Annals of Occupational and Environmental Medicine

Original article

Determinants of suicidal ideation among male wage workers before and during the COVID-19 pandemic in South Korea: a repeated cross-sectional study: Jisue Yoon, Jeongbae Rhie, Jonghyuk Choi; Ann Occup Environ Med 2026;e46. Published online October 30, 2026; DOI: https://doi.org/10.35371/aoem.2026.38.e46 [Accepted]

Abstract PDF: Background
South Korea has long recorded one of the highest suicide rates among OECD countries, with men dying by suicide at more than twice the rate of women. Male wage workers are especially exposed to occupational and economic stressors linked to suicidal ideation. Because the COVID-19 pandemic generated large-scale labor market disruption, the factors driving suicidal ideation in this group may have changed. This study compared the prevalence and determinants of suicidal ideation among Korean male wage workers before and during the pandemic.
Methods
Using nationally representative data from the Korea National Health and Nutrition Examination Survey, we analyzed 2,566 male wage workers in the pre-pandemic period (2017–2019) and 2,131 in the pandemic period (2020–2022). Suicidal ideation was self-reported. Socioeconomic factors (age, education, marital status, household income) and occupational factors (occupation group, employment status, weekly working hours) were examined using survey-weighted chi-square tests and multivariable logistic regression, conducted separately for each period.
Results
The weighted prevalence of suicidal ideation rose from 2.2% to 2.8% across the two periods. Before the pandemic, elementary school education (adjusted odds ratio [aOR] 5.05, 95% confidence interval [CI] 1.12–22.91) and daily employment (aOR 3.06, 95% CI 1.13–8.28) were independently associated with suicidal ideation. During the pandemic, low household income became the sole independent determinant (aOR 4.07, 95% CI 1.45–11.40), while the pre-pandemic associations with education and employment status no longer reached significance. Occupation and weekly working hours were not associated with suicidal ideation in either period.
Conclusions
Among Korean male wage workers, suicidal ideation was associated with structural vulnerabilities before the pandemic and with economic vulnerability during it, although between-period differences were not formally tested. These findings indicate that suicide prevention for male workers should be context-dependent—addressing precarious employment and low education in ordinary times, while prioritizing income protection during large-scale crises.

226 View
6 Download

Original article

Trajectories of cardiometabolic disease risk factors by industrial sector and night shift work status in South Korea during the COVID-19 pandemic: a retrospective longitudinal cohort study: Miso Lee, Chiwon Sung, Heun Lee, Aram Kim; Ann Occup Environ Med 2026;e45. Published online October 26, 2026; DOI: https://doi.org/10.35371/aoem.2026.38.e45 [Accepted]

Abstract PDF: Background
The COVID-19 pandemic imposed unprecedented psychosocial and behavioral burdens on workers; however, the trajectories of cardiometabolic diseases by occupational vulnerabilities remain unclear. This study examined longitudinal health deterioration across industrial sectors and shift workers in South Korea.
Methods
A retrospective cohort of 22,458 workers was followed at three time points (2019, 2021, and 2023). Generalized linear mixed models with year × industry and year × night shift interactions assessed the prevalence of cerebro-cardiovascular disease (CCVD), metabolic syndrome components, obesity, job stress, and lifestyle behaviors across industries and shift work. Generalized estimating equations evaluated the incidence of cardiometabolic risk factors across pandemic periods.
Results
The prevalence of CCVD, metabolic syndrome components, and obesity increased significantly over time (all P < 0.001). Dyslipidemia incidence rose during the early pandemic period (2019–2021), whereas hypertension risk was higher during the late pandemic period (2021–2023). Despite declining overall job stress across the cohort, health/medical workers showed increased job stress in 2021 relative to manufacturing workers. Compared with day workers, night shift workers showed a smaller increase in strength training participation and a greater increase in obesity prevalence by 2023, as well as higher diabetes incidence during the late pandemic period.
Conclusions
The pandemic was associated with distinct cardiometabolic health declines linked to occupational characteristics. Health/medical workers experienced increased psychosocial stress, whereas night shift workers showed a smaller increase in strength training participation and a greater increase in obesity prevalence than day workers. These findings suggest the need for occupational health policies moving from broad to targeted interventions, including cardiovascular screening and psychological support for health/medical workers and flexible health programs for shift workers.

337 View
14 Download

Original Article

A proposed screening protocol for musculoskeletal disorders among Korean fishers: results from field application: Soohyeong Park, Hyemin Kim, Bonggyun Ju, Chulgab Lee, Hansoo Song; Ann Occup Environ Med 2026;e44. Published online October 7, 2026; DOI: https://doi.org/10.35371/aoem.2026.38.e44 [Accepted]

Abstract PDF: Background
Musculoskeletal disorders (MSDs) are highly prevalent in physically demanding occupations, including fisheries; however, standardized and field-applicable screening approaches remain limited. The lack of practical frameworks integrating symptoms, functional impairments, and objective findings constrains early identification and prevention in occupational settings. This study applied a structured musculoskeletal screening protocol to characterize musculoskeletal conditions among Korean fishers and evaluate its feasibility in occupational health settings.
Methods
This field-based study included 329 fishers who participated in a health-screening program. The protocol integrated standardized questionnaires (Western Ontario and McMaster Universities Arthritis Index Short Form, Oswestry Disability Index, and QuickDASH), physical examinations, and radiographic assessments. Percentile-based thresholds (upper 20% of normalized scores) were used to identify a higher symptom burden. Participants were classified into Adequate, Caution, and Disorder-level (screen-positive) groups based on predefined operational criteria. Physical workload was assessed using a structured questionnaire, and a physical strain score was calculated as a relative index of musculoskeletal workload. Logistic regression analyses explored associations with occupational factors.
Results
Among the participants (mean age, 60.4 years; 63.2% male), 46.5% were classified into the Disorder-level group for at least one condition, and 90.9% were classified into either the Disorder-level or Caution group. Upper extremity MSDs were the most frequently identified condition (32.5%). Higher physical strain scores were associated with an increased likelihood of Disorder-level classification, particularly for upper extremity MSDs (adjusted odds ratio [aOR]: 3.30–3.75) and degenerative lumbar disorder (aOR: 4.98–10.97). Differences were also observed by fishing type, with higher lumbar involvement among aquaculture workers.
Conclusions
This study presents a structured screening protocol for MSDs among fishers and demonstrates its feasibility and applicability in field settings. The protocol may support risk stratification and the identification of individuals requiring further evaluation or preventive management. The diagnostic performance and longitudinal impact of this method warrant further investigation.

565 View
13 Download

Original Article

Toward revising Korea's occupational blood-lead regulations for lead-exposed workers: associations between blood lead levels and biological markers in Korean National Environmental Health Survey (KoNEHS) cycles 3–5 (2015–2023): Chul Gab Lee; Ann Occup Environ Med 2026;e43. Published online October 2, 2026; DOI: https://doi.org/10.35371/aoem.2026.38.e43 [Accepted]

Abstract PDF: Background
Lead toxicity manifests at blood lead concentrations (BPb) well below the limits stipulated in Korea's occupational regulations, which set a surveillance trigger at 30 μg/dL and an occupational-disease threshold at 40 μg/dL. This study investigated subclinical effects in a Korean population with low exposure and assessed whether these findings could inform revision of Korea's occupational blood-lead regulations.
Methods
Data from three Korean National Environmental Health Survey cycles were analyzed (KoNEHS 3–5, 2015–2023; adults ≥19 years). Whole-blood lead was measured by inductively coupled plasma mass spectrometry. BPb distributions were summarized by cycle, sex, age, and occupation. Covariate-adjusted partial correlations (r) between log-BPb and erythropoietic markers (hemoglobin, hematocrit, red blood cell [RBC] count, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration [MCHC]), glycemic (glycated hemoglobin [HbA1c]), and renal glomerular filtration rate (serum β2-microglobulin [β2-MG]) biomarkers were computed across six BPb cut-offs (1.0–3.5 μg/dL) and characterized with restricted cubic splines.
Results
The weighted geometric mean (GM) BPb was 1.52 μg/dL (P97.5 4.03 μg/dL). Inter-occupational differences in BPb remained modest after adjusting for key covariates (sex, age, cycle, smoking, alcohol, exercise). Hemoglobin, hematocrit, and RBC count rose at low BPb but reversed to negative correlations above ≈2.2–2.5 μg/dL, reaching r ≈ −0.10 to −0.15 above 3.0 μg/dL; MCHC showed a weaker reversal (≈1.7 μg/dL). The hematologic sign-reversal persisted within risk occupations and most sex-age strata, most pronounced in men. Serum β2-MG increased monotonically with blood lead (adjusted pcur = 0.002, plin < 0.001), and HbA1c declined monotonically.
Conclusions
In a representative Korean sample, blood lead levels show subclinical hematologic signals below 3 μg/dL, far below the current occupational reference values, indicating that these values are unlikely to remain appropriate and that their revision is warranted. The phased strengthening presented as an illustrative policy scenario should proceed through scientific evaluation followed by stakeholder consultation to ensure both health protection and feasibility.

734 View
15 Download

First
Prev
Page of 1
Next
Last

Accepted articles