors. We used generalized linear regression analysis with adjusting for the general characteristics and/or the morning HRV.
RESULTS
The subjects exposed to noise or a hot environment showed increased HRV in the afternoon and decreased HRV in the morning. Machine oil and interpersonal conflict decreased the HRV in the morning, but other chemicals did not show any effect on the HRV. A physical workload decreased the HRV in both the morning and afternoon.
CONCLUSION
The physical and chemical environment, psychosocial stress and a physical workload may affect the autonomic nerve system.

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Original Article

Work Related Factors Affecting Perceived Fatigue in Male Metal Assemblers: Jun Ho Jang, Dongmug Kang, Sang Baek Koh, Jungwon Kim, Byung Mann Cho, Su Ill Lee; Korean Journal of Occupational and Environmental Medicine 2004;16(2):155-165. Published online June 30, 2004; DOI: https://doi.org/10.35371/kjoem.2004.16.2.155

Abstract PDF

OBJECTIVES
To find work related factors affecting perceived fatigue among male metal product assemblers.
METHODS
The study subjects were metal product assemblers from three metal product companies (476 car parts assemblers, 610 car engine assemblers, 454 ship engine assemblers). From the total of 1,540 subjects, 1,136 (73.8%) were included and 38 respondents with insufficient replies were excluded. Associations between fatigue score and other variables (general characteristics, job related factors, workload, job stresses) were investigated in terms of the concept of multidimensional fatigue construct by self administered questionnaire. Using MFS (Multidimensional Fatigue Scale), JCQ (Job Content Questionnaire), and Borg's scale, we estimated the fatigue, job stress, and workload, respectively. Fatigue score was estimated by 'sum of fatigue' in MFS. Associations were tested by linear regression analysis using SAS v.8.0.
RESULTS
In this study, the fatigue related factors were older age, longer working hours per week, higher workload, higher job demand, lower decision latitude, and lower supervisor support.
CONCLUSIONS
Prolonged working hours, higher workload, higher job demand, poor supervisor support and lower decision latitude were fatigue related factors among the male metal product assemblers of this study.

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Original Article

Effects of Physical Workload on Salivary Cortisol Level: Dong Mug Kang, Byung Min Son, Sang Baek Koh, Junho Jang, Mia Son, Jongwon Kim, Byung Mann Cho, Su Ill Lee; Korean Journal of Occupational and Environmental Medicine 2004;16(1):57-69. Published online March 31, 2004; DOI: https://doi.org/10.35371/kjoem.2004.16.1.57

Abstract PDF

OBJECTIVE: Workload is known to affect the hypothalamus-pituitary-adrenal axis. Although many studies had revealed that job stress related factors could affect the neuroendocrine system among blue-collar workers, these studies had limitations as they had not evaluated the workload by objective methods which took into consideration individual physiological differences. This study was conducted to evaluate the effects of physical workload adjusted job stress on cortisol regulation by using objective tools for workers having various job tasks.
METHODS
Among 110 foundry workers, shipyard workers, and fine machine assemblers for whom saliva samples were obtained, 102 without any past history of conditions that could affect hormonal regulation such as diabetes, and hypertension were included in this study. Among the 102 study participants, 15 workers whose saliva for morning or afternoon or heart rate monitoring data was not attained were excluded from the final analysis. Workload was evaluated by RHR (relative heart rate) using a heart rate monitor, and job stress was evaluated by Karasek's Job Content Questionnaire. Saliva samples were gathered during 8 - 9 am and 5 - 6 pm, and salivary cortisol levels were analysed by radioimmunoassay.
RESULTS
After adjusting several variables which could effect cortisol secretion including job stress, among the higher RHR group morning salivary cortisol level was increased (beta=60.32, S.E.=26.35, p=0.0266), afternoon salivary cortisol level was decreased (beta=-7.43, S.E.=29.73, p=0.8044), and salivary cortisol level difference between morning and afternoon was increased (beta=72.10, SE=35.50, p=0.0509).
CONCLUSIONS
As physical workload increases morning cortisol level, which is caused by the effect of arousal, and decreases afternoon cortisol level, which is caused by exhaustion, physical workload enlarges the width of diurnal cortisol variance. Therefore, physical exhaustion due to excessive workload could have adverse effects on the neuroendocrine system.

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Seon Soo Kim, Meiling Luo, Yeon Ju Oh, Yong Hee Lee
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Original Article

Reliability and Validity of Questionnaire for Assessing Physical Workloads: Dongjun Lee, Dongmug Kang, Sang Baek Koh, Jungwon Kim, Junho Jang, Jongeun Kim, Byungmann Cho, Suill Lee; Korean Journal of Occupational and Environmental Medicine 2003;15(4):388-400. Published online December 31, 2003; DOI: https://doi.org/10.35371/kjoem.2003.15.4.388

Abstract PDF

OBJECTIVES
The aims of the study were to make a questionnaire for assessing physical workloads and to evaluate its reliability and validity.
METHODS
A total of 220 workers (foundry workers 30, large vehicle assemblers 30, shipyard workers 75, and automobile manufacturers 80) completed a self-administered questionnaire and took examinations for physical work capacity and working heart rate. We excluded data with insufficient responses or incorrect physical work capacity and working heart rate. Finally, the data of 154 workers (70.0%) were used for our study. In order to evaluate the reliability and validity of the questionnaire, we used statistical analyses including the scaling assumption test and a comparison with the objective tool for physical workload which was evaluated by working energy expenditure.
RESULTS
The items of the questionnaire in the same categories had close distribution in the evaluation of the scaling assumption. The item internal consistency was 0.41-0.73 for posture factor, and 0.62-0.79 for non-posture factor. The item discriminate validity was 100%. Cronbach's alphacoefficient of the total items was 0.73 (0.58 for posture factor and 0.74 for nonposture factor). In the correlation between working energy expenditure and questions, general physical activity (p=0.008), proportion of the workday with hands above shoulder (p=0.002), proportion of the workday with trunk bent (p=0.028), proportion of the workday with awkward posture (p=0.048), sweating after work (p=0.006), total scales (p=0.003) and Borg scale (p=0.011) all had statistical significance.
CONCLUSIONS
Our questionnaire for assessing physical workloads demonstrated statistically significant reliability and validity. But the questions for the proportions of the workday with sitting work posture and with static posture should be modified via a larger study.

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