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List of occupational diseases among farmers in Korea: a literature review

List of occupational diseases for farmers in Korea

Article information

Ann Occup Environ Med. 2025;.aoem.2025.37.e2
Publication date (electronic) : 2025 January 15
doi : https://doi.org/10.35371/aoem.2025.37.e2
Hansoo Song1,orcid_icon, Seok-Ju Yoo2orcid_icon, Won-Ju Park3orcid_icon, Seunghyeon Cho3orcid_icon, Ki Soo Park4orcid_icon, Joo Hyun Sung5orcid_icon, Sang Jin Park5orcid_icon, Seong-yong Yoon6orcid_icon, Kyeongsoo Kim7orcid_icon, Dong-phil Choi7orcid_icon, Hye-min Kim1orcid_icon, Bounggyun Ju1orcid_icon, Kanwoo Youn8orcid_icon
1Department of Occupational and Environmental Medicine, Chosun University Hospital, Gwangju, Korea
2Department of Preventive Medicine, Dongguk University College of Medicine, Gyeongju, Korea
3Department of Occupational and Environmental Medicine, Chonnam National University Hwasun Hospital, Hwasun, Korea
4Department of Preventive Medicine & Institute of Medical Sciences, Gyeongsang National University College of Medicine, Jinju, Korea
5Department of Occupational and Environmental Medicine, Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, Korea
6Department of Occupational and Environmental Medicine, Soonchunhyang University Gumi Hospital, Gumi, Korea
7Agricultural Safety and Health Division, Department of Agricultural Engineering, National Institute of Agricultural Science, Rural Development Administration, Jeonju, Korea
8Department of Occupational & Environmental Medicine, Wonjin Green Hospital, Korea
*Corresponding author: Hansoo Song Department of Occupational and Environmental Medicine, Chosun University Hospital, 365 Pilmun-daero, Dong-gu, Gwangju 61453, Korea E-mail: oemsong@chosun.ac.kr
Received 2024 October 12; Revised 2024 December 24; Accepted 2024 December 25.

Abstract

A comprehensive list of occupational diseases among farmers is crucial for both compensation and prevention efforts. In Korea, most farmers are self-employed, and some occupational diseases are compensated through farmer safety insurance. However, it is not harmonized with industrial accident compensation insurance and does not adequately reflect the true burden of occupational diseases among farmers. To address this gap, the authors compiled a list of occupational diseases tailored to Korean farmers by reviewing the International Labor Organization’s list of occupational diseases, the Korean Industrial Accident Compensation Insurance List, the occupational disease lists of other countries, and relevant literature on farmers’ work-related diseases.

Keywords: Occupational diseases; Farmers; Compensation

BACKGROUND

Occupational diseases are defined as those caused by workplace hazards with a higher prevalence or incidence rate compared to the general population.1 These diseases are identified based on the expectation that their occurrence can be reduced by controlling the cause through an integrated interpretation of epidemiological studies and research on their pathogenesis.2,3 Establishing a list of occupational diseases is essential for both prevention and compensation efforts. The International Labor Organization’s (ILO) Recommendation No. 194 encourages member states to develop national lists of occupational diseases for prevention, recording, notification, and compensation.4 The ILO’s list includes open items that allow countries to adapt based on their national conditions and practices.1

In Korea, occupational diseases for workers are established by law. Under Article 34 (Standards for Recognition of Occupational Diseases) of the Enforcement Decree of the Industrial Accident Compensation Insurance (IACI) Act, 12 disease categories and a comprehensive item are provided in Appendix 3.5 Compensation for workers' occupational diseases based on this list, and various occupational health programs are in place to reduce their incidence.

However, most Korean farmers are not covered by the IACI Act. Although there are approximately 2 million farmers in Korea, only 194,000 corporate-employed farmers were eligible for IACI in 2021. As a result, more than 90% of Korean farmers, being self-employed, are not covered by IACI. Instead, farmers’ safety insurance is available to compensate for injuries and diseases; however, this is not mandatory social insurance. Under Article 4 of the Enforcement Decree of the Act on Safety Insurance and Safety Accident Prevention for Farmers and Fishermen, Annex 1 outlines the diseases eligible for compensation in farming work safety accidents.6 However, this list excludes many diseases that are recognized as occupational diseases for workers while including some infectious diseases that are unlikely to occur by farm work (Supplementary Data 1).

Establishing a comprehensive list of occupational diseases for farmers holds significant social value by enabling proper compensation and setting clear goals for disease prevention.

Although occupational diseases in agriculture have been addressed in textbooks such as Agricultural Medicine: A Practical Guide (Springer),7 Agricultural Medicine: Rural Occupational and Environmental Health for the Health Professions (Wiley-Blackwell),8 and Occupational and Environmental Medicine, 2nd Edition (Gyechukmunhwasa),9 no list has been developed considering the prevalence of domestic farmers, their major crops, or relevant hazards.

This study compiles a list of occupational diseases for Korean farmers based on the ILO list, Korea's IACI Act, and lists from other countries. The final list was developed through expert discussions in occupational and environmental medicine and preventive medicine.

METHODS

We reviewed the occupational diseases relevant to domestic farmers, using the ILO’s 2010 revised list of occupational diseases as a reference. First, we assessed whether any of the diseases listed by the ILO were applicable to domestic farmers. Second, we examined the occupational diseases covered under Korea’s IACI Act to identify those relevant to domestic farmers. This process included a review of epidemiological studies on farmers, the International Agency for Research on Cancer (IARC) monographs, and agricultural medicine textbooks. Third, to identify additional diseases specific to Korean farmers beyond those listed by the ILO and the IACI Act, we compared our findings with occupational disease lists from the United Kingdom, France, Germany, and Japan. We also conducted a comprehensive search of domestic literature and reports to ensure no relevant diseases were overlooked. Finally, the final list was determined through expert consensus at a meeting with the researchers involved in this study.

RESULTS AND DISCUSSION

This list of occupational diseases is categorized into three main groups: diseases caused by exposure to occupational activities, occupational diseases according to target organs, and occupational cancer. Diseases related to exposure to hazardous factors are further subdivided into chemical, physical, and biological agents. The list of organ-specific occupational diseases includes respiratory diseases, skin diseases, musculoskeletal disorders, and mental and behavioral disorders. Occupational cancers are presented as specific carcinogen-cancer pairs. The ILO defines “not classified” occupational diseases as those established scientifically or determined by methods appropriate to national conditions and practices considering a direct link between work activities and the onset of the disease.1 We have compiled a list of occupational diseases for Korean farmers in alignment with the ILO recommendations and objectives (Table 1).

The list of occupational diseases in Korea

Occupational diseases caused by exposure to agents arising from work activities

Diseases caused by chemical agents

Pesticides, carbon monoxide, hydrogen sulfide, and ammonia were identified as chemical hazards responsible for acute and chronic diseases in farmers. The chemical agents listed in the ILO occupational disease list include various organic solvents and metals. However, in agriculture, exposure to metals and organic solvents typically occurs through pesticides. Pesticides are the leading cause of acute poisoning among farmers.10 Carbon monoxide exposure can occur in confined spaces, such as greenhouses and livestock sheds, when using fossil fuel-based heating systems or agricultural machinery with engines.11 Hydrogen sulfide and ammonia are produced from livestock manure and can lead to acute poisoning.12 Carbon monoxide and hydrogen sulfide are asphyxiating gases that pose a significant risk to farmers.

Diseases caused by physical agents

Farmers are typical outdoor workers exposed to sunlight, heat, and cold.13-16 The list of diseases associated with physical factors includes skin diseases, such as sunburn, actinic keratoses, and non-melanoma skin cancer, as well as ocular diseases like photokeratitis, climatic droplet keratopathy, pterygium, and cortical cataract.17-19 Heat-related and cold-related illnesses are also significant concerns. According to the Korea Disease Control and Prevention Agency, most cases of heat-related illness occur among outdoor workers.20 The incidence of heat-related illness among agricultural workers is increasing in Korea. Farmers are at greater risk due to the frequent occurrence of heat waves, farming activities in hot and humid greenhouses, and high-intensity labor.21 Additionally, farmers using agricultural machinery are exposed to noise and vibration. Equipment such as tractors, combiners, grain dryers, pesticide sprayers, and weeders generate noise and vibration levels.22-24

Diseases caused by biological agents and infectious or parasitic diseases

Occupational infectious diseases have varying sources of infection depending on the country and occupation. Tsutsugamushi disease is endemic in Korea and is the most common rickettsial disease among farmers.25 Tick-borne infectious diseases prevalent in Korea include tsutsugamushi disease and severe fever with thrombocytopenia syndrome.26-28 Rodent-borne viral infections include hemorrhagic fever with renal syndrome and leptospirosis.29-31 Bacterial infections from livestock include brucellosis, Q fever, and anthrax.32-35 Tetanus, which is transmitted through soil and feces, and malaria, which is transmitted through mosquitoes, are also notable infections reported in Korea.36-39 Anthrax is designated as a type 1 notifiable infectious disease, whereas the others are classified as type 4 notifiable infectious diseases. Owing to climate change, there is potential for mosquito-borne infectious diseases, such as dengue fever, Zika virus, yellow fever, and Chikungunya fever, to become endemic in Korea. However, as of now, these diseases are mainly brought in by travelers and cannot yet be included in the list of occupational diseases for farmers.40 The Farmer Safety Insurance's list of occupational diseases includes hepatitis virus, human immunodeficiency virus, and tuberculosis, although it is difficult to believe that these diseases commonly occur during agricultural activities.6

Occupational diseases by target organ systems

Occupational diseases categorized by target organs, as presented by the ILO, include respiratory diseases, musculoskeletal disorders, mental health disorders, and skin diseases. We have observed that all of these diseases can also be caused by occupational factors in farmers.

Respiratory diseases

The ILO’s list of occupational respiratory diseases includes pneumoconiosis, asthma, extrinsic allergic alveolitis, chronic obstructive pulmonary diseases (COPD), and upper airway disorders. Farmers are generally not exposed to mineral dust in concentrations sufficient to cause pneumoconiosis.41 However, they are exposed to various allergenic dusts from animals, plants, and mites. The risk of high-concentration exposure increases in enclosed environments such as greenhouses and livestock facilities.42-46

Respiratory diseases like allergic rhinitis, asthma, and hypersensitivity pneumonitis are well-known to result from hypersensitivity reactions.47-51 Additionally, repeated exposure to irritant gases, combustion by-products, and pesticides can lead to the development of COPD.52-54 Several studies have indicated that farmers may have an elevated risk of idiopathic pulmonary fibrosis (IPF), suggesting it could be considered an occupational disease in this population.55-57 However, it is hypothesized that the increased occurrence of IPF among farmers is related to hypersensitivity pneumonitis. A case-control study conducted in Korea found an increased risk of IPF associated with pesticide exposure; however, the association was not statistically significant after adjusting for smoking.56 Furthermore, there is insufficient evidence to conclude that paraquat, which is known to cause pulmonary fibrosis when ingested, also causes pulmonary fibrosis via inhalation during pesticide application.58,59 Importantly, paraquat has been banned in Korea since 2008. Consequently, the current evidence is inadequate to classify IPF as an occupational disease.60

Musculoskeletal disorders

The ILO's list of musculoskeletal disorders includes conditions such as wrist tenosynovitis, elbow bursitis, knee bursitis, epicondylitis, meniscal injuries of the knee, carpal tunnel syndrome, and other diseases. In Korea, the list of occupational diseases affecting farmers includes triangular fibrocartilage complex (TFCC) injuries, rotator cuff disease, cervical spine disorders, lumbar spine disorders, and arthritis affecting the hand, knee, and hip joints.61-65 These musculoskeletal disorders are already widely recognized as occupational diseases under the IACI Act.5 Musculoskeletal disorders are typically multifactorial in origin and closely related to age. Given the aging agricultural workforce, it has been hypothesized that the high prevalence of musculoskeletal disorders in farmers could be attributed to aging. However, epidemiological studies indicate that farmers experience degenerative changes at younger ages than the general population and are exposed to various significant ergonomic factors.66,67 There is substantial epidemiological evidence linking lumbar spine disorders and osteoarthritis with the pathogenesis and exposure to ergonomic factors. On the other hand, epidemiological studies on TFCC injuries, rotator cuff syndrome, and cervical spine disorders are relatively limited. Nonetheless, research on elite sports activities or other occupations with similar biomechanical demands, along with studies on the pathogenesis of these conditions, provides supporting evidence for causal relationships.68-74

Cerebro-cardiovascular disease

Cerebro-cardiovascular diseases are not included in the ILO’s list of occupational diseases. However, recent meta-studies have confirmed that long working hours and job stress are significant risk factors for cardiovascular disease.75-78 In Korea, cerebrovascular disease is recognized as being potentially caused by overwork, and the IACI Act provides compensation for workers who log 52 working hours per week, along with other occupational risk factors, as in the enforcement of the Act.79

Domestic farmers work longer hours than the national average, with working hours often compressed during peak farming seasons. Farmers tend to work intensively during sowing and harvesting periods while also contending with the uncertainty of agricultural production due to climate variability. In addition to psychological stressors, they face physical stressors such as heavy physical labor, extreme heat, and cold.80,81 Studies comparing the incidence of cerebro-cardiovascular diseases between farmers and non-farmers have shown that farmers are at a higher risk of developing these conditions.82,83 The list of occupational cerebro-cardiovascular diseases for farmers includes stroke and ischemic heart disease, which are also recognized under the Enforcement Decree of the IACI Act.

Occupational cancer

Occupational cancer is not included in this list. Lung cancer and lympho-hematopoietic cancer were considered as candidates for inclusion.84,85 In 2012, the IARC classified arsenic compounds (commonly found in pesticides) as group 1 carcinogens, and in 2018, the IARC classified lindane (hexachlorocyclohexanes) as group 1 carcinogen and dichlorodiphenyltrichloroethane (DDT) as group 2A (probable carcinogen).86,87 Arsenic is known to cause lung cancer, whereas lindane and DDT are associated with lympho-hematopoietic cancer. In Korea, the use of lindane was banned in 1979, DDT in 1973, and arsenic compounds in 2000. Therefore, lung cancer and lympho-hematopoietic cancers were excluded from the list of occupational cancers. For other pesticide exposures, the evidence for carcinogenicity remains inconclusive. There is ongoing debate regarding the carcinogenic potential of several pesticides still in use, including tetrachlorvinphos (an insecticide), parathion (an insecticide), glyphosate (a herbicide), malathion (an insecticide), and diazinon (an insecticide).88 However, current evidence is insufficient to definitively establish a causal link between these pesticides and cancer. This warrants periodic reevaluation as future research emerges. In contrast, there is strong evidence supporting the association between ultraviolet radiation exposure and the development of skin cancer, which is discussed in the section on diseases caused by physical factors in this list.17,18,89

Mental and behavioral disorders

Work-related mental illness in agriculture has been overlooked; however, we believe it is a crucial issue. In particular, suicide among older farmers using pesticides remains a serious problem.90,91 Several studies have reported increased risks of stress, suicidal ideation, and depression in farmers. Mental health risk factors related to agricultural activities are strongly associated with financial instability, which is often unpredictable due to factors such as crop pests, disease, and climate change.92

Consequently, there was a consensus that post-traumatic stress syndrome (PTSD) caused by external stressors should naturally be included in the list, along with adjustment disorder or acute stress syndrome, which are already part of the recognition criteria for occupational diseases under workers’ compensation.

Skin diseases

The ILO’s list of skin diseases includes allergic contact dermatitis, irritant contact dermatitis, and vitiligo. This list is directly reflected in the occupational skin diseases recognized in farmers.93 Farmers are frequently exposed to potential plant allergens, grain dust, and animal allergens.94-97 Most insecticides are irritants and can cause allergic skin reactions.98 Vitiligo is also recognized as an occupational skin disease for farmers. Various phenolic compounds (such as nitrophenol, 2,4-dinitrophenol, pentachlorophenol, and 4,6-dinitro-O-cresol) found in pesticides can have toxic effects on melanocytes in the skin.99,100 Additionally, depigmentation can occur following episodes of allergic dermatitis.

CONCLUSIONS

The list of occupational diseases among farmers serves as the first step in evaluating the long-term effectiveness of prevention projects by analyzing statistics on occupational diseases in this population. For this purpose, the list must strike a balance between reflecting scientific evidence and aligning with policy objectives. Additionally, it should be continuously updated based on the latest research findings.

The presented list was developed with a scientific basis for work-relatedness, considering both acute poisoning and chronic exposure, as assessed by experts in occupational environmental medicine and preventive medicine. We also reviewed the literature on occupational diseases among domestic farmers to ensure the list’s relevance to the local context. This list can be used to compile statistics on the occurrence of occupational diseases among farmers and as a tool to evaluate the long-term effectiveness of farmers’ occupational health initiatives.

However, to fully achieve these goals, further research is needed to properly extract and utilize relevant data from the National Health Insurance Service. It is important to note that this is not a definitive list for compensation purposes. To reflect this list of compensable diseases, additional reviews are required concerning legal standards, insurance finances, and the procedures for determining work-relatedness. As research on the health effects of hazardous factors continues, new hazardous substances emerge, and exposure patterns change, the list of occupational diseases for farmers may also need to be revised in the future.

Abbreviations

COPD

chronic obstructive pulmonary disease

DDT

dichlorodiphenyltrichloroethane

HFRS

hemorrhagic fever with renal syndrome

IACI

Industrial Accident Compensation Insurance

IARC

International Agency for Research on Cancer

ILO

International Labor Organization

IPF

idiopathic pulmonary fibrosis

PTSD

post-traumatic stress syndrome

SFTS

severe fever with thrombocytopenia syndrome

TFCC

triangular fibrocartilage complex

Notes

Funding

This research was support by the Rural Development Administration (RDA) through the research project title “Development of criteria for occupational diseases and customized health care programs for farmers” (NRF-SA00018083).

Competing interests

Hansoo Song and Won-Ju Park contributing editors of the Annals of Occupational and Environmental Medicine, were not involved in the editorial evaluation or decision to publish this article. All remaining authors have declared no conflicts of interest.

Author contributions

Conceptualization: Song H. Data curation: Song H. Formal analysis: Song H. Funding acquisition: Park KS. Investigation: Song H, Yoo SJ, Park WJ, Cho S, Sung JH, Park SJ, Yoon SY, Kim K, Kim HM, Ju B, Youn K. Methodology: Song HS. Software: Song H. Validation: Song H. Visualization: Song H. Writing - original draft: Song H. Writing - review & editing: Song H, Choi DP, Kim KS, Park K.

Acknowledgments

The authors thank the Agricultural Worker Safety Team at the National Institute of Agricultural Sciences, Rural Development Administration, for their assistance in facilitating the smooth operation of this study.

SUPPLEMENTARY MATERIAL

Supplementary Data 1.

Under Article 4 of the Enforcement Decree of the Act on Safety Insurance and Safety Accident Prevention for Farmers and Fishermen.

aoem-2025-37-e2_Supplementary-Data-1.pdf

References

1. International Labour Organization. Diagnostic and exposure criteria for occupational diseases: guidance notes for diagnosis and prevention of the diseases in the ILO List of Occupational Diseases (revised 2010). https://www.ilo.org/sites/default/files/wcmsp5/groups/public/@ed_dialogue/@lab_admin/documents/publication/wcms_836362.pdf. Updated 2022. Accessed October 2, 2024.
2. Kundi M. Causality and the interpretation of epidemiologic evidence. Environ Health Perspect 2006;114(7):969–74.
3. Verbeek J. When work is related to disease, what establishes evidence for a causal relation? Saf Health Work 2012;3(2):110–6.
4. International Labour Organization. R194: list of occupational diseases recommendation, 2002 (No. 194). https://normlex.ilo.org/dyn/normlex/en/f?p=NORMLEXPUB:12100:0::NO::P12100_ILO_CODE:R194. Updated 2002. Accessed October 2, 2024.
5. The enforcement decree of the Industrial Accident Compensation Insurance Act. https://www.law.go.kr/%EB%B2%95%EB%A0%B9/%EC%82%B0%EC%97%85%EC%9E%AC%ED%95%B4%EB%B3%B4%EC%83%81%EB%B3%B4%ED%97%98%EB%B2%95%EC%8B%9C%ED%96%89%EB%A0%B9. Updated 2024. Accessed October 2, 2024.
7. Ferguson L, Lessenger JE. Agricultural medicine 1st edth ed. New York, USA: Springer; 2006.
8. Kelley JD, Anders T. Agricultural Medicine: Rural Occupational and Environmental Health, Safety, and Prevention 2nd edth ed. New Jersey, USA: Wiley-Blackwell; 2016.
9. Korean Society of Occupational & Environmental Medicine. Occupational and Environmental Medicine 2nd edth ed. Seoul, Korea: Gyechukmunhwasa. 2022.
10. Lee WJ, Cha ES, Park J, Ko Y, Kim HJ, Kim J. Incidence of acute occupational pesticide poisoning among male farmers in South Korea. Am J Ind Med 2012;55(9):799–807.
11. The National Institute for Occupational Safety and Health (NIOSH). Preventing carbon monoxide poisoning from small gasoline-powered engines and tools. https://www.cdc.gov/niosh/docs/96-118a/default.html. Updated 2014. Accessed October 9, 2024.
12. Park J, Kang T, Heo Y, Lee K, Kim K, Lee K, et al. Evaluation of short-term exposure levels on ammonia and hydrogen sulfide during manure-handling processes at livestock farms. Saf Health Work 2020;11(1):109–17.
13. Koh DH, Park JH, Lee SG, Kim HC, Jung H, Kim I, et al. Assessment of sunlight exposure across industries and occupations using blood vitamin D as a biomarker. J Occup Health 2022;64(1)e12318.
14. Slavinsky V, Helmy J, Vroman J, Valdebran M. Solar ultraviolet radiation exposure in workers with outdoor occupations: a systematic review and call to action. Int J Dermatol 2024;63(3):288–97.
15. Gibb K, Beckman S, Vergara XP, Heinzerling A, Harrison R. Extreme heat and occupational health risks. Annu Rev Public Health 2024;45(1):315–35.
16. Geng Q, Stuthridge RW, Field WE. Hazards for farmers with disabilities: working in cold environments. J Agromedicine 2013;18(2):140–50.
17. Solar and ultraviolet radiation. IARC Monogr Eval Carcinog Risks Hum 1992;55:1–316.
18. Park K, Bae JM, Chung KY, Yun SJ, Seo SH, Ahn HH, et al. Incidence and prevalence of skin cancers in South Korea from 2008 to 2016: a nation-wide population based study. Ann Dermatol 2022;34(2):105–9.
19. Yam JC, Kwok AK. Ultraviolet light and ocular diseases. Int Ophthalmol 2014;34(2):383–400.
20. Korea Disease Control and Prevention Agency (KDCA). Results of the 2020 heat-related illness surveillance. https://www.kdca.go.kr/filepath/boardDownload.es?bid=0031&list_no=713313&seq=1. Accessed October 2, 2024.
21. Jung W, Kim H. Evaluation of heat stress levels inside greenhouses during summer in Korea. Int J Environ Res Public Health 2022;19(19):12497.
22. Choochouy N, Kongtip P, Chantanakul S, Nankongnab N, Sujirarat D, Woskie SR. Hearing loss in agricultural workers exposed to pesticides and noise. Ann Work Expo Health 2019;63(7):707–18.
23. Cecchini M, Assettati L, Rossi P, Monarca D, Riccioni S. Noise exposure, prevention, and control in agriculture and forestry: a scoping review. Safety 2024;10(1):15.
24. Vallone M, Bono F, Quendler E, Febo P, Catania P. Risk exposure to vibration and noise in the use of agricultural track-laying tractors. Ann Agric Environ Med 2016;23(4):591–7.
25. Ma CJ, Oh GJ, Kang GU, Lee JM, Lee DU, Nam HS, et al. Differences in agricultural activities related to incidence of scrub typhus between Korea and Japan. Epidemiol Health 2017;39e2017051.
26. Lee HW, Cho PY, Moon SU, Na BK, Kang YJ, Sohn Y, et al. Current situation of scrub typhus in South Korea from 2001-2013. Parasit Vectors 2015;8:238.
27. Yun SM, Lee WG, Ryou J, Yang SC, Park SW, Roh JY, et al. Severe fever with thrombocytopenia syndrome virus in ticks collected from humans, South Korea, 2013. Emerg Infect Dis 2014;20(8):1358–61.
28. Seo JW, Kim D, Yun N, Kim DM. Clinical update of severe fever with thrombocytopenia syndrome. Viruses 2021;13(7):1213.
29. Sehgal A, Mehta S, Sahay K, Martynova E, Rizvanov A, Baranwal M, et al. Hemorrhagic fever with renal syndrome in Asia: history, pathogenesis, diagnosis, treatment, and prevention. Viruses 2023;15(2)
30. Tariq M, Kim DM. Hemorrhagic fever with renal syndrome: literature review, epidemiology, clinical picture and pathogenesis. Infect Chemother 2022;54(1):1–19.
31. Noh JY, Jung J, Song JW. Hemorrhagic fever with renal syndrome. Infect Chemother 2019;51(4):405–13.
32. Kim EK, Hwang JH, Hwang JH, Lee CS. Is human brucellosis endemics in Korea? Yonsei Med J 2017;58(1):259–60.
33. Cho YS, Park JH, Kim JW, Lee JJ, Youn SY, Byeon HS, et al. Current status of Q fever and the challenge of outbreak preparedness in Korea: one health approach to zoonoses. J Korean Med Sci 2023;38(24)e197.
34. Lim HS, Cheong HK, Kim JS, Ohr H, Rhie DM, Kim HH. An epidemiologic investigation on an outbreak of anthrax occurred in Kyongju by eating dead cow's meat. Korean J Prev Med 1994;27:693–710.
35. Lim HS, Song YG, Yoo HS, Keun SW, Kim JW. Anthrax: an overview. Korean J Epidemiol 2005;27:12–25.
36. Bae S, Go M, Kim Y, Hwang S, Kim SW, Kwon KT, et al. Clinical outcomes and healthcare costs of inpatients with tetanus in Korea, 2011-2019. BMC Infect Dis 2021;21(1):247.
37. Shin DH, Yu HS, Park JH, Shin JH, Kim SJ. Recently occurring adult tetanus in Korea: emphasis on immunization and awareness of tetanus. J Korean Med Sci 2003;18(1):11–6.
38. Chai JY. History and current status of malaria in Korea. Infect Chemother 2020;52(3):441–52.
39. Kim YH, Ahn HJ, Kim D, Hong SJ, Kim TS, Nam HW. Recent spatial and temporal trends of malaria in Korea. Korean J Parasitol 2021;59(6):585–93.
40. Lee SH, Nam KW, Jeong JY, Yoo SJ, Koh YS, Lee S, et al. The effects of climate change and globalization on mosquito vectors: evidence from Jeju Island, South Korea on the potential for Asian tiger mosquito (Aedes albopictus) influxes and survival from Vietnam rather than Japan. PLoS One 2013;8(7)e68512.
41. Schenker M. Exposures and health effects from inorganic agricultural dusts. Environ Health Perspect 2000;108 Suppl 4(Suppl 4):661–4.
42. Kim EY, Han J, Lee YK, Kim W, Lee SJ. Bioaerosol exposure by farm type in Korea. Ann Agric Environ Med 2022;29(1):38–43.
43. Sigsgaard T, Basinas I, Doekes G, de Blay F, Folletti I, Heederik D, et al. Respiratory diseases and allergy in farmers working with livestock: a EAACI position paper. Clin Transl Allergy 2020;10:29.
44. Kim YK, Kim YY. Spider-mite allergy and asthma in fruit growers. Curr Opin Allergy Clin Immunol 2002;2(2):103–7.
45. Kim YK, Son JW, Kim HY, Park HS, Lee MH, Cho SH, et al. Citrus red mite (Panonychus citri) is the most common sensitizing allergen of asthma and rhinitis in citrus farmers. Clin Exp Allergy 1999;29(8):1102–9.
46. Zhou Y, Jia H, Zhou X, Cui Y, Qian J. Epidemiology of spider mite sensitivity: a meta-analysis and systematic review. Clin Transl Allergy 2018;8:21.
47. Mazurek JM, White GE, Rodman C, Schleiff PL. Farm work-related asthma among US primary farm operators. J Agromedicine 2015;20(1):31–42.
48. Omland O, Hjort C, Pedersen OF, Miller MR, Sigsgaard T. New-onset asthma and the effect of environment and occupation among farming and nonfarming rural subjects. J Allergy Clin Immunol 2011;128(4):761–5.
49. Monso E, Magarolas R, Badorrey I, Radon K, Nowak D, Morera J. Occupational asthma in greenhouse flower and ornamental plant growers. Am J Respir Crit Care Med 2002;165(7):954–60.
50. Moore JE, Convery RP, Millar BC, Rao JR, Elborn JS. Hypersensitivity pneumonitis associated with mushroom worker's lung: an update on the clinical significance of the importation of exotic mushroom varieties. Int Arch Allergy Immunol 2005;136(1):98–102.
51. Iversen IB, Vestergaard JM, Basinas I, Ohlander J, Peters S, Bendstrup E, et al. Risk of hypersensitivity pneumonitis and other interstitial lung diseases following organic dust exposure. Thorax 2024;79(9):853–60.
52. Guillien A, Puyraveau M, Soumagne T, Guillot S, Rannou F, Marquette D, et al. Prevalence and risk factors for COPD in farmers: a cross-sectional controlled study. Eur Respir J 2016;47(1):95–103.
53. Szczyrek M, Krawczyk P, Milanowski J, Jastrzebska I, Zwolak A, Daniluk J. Chronic obstructive pulmonary disease in farmers and agricultural workers - an overview. Ann Agric Environ Med 2011;18(2):310–3.
54. Marescaux A, Degano B, Soumagne T, Thaon I, Laplante JJ, Dalphin JC. Impact of farm modernity on the prevalence of chronic obstructive pulmonary disease in dairy farmers. Occup Environ Med 2016;73(2):127–33.
55. Park Y, Ahn C, Kim TH. Occupational and environmental risk factors of idiopathic pulmonary fibrosis: a systematic review and meta-analyses. Sci Rep 2021;11(1):4318.
56. Lee HE, Myong JP, Kim HR, Rhee CK, Yoon HK, Koo JW. Incidence and prevalence of idiopathic interstitial pneumonia and idiopathic pulmonary fibrosis in Korea. Int J Tuberc Lung Dis 2016;20(7):978–84.
57. Kim SY, Kang DM, Lee HK, Kim KH, Choi J. Occupational and Environmental Risk Factors for Chronic Fibrosing idiopathic Interstitial Pneumonia in South Korea. J Occup Environ Med 2017;59(11):e221–6.
58. Dalvie MA, White N, Raine R, Myers JE, London L, Thompson M, et al. Long-term respiratory health effects of the herbicide, paraquat, among workers in the Western Cape. Occup Environ Med 1999;56(6):391–6.
59. Cha ES, Lee YK, Moon EK, Kim YB, Lee YJ, Jeong WC, et al. Paraquat application and respiratory health effects among South Korean farmers. Occup Environ Med 2012;69(6):398–403.
60. Cha ES, Chang SS, Gunnell D, Eddleston M, Khang YH, Lee WJ. Impact of paraquat regulation on suicide in South Korea. Int J Epidemiol 2016;45(2):470–9.
61. Wang X, Perry TA, Arden N, Chen L, Parsons CM, Cooper C, et al. Occupational risk in knee osteoarthritis: a systematic review and meta-analysis of observational studies. Arthritis Care Res (Hoboken) 2020;72(9):1213–23.
62. Verbeek J, Mischke C, Robinson R, Ijaz S, Kuijer P, Kievit A, et al. Occupational exposure to knee loading and the risk of osteoarthritis of the knee: a systematic review and a dose-response meta-analysis. Saf Health Work 2017;8(2):130–42.
63. Macedo LG, Battie MC. The association between occupational loading and spine degeneration on imaging: a systematic review and meta-analysis. BMC Musculoskelet Disord 2019;20(1):489.
64. Petersen JA, Brauer C, Thygesen LC, Flachs EM, Lund CB, Thomsen JF. Prospective, population-based study of occupational movements and postures of the neck as risk factors for cervical disc herniation. BMJ Open 2022;12(2)e053999.
65. Seok H, Choi SJ, Yoon JH, Song GG, Won JU, Kim JH, et al. The association between osteoarthritis and occupational clusters in the Korean population: a nationwide study. PLoS One 2017;12(1)e0170229.
66. Chan JJ, Teunis T, Ring D. Prevalence of triangular fibrocartilage complex abnormalities regardless of symptoms rise with age: systematic review and pooled analysis. Clin Orthop Relat Res 2014;472(12):3987–94.
67. Hong CY, Lee CG, Kim DH, Cho YS, Kim KY, Ryu SY, et al. Work-related risk factors of knee meniscal tears in Korean farmers: a cross-sectional study. Saf Health Work 2020;11(4):485–90.
68. Ahmad S, Muzammil M. Revised NIOSH lifting equation: a critical evaluation. Int J Occup Saf Ergon 2023;29(1):358–65.
69. Yung M, Dale AM, Kapellusch J, Bao S, Harris-Adamson C, Meyers AR, et al. Modeling the effect of the 2018 revised ACGIH((R)) Hand Activity Threshold Limit Value((R)) (TLV) at reducing risk for carpal tunnel syndrome. J Occup Environ Hyg 2019;16(9):628–33.
70. Kim M, Yoo JI, Kim MJ, Na JB, Lee SI, Park KS. Prevalence of upper extremity musculoskeletal diseases and disability among fruit tree farmers in Korea: cross-sectional study. Yonsei Med J 2019;60(9):870–5.
71. Yanik EL, Keener JD, Stevens MJ, Walker-Bone KE, Dale AM, Ma Y, et al. Occupational demands associated with rotator cuff disease surgery in the UK Biobank. Scand J Work Environ Health 2023;49(1):53–63.
72. Ko JH, Wiedrich TA. Triangular fibrocartilage complex injuries in the elite athlete. Hand Clin 2012;28(3):307–21.
73. Ju B, Lee J, Kim HM, Lee CG, Song H. Impact of neck posture and insulating stick use on neck disability in Korean line workers: a cross-sectional study. Ann Occup Environ Med 2024;36e11.
74. Snoeker BA, Bakker EW, Kegel CA, Lucas C. Risk factors for meniscal tears: a systematic review including meta-analysis. J Orthop Sports Phys Ther 2013;43(6):352–67.
75. Li J, Pega F, Ujita Y, Brisson C, Clays E, Descatha A, et al. The effect of exposure to long working hours on ischaemic heart disease: a systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury. Environ Int 2020;142:105739.
76. Descatha A, Sembajwe G, Pega F, Ujita Y, Baer M, Boccuni F, et al. The effect of exposure to long working hours on stroke: a systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury. Environ Int 2020;142(9):105746.
77. Sara JD, Prasad M, Eleid MF, Zhang M, Widmer RJ, Lerman A. Association between work-related stress and coronary heart disease: a review of prospective studies through the job strain, effort-reward balance, and organizational justice models. J Am Heart Assoc 2018;7(9)e008073.
78. Huang Y, Xu S, Hua J, Zhu D, Liu C, Hu Y, et al. Association between job strain and risk of incident stroke: a meta-analysis. Neurology 2015;85(19):1648–54.
79. Kim UJ, Choi WJ, Kang SK, Lee W, Ham S, Lee J, et al. Standards for recognition and approval rate of occupational cerebro-cardiovascular diseases in Korea. Ann Occup Environ Med 2022;34(6)e30.
80. Liu J, Varghese BM, Hansen A, Zhang Y, Driscoll T, Morgan G, et al. Heat exposure and cardiovascular health outcomes: a systematic review and meta-analysis. Lancet Planet Health 2022;6(6):e484–95.
81. Fan JF, Xiao YC, Feng YF, Niu LY, Tan X, Sun JC, et al. A systematic review and meta-analysis of cold exposure and cardiovascular disease outcomes. Front Cardiovasc Med 2023;10:1084611.
82. Lee S, Lee H, Kim HS, Koh SB. Incidence, risk factors, and prediction of myocardial infarction and stroke in farmers: a Korean nationwide population-based study. J Prev Med Public Health 2020;53(5):313–22.
83. Lee HE, Kim HR, Chung YK, Kang SK, Kim EA. Mortality rates by occupation in Korea: a nationwide, 13-year follow-up study. Occup Environ Med 2016;73(5):329–35.
84. Lemarchand C, Tual S, Leveque-Morlais N, Perrier S, Belot A, Velten M, et al. Cancer incidence in the AGRICAN cohort study (2005-2011). Cancer Epidemiol 2017;49:175–85.
85. Togawa K, Leon ME, Lebailly P, Beane Freeman LE, Nordby KC, Baldi I, et al. Cancer incidence in agricultural workers: findings from an international consortium of agricultural cohort studies (AGRICOH). Environ Int 2021;157:106825.
86. International Agency for Research on Cancer (IARC). Arsenic, metals, fibers, and dusts. IARC monographs on the evaluation of carcinogenic risks to humans, Vol. 100C. https://publications.iarc.fr/_publications/media/download/6143/ef2dcba35d394362f6f5346d042bd48e5792ded3.pdf. Updated 2012. Accessed July 3, 2024.
87. International Agency for Research on Cancer (IARC). DDT, lindane, and 2,4-D. IARC monographs on the evaluation of carcinogenic risks to humans, Vol. 113. https://publications.iarc.fr/_publications/media/download/6117/a21e0a3a3eb924db809e0e9629b698e1e73e266f.pdf. Updated 2018. Accessed July 3, 2024.
88. Guyton KZ, Loomis D, Grosse Y, El Ghissassi F, Benbrahim-Tallaa L, Guha N, et al. Carcinogenicity of tetrachlorvinphos, parathion, malathion, diazinon, and glyphosate. Lancet Oncol 2015;16(5):490–1.
89. Ragan KR, Buchanan Lunsford N, Thomas CC, Tai EW, Sussell A, Holman DM. Skin cancer prevention behaviors among agricultural and construction workers in the United States, 2015. Prev Chronic Dis 2019;16:E15.
90. Kim Y, Min J, Lee SJ. Suicide overall and suicide by pesticide rates among South Korean workers: a 15-year population-based study. Int J Environ Res Public Health 2019;16(23):4866.
91. Gunnell D, Knipe D, Chang SS, Pearson M, Konradsen F, Lee WJ, et al. Prevention of suicide with regulations aimed at restricting access to highly hazardous pesticides: a systematic review of the international evidence. Lancet Glob Health 2017;5(10):e1026–37.
92. Daghagh Yazd S, Wheeler SA, Zuo A. Key risk factors affecting farmers' mental health: a systematic review. Int J Environ Res Public Health 2019;16(23):4849.
93. Irby CE, Yentzer BA, Vallejos QM, Arcury TA, Quandt SA, Feldman SR. The prevalence and possible causes of contact dermatitis in farmworkers. Int J Dermatol 2009;48(11):1166–70.
94. Abraham NF, Feldman SR, Vallejos Q, Whalley LE, Brooks T, Cabral G, et al. Contact dermatitis in tobacco farmworkers. Contact Dermatitis 2007;57(1):40–3.
95. Bovenschen HJ, Peters B, Koetsier MI, Van der Valk PG. Occupational contact dermatitis due to multiple sensitizations in a pig farmer. Contact Dermatitis 2009;61(2):127–8.
96. Han J, Kim Y, Lee S, Lee SJ. Association between the prevalence of allergic reactions to skin prick tests and workplace types among agricultural workers in South Korea. Ann Occup Environ Med 2020;32e36.
97. Arcangeli G, Traversini V, Tomasini E, Baldassarre A, Lecca LI, Galea RP, et al. Allergic anaphylactic risk in farming activities: a systematic review. Int J Environ Res Public Health 2020;17(14):4921.
98. Sharma A, Mahajan VK, Mehta KS, Chauhan PS, Sharma V, Sharma A, et al. Pesticide contact dermatitis in agricultural workers of Himachal Pradesh (India). Contact Dermatitis 2018;79(4):213–7.
99. Harris JE. Chemical-induced vitiligo. Dermatol Clin 2017;35(2):151–61.
100. Rmadi N, Kotti N, Bahloul E, Dhouib F, Sellami I, Sellami K, et al. Role of chemical exposure in the incidence of vitiligo: a case-control study in Tunisia. Libyan J Med 2023;18(1):2132628.

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Table 1.

The list of occupational diseases in Korea

Category Sub-group ILOa Korea Others Nation
Agents Chemical agents Pesticide Y - Y EGF
Asphyxias Y Y Y EG
Ammonia Y - Y E
Physical agents Noise Y Y Y EGFJa
Vibration Y Y Y EGF
Solar radiation Y Y Y GJ
Heat Y Y Y J
Cold Y Y Y FJ
Biological agents Brucellosis Y Y Y EGFJG
Tetanus Y - Y F
Anthrax Y - Y EGJ
Leptospira Y Y Y EJ
Tsutsugamushi - Y Y FJ
HFRS - Y - -
SFTS - - - -
Malaria - Y - -
Q fever - - Y E
Organ systems Cerebro-cardiovascular disease Stroke - Y Y J
Ischemic heart disease - Y Y J
Musculoskeletal disorders Epicondylitis Y Y - -
Carpal tunnel syndrome Y Y Y EG
Tenosynovitis (hand) Y - Y J
Rotator cuff disease - Y - -
TFCC tear Y Y - -
Meniscus injury - Y Y EGF
Cervical spine disease - Y Y G
Lumbar spine disease - Y Y G
Osteoarthritis - - Y EG
Respiratory diseases Asthma Y Y Y EGFJ
Exogenous allergic alveolitis Y Y Y EG
COPD Y Y Y EG
Upper respiratory disease Y Y - EFJ
Mental and behavioral disorders PTSD Y Y Y J
Depression episodes - Y - -
Adjustment disorders - Y - -
Skin diseases Allergic contact dermatitis Y Y Y EGFJE
Irritant contact dermatitis Y Y Y GFJE
Vitiligo Y Y Y -

ILO: International Labor Organization; HFRS: hemorrhagic fever with renal syndrome; SFTS: severe fever with thrombocytopenia syndrome; TFCC: Triangular fibrocartilage complex; COPD: chronic obstructive pulmonary disease; PTSD: post-traumatic stress disorder.

a

The United States and Italy do not have a separate list of occupational diseases because all diseases can be registered as occupational diseases. The UK has the list of diseases covered by industrial injuries disablement benefit (https://www.gov.uk), France has the Institut National de la Recherche Scientifique list of diseases for farmers (https://www.inrs.fr), Germany has An-lage 1 BKV - Einzelnorm (gesetze-im-internet.de), and Japan based its judgment on the Ministry of Health, Labor and Welfare list (https://mhlw.go.jp). E: UK, G: Germany, F: France, J: Japan.