Annals of Occupational and Environmental Medicine

Volume 35; 2023

Original Article

Relationship between the use of plastics in refrigerator food storage and urine phthalate metabolites: the Korean National Environmental Health Survey (KoNEHS) cycle 3: Jisoo Kang, Seong-yong Cho, Seongyong Yoon; Ann Occup Environ Med 2023;35:e53. Published online December 27, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e53

Background

Plastics are high-molecular-weight materials composed of long carbon chains. They are prevalent in daily life, present in various items such as food containers and microwavable packaging. Phthalates, an additive used to enhance their flexibility, are endocrine-disrupting chemicals. We utilized the data from the Korean National Environmental Health Survey (KoNEHS) cycle 3, representing the general South Korean population, to investigate the relationship between the use of plastics in refrigerator food storage and phthalate exposure.

Methods

We assessed 3,333 adult participants (aged ≥ 19 years) including 1,526 men and 1,807 women, using data from KoNEHS cycle 3. Using the 75th percentile concentration, urine phthalate metabolites were categorized into high and low-concentration groups. χ² test was conducted to analyze variations in the distribution of each variable, considering sociodemographic factors, health-related factors, food intake, the use of plastics, and the concentration of urine phthalate metabolites as the variables. To calculate odds ratios (ORs) for the high-concentration group of urine phthalate metabolites based on the use of plastics in refrigerator food storage, logistic regression analysis was conducted.

Results

In men, the use of plastics in refrigerator food storage had significantly higher adjusted ORs compared to those using the others. The adjusted ORs were calculated as follows: mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) had an OR of 1.35 (95% confidence interval [CI]: 1.05–1.72), mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP) had an OR of 1.48 (95% CI: 1.16–1.88), mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP) had an OR of 1.32 (95% CI: 1.04–1.66), ∑di(2-ethylhexyl) phthalate (∑DEHP) had an OR of 1.37 (95% CI: 1.08–1.74) and mono-n-butyl phthalate (MnBP) had an OR of 1.44 (95% CI: 1.13–1.84).

Conclusion

The concentrations of urine phthalate metabolites (MEHHP, MEOHP, MECPP, ∑DEHP, and MnBP) were significantly higher in men who used plastics in refrigerator food storage compared to those using the others.

제3기(2015-2017) 국민환경보건 기초조사 자료를 이용한 냉장고 식품보관 시 플라스틱을 사용하는 경우와 요중 프탈레이트 대사체간의 관계
목적
플라스틱은 긴 탄소 사슬로 구성된 고분자 물질로 일상생활에서 식품용기, 전자레인지용 포장용기 등 다양한 곳에서 사용되고 있다. 프탈레이트는 플라스틱의 유연성을 증가시키는 가소제로 사용되는데, 이는 내분비계 장애물질로 알려져있다. 본 연구에서는 우리나라 인구를 대표하는 자료인 국민환경보건 기초조사 3기를 이용하여 가정내 냉장고 식품보관 시 플라스틱을 사용하는 경우와 요중 프탈레이트 대사체와의 연관성을 조사하였다.
방법
본 연구는 국민환경보건 기초조사 3기에서 3,333명의 19세 이상 성인을 연구 대상자로 선정하였다. (남자: 1,526명 여자: 1,807명) 요중 프탈레이트 대사체는 75th percentile값을 기준으로 요중 프탈레이트 대사체 고농도군과 저농도군으로 정의하였다. 사회인구학적 요인, 건강행태 요인, 식이요인과 플라스틱 사용, 요중 프탈레이트 대사체 농도간의 분포를 분석하기위해 χ2-test를 사용하였다. 또한 로지스틱 회귀분석을 사용하여 가정내 냉장고 식품보관 시 플라스틱을 사용하는 경우와 요중 프탈레이트 대사체 고농도군에 속할 OR값을 계산하였다.
결과
남성에서 가정내 냉장고 식품보관시 플라스틱을 사용하는 경우 플라스틱을 사용하지 않는 경우보다 요중 프탈레이트 대사체 농도가 높았다. 플라스틱을 사용하는 경우 MEHHP의 고농도군에 해당될 adjusted ORs은 1.35(95%CI: 1.05-1.72), MEOHP 1.48(95%CI: 1.16-1.88), MECPP 1.32(95%CI: 1.04-1.66), ∑DEHP 1.37(95%CI: 1.08-1.74), MnBP 1.44(95%CI: 1.13-1.84)으로 조사되었다.
결론
남성에서 가정내 냉장고 식품 보관 시 플라스틱을 사용하는 경우는 플라스틱을 사용하지 않는 경우보다 요중 프탈레이트 대사체(MEHHP, MEOHP, MECPP, ∑DEHP, MnBP) 농도가 높았다.

Citations

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Biomonitoring of Endocrine Disrupting Chemicals in Exclusively Breastfed Infants and Correlation with the Mother Surveys
Adnan Barutcu, Pinar Efeoglu Ozseker, Hacer Yapicioglu Yildizdas, Saliha Barutcu, Alihan Sursal, Ali Evrim Dogan, Nurdan Evliyaoglu
Exposure and Health.2025; 17(6): 1443. CrossRef
Microplastic Migration from Plastic Packaging into Honey
Klytaimnistra Katsara, Zacharias Viskadourakis, Eleftherios Alissandrakis, George Kenanakis, Vassilis M. Papadakis
Microplastics.2025; 4(4): 90. CrossRef
Microplastic particles in human blood and their association with coagulation markers
Dong-Wook Lee, Jaehak Jung, Seul-ah Park, Yunjeong Lee, Juyang Kim, Changwoo Han, Hwan-Cheol Kim, Joon Hee Lee, Yun-Chul Hong
Scientific Reports.2024;[Epub] CrossRef

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Case Report

Prostate cancer in workers exposed to night-shift work: two cases recognized by the Korean Epidemiologic Investigation Evaluation Committee: Sungkyun Park, Seongwon Ma, Hoekyeong Seo, Sang Gil Lee, Jihye Lee, Shinhee Ye; Ann Occup Environ Med 2023;35:e52. Published online December 7, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e52

Abstract Abstract in Korean PDF

Background

In 2019, the International Agency for Research on Cancer re-evaluated the carcinogenicity of night-shift work and reported that there is limited evidence that night-shift work is carcinogenic for the development of prostate cancer. Therefore, in 2020 and 2021, the Korean Epidemiologic Investigation Evaluation Committee concluded that 2 cases of prostate cancer were occupational diseases related to the night-shift work. Here, we report the 2 cases of prostate cancer in night-shift workers which were first concluded as occupational diseases by the Korean Epidemiologic Investigation Evaluation Committee.

Case presentation

Patient A: A 61-year-old man worked as a city bus driver for approximately 17 years, from 2002 to 2019, and was exposed to night-shift work during this period. In March 2017, the patient was diagnosed with high-grade prostate cancer through core-needle biopsy after experiencing stinging pain lasting for 2 months. Patient B: A 56-year-old man worked as an electrician and an automated equipment operator in a cement manufacturing plant for 35 years from 1976 to 2013 and was exposed to night-shift work during this period. In 2013, the patient was diagnosed with high-grade prostate cancer through core needle biopsy at a university hospital because of dysuria that lasted for 6 months.

Conclusions

The 2 workers were diagnosed with high-grade prostate cancer after working night shifts for 17 and 35 years respectively. Additionally, previous studies have reported that high-grade prostate cancer has a stronger relationship with night-shift work than low or medium-grade prostate cancer. Therefore, the Korean Epidemiologic Investigation Evaluation Committee concluded that night-shift work in these 2 patients contributed to the development of their prostate cancer.

야간교대근무 근로자에서 발생한 전립선암 2례
배경
2019년 국제암연구소(IARC)은 야간교대근무의 발암성을 재평가하였고 야간교대근무와 전립선암이 양의 연관성을 가지고 있다고 보고하였다. 2020년과 2021년에 역학조사평가위원회는 두 명의 야간교대근무 근로자에서 발생한 전립선암이 야간교대근무와 관련된 직업병이라고 결론지었다. 따라서 국내에서 처음으로 직업병으로 인정된 야간교대근무 근로자에서 발생한 전립선암 2건의 사례를 소개하고자 한다.
증례
남성 근로자 A는 만 61세에 두 달간 지속된 찌르는 듯한 증상으로 비뇨기과를 방문하였고전립성특이항원 검사와 전립선 중심바늘생검을 받은 후 전립선암을 진단받았다. 근로자 A 는 2002년부터 2019년까지 시내버스를 운행하였고, 약 17년간 야간교대근무를 하면서 하루에 10시간 이상, 주당 6일간 업무를 수행하였다. 남성 근로자 B는 6개월간 지속된 배뇨곤란 증상으로 병원에서 중심바늘생검을 통해 전립선암을 진단받았다. 근로자 B는 1976년부터 2013년까지 시멘트 제조공장에서 전기기사와 자동화기기 오퍼레이터로 근무하였으며, 약 35년간 야간교대근무에 노출되었다. 근로자 A와 B는 전립선암 조직검사에서 Gleason’s score가 높은 공격적인 전립선암을 진단받았고, 업무 중 디젤엔진배출물질에도 노출되었다.
고찰
국제암연구소는 야간교대근무가 전립선암 발암성에 미치는 영향에 대해 제한적인 근거가 있다고 하였다. 이 외에도 2018년에 보고된 프랑스의 환자-대조군 연구는 긴 교대시간 길이(>10시간), 최소 6박 연속 야간근무, 장기간(20년 이상 또는 1,314일 이상)의 영구적인 야간근무가 공격적인 전립선암과 특히 유의한 연관성이 있다고 하였다. 몇 건의 메타분석 연구에서도 야간교대근무가 전립선암과 유의하다는 결과가 있었고, 특히 아시아 국가 남성에서 그 결과가 유의하다고 하였다. 또한, 디젤엔진배출물질과 전립선암이 유의한 연관성이 있다는 문헌이 일부 확인되었다. 따라서, 역학조사평가위원회는 두 근로자에서 발생한 전립선암에 대한 업무관련성의 과학적 근거가 상당하다고 판단하였다. 따라서, 야간교대근무가 전립선암 발병에 기여하는 위험성을 인지하고, 야간교대근무 근로자를 대상으로 작업시간 조절과 전립선암의 조기발견을 위한 적절한 건강검진 제공에 대한 고려가 필요하다.

Citations

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Original Article

Association between ambient particulate matter levels and hypertension: results from the Korean Genome and Epidemiology Study: Sewhan Na, Jong-Tae Park, Seungbeom Kim, Jinwoo Han, Saemi Jung, Kyeongmin Kwak; Ann Occup Environ Med 2023;35:e51. Published online December 4, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e51

Abstract Abstract in Korean PDF Supplementary Material

Background

Recently, there has been increasing worldwide concern about outdoor air pollution, especially particulate matter (PM), which has been extensively researched for its harmful effects on the respiratory system. However, sufficient research on its effects on cardiovascular diseases, such as hypertension, remains lacking. In this study, we examine the associations between PM levels and hypertension and hypothesize that higher PM concentrations are associated with elevated blood pressure.

Methods

A total of 133,935 adults aged ≥ 40 years who participated in the Korean Genome and Epidemiology Study were analyzed. Multiple linear regression analyses were conducted to investigate the short- (1–14 days), medium- (1 and 3 months), and long-term (1 and 2 years) impacts of PM on blood pressure. Logistic regression analyses were conducted to evaluate the medium- and long-term effects of PM on blood pressure elevation after adjusting for sex, age, body mass index, health-related lifestyle behaviors, and geographic areas.

Results

Using multiple linear regression analyses, both crude and adjusted models generated positive estimates, indicating an association with increased blood pressure, with all results being statistically significant, with the exception of PM levels over the long-term period (1 and 2 years) in non-hypertensive participants. In the logistic regression analyses on non-hypertensive participants, moderate PM₁₀ (particulate matter with diameters < 10 μm) and PM_2.5 (particulate matter with diameters < 2.5 μm) levels over the long-term period and all high PM₁₀ and PM_2.5 levels were statistically significant after adjusting for various covariates. Notably, high PM_2.5 levels of the 1 year exhibited the highest odds ratio of 1.23 (95% confidence interval: 1.19–1.28) after adjustment.

Conclusions

These findings suggest that both short- and long-term exposure to PM is associated with blood pressure elevation.

대기 중 미세먼지 농도와 고혈압과의 연관성: 한국인유전체역학조사사업 자료를 기반으로
목적
환경보건에서 대기 중 미세먼지 농도의 중요성이 갈수록 커지고 있으나 아직 미세먼지 농도와 고혈압과의 연관성에 대한 연구 결과가 충분하지 못하여 확실한 결론을 내리기 어려운 상황에 처해있다. 본 연구는 대기 중 미세먼지 노출과 혈압 상승의 상관관계를 밝히는 데에 목적을 두고 있다.
방법
본 연구는 질병관리청 국립보건연구원에서 담당하고 있는 한국인유전체역학조사사업 코호트와 대기오염 모니터링 자료가 연계된 데이터에서 추출한 133,935 명을 대상으로 하였다. 다중선형 회귀분석과 로지스틱 회귀분석을 수행하여 대기 중 미세먼지 농도와 혈압 수준과의 상관관계를 평가하였다.
결과
다중선형 회귀분석에서는 성별, 나이 등과 같은 공변수들을 보정하기 전과 후 모두 통계적으로 유의하게 미세먼지 농도가 증가할수록, 혈압이 상승하였다. 로지스틱 회귀분석에서 고혈압의 오즈비(odds ratio; OR)는 높은 대기 중 미세먼지 농도에 노출된 참여자들에서 통계적으로 유의하게 증가한 반면, 중등도의 미세먼지 농도에 노출된 참여자들에서는 노출기간에 따라 결과가 달라지는 양상을 보였다.
결론
본 연구의 결과는 대기 중 미세먼지 노출이 고혈압 위험도 증가와 관련될 수 있음을 시사한다.

Citations

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Original Article

Association between receiving work communications outside of work hours via telecommunication devices and work-related headaches and eyestrain: a cross-sectional analysis of the 6th Korean Working Conditions Survey: Yoon-Soo Jang, Jae-Han Lee, Na-Rae Lee, Dong-Woo Kim, June-Hee Lee, Kyung-Jae Lee; Ann Occup Environ Med 2023;35:e50. Published online December 1, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e50

Abstract Abstract in Korean PDF

Background

The rise in telecommuting or non-face-to-face work owing to the coronavirus disease 2019 pandemic has fueled conversations regarding the “right to disconnect.” Although evidence suggests that receiving work-related communications through telecommunication devices outside of work hours may lead to various symptoms and illnesses, limited research has been undertaken on these symptoms. This study therefore aims to investigate the correlation between receiving work communications through telecommunication devices after work hours and the occurrence of work-related headaches and eyestrain in full-time, non-shift white-collar workers.

Methods

This study used data from the 6th Korean Working Conditions Survey. The frequency of using telecommunication devices for work purposes outside of working hours was divided into five categories: “Every day,” “Several times a week,” “Several times a month,” “Rarely,” and “Never.” Work-related headaches and eyestrain were categorized based on a “yes” or “no” response to the survey questions. Descriptive statistics, χ² tests, and multiple logistic regression analyses were performed using SPSS 27.0.

Results

After adjusting for sex, age, income level, education, occupation, workplace size, work hours, and sleep disorders, the odds ratio (OR) of work-related headaches and eyestrain based on frequency of telecommunication device usage were as follows: “rarely” (OR: 1.292; 95% confidence interval [CI]: 1.111–1.503), “several times a month” (OR: 1.551; 95% CI: 1.249–1.926), “several times a week” (OR: 1.474; 95% CI: 1.217–1.784), and “every day” (OR: 1.548; 95% CI: 1.321–1.813).

Conclusions

Employees who use telecommunication devices for work after regular hours are more susceptible to experiencing work-related headaches and eyestrain compared to those who do not. However, there is a dearth of research examining the physical and mental health impacts of using telecommunication devices for after-hours work. Furthermore, the existing preventative measures in Korea are insufficient. Consequently, it is imperative to develop effective measures and conduct additional research to address this issue.

근무시간 외 통신기기를 통한 업무 연락 수신과 업무 관련 두통/눈의 피로의 연관성
목적
코로나19의 영향으로 재택근무, 비대면 업무가 증가하면서 “연결차단권”에 대한 논의가 계속되고 있다. 근무시간 외에 통신기기를 통한 업무 연락 수신은 다양한 증상과 질병을 유발할 수 있을 것으로 생각된다. 그러나 각각의 증상에 대한 연구는 제한적이다. 이에 본 연구에서는 교대근무를 하지 않는 정규직 사무직 근로자를 대상으로 근무시간 외 통신기기를 통한 업무 연락 수신과 업무 관련 두통/눈의 피로 발생 간의 상관관계를 조사하고자 한다.
방법
제6차 한국 근로환경조사의 데이터를 바탕으로 근무시간 외 업무 목적으로 통신기기를 사용하는 빈도를 5가지 항목: "매일", "일주일에 여러 번", "한 달에 여러 번", "드물게”, "전혀 없었음"으로 나누어 조사하였다. 업무 관련 두통/눈의 피로는 "예" 또는 "아니오" 응답에 따라 두 가지 범주로 분류하였다. SPSS 27.0을 사용하여 기술 통계, 카이제곱 검정, 다중회귀분석을 시행하였고, 근무시간 외 업무 목적의 통신기기 사용 빈도에 따른 업무 관련 두통/눈의 피로의 odds ratio를 구하였다.
결과
근무시간 외 업무 목적의 통신기기 사용 빈도에 따른 업무 관련 두통/눈의 피로의 odds ratio는 “드물게”(odds ratio [OR]:1.292, 95% confidence interval [CI]:1.111-1. 503), “한 달에 여러 번”(OR:1.551, 95% CI:1.249-1.926), “일주일에 여러 번”(OR:1.474, 95% CI:1.217-1.784), “매일”(OR:1.548, 95% CI:1.321-1.813)로 나타났다.
결론
근무시간 외에 통신기기를 통해 업무 관련 연락을 받는 근로자는 그렇지 않은 근로자에 비해 업무 관련 두통/눈의 피로의 위험이 더 크다. 그러나 근무 시간 외 통신기기를 통한 업무 연락 수신이 근로자의 신체적, 정신적 건강에 미치는 영향을 조사한 연구는 제한적이며, 관련 예방 및 중재 조치 또한 미흡하다. 따라서 해당 분야에 대한 후속 연구 및 실효성 있는 대책 마련이 필요할 것으로 생각된다.

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Data Profile

Data resource profile: the Korean Working Conditions Survey (KWCS): Yoonho Cho; Ann Occup Environ Med 2023;35:e49. Published online November 23, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e49

Abstract Abstract in Korean PDF

The Korean Working Conditions Survey (KWCS) is a state-approved statistical survey that has been conducted by the Occupational Safety and Health Research Institute (OSHRI) every 3 years since 2006 to monitor changes in the working conditions of Koreans. This cross-sectional national survey involves a sample of 50,000 employed people aged 15 or older. KWCS measures various working conditions through > 130 survey questions, including questions regarding working hours, labor intensity, work–life balance, degree of exposure to risk factors, and subjective health status. Professional survey interviewers visit households and conduct face to face interviews. KWCS provides data and statistics for occupational safety and health polices and research in Korea. Furthermore, OSHRI holds academic conferences every year, awards high-quality academic papers, and supports researchers using data. Microdata is publicly available through the OSHRI website (https://oshri.kosha.or.kr).

자료원 프로파일: 근로환경조사
KWCS는 국가승인통계로 대한민국에 거주하는 만15세 이상 취업자 5만명을 표본으로 매 3년마다 실시하는 단면적 조사로, 2006년부터 산업안전보건연구원에서 실시하고 있다. KWCS는 전문조사원에 의해 가구를 방문하여 1:1 면접 조사로 이루어지며, 근무시간, 노동강도, 일과 삶의 균형, 유해위험요인에 대한 노출 정도, 주관적 건강상태 등 다양한 근로환경에 대해 130여개 이상의 문항에 대해 조사한다. 조사 결과는 정책 수립과 연구자를 위한 기초 자료로 제공하고 있으며, 마이크로데이터는 산업안전보건연구원 홈페이지(OSHRI.OR.KR)를 통해 공개하고 있다.

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Original Article

Effects of a supportive workplace environment on the success rate for smoking cessation camp: Woojin Kim, A Ram Kim, Minsu Ock, Young-Jee Jeon, Heun Lee, Daehwan Kim, Minjun Kim, Cheolin Yoo; Ann Occup Environ Med 2023;35:e48. Published online November 22, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e48

Abstract Abstract in Korean PDF

Background

This study was conducted to identify the success rate for smoking cessation over time after participation in a therapeutic smoking cessation camp, and to identify how participant characteristics, including a supportive workplace environment for smoking cessation (SWESC), affect the success rate for smoking cessation.

Methods

In all, 296 participants at smoking cessation camps in Ulsan between 2015 and 2020 were investigated. The success rates of smoking cessation after weeks 4, 6, 12, and 24 at camp were investigated. The participants were grouped as workers with an SWESC, and workers without an SWESC, and variables (age, education, household income, marital status, drinking, exercise, body mass index, morbidity, job, number of counseling sessions, cigarettes smoked per day and smoking initiation age) were investigated. Multiple logistic regression analysis was conducted at each time point. In addition, Cox regression analysis was performed to evaluate the variables affecting the success rate for smoking cessation over time.

Results

The smoking cessation success rate of workers with an SWESC at week 24 (90.7%) was higher than that for workers without an SWESC (60.5%). Multiple logistic regression was performed to determine the relationship between each variable and the success rates for smoking cessation at week 6, 12, and 24. SWESC was confirmed as significant (p < 0.05) variables for increased success rate for smoking cessation at all 3 time points. After adjusting for all variables, the Cox proportional hazards survival analysis showed a hazard ratio of 6.17 for SWESC (p < 0.001,; 95% confidence interval: 3.08–12.38).

Conclusions

At a professional treatment smoking cessation camp, participants with an SWESC showed a significantly higher success rate for smoking cessation. Supportive workplace environment for workers’ health is expected to be an important factor for smoking cessation projects as well as other health promotion projects at workplace.

직장의 금연에 대한 지지적 환경이 전문 치료형 금연 캠프의 금연성공률에 미치는 영향
목적
본 연구는 울산에서 진행된 전문 치료형 금연 캠프에 참가한 후 시간 경과에 따른 금연 성공률을 알아보고, 직장의 금연에 대한 지지적 환경 (SWESC: supportive workplace environment for smoking cessation)을 포함한 각 참가자의 특성이 금연 성공률에 어떤 영향을 미치는지 알아보기 위해 실시되었다.
방법
2015-2020년 울산 지역 금연 캠프 참가자 455명을 대상으로 자가 보고, 호기 일산화탄소, 소변 코티닌 수치를 이용하여 캠프 후 4주, 6주, 12주, 24주차 금연 성공률을 조사하였다. 캠프 참가자를 SWESC가 있는 근로자 및 SWESC가 없는 근로자로 분류하여 각 집단에서 변수 (연령, 교육 수준, 가계 소득, 배우자 유무, 음주, 운동, 체질량지수, 현병력, 직업, 상담 횟수, 하루 흡연량, 흡연 시작 연령)들의 비율을 알아보았고, 시점별 금연 성공률을 집계하였다. 변수와 금연 성공의 관계를 알아보기 위해 각 시점에서 다중 로지스틱 회귀 분석을 실시하였다. 또한 시간 경과에 따른 금연 성공률에 영향을 미치는 변수를 평가하기 위해 Cox 생존 분석을 시행하였다.
결과
SWESC가 있는 근로자의 24주 금연 성공률 (90.7%)은 SWE가 없는 근로자 (60.5%)보다 높았다. 캠프 후 6주, 12주, 24주째 금연성공률과 변수에 대하여 다중 로지스틱 회귀 분석을 실시한 결과, 세 시점에서 모두 금연에 유의한 (p < 0.05) 변수는 SWESC로 나타났다. 모든 변수를 조정하여 Cox 비례 위험 생존 분석을 실시한 결과 SWESC의 위험비는 6.17 ( 95% 신뢰구간: 3.08-12.38)였다.
결론
금연 캠프 참가자 중 SWESC가 있는 참가자는 금연 성공률이 유의하게 높았다. 근로자의 건강에 대한 지지적인 직장 환경은 금연 사업 등 보건 사업의 성공에 중요한 요인이 될 것으로 예상된다.

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Original Article

Mediation analysis of chronotype, sleep-related factors, and depressive symptoms among workers: a cross-sectional study: Seo Young Kim, Hyo Jeong Kim, Seong-Sik Cho, Min Young Park, Mo-Yeol Kang; Ann Occup Environ Med 2023;35:e47. Published online November 20, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e47

Abstract Abstract in Korean PDF Supplementary Material

Background

This study aimed to examine the impact of chronotype on depressive symptoms and explore the mediating effects of sleep quality, pre-sleep cognitive arousal, and social jetlag in a sample of wage earners.

Methods

A total of 3,917 waged workers were surveyed online in July 2022. Logistic regression and mediation analysis were used to assess the relationship between chronotype (morningness, intermediate, and eveningness) and depressive symptoms (Patient Health Questionnaire ≥ 5), and the mediating effects of Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), and Pre-Sleep Arousal Scale (PSAS). All analyses were adjusted for age, education level, income level, marital status, coffee consumption, alcohol consumption, physical activity, occupation, employment status, and working hours to calculate odds ratios (ORs).

Results

The chronotypes of all the participants were divided into morningness (4.7%), intermediate (93.5%), and eveningness (1.8%). Multiple logistic regression analysis showed an increased risk of depression in the eveningness chronotype (OR: 2.96; 95% confidence interval [CI]: 1.51, 5.86). Regarding the mediation analysis, ISI mediated 28.44% (95% CI: 16.39–40.5), PSQI for 31.25% (95% CI: 19.36, 43.15), and PSAS-Cognitive Score (PSAS-C) for 23.58% (95% CI: 10.66, 36.50) of the association between chronotype and depressive symptoms. However, social jetlag did not significantly mediate this relationship. (percentage mediated = 0.75%, 95% CI: −3.88, 5.39)

Conclusions

Evening chronotypes exhibit an increased risk of depressive symptoms, which ISI, PSQI, and PSAS-C partially mediated. This suggests that interventions to improve sleep quality and maintain adequate sleep habits may effectively prevent and treat depression in employees with an eveningness chronotype.

직장인의 크로노타입이 우울 증상에 미치는 영향과 수면 관련 요인의 매개 분석
목적
본 연구는 국내 임금 근로자를 대상으로 크로노타입이 우울 증상에 미치는 영향과 수면의 질, 수면 전 인지적 각성, 사회적 시차 등의 매개 효과에 대해 분석하고자 한다.
방법
2022년 7월 온라인 설문조사를 통해 모집한 만 19세 이상의 임금 근로자 3917명을 대상으로 분석을 시행하였다. 로지스틱 회귀분석으로 성별을 층화하여 크로노타입 (아침형, 중간형, 저녁형)과 우울증상 간의 관계를 살펴본 후, 매개효과 분석을 통해 불면척도, 수면의 질, 수면 전 각성 척도, 사회적 시차의 각각의 우울 증상에 대한 매개 효과를 계산했다. 모든 분석은 연령, 교육수준, 소득, 결혼 여부, 동거인 여부, 커피, 흡연, 음주, 신체활동, 직종, 고용형태, 근무 시간을 보정하였다.
결과
참가자는 아침형(4.7%), 중간형(93.5%), 저녁형(1.8%)으로 나뉘었다. 인구사회학적 특성 및 업무 관련 요인을 통제한 다중 로지스틱 회귀분석 결과, 저녁형 그룹에서 우울증상 오즈비는 2.95 (95% 신뢰구간: 1.51–5.86)로 아침형 그룹에 비해 높게 나타났다. 매개 분석 결과에서 불면 척도는 28.44% (95% 신뢰구간 16.39–40.5), 수면의 질은 31.25% (95% 신뢰구간 19.36–43.15), 수면 전 인지적 각성척도은 23.58% (95% 신뢰구간 10.66–36.50)를 매개하였다. 그러나 사회적 시차는 매개 효과가 0.75% (95% 신뢰구간 -3.88–5.39)로 유의하지 않은 것으로 나타났다.
결론
본 연구 결과에 따르면 저녁형 크로노타입을 가진 근로자들이 아침형 근로자보다 우울증상의 위험도가 증가하는 것으로 나타났으며, 이에 대한 매개 효과 분석에서는 불면 척도, 수면의 질과 수면 전 인지적 각성이 우울 증상을 부분적으로 매개하는 것으로 나타났다. 이는 저녁형 크로노타입 근로자들과 같은 우울증의 상대적 고위험군에서 수면의 질을 개선하고 수면 습관을 적절히 유지하도록 개입하는 것이 우울증의 예방 및 치료에 효과적일 수 있음을 시사한다.

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Original Article

Association between unpredictable work schedule and work-family conflict in Korea: Sang Moon Choi, Chan Woo Kim, Hyoung Ouk Park, Yong Tae Park; Ann Occup Environ Med 2023;35:e46. Published online November 10, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e46

Abstract Abstract in Korean PDF

Background

As unpredictable work schedule (UWS) has increased worldwide, various studies have been conducted on the resulting health effects on workers. However, research on the effect of UWS on workers' well-being in Korea is still insufficient. This study aimed to investigate the relationship between UWS and work-family conflict (WFC) using 6th Korean Working Conditions Survey (KWCS).

Methods

Both UWS and WFC were measured using self-reported questionnaires, using data from the 6th KWCS conducted between 2020 and 2021, including 31,859 participants. UWS was measured by questions regarding the frequency of changes in work schedules and limited advanced notice. WFC was measured by questions regarding work to family and family to work conflicts. Logistic regression analysis was conducted to investigate the association between UWS and WFC.

Results

The prevalence of UWS was higher among men, those under 40 years old, service and sales workers and blue-collar workers, and those with higher salaries. Workplace size also influenced UWS prevalence, with smaller workplaces (less than 50 employees) showing a higher prevalence. The odds ratio (OR) for WFC was significantly higher in workers with UWS compared to workers without UWS after adjusting for gender, age, marital status, occupation, salary, education, weekly working hours, shift work, company size, and having a child under the age of 18 years, employment status (OR: 3.71; 95% confidence interval: 3.23–4.25).

Conclusions

The analysis of nationwide data revealed that UWS interferes with workers’ performance of family roles, which can lead to WFC. Our findings suggest that it is crucial to implement policies to address unfair work schedule management, promoting a healthier work-life balance and fostering a conducive environment for family responsibilities.

예측 불가능한 근무 일정과 일-가정 갈등의 연관성
목적
전 세계적으로 예측 불가능한 근무 일정(unpredictable work schedule, UWS)이 증가함에 따라, 근로자에게 미치는 건강 영향에 대한 다양한 연구가 진행되었다. 그러나, UWS가 근로자의 삶에 미치는 영향에 대한 국내 연구는 아직 미흡하다. 본 연구는 제6차 한국근로환경조사(Korean Working Conditions Survey, KWCS)를 이용하여 UWS와 일-가정 갈등(Work-Family Conflict, WFC)의 관계를 알아보고자 하였다.
방법
2020년과 2021년 사이에 수행된 제6차 KWCS의 데이터를 사용하여 총 31859명이 연구 대상으로 포함되었고 UWS와 WFC는 모두 자기기입식 설문을 통해 측정되었다. UWS는 업무 일정의 변경 빈도 및 제한된 사전통지에 관한 질문으로 측정되었으며, WFC는 업무로부터 발생하는 가족 갈등과 및 가족으로 발생하는 업무 갈등에 관한 질문으로 측정되었다. UWS와 WFC의 연관성을 조사하기 위해 로지스틱 회귀 분석을 수행하였다.
결과
UWS는 남성, 40세미만, 서비스 및 판매 종사자, 블루칼라 종사자, 그리고 더 높은 급여를 받는 사람들 사이에서 더 많았다. 작업장 규모도 UWS에 영향을 미쳤으며, 소규모 작업장(직원 수 50명 미만)에서 더 많았습니다. WFC의 오즈비는 성별, 연령, 결혼 여부, 직업, 급여, 교육, 주간 근로시간, 교대근무, 회사 규모, 18세 미만 자녀 여부, 정규직 여부를 보정한 후 나타난 결과에서 UWS가 없는 근로자에 비해 UWS가 있는 근로자에서 유의하게 높았다(OR: 3.78, 95% CI: 3.28-4.34).
결론
전국적인 자료를 분석한 결과, UWS가 근로자의 가족 역할 수행을 방해하여 WFC를 유발할 수 있는 것으로 나타났다. 본 연구는 근로자에게 건강한 일과 삶의 균형을 제공하고 가족 역할을 수행하기 좋은 환경을 조성하기 위해 불공정한 근무 일정 관리를 해소시키는 정책의 필요성을 시사한다.

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Editorial

Research misconduct using a ghostwriter in a paper-writing company: Kyunghee Jung-Choi; Ann Occup Environ Med 2023;35:e45. Published online November 7, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e45

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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: 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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Original Article

Association between exposure to violence, job stress and depressive symptoms among gig economy workers in Korea: Min-Seok Kim, Juyeon Oh, Juho Sim, Byung-Yoon Yun, Jin-Ha Yoon; Ann Occup Environ Med 2023;35:e43. Published online October 30, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e43

Abstract Abstract in Korean PDF

Background

Gig workers, also known as platform workers, are independent workers who are not employed by any particular company. The number of gig economy workers has rapidly increased worldwide in the past decade. There is a dearth of occupational health studies among gig economy workers. We aimed to investigate the association between exposure to violence and job stress in gig economy workers and depressive symptoms.

Methods

A total of 955 individuals (521 gig workers and 434 general workers) participated in this study and variables were measured through self-report questionnaires. Depressive symptoms were evaluated by the Patient Health Questionnaire-9 when the score was greater than or equal to 10 points. The odds ratio with 95% confidence interval was calculated using multivariable logistic regression adjusted for age, sex, working hours, education level, exposure to violence and job stress.

Results

19% of gig economy workers reported depressive symptoms, while only 11% of general workers reported the depressive symptoms. In association to depressive symptoms among gig economy workers, the mainly result of odds ratios for depressive symptoms were as follows: 1.81 for workers type, 3.53 for humiliating treatment, 2.65 for sexual harassment, 3.55 for less than three meals per day, 3.69 for feeling too tired to do housework after leaving work.

Conclusions

Gig economic workers are exposed to violence and job stress in the workplace more than general workers, and the proportion of workers reporting depressive symptoms is also high. These factors are associated to depressive symptoms. Furthermore, the gig workers associated between depressive symptoms and exposure to violence, job stress.

한국 긱경제 근로자에서 폭력 및 직무 스트레스 노출과 우울 증상관의 연관성
목적
긱경제 근로자 또는 플랫폼 근로자는 특정 회사에 고용되지 않은 독립적인 근로자들을 말한다. 긱경제는 그 규모가 커지고 있고, 종사하는 근로자들도 많아지고 있으나, 긱경제 노동자들의 산업 보건 연구가 부족한 실정이다. 우리는 긱경제 근로자에서 폭력 노출과 직무 스트레스에 노출되는 것이 우울 증상과 연관성이 있는지 조사하는 것을 목표로 했다.
방법
총 955명(긱 근로자 521명, 일반 근로자 434명)이 본 연구에 참여하였으며, 우울 증상은 PHQ-9(Patient Health Questionnaire-9) 점수가 10점 이상일 때로 평가하였다. 폭력 노출과 직무 스트레스는 자기보고식 설문지를 이용하여 측정하였다. 연령, 성별, 근무시간, 교육수준을 보정한 다변량 로지스틱 회귀분석을 이용하여 Odds Ratio, 95% Confidence Interval를 산출했다.
결과
긱 근로자의 19%가 우울 증상을 보고한 반면, 일반 근로자의 11%만이 우울 증상을 보고했습니다. 긱경제 근로자의 우울상과 관련하여 우울상 Odds ratio의 주요 결과는표3에서 ‘긱경제 근로자’ 1.89, ‘굴욕적 처우 경험’ 3.53, ‘성희롱 경험’ 2.65, ‘하루 세 끼 미만의 식사’ 3.55, ‘퇴근 후 집안일을 하기엔 너무 피곤함’ 3.69로 나타났다.
결론
긱경제 근로자는 일반 근로자에 비해 직장 내 폭력과 직무스트레스에 더 많이 노출되고, 우울 증상을 호소하는 근로자의 비율도 높다. 이러한 요인은 우울 증상과 관련이 있다. 더욱이, 긱경제 근로자들은 우울 증상과 폭력 노출, 직업 스트레스와 관련이 있다.

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Opinion

The use of ChatGPT in occupational medicine: opportunities and threats: Chayma Sridi, Salem Brigui; Ann Occup Environ Med 2023;35:e42. Published online October 23, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e42

Abstract PDF

ChatGPT has the potential to revolutionize occupational medicine by providing a powerful tool for analyzing data, improving communication, and increasing efficiency. It can help identify patterns and trends in workplace health and safety, act as a virtual assistant for workers, employers, and occupational health professionals, and automate certain tasks. However, caution is required due to ethical concerns, the need to maintain confidentiality, and the risk of inconsistent or inaccurate results. ChatGPT cannot replace the crucial role of the occupational health professional in the medical surveillance of workers and the analysis of data on workers’ health.

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Original Article

Association between shift work and the risk of hypothyroidism in adult male workers in Korea: a cohort study: Seonghyeon Kwon, Yesung Lee, Eunhye Seo, Daehoon Kim, Jaehong Lee, Youshik Jeong, Jihoon Kim, Jinsook Jeong, Woncheol Lee; Ann Occup Environ Med 2023;35:e41. Published online October 19, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e41

Abstract Abstract in Korean PDF Supplementary Material

Background

Shift work has been reported to have several harmful effects on the human body. However, a small number of studies have evaluated the association between shift work and adverse effects on the thyroid. In our longitudinal study, we examined the causal association between shift work and the risk of hypothyroidism.

Methods

A Kangbuk Samsung Cohort Study was conducted on 112,648 men without thyroid disease at baseline who were followed up at least once between 2012 and 2019. Shift work status and shift schedule types were categorized using standardized questionnaires. Hypothyroidism was defined using the reference ranges of serum thyroid-stimulating hormones and free thyroxine levels. Hazard ratios (HRs) and 95% confidence intervals (CIs) for incident hypothyroidism were estimated using Cox proportional hazards regression analyses with the daytime work group as the reference.

Results

During the 501,237 person-years of follow-up, there were 6,306 incident cases of hypothyroidism (incidence density, 1.26 per 100 person-years). The multivariable-adjusted HR of incident hypothyroidism for the shift work total group that included all shifts compared with the daytime work group was 1.27 (95% CI: 1.15–1.40). For the fixed evening, fixed night, rotating shift, and other shift workers, the multivariable-adjusted HRs (95% CI) were 1.11 (0.76–1.61), 2.18 (1.20–3.93), 1.39 (1.23–1.56), and 1.00 (0.82–1.22), respectively. In subgroup analyses by age, the association between shift work and hypothyroidism was more pronounced in younger participants (< 40 years; HR: 1.31; 95% CI: 1.16–1.47).

Conclusions

Our large-scale cohort study showed an association between shift work and the incidence of hypothyroidism, especially in younger workers with night shifts.

한국 성인 남성 근로자에서 교대근무와 갑상선 기능 저하증 위험의 연관성: 코호트 연구
목적
교대 근무는 인체에 여러 가지 해로운 영향을 미치는 것으로 보고되어 왔다. 그러나 소수의 연구만이 교대 근무와 갑상선에 대한 이상 반응 사이의 연관성을 평가하였다. 따라서 이번 종단 연구에서는, 교대 근무와 갑상선 기능 저하증의 위험 간의 인과 관계를 평가하고자 한다.
방법
본 강북삼성 코호트 연구는 2012년과 2019년 사이에 최소 한 번 이상 추적 검사를 받았고, 연구 시작 시점에서 갑상선 질환이 없는 112,648명의 남성을 대상으로 수행되었다. 표준화된 설문지를 이용하여 교대근무 현황 및 교대근무 유형을 분류하였다. 갑상선 기능 저하증은 혈청 갑상선 자극 호르몬과 유리 티록신 수치의 참고치를 기준으로 정의되었다. 갑상선 기능 저하증에 대한 위험비(HR)와 95% 신뢰구간(CI)은 주간 근무 그룹을 기준으로 콕스 비례위험 회귀분석을 사용하여 추정되었다.
결과
501,237인년의 추적 조사 기간 중 6,306건의 갑상선 기능 저하증 케이스가 발생하였다 (발생밀도, 100인년당 1.26). 주간 근무 그룹과 비교하여 모든 교대 근무 유형을 포함한 그룹에 대한 갑상선 기능 저하증의 다변량 조정 위험비는 1.27 (95% 신뢰구간, 1.15–1.40)이었다. 고정 저녁, 고정 야간, 윤번 교대 및 기타 교대 근무 그룹의 경우 다변량 조정 위험비 (95% 신뢰구간)는 각각 1.11 (0.76–1.61), 2.18 (1.20–3.93), 1.39 (1.23–1.56) 및 1.00 (0.82–1.22)이었다. 연령에 따른 하위집단 분석에서 교대근무와 갑상선 기능 저하증의 연관성은 젊은 참가자들에게서 더 두드러졌다 (<40세; 위험비, 1.31; 95% 신뢰구간, 1.16–1.47).
결론
본 대규모 코호트 연구를 통해 특히 야간 근무를 하는 젊은 근로자들에서, 교대 근무와 갑상선 기능 저하증 발생 사이의 연관성을 확인할 수 있었다.

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Science of The Total Environment.2025; 958: 178017. CrossRef

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Original Article

The relationship between skeletal muscle mass and the KOSHA cardiovascular risk in obese male workers: Hyo Won Chong, JunSeok Son, Changho Chae, Changho Jae; Ann Occup Environ Med 2023;35:e40. Published online October 4, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e40

Abstract Abstract in Korean PDF

Background

Efforts for the prevention and management of cardiovascular diseases (CVDs) in workers have been actively pursued. Obesity is one of the important risk factors related to CVDs. Obesity has various metabolic characteristics, and some individuals can be metabolically healthy. Body composition including skeletal muscle mass is known to have protective effect in obesity. The study aims to investigate the association between skeletal muscle mass and Korea Occupational Safety and Health Agency (KOSHA) CVD risk among obese male manufacturing workers in Korea and to identify appropriate indicators of skeletal muscle mass for predicting risk of CVDs.

Methods

The study was conducted on 2,007 obese male workers at a manufacturing industry aged more than 19 years. Skeletal muscle mass, skeletal muscle index (SMI), skeletal muscle mass percent (SMM%) and skeletal muscle to body fat ratio (MFR) were used to evaluate body composition and these indicators were divided into quartiles. The odds ratios (ORs) and 95% confidence intervals (CIs) for the KOSHA CVD risk groups according to quartiles of skeletal muscle mass indicators were estimated using ordinal logistic regression analysis.

Results

The OR for the KOSHA CVD risk groups in the highest quartile of SMI was 1.67 (95% CI: 1.42–1.92), while the ORs for the KOSHA CVD risk groups in the highest quartiles of SMM%, SMM/body mass index (BMI), and MFR were 0.47 (95% CI: 0.22–0.72), 0.51 (95% CI: 0.05–0.76), and 0.48 (95% CI: 0.23–0.74), respectively.

Conclusions

We found that high SMI increase the likelihood of high risk of CVDs, while high SMM%, SMM/BMI, and MFR lower the likelihood of high risk of CVDs. Accurate evaluation of skeletal muscle mass can help assess the cardiovascular risk in obese male workers.

비만 남성 근로자에서 골격근량과 KOSHA 심혈관질환 위험도와의 연관성
목적
근로자의 심혈관질환의 예방과 사후관리를 위한 노력이 활발이 이루어지고 있다. 비만은 심혈관질환과 관련한 중요한 위험인자로 알려져 있다. 비만은 다양한 대사 특성을 나타내며 일부는 대사적으로 건강하다. 기전 중 하나로 골격근량을 포함한 체성분 구성의 대사적 보호 효과가 알려져 있다. 본 연구를 통해 국내 제조업 비만 남성 근로자를 대상으로 골격근량과 KOSHA 심혈관질환 위험도 간의 연관성을 확인하고, 심혈관질환 위험도를 예측할 수 있는 적절한 골격근량 지표를 확인하고자 하였다.
방법
제조업에 근무하는 19세 이상의 비만 남성 근로자 2,007명을 대상으로 연구를 진행하였다. 체성분을 평가하기 위해 골격근량, skeletal muscle index (SMI), skeletal muscle mass percent (SMM%) 및 skeletal muscle to body fat ratio (MFR) 지표를 사용하였으며 4분위수로 나누었다. 순서형 로지스틱 회귀분석을 시행하여 골격근량 지표의 사분위수에 대한 KOSHA 심혈관질환 위험도의 교차비와 95% 신뢰구간을 산출하였다.
결과
순서형 로지스틱 회귀분석을 시행한 결과, SMI 의 높은 사분위수에서 심혈관질환 위험군의 교차비는 1.67 (95% CI, 1.42-1.92) 으로 나타났다. SMM%, SMM/BMI 및 MFR 의 높은 사분위수에서 MHO 군의 심혈관질환 위험군의 교차비는 각각 0.47 (95% CI, 0.22-0.72), 0.51 (95% CI, 0.05-0.76), 및 0.48 (95% CI, 0.23-0.74) 으로 나타났다.
결론
본 연구에서 높은 SMI 에서 KOSHA 심혈관질환 위험도가 높게 나타날 가능성이 높으며, 높은 SMM%, SMM/BMI 및 MFR 에서 KOSHA 심혈관질환 위험도가 높게 나타날 가능성이 낮았다. 정확한 골격근량의 평가는 비만 남성 근로자의 심혈관질환 위험도를 가늠하는데 도움이 될 것으로 보인다.

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Original Article

Dynamics of pre-shift and post-shift lung function parameters among wood workers in Ghana: John Ekman, Philip Quartey, Abdala Mumuni Ussif, Niklas Ricklund, Daniel Lawer Egbenya, Gideon Akuamoah Wiafe, Korantema Mawuena Tsegah, Akua Karikari, Håkan Löfstedt, Francis Tanam Djankpa; Ann Occup Environ Med 2023;35:e39. Published online September 12, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e39

Abstract PDF

Background

Diseases affecting the lungs and airways contribute significantly to the global burden of disease. The problem in low- and middle-income countries appears to be exacerbated by a shift in global manufacturing base to these countries and inadequate enforcement of environmental and safety standards. In Ghana, the potential adverse effects on respiratory function associated with occupational wood dust exposure have not been thoroughly investigated.

Methods

Sixty-four male sawmill workers and 64 non-woodworkers participated in this study. The concentration of wood dust exposure, prevalence and likelihood of association of respiratory symptoms with wood dust exposure and changes in pulmonary function test (PFT) parameters in association with wood dust exposure were determined from dust concentration measurements, symptoms questionnaire and lung function test parameters.

Results

Sawmill workers were exposed to inhalable dust concentration of 3.09 ± 0.04 mg/m³ but did not use respirators and engaged in personal grooming habits that are known to increase dust inhalation. The sawmill operators also showed higher prevalence and likelihoods of association with respiratory symptoms, a significant cross-shift decline in some PFT parameters and a shift towards a restrictive pattern of lung dysfunction by end of daily shift. The before-shift PFT parameters of woodworkers were comparable to those of non-woodworkers, indicating a lack of chronic effects of wood dust exposure.

Conclusions

Wood dust exposure at the study site was associated with acute respiratory symptoms and acute changes in some PFT parameters. This calls for institution and enforcement of workplace and environmental safety policies to minimise exposure at sawmill operating sites, and ultimately, decrease the burden of respiratory diseases.

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Original Article

Association between hearing loss and high-sensitivity C-reactive protein: the Kangbuk Samsung Cohort Study: Jihoon Kim, Yesung Lee, Eunhye Seo, Daehoon Kim, Jaehong Lee, Youshik Jeong, Seonghyun Kwon, Jinsook Jeong, Woncheol Lee; Ann Occup Environ Med 2023;35:e38. Published online September 11, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e38

Abstract Abstract in Korean PDF

Background

Hearing loss (HL) is linked to an elevated risk of cardiovascular diseases (CVDs). The pathogeneses of HL and CVD commonly involve inflammatory responses. Previous studies investigated elevated levels of inflammatory biomarkers in subjects with HL, however, their findings did not demonstrate statistical significance. In our cross-sectional and longitudinal study, we investigated the correlation between HL and increased high-sensitivity C-reactive protein (hsCRP) levels to determine how HL is associated with CVDs.

Methods

We conducted a cross-sectional study with workers aged over 18 years who underwent health check-ups at our institution between 2012 and 2018 (n = 566,507), followed by conducting a longitudinal study of workers aged > 18 who underwent health checkups at least twice at our institution between 2012 and 2018 (n = 173,794). The definition of HL was as an average threshold of ≥ 20 dB in pure-tone air conduction at 0.5, 1.0, and 2.0 kHz in both ears. The incidence of increased hsCRP levels throughout the follow-up period was defined as a level exceeding 3 mg/L. Logistic regression and generalized estimating equations were performed to estimate the risk of increased hsCRP levels according to the occurrence of HL in groups stratified by age.

Results

In the cross-sectional study, the multivariate-adjusted odds ratio (OR) was 1.17 (95% confidence interval [CI]: 1.02–1.34); the OR was 0.99 (95% CI: 0.80–1.22) in those under 40 and 1.28 (1.08–1.53) in those over 40. In the longitudinal study, the multivariable-adjusted OR was 1.05 (95% CI: 0.92–1.19); the OR was 1.10 (95% CI: 0.90–1.35) in those under 40 and 1.20 (1.01–1.43) in those over 40.

Conclusions

This cross-sectional and longitudinal study identified an association between HL and increased hsCRP levels in workers aged over 40 years.

청력손실과 고감도 C-반응단백의 연관성
목적
청력손실은 심혈관질환 발생 및 사망률 증가와 관련 있다. 청력손실과 심혈관질환의 병인은 공통으로 염증반응을 포함한다. 몇몇 연구에서 청력손실 환자의 염증성 바이오마커 수치가 증가했음을 연구하였으나 유의하지 않은 결과를 제시하였다. 따라서 본 단면연구 및 종단연구에서는 청력손실이 심혈관질환과 어떠한 관련성이 있는지 알아보기 위해 청력손실과 염증성 바이오마커인 고감도 C-반응단백의 연관성을 연구하였다.
방법
2012년부터 2018년까지 우리 기관에서 건강검진을 받은 18세 이상의 근로자를 대상으로 단면연구를 수행하였다 (n=566,507). 이후 2012년부터 2018년까지 우리 기관에서 건강검진을 2회 이상 받은 18세 이상의 근로자를 대상으로 종단연구를 수행하였다 (n=173,794). 청력손실은 3분법에 의한 순음청력역치가 양측 모두 20 dB 이상인 경우로 정의하였다. 추적관찰 동안 고감도 C-반응단백의 증가는 혈중 농도 3 mg/L 초과인 경우로 정의하였다. 청력손실 발생에 따른 고감도 C-반응단백 증가의 위험을 분석하기 위해 로지스틱 회귀분석과 일반화 추정방정식을 활용하였다. 또한 연령에 따라 계층화하여 추가적인 분석을 하였다.
결과
단면연구에서 최종참가자 204,091명 중 난청 유병률은 0.02% 이었다. 다변량 보정 교차비는 1.17 (95% 신뢰구간 1.02-1.34) 이었다. 40세 이하와 초과인 군에서는 각각 0.99 (0.80-1.22) 와 1.28 (1.08-1.53) 이었다. 종단연구에서 추적관찰 동안 고감도 C-반응단백 수치는 청력손실군 2,349 명 중 272 명, 비청력손실군 116,301명 중 11,049 명에서 증가하였다. 다변수 보정 교차비는 1.05 (95% 신뢰구간 0.92-1.19) 이었다. 40세 이하와 초과인 군에서는 각각 1.10 (0.90-1.35) 과 1.20 (1.01-1.43) 이었다.
결론
본 단면연구 및 종단연구에서는 40세 초과하는 근로자에서 청력손실과 고감도 C-반응단백의 증가에 유의한 연관성이 있음을 확인하였다.

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Retraction

Retraction Notice to: A pilot study to assess a risk of a high-risk group of low back pain membership in workers who perform the manual material handling tasks (Ann Occup Environ Med 2021;33:e34): Ann Occup Environ Med 2023;35:e37. Published online August 29, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e37

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Original Article

Risk of insomnia symptoms according to Work-Family Conflict by workers’ characteristics: Kwanghyun Seo, Seungjun Ryu, Saebomi Jeong, Hee-Tae Kang, Sung-Kyung Kim, Sang-Baek Koh, Kyoung Sook Jeong, Sung-Soo Oh; Ann Occup Environ Med 2023;35:e36. Published online August 23, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e36

Abstract Abstract in Korean PDF

Background

Work-Family Conflict means that the demands of work and family roles cannot be met simultaneously, so one cannot concentrate on one’s work or family role. This conflict can negatively affect mental health and cause insomnia symptoms.

Methods

This study was conducted on 20,442 subjects. Insomnia symptoms were assessed using the Minimal Insomnia Symptom Scale, and other variables were assessed using the questionnaire method. Logistic regression analyses were performed to evaluate the effect of Work-Family Conflict on insomnia symptoms, and subgroup logistic regression analyses were also performed.

Results

The number of people with insomnia symptoms was 4,322 (15.1%). Compared with Low Work-Family Conflict, the odds ratios (ORs) for the risk of insomnia symptoms were 1.84 (95% confidence interval: 1.56–2.16) in High work-to-family conflict, 1.16 (1.02–1.32) in High family-to-work conflict, and 3.19 (2.87–3.55) in High Work-Family Conflict. The ORs were higher for men than women in High WFC but higher for women than men in High Work-Family Conflict.

Conclusions

The risk of insomnia symptoms was highest in High Work-Family Conflict.

근로자 특성별 일-가정 갈등에 따른 불면증 증상의 발생 위험
목적
일-가정 갈등이 근로자의 불면증 증상 발생에 미치는 영향을 확인하고자 한다.
방법
이 연구는 20,442명의 피험자를 대상으로 수행되었다. 불면증 증상은 Minimal Insomnia Symptom Scale을 사용하여 평가하였고, 기타 변수는 설문지 방법을 사용하여 수집하였다. 일-가정 갈등이 불면증 증상 발생에 미치는 영향을 알아보기 위해 로지스틱 회귀 분석을 수행하였으며, 하위그룹 로지스틱 회귀 분석 또한 수행하였다.
결과
불면증이 있는 사람은 4,322명(15.1%)이었다. 전체 일-가정 갈등이 낮은 근로자와 비교했을 때, 불면증 증상 발생에 대한 오즈비는 WFC가 높은 근로자에서 1.84(95% 신뢰 구간 1.56-2.16), FWC가 높은 근로자에서 1.16(95% CI 1.02-1.32), 전체 일-가정 갈등이 높은 근로자에서 3.19(95% CI 2.87-3.55)이었다. 남성과 여성을 나누어 분석했을 때, WFC가 높은 근로자에서는 남성이 여성보다 오즈비가 높았으나 전체 일-가정 갈등이 높은 근로자에서는 여성이 남성보다 오즈비가 높았다.
결론
전체 일-가정 갈등이 높은 근로자에서 불면증 증상의 발생 위험이 가장 컸다.

Citations

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Longitudinal trajectories and risk factors of insomnia symptoms among Chinese bus drivers
Jingbo Zhao, Huatao Yang, Qiling Fan, Zijie Ma, Yang Yang, Zicong Guan, Guoxi He
Frontiers in Public Health.2026;[Epub] CrossRef
Benefits and Drawbacks of 12-hour Shifts in Steel Manufacturing: a Comprehensive Qualitative Investigation of Workers, Managers, and Family Perspectives
Alireza Choobineh, Mahnaz Shakerian, Majid Faraji, Hossein Modaresifar, Javad Kiani, Mehdi Hatami, Reza Tahmasebi
Occupational Health Science.2025; 9(4): 1075. CrossRef
Female workers with long working hours are more likely to have depressive symptoms when having family-to-work conflict
Garin Lee, Ji-Hwan Kim, Seung-Sup Kim
International Archives of Occupational and Environmental Health.2024; 97(2): 199. CrossRef
Association between long working hours and engagement in preventive healthcare services in Korean workers: Findings from the Korean National Health and Nutrition Examination Survey
Seong-Uk Baek, Yu-Min Lee, Jin-Ha Yoon
Preventive Medicine.2024; 180: 107849. CrossRef
Difficulty Falling Asleep, Nocturnal Awakening, Sleep Dissatisfaction, and Irritability in the General Population
Tetsuya Akaishi
The Tohoku Journal of Experimental Medicine.2024; 263(4): 261. CrossRef
Association between single-person household wage workers in South Korea and insomnia symptoms: the 6th Korean Working Conditions Survey (KWCS)
Yoon Ho Lee, Yong-Jin Lee, Eun-Chul Jang, Young-Sun Min, Soon-Chan Kwon
Ann Occup Environ Med.2024; 36: e25. CrossRef

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Original Article

Comparing Korea Occupational Safety & Health Agency and National Health Insurance Service’s cardio-cerebrovascular diseases risk-assessment tools using data from one hospital’s health checkups: Yunrae Cho, Dong Geon Kim, Byung-Chan Park, Seonhee Yang, Sang Kyu Kim; Ann Occup Environ Med 2023;35:e35. Published online August 21, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e35

Abstract Abstract in Korean PDF

Background

Cardio-cerebrovascular diseases (CVDs) are the most common cause of death worldwide. Various CVD risk assessment tools have been developed. In South Korea, the Korea Occupational Safety & Health Agency (KOSHA) and the National Health Insurance Service (NHIS) have provided CVD risk assessments with health checkups. Since 2018, the KOSHA guide has stated that NHIS CVD risk assessment tool could be used as an alternative of KOSHA assessment tool for evaluating CVD risk of workers. The objective of this study was to determine the correlation and agreement between the KOSHA and the NHIS CVD risk assessment tools.

Methods

Subjects of this study were 17,485 examinees aged 20 to 64 years who had undergone medical examinations from January 2021 to December 2021 at a general hospital. We classified subjects into low-risk, moderate-risk, high-risk, and highest-risk groups according to KOSHA and NHIS’s CVD risk assessment tools. We then compared them with cross-analysis, Spearman correlation analysis, and linearly weighted kappa coefficient.

Results

The correlation between KOSHA and NHIS tools was statistically significant (p-value < 0.001), with a correlation coefficient of 0.403 and a kappa coefficient of 0.203. When we compared risk group distribution using KOSHA and NHIS tools, CVD risk of 6,498 (37.1%) participants showed a concordance. Compared to the NHIS tool, the KOSHA tool classified 9,908 (56.7%) participants into a lower risk category and 1,079 (6.2%) participants into a higher risk category.

Conclusions

In this study, KOSHA and NHIS tools showed a moderate correlation with a fair agreement. The NHIS tool showed a tendency to classify participants to higher CVD risk group than the KOSHA tool. To prevent CVD more effectively, a higher estimation tool among verified CVD risk assessment methods should be selected and managements such as early intervention and treatment of risk factors should be performed targeting the high-risk group.

일개 병원 건강검진 자료를 이용한 한국산업안전보건공단과 건강보험공단의 심뇌혈관질환 위험도 평가의 비교
목적
심뇌혈관질환은 전 세계적으로 가장 많은 사망원인으로, 국내외에서 다양한 위험도 예측모형이 개발되었다. 국내에서는 한국산업안전보건공단의 뇌심혈관계질환 발병위험도 평가와 건강보험공단의 심뇌혈관질환 위험 평가가 있으며, 국가건강검진과 함께 제공되고 있다. 한국산업안전보건공단은 2018년부터 건강보험공단의 심뇌혈관질환 위험 평가의 결과를 평가에 이용할 수 있도록 하고 있어, 두가지 위험도 평가도구를 비교하고 그 상관관계와 일치도를 확인하고자 하였다.
방법
이 연구는 경주의 일개 종합병원에서 2021년 1월부터 12월까지 건강검진을 시행한 17,485명의 수검자를 대상으로 하였다. 건강검진 결과를 이용하여 한국산업안전보건공단와 건강보험공단의 지침에 따라 위험도 평가를 실시하였으며, 저위험군, 중등도위험군, 고위험군, 최고위험군으로 분류하였다. 이후 각각의 위험도 평가에 따른 위험군에 대하여 교차분석 및 스피어만 상관분석, 그리고 선형가중카파를 이용한 일치도 분석을 실시하였다.
결과
한국산업안전보건공단과 건강보험공단의 위험도 평가도구의 상관관계와 일치도는 통계적으로 유의하게 나타났고(p-value < 0.001), 상관계수는 0.403, 카파계수는 0.203으로 나타났다. 두가지 도구의 위험군 분포를 비교하였을 때, 6,498명(37.2%)는 동일한 위험군으로 평가되었다. 건강보험공단의 도구에서 더 높은 위험군으로 평가한 경우는 9,908명(56.7%), 한국산업안전보건공단의 도구에서 더 높은 위험군으로 평가한 경우는 1,079명(6.2%)로 나타났다.
결론
이 연구에서 한국산업안전보건공단과 건강보험공단의 위험도 평가도구는 중간정도의 상관관계와 어느정도의 일치도를 보였다. 두가지 도구 중 한가지만 사용할 경우에는 도구와 수검자의 특성에 따른 신중한 선택이 필요하다. 두가지 도구 중 건강보험공단의 도구가 더 높은 위험군으로 평가하는 경향을 보였다. 검증된 두가지 도구 중 더 높은 위험군으로 평가하는 쪽을 선택함으로써 위험요인을 조기에 발견하고 관리한다면 심뇌혈관질환의 효과적인 예방에 도움이 될 것이다.

Citations

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Association Between Food Insecurity and Poor Cardiovascular Health Assessed by the Life’s Essential 8 Metric: A Population-Based Study of Korean Adults
Seong-Uk Baek, Jin-Ha Yoon
Nutrients.2025; 17(13): 2148. CrossRef

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Case Report

A case of syncope in a villager with hypertrophic cardiomyopathy after hydrogen sulfide exposure by an unauthorized discharge of wastewater: Hyeonjun Kim, Seunghyeon Cho, Inho Jung, Sunjin Jung, Won-Ju Park; Ann Occup Environ Med 2023;35:e34. Published online August 21, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e34

Abstract Abstract in Korean PDF

Background

Hydrogen sulfide is a toxic substance that humans can be exposed to occupationally, and cases of hydrogen sulfide poisoning of workers in industrial sites are commonly reported. However, there have been no cases of poisoning of the public due to an unauthorized discharge of wastewater, so it is important to describe this incident.

Case presentation

In a small village in Jeollanam-do, Republic of Korea, accounts of a terrible stench had been reported. A 26-year-old man who lived and worked in a foul-smelling area was taken to the emergency room with a headache, dizziness, nausea, and repeated syncope. A subsequent police and Ministry of Environment investigation determined that the cause of the stench was the unauthorized discharge of 9 tons of wastewater containing hydrogen sulfide through a stormwater pipe while the villagers were sleeping. The patient had no previous medical history or experience of symptoms. Leukocytes and cardiac markers were elevated, an electrocardiogram indicated biatrial enlargement, left ventricular hypertrophy, and corrected QT interval prolongation. Myocardial hypertrophy was detected on a chest computed tomography scan, and hypertrophic cardiomyopathy was confirmed on echocardiography. After hospitalization, cardiac marker concentrations declined, symptoms improved, and the patient was discharged after 7 days of hospitalization. There was no recurrence of symptoms after discharge.

Conclusions

We suspect that previously unrecognized heart disease manifested or was aggravated in this patient due to exposure to hydrogen sulfide. Attention should be paid to the possibility of unauthorized discharge of hydrogen sulfide, etc., in occasional local incidents and damage to public health. In the event of such an accident, it is necessary to have government guidelines in place to investigate health impact and follow-up clinical management of exposed residents.

무단 방류된 황화수소 노출에 의해 비후성심근증이 악화되어 실신한 마을 주민 사례
배경
황화수소 중독은 산업현장, 하수처리시설 또는 관리되지 않는 화장실 등에서 흔하게 보고된다. 다만 폐수 무단 방류로 인해 일반 주민에게 건강 영향이 발생한 사례는 보고된 바 없어 이를 보고한다.
증례
전라남도 한 지역에서 새벽부터 심한 악취가 난다는 주민 신고가 다수 발생하였다. 경찰과 환경청의 조사 결과 악취의 원인은 새벽에 주민들이 잠든 사이 폐수처리업체에서 황화수소가 포함된 폐수 9톤을 우수관을 통해 무단으로 방류한 것으로 밝혀졌다. 심한 악취가 나는 지역에서 장시간 활동했던 26살 남성이 두통, 어지럼증, 메스꺼움과 짧은 실신을 반복하여 119를 통해 응급실로 내원하였다. 환자는 과거에 특별한 병력이나 증상 경험은 없었다. 검사상 환자의 백혈구와 심장 표지자 수치가 상승되어 있었다. 심전도에서 양측 심방 확장, 좌심실 비대 및 QTc 연장이 관찰되었다. 흉부 컴퓨터 단층 촬영 상 심근비대 소견과 심장 초음파 검사 상 비후성심근증이 확인되었다. 입원하여 대증치료 후 심장 표지자 수치는 감소하였고, 증상은 호전되어 입원 7일 만에 퇴원하였다. 퇴원 이후 추적관찰 동안 특별한 증상은 재발하지 않았다.
결과
본 사례는 환자가 이전에 인지하지 못하고 증상도 없었던 비후성심근증이 황화수소 노출로 인해 급성 악화된 것으로 판단된다. 종종 발생하는 지역의 악취 사건에 황화수소가 무단 방류되었을 가능성을 고려해야 할 것이며, 향후 이러한 화학사고 발생 시 화학물질관리법에 따른 주민 건강영향조사를 실시하여 주민 건강을 관리해야 할 것이다.

Citations

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Assessment of the Impact of Blasting Operations on the Intensity of Gas Emission from Rock Masses: A Case Study of Hydrogen Sulfide Occurrence in a Polish Copper Ore Mine
Aleksandra Banasiewicz, Michalina Kotyla, Sebastian Gola
Applied Sciences.2025; 15(23): 12781. CrossRef

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Original Article

Occupational stress changes and new-onset depression among male Korean manufacturing workers: Jiho Kim, Hwan-Cheol Kim, Minsun Kim, Seong-Cheol Yang, Shin-Goo Park, Jong-Han Leem, Dong-Wook Lee; Ann Occup Environ Med 2023;35:e33. Published online August 17, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e33

Abstract Abstract in Korean PDF

Background

Studies on the association between occupational stress and depression have been frequently reported. However, the cross-sectional designs of studies limited insight into causal associations. In this study, we investigated the longitudinal association between occupational stress and new-onset depression among employees in a single manufacturing plant.

Methods

The annual health checkup data of employees at a manufacturing plant in Korea were collected. A total of 1,837 male employees without depression who completed a health checkup during two consecutive years were included. Occupational stress was measured using a short form of the Korea Occupational Stress Scale (KOSS-SF), and depression was assessed using a Patient Health Questionnaire-2. The association between occupational stress change over the two years and newly developed depression was investigated using two logistic regression models.

Results

Across all sub-factors of KOSS-SF, employees who reported increased occupational stress had a higher risk of new-onset depression. Newly developed depression was significantly associated with job demand (odds ratio [OR]: 4.34; 95% confidence interval [CI]: 2.37–7.96), job insecurity (OR: 3.21; 95% CI: 1.89–5.48), occupational climate (OR: 3.18; 95% CI: 1.91–5.31), lack of reward (OR: 2.28; 95% CI: 1.26–4.12), interpersonal conflict (OR: 2.14; 95% CI: 1.18–3.86), insufficient job control (OR: 1.93; 95% CI: 1.05–3.56), and the organizational system (OR: 1.84; 95% CI: 1.01–3.36).

Conclusions

For every sub-factor of the KOSS-SF, occupational stress increase and persistent high stress were associated with the risk of developing new-onset depression. Among the seven sub-factors, job demand had the most significant effect. Our results show that occupational stress should be managed to promote employee mental healthcare.

한국 남성 제조업 근로자의 직무 스트레스 변화와 우울증 발생의 관계
목적
직무 스트레스와 우울증의 연관성에 대한 연구는 지속적으로 보고되고 있다. 그러나 국내 연구는 부족한 실정이며 주로 단면적 분석 설계에 국한되고 있다. 이 연구에서 우리는 단일 제조업 공장의 근로자들에서 직무 스트레스와 새롭게 발병하는 우울증 사이의 종단적 연관성을 조사하였다.
방법
국내 한 제조업 공장 근로자들의 연간 건강검진 자료를 수집하였다. 2년 연속 건강검진을 완료한 이들 중 우울증이 없는 남성은 총 1837명이었다. 직무 스트레스는 Korea Occupational Stress Scale KOSS Short Form (KOSS-SF)으로 측정하였고, 우울증은 Patient Health Questionnaire-2(PHQ-2)로 평가하였다. 1년 간의 직무 스트레스 변화와 새로 발생한 우울증과의 연관성을 로지스틱 회귀 모델을 사용하여 분석했다.
결과
KOSS-SF의 모든 하위 영역에서 직무 스트레스가 증가했다고 보고한 근로자는 새로운 우울증 발병 위험이 더 높았다. 새로 발생한 우울증의 위험은 각각 직무 요구[교차비(OR)=4.34, 95% 신뢰 구간(CI)= 2.37–7.96], 직무 불안정(OR=3.21, 95%CI=1.89–5.48), 직장문화(OR=3.18, 95%CI=1.91–5.31), 보상 부적절(OR=2.28, 95%CI=1.26–4.12), 관계 갈등(OR=2.14, 95%CI=1.18–3.86), 직무 자율성 결여(OR=1.93, 95%CI=1.05–3.56) 및 조직체계(OR=1.84, 95%CI=1.01–3.36) 순이었다.
결론
KOSS-SF의 모든 하위 영역에서 직무 스트레스 증가와 높은 스트레스 상태의 지속은 새로운 우울증 발병 위험과 관련이 있었다. 7가지 하위 영역 중 직무 요구가 가장 큰 영향을 미쳤다. 우리의 결과는 근로자 정신 건강을 증진하기 위해 직무 스트레스를 관리해야 함을 시사한다

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Dahuan Cai, Yanxin Zeng, Fengqiong Chen, Xiaohua Wu, Xiaobin Xian, Min Chen, Mengliang Ye
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WORK: A Journal of Prevention, Assessment & Rehabilitation.2025; 82(4): 1008. CrossRef

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Original Article

The relationship between fatigue and sickness absence from work: Minsun Kim, Jiho Kim, SeongCheol Yang, Dong-Wook Lee, Shin-Goo Park, Jong-Han Leem, Hwan-Cheol Kim; Ann Occup Environ Med 2023;35:e32. Published online August 10, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e32

Abstract Abstract in Korean PDF

Background

Although many studies have been conducted on worker fatigue and sickness absence, the association between fatigue and sickness absence is unclear in Korean workers. This study was conducted to investigate the effect of worker fatigue on future sickness absence.

Methods

The study was conducted on workers who received medical check-ups at a university hospital for two consecutive years (2014–2015). During check-ups in the first year, the Fatigue Severity Scale (FSS) was used to assess fatigue levels, and during check-ups in the second year, sickness absence was surveyed to determine whether they had been absent from work due to physical or mental illness during previous 12 months. The χ² test was used to analyze relationships between sociodemographic and occupational characteristics, fatigue levels, and sickness absence. Odds ratios (ORs) were calculated by logistic regression analysis controlled for confounding factors.

Results

A total of 12,250 workers were included in the study, and 396 (3.2%) workers experienced more than one day of sickness absence during the study period. Adjusted ORs for sickness absence were 3.35 (95% confidence interval [CI]: 2.64–4.28) in the moderate-fatigue group and 6.87 (95% CI: 4.93–9.57) in the high-fatigue group versus the low-fatigue group. For men in the moderate- and high-fatigue groups, adjusted ORs for sickness absence were 3.40 (95% CI: 2.58–4.48) and 8.94 (95% CI: 6.12–13.07), and for women in the moderate- and high-fatigue groups, adjusted ORs for sickness absence were 2.93 (95% CI: 1.68–5.10) and 3.71 (95% CI: 1.84–7.49), respectively.

Conclusions

Worker fatigue is associated with sickness absence during the following 12 months, and this association appears to be stronger for men than women. These results support the notion that sickness absence can be reduced by evaluating and managing work-related fatigue.

근로자의 피로와 질병 결근의 연관성
목적
근로자의 피로와 질병 결근에 관한 많은 연구가 이루어졌으나, 한국 근로자의 피로와 질병 결근의 연관성은 불분명하다. 본 연구는 근로자의 피로가 미래의 질병 결근에 미치는 영향을 조사하기 위해 수행되었다.
방법
본 연구는 2년 연속(2014년-2015년) 대학병원에서 건강검진을 받은 근로자들을 대상으로 실시되었다. 첫번째 2014년 건강검진에서는 피로 심각도 척도를 이용하여 피로도를 평가했고, 다음해인 2015년 건강검진에서는 같은 근로자를 대상으로 지난 12개월 간 신체적 질환 또는 정신적 질환으로 인한 결근한 적이 있는지를 조사했다. χ2 분석으로 사회인구학적 특성과 직업적 특성, 피로도와 질병 결근의 연관성을 분석하였다. 오즈비는 교란 요인들을 통제 후 로지스틱 회귀 분석을 통해 측정되었다.
결과
연구 대상에는 총 12,250명의 근로자가 포함되었으며, 12개월 동안 396명(3.2%)의 근로자가 하루 이상의 질병 결근을 하였다. 질병 결근에 대한 조정된 오즈비는 낮은 피로 그룹에 비해 중간 피로 그룹에서 3.35 (95% CI: 2.64-4.28), 고 피로 그룹에서 6.87 (95% CI: 4.93-9.57)였다. 남성의 질병 결근에 대한 조정된 오즈비는 중간 피로 그룹에서 3.40 (95% CI: 2.58-4.48), 고 피로 그룹에서 8.94 (95% CI: 6.12-13.07)였으며, 여성의 질병 결근에 대한 조정된 오즈비는 중간 피로 그룹에서 2.93 (95% CI: 1.68-5.10), 고 피로 그룹에서 3.71 (95% CI: 1.84-7.49)이었다.
결론
근로자의 피로는 이후 12개월 동안의 질병 결근과 관련이 있으며, 이 연관성은 여성보다 남성에게 더 강한 것으로 보인다. 이러한 결과는 업무 관련 피로를 평가하고 관리함으로써 질병 결근을 줄일 수 있다는 개념을 뒷받침한다.

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Original Article

Particulate matter concentration effects on attention to environmental issues: a cross-sectional study among residents in Korea’s Pohang Industrial Complex: Hye-seung Ryu, Jea Chul Ha, Insung Chung, Seonhee Yang, Hyunjoo Kim, Sung-Deuk Choi; Ann Occup Environ Med 2023;35:e31. Published online August 10, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e31

Abstract Abstract in Korean PDF Supplementary Material

Background

With modernization, air pollution has become increasingly serious, and its effects on health have been revealed. As a result, public interest in environmental pollution has become critical for regulating air pollution. In our study, we aim to evaluate the impact of air pollution levels on public attention to environmental issues and examine whether awareness of the residential environment’s impact on health acts as a mediator in this relationship.

Methods

We conducted an analysis on 400 individuals surveyed in the preliminary feasibility study on adverse health effects in the Pohang Industrial Complex, to examine the relationship between particulate matter 2.5 (PM2.5) and attention to environmental issues. Logistic regression analysis was performed, and mediation analysis was used to determine whether awareness of the residential environment’s impact on health mediated the relationship.

Results

The logistic regression analysis results showed that PM2.5 levels were associated with attention to environmental issues (adjusted odds ratio [AOR]: 2.1; 95% confidence interval [CI]: 1.3–3.5; p = 0.003) and awareness of health impacts (AOR: 3.4; 95% CI: 1.6–7.1; p = 0.001). The PM2.5 levels showed 9.9% (95% CI: 5.4–14.0) increase in the prevalence of high attention to environmental issues, of which, only 1.0% (95% CI: 0.2–2.3) were mediated by health impact awareness. In the overall analysis, 10% of the total effect of PM2.5 on attention to environmental issues was mediated by health impact awareness.

Conclusions

According to this study’s results, there was a correlation between air pollution levels and attention to environmental issues. Awareness of the health impacts of air pollution partially mediated the effect of air pollution levels on attention to environmental issues. In future studies, it is recommended to identify other mediators to further understand this structure.

미세먼지(Particular matter)농도가 환경문제에 대한 관심에 미치는 영향 : 포항시 거주민을 대상으로 한 단면연구
목적
근현대화가 진행되어오면서 대기오염은 심각해지고 대기오염에 의한 건강영향이 밝혀지면서 대기오염을 규제하기위해 환경오염에 대한 대중의 관심도가 중요해졌다. 이번 연구에서는 대기오염 수치가 환경오염에 대한 관심도에 미치는 영향을 평가하고 그 구조로써 건강영향에 대한 인식이 매개체로써 작용하는지 탐구하고자 하였다.
방법
포항 산업단지 건강피해 예비타당성 위해소통 설문조사에서 파악된 400명에 대하여 분석을 시행하였다. PM2.5와 환경오염에 대한 관심의 관계에 대해서 보기위해 로지스틱 회귀분석을 시행하였고, 그 구조를 파악하기 위해 매개분석을 사용하여 건강영향에 대한 인식이 매개체로써 작용하는지 확인하였다.
결과
로지스틱 분석 결과 PM2.5 수치는 환경에 대한 관심과 관련이 있었고([AOR]: 2.1, 95% CI: 1.3, 3.5, P = 0.003), 건강영향에 대한 인식도와도 관련이 있었다(AOR: 3.4, 95% CI: 1.6, 7.1, P = 0.001). PM2.5수치는 전체 환경에 대한 관심도에 비교위험(%)이 9.9 (95 % CI: 5.4, 14.0)인데 전체에서 1.0 (95 % CI: 0.2, 2.3) 만이 건강영향 인식도에 의해 매개되는 비교위험이다. 전체 분석 결과에서 PM2.5가 환경에 대한 관심에 미치는 전체 영향의 10%가 건강영향 인식에 매개되었다.
결론
연구결과에 따르면 대기오염 수준은 환경오염에 대한 관심도와 관련이 있었다. 건강영향에 대한 인식은 대기오염수준이 환경오염에 대한 관심도에 미치는 영향의 일부를 매개하였다.

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Original Article

Associations of chronotype and insomnia with menstrual problems in newly employed nurses at university hospitals in the Republic of Korea: Han-Na Jung, Dongwhan Suh, Woo Chul Jeong, Jia Ryu, Yu-Mi Kim, Seohyun Yoon, Hyunjoo Kim; Ann Occup Environ Med 2023;35:e30. Published online August 4, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e30

Abstract Abstract in Korean PDF

Background

Dysmenorrhea and menstrual cycle changes occur in women working shifts. Circadian rhythm disruption and sleep disturbances associated with shift work leads to health problems. We identified chronotypes and the occurrence of insomnia among newly employed university hospital nurses and investigated the association of these factors with menstrual problems.

Methods

We conducted pre-placement health examinations for shift workers using self-reported questionnaires between 2018 and 2020. A total of 463 nurses were included in the study. Sociodemographic data, shift work experience, and information on insomnia were collected from health examination data. In addition, details regarding chronotype, dysmenorrhea, irregular and abnormal menstrual cycles, amenorrhea, and contraceptive use were obtained from the questionnaire. Multiple logistic regression analysis was performed to study the association between chronotype, insomnia, and menstrual problems after controlling for age, body mass index, contraceptive use, amenorrhea, and prior shift work.

Results

The prevalence rates of dysmenorrhea, irregular menstrual cycles, and longer menstrual cycles were 23.8%, 14.9%, and 4.1%, respectively. The risk of dysmenorrhea increased in the evening-type (odds ratio [OR]: 3.209; 95% confidence interval [CI]: 1.685–6.113) and those with insomnia (OR: 1.871; 95% CI: 1.074–3.261). Additionally, the risk of an irregular menstrual cycle (OR: 2.698; 95% CI: 1.167–6.237) increased in the evening-type, and the risk of a longer menstrual cycle (OR: 4.008; 95% CI: 1.354–11.864) increased in individuals with insomnia.

Conclusions

Our findings suggest that dysmenorrhea is promoted in the evening-type and insomnia individuals. There may be an increased risk of irregular menstrual cycles among evening-type nurses and an increased risk of longer menstrual cycles among those with insomnia. Therefore, factors such as evening-type and insomnia should be considered for the prevention of menstrual problems in women performing shift work.

대학병원 신입 간호사에서 수면 관련 요인과 월경 건강과의 연관성
목적
이 연구는 간호사의 건강증진을 위한 효과적인 전략을 개발하는 데 있어 근거자료를 제공하는 것을 목적으로 하며, 구체적으로 일주기리듬 유형(크로노 타입) 및 불면 증상과 월경 건강 관련 문제들과의 연관성을 파악하였다.
방법
연구 대상자는 야간작업에 대한 배치 전 건강진단을 받은 두 개 대학병원에서 근무 중인 463명의 신규 간호사이다. 배치 전 건강진단 자료에서 연령, 체질량지수, 흡연, 음주, 운동 정도, 이전 교대 근무 경험 여부, 불면 증상에 대한 정보를 확보하였다. 일주기 리듬 유형, 피임방법 사용 여부, 무월경 경험, 월경통 및 월경주기의 규칙성과 간격에 대한 정보는 설문조사로 확인하였다. 연령, 체질량지수, 피임방법 사용 여부, 무월경 경험, 교대 근무 경험을 통제하여 일주기리듬 유형 및 불면 증상의 월경 건강 관련 문제들에 대한 위험비를 산출하기 위해 다중 로지스틱 회귀 분석을 수행하였다.
결과
월경곤란증, 불규칙한 월경주기, 긴 월경주기의 유병률은 각각 23.8%, 14.9%, 4.1%였다. 월경통에서 저녁형 일주기리듬 유형의 오즈비가 저녁형 외 일주기리듬 유형 그룹에 비해 3.209배(95% C.I. 1.685-6.113) 높았고, 불면 증상이 있다면 1.871배 (95% C.I. 1.074-3.261) 높았다. 또한 저녁형 일주기 리듬은 월경주기 간격이 불규칙한 경우에(오즈비 2.698 95% C.I. 1.167-6.237), 불면 증상이 있다면 40일 이상의 긴 월경 주기에(오즈비 4.008 95% C.I. 1.354-11.864) 각각 통계적으로 유의한 영향을 미치는 것을 확인하였다.
결론
우리 연구 결과로 저녁형 일주기리듬 유형 간호사에서 월경통과 불규칙 월경 이상이 관찰될 확률이 더 높고, 불면 증상이 있는 집단에서 월경통과 긴 월경주기가 증가할 가능성을 유추할 수 있다. 저녁형 일주기리듬과 불면 증상 같은 요인들은 여성 근로자의 월경 건강에 악영향을 미치는 경로를 연구하는 데 있어 고려해야 할 것들 중 하나가 될 수 있다.

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Original Article

Association between lone work and self-rated health status: using the 5th Korean Working Conditions Survey: Eunseun Han, Ui-Jin Kim, Yongho Lee, Sanghyuk Lee, Seunghon Ham, Wanhyung Lee, Won-Jun Choi, Seong-Kyu Kang; Ann Occup Environ Med 2023;35:e29. Published online July 31, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e29

Abstract PDF Supplementary Material

Background

Lone workers are generally defined as individuals who work alone without supervision, including self-employed people. While lone workers are considered a vulnerable group in some countries, there is a lack of research on their health status in domestic studies. Globally, the number of lone workers has been increasing, and this trend has been further accelerated since the coronavirus disease 2019 (COVID-19) pandemic with the rise of remote work.

Methods

The study analyzed data from 44,281 participants, excluding unpaid family workers, soldiers, and those with missing data. Lone workers were defined as individuals who reported having no colleagues with the same job at their current workplace. Self-rated health status was categorized as “good” or “poor.”

Results

This study found a statistically significant higher number of lone workers among women compare to men. The largest occupational category for lone workers was service and sales workers, followed by agriculture and fisheries workers. A majority of non-lone workers reported working 40 hours or less per week, while the majority of lone workers reported working 53 hours or more per week. In addition, lone workers had significantly poorer health status evaluations compared to non-lone workers (odds ratio: 1.297; 95% confidence interval: 1.165–1.444).

Conclusions

Further research is needed to investigate the causal relationship between lone work and health, using data collected after the COVID-19 pandemic.

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Original Article

Combined effect of work from home and work during nonwork time on sleep disturbance: Jiyoung Lim, Hyundong Lee, Jae Bum Park, Kyung-Jong Lee, Inchul Jeong, Jaehyuk Jung; Ann Occup Environ Med 2023;35:e28. Published online July 31, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e28

Abstract PDF Supplementary Material

Background

Owing to the coronavirus disease 2019 pandemic, being exposed to work from home and work during nonwork time simultaneously can lead to sleep disturbance; however, their combined effect is unclear. We aimed to investigate the combined effect of work from home and work during nonwork time on sleep disturbance.

Methods

This study used data from the Sixth Korean Working Condition Survey and included 27,473 paid workers. Logistic regression analysis was conducted to investigate the relationship between work from home, work during nonwork time, and sleep disturbance according to sex. We re-classified participants into 4 groups based on their working from home (No/Yes) and working during nonwork time (No/Yes). The relative excess risk due to interaction was calculated to examine the effect of exposure to both telecommuting and non-regular work hours on sleep disturbance.

Results

Workers exposed to work from home and work during nonwork time had significantly higher risks of sleep disturbance for all, men, and women workers (OR [95% CI]: 1.71 [1.46–2.02], 1.79 [1.43–2.23], and 1.64 [1.29–2.08] for work from home and 3.04 [2.70–3.42], 3.61 [3.09–4.22], and 2.41 [2.01–2.90] for work during nonwork time, respectively). Compared to those who were not exposed to both factors, when workers had both job factors, the ORs (95% CI) of sleep disturbance for all, men, and women were 3.93 (2.80–5.53), 5.08 (3.21–8.03), and 2.91 (1.74–4.87), respectively. The relative excess risk due to interaction of work from home and work during nonwork time was not significant for sleep disturbance.

Conclusions

Work from home and work during nonwork time were each associated with sleep disturbance, but the interaction between the two factors on sleep disturbance was not observed in both men and women.

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Original Article

Environment-wide association study of elevated liver enzymes: results from the Korean National Environmental Health Survey 2018–2022: Youngchan Chi, Jong-Tae Park, Sewhan Na, Kyeongmin Kwak; Ann Occup Environ Med 2023;35:e27. Published online July 31, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e27

Abstract PDF Supplementary Material

Background

Environmental exposure is characterized by low concentration, chronic, and complex exposure. Traditional epidemiological studies show limitations in reflecting these characteristics since they usually focus on a single or very limited number of exposure factors at a time. In this study, we adopted the methodology of environment-wide association study (EWAS) to figure out the association of human liver function with various environmentally hazardous substances.

Methods

We analyzed 2,961 participants from the Korean National Environmental Health Survey Cycle 4 (2018–2020). Using generalized linear model (GLM) analysis, we analyzed the association of 72 variables with 3 liver function indices (aspartate aminotransferase [AST], alanine aminotransferase [ALT], and gamma glutamyl transferase [GGT]). Finally, we visualized our results with Manhattan plot.

Results

In GLM analysis, perfluorooctanesulfonate were positively associated with ALT (odds ratio [OR]: 2.2; 95% confidence interval [CI]: 1.39–3.46; p _adjusted = 0.0147) and perfluorodecanoic acid showed positive association with GGT (OR: 2.73; 95% CI: 1.36–5.5; p _adjusted = 0.0256). Plasma mercury showed positive association with GGT (OR: 1.45; 95% CI: 1.14–1.84; p _adjusted = 0.0315). Using a plastic container while keeping food in the refrigerator was associated with elevated GGT compared to using a glass container (OR: 1.51; 95% CI: 1.16–1.95; p _adjusted = 0.0153). 2-ethyl-5-oxohexyl phthalate, showed a negative trend with all 3 indices, with AST (OR: 0.54; 95% CI: 0.39–0.73; p _adjusted = 0.00357), ALT (OR: 0.5; 95% CI: 0.34–0.75; p _adjusted = 0.036), GGT (OR: 0.55; 95% CI: 0.4–0.76; p _adjusted = 0.00697). Bisphenol S and frequent use of sunblock cream showed negative association with ALT (OR: 0.77; 95% CI: 0.66–0.89), and GGT (OR: 0.25; 95% CI: 0.11–0.55), respectively.

Conclusions

We conducted an exploratory study on environmental exposure and human liver function. By using EWAS methodology, we identified 7 factors that could have potential association with liver function.

Citations

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Hyuna Jang, Jiyun Lee, Vy Kim Nguyen, Hyeong-Moo Shin
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Seong-Uk Baek, Jin-Ha Yoon
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Metals exposure and biomarkers of liver damage: a systematic review and meta-analysis of observational studies
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Journal of Environmental Sciences.2025;[Epub] CrossRef

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Original Article

Incidence rates of injury, musculoskeletal, skin, pulmonary and chronic diseases among construction workers by classification of occupations in South Korea: a 1,027 subject-based cohort of the Korean Construction Worker’s Cohort (KCWC): Seungho Lee, Yoon-Ji Kim, Youngki Kim, Dongmug Kang, Seung Chan Kim, Se-Yeong Kim; Ann Occup Environ Med 2023;35:e26. Published online July 24, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e26

Abstract Abstract in Korean PDF Supplementary Material

Background

The objective of this study is to investigate the differences in incidence rates of targeted diseases by classification of occupations among construction workers in Korea.

Methods

In a subject-based cohort of the Korean Construction Worker’s Cohort, we surveyed a total of 1,027 construction workers. As occupational exposure, the classification of occupations was developed using two axes: construction business and job type. To analyze disease incidence, we linked survey data with National Health Insurance Service data. Eleven target disease categories with high prevalence or estimated work-relatedness among construction workers were evaluated in our study. The average incidence rates were calculated as cases per 1,000 person-years (PY).

Results

Injury, poisoning, and certain other consequences of external causes had the highest incidence rate of 344.08 per 1,000 PY, followed by disease of the musculoskeletal system and connective tissue for 208.64 and diseases of the skin and subcutaneous tissue for 197.87 in our cohort. We especially found that chronic obstructive pulmonary disease was more common in construction painters, civil engineering welders, and civil engineering frame mold carpenters, asthma in construction painters, landscape, and construction water proofers, interstitial lung diseases in construction water proofers.

Conclusions

This is the first study to systematically classify complex construction occupations in order to analyze occupational diseases in Korean construction workers. There were differences in disease incidences among construction workers based on the classification of occupations. It is necessary to develop customized occupational safety and health policies for high-risk occupations for each disease in the construction industry.

한국 건설업 종사자의 손상, 근골격계 질환, 피부, 호흡기 및 만성질환의 건설 직종에 따른 발생률: 한국 건설업 종사자 코호트(KCWC) 의 1027명 대상자 기반 세부 코호트 분석
목적
본 연구의 목적은 한국 건설업 종사자에 있어 주요 질환의 건설 직종별 발생률 차이를 알아보는 것이다.
방법
한국 건설업 종사자 코호트(KCWC)의 대상자 기반 세부 코호트로 총 1,027명의 건설업 종사자가 1:1면접설문조사를 통해 입적되었다. 직업적 노출요인으로 직종은 크게 건설산업환경과 직무 두 가지 축으로 분류되었다: 직업적 노출(설문조사) 자료와 국민건강보험공단 청구 맞춤형 자료를 연계하여 질환의 평균 발생률을 분석하였다. 주요 질환은 건설업 종사자에서 유병률이 높거나 업무 관련성이 있을 것으로 추정되는 11개의 대상 질환을 평가하였다. 질환별 평균 발생률은 1,000인년당 발병 사례수(명)으로 계산하였다.
결과
손상, 중독 및 외인에 의한 특정 기타 결과가 1,000인년당 344.08명으로 가장 높은 발생률을 보였고, 그 다음으로 근골격계 및 결체조직의 질환이 1,000인년당 208.64명, 피부 및 피하조직 질환이 1,000인녕당 197.87명 순으로 높았다. 특히, 만성 폐쇄성 폐질환이 건축 도장공, 토목 용접공, 토목 형틀목공에서 타 직종에 비해 상대적으로 높은 발생률을 보였고, 천식은 건축 도장공, 조경, 건축 방수공에서, 간질성 폐질환은 건축 방수공에서 상대적으로 높은 발생률을 보였다.
결론
본 연구는 한국 건설업 종사자의 주요 직업성 질환 및 호발 질환 등을 복잡한 건설산업의 직종을 체계적으로 분류하여 분석한 최초의 연구로 연구진들은 건설업 종사자의 질환별 발생률에 있어 직종별 차이를 확인하였다. 건설 산업에서 각 질환별 고위험 직종별로 맞춤형 산업안전보건정책 개발이 필요하다.

Citations

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Occupational disease monitoring by the Korea Occupational Disease Surveillance Center: a narrative review
Dong-Wook Lee, Inah Kim, Jungho Hwang, Sunhaeng Choi, Tae-Won Jang, Insung Chung, Hwan-Cheol Kim, Jaebum Park, Jungwon Kim, Kyoung Sook Jeong, Youngki Kim, Eun-Soo Lee, Yangwoo Kim, Inchul Jeong, Hyunjeong Oh, Hyeoncheol Oh, Jea Chul Ha, Jeehee Min, Chul
The Ewha Medical Journal.2025;[Epub] CrossRef
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Weiner Santos, Alejandro Lorente, Carmen Rojas, Rui Isidoro, Ana Dias, Gonzalo Mariscal, Ahmed Hamdy Zabady, Rafael Lorente
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Original Article

Association between discrimination in the workplace and insomnia symptoms: Suhwan Ju, Seong-Sik Cho, Jung Il Kim, Hoje Ryu, Hyunjun Kim; Ann Occup Environ Med 2023;35:e25. Published online July 23, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e25

Abstract Abstract in Korean PDF

Background

In Korea, little research has focused on the relationship between discrimination in the workplace and sleep health. Thus, this study aims to investigate the association between such discriminatory experiences and insomnia, a common sleep disorder, using Korean employees’ data.

Methods

This study used data from the 6th Korea Working Conditions Survey. Discrimination experiences due to age, ethnic background, nationality, race, sex, religion, disability, sexual orientation, educational level, hometown, and employment status were investigated. The Minimal Insomnia Symptom Scale estimated insomnia symptoms. The association between discrimination experience and insomnia symptoms were analyzed using survey-weighted logistic regression analysis.

Results

Based on experiences of discrimination over the past 12 months, insomnia symptoms were associated with discrimination experience due to religion (odds ratio [OR]: 3.70; 95% confidential interval [CI]: 1.58–8.69), sex (OR: 2.51; 95% CI: 1.87–3.37), age (OR: 2.30; 95% CI: 1.88–2.81), hometown (OR: 2.07; 95% CI: 1.44–2.97), employment status (OR: 1.69; 95% CI: 1.37–2.10), and educational level (OR: 1.67; 95% CI: 1.31–2.14). Furthermore, the prevalence of insomnia symptoms increased with the number of discrimination experiences.

Conclusions

In this study, discrimination experiences due to religion, sex, age, hometown, employment status, and educational level were significantly associated with insomnia symptoms. Furthermore, as the number of discrimination experiences increased, so did the prevalence of insomnia. Preventing workplace discrimination may improve workers’ sleep health.

직장에서의 차별 경험과 불면증 증상 간의 연관성
목적
한국에서 차별 경험과 수면 장애 간의 연관성에 대한 연구가 거의 없었다. 따라서, 이 연구의 목적은 직장에서의 차별 경험과 불면증 증상의 연관성을 조사하는 것이다.
방법
이 연구는 제6차 근로환경조사의 자료를 활용하였다. 나이, 출신민족, 국적, 인종, 성, 종교, 장애, 성적 지향성, 학벌, 출신 지역, 고용 형태 등 총 11개 종류의 차별에 대한 경험 유무를 조사하였다. 수면 장애는 minimal insomnia symptom scale (MISS)을 사용하여 불면증 증상의 유무를 조사하였다. 둘 사이의 연관성을 평가하기 위해 가중치를 이용한 로지스틱 회귀분석을 사용하였다.
결과
종교(odds ratio [OR], 3.70; 95% confidential interval [CI], 1.58–8.69), 성 (OR, 2.51 ; 95% CI, 1.87–3.37), 나이 (OR, 2.30 ; 95% CI, 1.88–2.81), 출신 지역 (OR, 2.07 ; 95% CI, 1.44–2.97), 고용 형태 (OR, 1.69 ; 95% CI, 1.37–2.10), 학벌 (OR, 1.67 ; 95% CI, 1.31–2.14)에 대한 차별 경험과 불면증 증상 간의 연관성이 확인되었다. 또한, 경험한 차별의 종류가 많을수록 불면증 증상의 유병률이 증가하는 경향이 확인되었다.
결론
이 연구에서 직장에서의 종교, 성별, 나이, 고향, 고용상태, 교육수준에 대한 차별 경험과 불면증 증상 간의 연관성이 확인되었다. 직장에서의 차별을 예방함으로써 근로자들의 수면 건강을 향상시킬 수 있을 것이다.

Citations

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Gender discrimination in the workplace and the onset of problematic alcohol use among female wage workers: A longitudinal study in Korea
Seong-Uk Baek, Jin-Ha Yoon, Jong-Uk Won
Social Science & Medicine.2025; 379: 118183. CrossRef
Joint Effects of Workplace and Everyday Discrimination on Sleep Disturbances: A 9-Year Prospective Cohort Study in U.S. Employees
Sunny Liu, Timothy A. Matthews, Megan Guardiano, Elizabeth Rose Mayeda, Jian Li
International Journal of Behavioral Medicine.2025;[Epub] CrossRef
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Original Article

Development of algorithm for work intensity evaluation using excess overwork index of construction workers with real-time heart rate measurement device: Jae-young Park, Jung Hwan Lee, Mo-Yeol Kang, Tae-Won Jang, Hyoung-Ryoul Kim, Se-Yeong Kim, Jongin Lee; Ann Occup Environ Med 2023;35:e24. Published online July 19, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e24

Abstract Abstract in Korean PDF Supplementary Material

Background

The construction workers are vulnerable to fatigue due to high physical workload. This study aimed to investigate the relationship between overwork and heart rate in construction workers and propose a scheme to prevent overwork in advance.

Methods

We measured the heart rates of construction workers at a construction site of a residential and commercial complex in Seoul from August to October 2021 and develop an index that monitors overwork in real-time. A total of 66 Korean workers participated in the study, wearing real-time heart rate monitoring equipment. The relative heart rate (RHR) was calculated using the minimum and maximum heart rates, and the maximum acceptable working time (MAWT) was estimated using RHR to calculate the workload. The overwork index (OI) was defined as the cumulative workload evaluated with the MAWT. An appropriate scenario line (PSL) was set as an index that can be compared to the OI to evaluate the degree of overwork in real-time. The excess overwork index (EOI) was evaluated in real-time during work performance using the difference between the OI and the PSL. The EOI value was used to perform receiver operating characteristic (ROC) curve analysis to find the optimal cut-off value for classification of overwork state.

Results

Of the 60 participants analyzed, 28 (46.7%) were classified as the overwork group based on their RHR. ROC curve analysis showed that the EOI was a good predictor of overwork, with an area under the curve of 0.824. The optimal cut-off values ranged from 21.8% to 24.0% depending on the method used to determine the cut-off point.

Conclusion

The EOI showed promising results as a predictive tool to assess overwork in real-time using heart rate monitoring and calculation through MAWT. Further research is needed to assess physical workload accurately and determine cut-off values across industries.

실시간 심박수 측정 장치를 이용한 건설업 근로자 과로 예측 알고리즘
목적
건설업 근로자는 육체적 업무강도가 높아 이에 따른 피로와 그에 따른 사고 및 건강 악영향 우려가 높다. 이 연구에서는 일개 사업장 건설업 근로자를 대상으로 과로와 심박수 사이의 관계를 탐색하고 실시간 심박수 모니터링을 이용하여 과로를 방지하는 방법을 제안하였다.
방법
서울의 일개 건설업 현장에서 근무하는 근로자를 대상으로 2021.08.-2021.10.까지 근무 중 심박수를 측정하였다. 총 66명의 한국인 근로자가 손목시계 형 장치를 이용하여 심박수 측정에 참여하였다. 안정시 심박수와 최대 심박수 추정치를 바탕으로 상대심박수(RHR)를 산출하였고, 이를 바탕으로 피로 없이 근무할 수 있는 최대시간(MAWT)를 계산하여 이를 바탕으로 업무 부담(workload)를 추정하였다. 이를 통해 산출한 누적 업무량으로 과로 지수(Overwork index)를 산출한 후 적정 업무 부담(PSL)과의 차이인 초과 과로 지수(Excess overwork index)를 정의하였다. EOI 값을 이용해 일평균 상대심박수 30%값을 기준으로 정의한 과로군-비과로군을 예측할 수 있는 최적 절단값을 ROC 분석을 통해 산출하였다.
결과
근로자 60명의 심박수 측정값을 분석한 결과 28(46.7%)가 일평균 상대심박수를 기준으로 과로군으로 분류되었다. ROC 분석 결과 EOI값이 과로를 예측하는데 유용함을 확인하였고 AUC값은 0.824였다. 최적 절단 값은 최적화 방법에 따라 21.8%에서 24.0%로 나타났다.
결론
실시간 심박수 모니터링과 MAWT를 이용해 산출한 EOI값은 과로를 예측하는데 유용한 지표임을 확인하였다. 단, 건설업을 비롯하여 다른 육체적 부담이 큰 업종에서 최적 절단값을 찾기 위해서는 추가 연구가 필요하다.

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Original Article

Association of heavy metal complex exposure and neurobehavioral function of children: Minkeun Kim, Chulyong Park, Joon Sakong, Shinhee Ye, So young Son, Kiook Baek; Ann Occup Environ Med 2023;35:e23. Published online July 6, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e23

Abstract Abstract in Korean PDF Supplementary Material

Background

Exposure to heavy metals is a public health concern worldwide. Previous studies on the association between heavy metal exposure and neurobehavioral functions in children have focused on single exposures and clinical manifestations. However, the present study evaluated the effects of heavy metal complex exposure on subclinical neurobehavioral function using a Korean Computerized Neurobehavior Test (KCNT).

Methods

Urinary mercury, lead, cadmium analyses as well as symbol digit substitution (SDS) and choice reaction time (CRT) tests of the KCNT were conducted in children aged between 10 and 12 years. Reaction time and urinary heavy metal levels were analyzed using partial correlation, linear regression, Bayesian kernel machine regression (BKMR), the weighted quantile sum (WQS) regression and quantile G-computation analysis.

Results

Participants of 203 SDS tests and 198 CRT tests were analyzed, excluding poor cooperation and inappropriate urine sample. Partial correlation analysis revealed no association between neurobehavioral function and exposure to individual heavy metals. The result of multiple linear regression shows significant positive association between urinary lead, mercury, and CRT. BMKR, WQS regression and quantile G-computation analysis showed a statistically significant positive association between complex urinary heavy metal concentrations, especially lead and mercury, and reaction time.

Conclusions

Assuming complex exposures, urinary heavy metal concentrations showed a statistically significant positive association with CRT. These results suggest that heavy metal complex exposure during childhood should be evaluated and managed strictly.

소아 신경 행동 기능과 중금속 복합 노출의 관련성
목적
중금속 노출은 많은 국가에서 공중보건 관련해서 큰 과제이다. 중금속 노출에 따른 신경계의 영향을 보기 위한 과거 연구들 에서는 노출의 경우 단일 중금속에 대한 노출을, 노출에 따른 결과로는 임상적 징후 또는 질환의 진단을 중점으로 이루어졌다. 본 연구는 중금속 복합 노출과 준임상적 수준을 포함한 신경 행동 기능의 관계를 확인하기 위해 계획되었다.
방법
소변 중 수은, 납, 카드뮴 분석과 한국형 컴퓨터 신경행동검사중 부호 숫자 짝짓기 검사와 선택 반응 시간 검사를 211명의 10-12세의 소아들에게 시행한 자료를 바탕으로, 반응 시간과 소변 중 중금속 수치를 성별과 연령을 보정하여 편상관분석과 회귀분석으로 분석하였다. 그 중 유의미한 결과가 확인되는 항목에 대해 복합노출에 대한 분석을 Bayesian Kernel Machine regression, Weighted Sum Regression analysis, Quantile G-computation 기법을 활용하여 심층 분석하였다.
결과
부호숫자 짝짓기 검사의 경우 203건, 선택반응 검사의 경우 198건에 대해 분석을 수행하였다. 부호숫자 짝짓기 검사의 경우 단일 중금속과 편상관분석 및 다중회귀분석에서 유의미한 관련성이 보이지 않았다. 선택반응 검사의 경우 편상관분석상 개별 중금속과는 별다른 관계를 보이지 않았으나 다중회귀분석에서 수은 및 납과 유의미한 관련성을 보였다. 복합노출에 대한 분석방법인 Bayesian Kernel Machine regression, Weighted Sum Regression analysis, Quantile G-computation 기법에서 소변 중 중금속과 선택 반응 시간 검사의 반응시간 간에 양의 상관관계를 보였으며, 세 분석에서 비교적 일관되게 복합노출 시 수은과 납이 선택 반응 시간 검사의 반응시간에 양의 상관관계를 보였다. 카드뮴의 경우 뚜렷한 양의 상관관계를 보이지 않거나 그 기여도가 적었다.
결론
본 연구 샘플의 요중 수은, 납, 카드뮴의 범위는 임상적인 증상을 나타낼 수 있는 것으로 알려진 여러 기준 수준에 비해 매우 낮은 수준에 있으나, 그 범위 내에서도 선택 반응 검사와 중금속의 복합노출은 통계적으로 유의한 반응시간 차이를 보였다. 위 결과는 소아 중금속 복합 노출이 매우 낮은 농도 수준에서도 신경계에 영향을 미친다는 가능성을 제시하며, 이는 중금속 노출에 대한 더욱 민감하고 엄격한 관리가 필요함을 보여주는 결과이다.

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Original Article

Effect of night shift work on the reduction of glomerular filtration rate using data from Korea Medical Institute (2016-2020): Beom Seok Ko, Sang Yop Shin, Ji Eun Hong, Sungbeom Kim, Jihhyeon Yi, Jeongbae Rhie; Ann Occup Environ Med 2023;35:e22. Published online June 30, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e22

Abstract Abstract in Korean PDF

Background

Shift work increases the risk of chronic diseases, including metabolic diseases. However, studies on the relationship between shift work and renal function are limited. The aim of this study was to investigate the association between shift work and a decreased glomerular filtration rate (GFR).

Methods

Data were evaluated for 1,324,930 workers who visited the Korean Medical Institute from January 1, 2016 to December 31, 2020 and underwent a health checkup. Daytime workers were randomly extracted at a ratio of 1:4 after matching for age and sex. In total, 18,190 workers aged over 40 years were included in the analyses; these included 3,638 shift workers and 14,552 daytime workers. Participants were categorized into the shift work group when they underwent a specific health checkup for night shift work or indicated that they were shift workers in the questionnaire. The odds ratio was calculated using a conditional logistic regression to investigate the relevance of shift work for changes in GFR.

Results

35 workers in the shift group and 54 in the daytime group exhibited an estimated GFR (eGFR) value of < 60 mL/min/1.73m² (p < 0.01). The difference in eGFR values between two checkups differed significantly depending on the type of work (p < 0.01); the difference in the shift work group (−9.64 mL/min/1.73 m²) was larger than that in the daytime work group (−7.45 mL/min/1.73 m²). The odds ratio for eGFR reduction to < 60 mL/min/1.73 m² in the shift group versus the daytime group was 4.07 (95% confidence interval: 2.54–6.52), which was statistically significant.

Conclusions

The results of this study suggest that eGFR decreases by a significantly larger value in shift workers than in daytime workers; thus, shift work could be a contributing factor for chronic kidney disease (CKD). Further prospective studies are necessary to validate this finding and identify measures to prevent CKD in shift workers.

교대근무가 신사구체 여과율에 미치는 영향
목적
교대근무는 대사질환을 포함한 만성질환의 위험도를 증가시키는 것으로 알려져 있다. 하지만 교대근무와 신기능과 관련된 연구는 제한적이다. 때문에, 본 연구의 목적은 교대 근무와 사구체 여과율 감소와의 연관성을 보고자 하는 것이다.
방법
본 연구는 2016년 1월 1일부터 2020년 12월 31일까지 한국의학연구소(KMI)에 내원하여 건강검진을 받은 1,324,930명의 직장인을 대상으로 시행하였다. 나이와 성별에 대해 매칭한 후, 낮 근무자를 4:1의 비율로 무작위 추출하였다. 총 18,190 명의 40세 이상 근로자를 분석 대상으로 하였으며, 교대 근무자 3,638 명과 낮 근무자 14,552 명이 포함되었다. 참가자들은 야간 특수 건강검진을 받았거나 설문지에서 교대 근무자임을 표시했을 때 교대 근무 그룹으로 분류하였다. 조건부 로지스틱 회귀분석을 사용하여 교대 근무의 관련성과 신기능 변화 간의 상관 관계를 조사하였다.
결과
교대 근무 그룹의 35 명과 낮 근무 그룹의 54 명이 추정 GFR(eGFR) 값이 60 mL/min/1.73m2 미만임을 보였다(P<0.01). 두 검진 간 eGFR 값 차이는 근무 형태에 따라 유의하게 차이가 나며(P<0.01), 교대 근무 그룹(-9.64 mL/min/1.73m2)의 차이가 낮 근무 그룹(-7.45 mL/min/1.73m2)보다 크게 나타났다. 주간근무군에 비해 교대근무군에서 사구체 여과율이 60ml/min/1.73m2 미만으로 떨어질 교차비는 4.07(95% CI 2.54-6.52) 로 통계적으로 유의하게 증가하였다.
결론
본 연구 결과 교대 근무자들의 eGFR 값이 주간 근무자들보다 유의하게 감소하였으며, 교대 근무는 만성 신질환 발생의 요인이 될 수 있다는 것을 알 수 있었다.

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[Special Collection] Working hours as a social determinants of workers' health

Original Article

Association between irregular working hours and work-related musculoskeletal pain: results from the 6th Korean Working Conditions Survey: Munyoung Yang, Jun-Pyo Myong, Jongin Lee, Min Young Park, Mo-Yeol Kang; Ann Occup Environ Med 2023;35:e21. Published online July 3, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e21

Abstract PDF Supplementary Material

Background

Recently, irregular working hours have become controversial issues in Korea. The health impact of irregular working hours on the work-related musculoskeletal pain (MSP) is scarcely researched before. We sought to investigate the association between irregular working hours and work-related MSP among South Korean workers.

Methods

This study used data from the sixth Korean Working Conditions Survey in 2020. The prevalence of work-related MSP was analyzed using the χ² test. A multiple logistic regression analysis was conducted to assess the association between irregular working hours and work-related MSP. We conducted stratified analysis by gender, weekly working hours, and workers’ control over their working hours. We calculated the adjusted odds ratios (ORs) of work-related MSP for irregular working hours combined with weekly working hours.

Results

The OR for work-related MSP was significantly higher in the population with irregular working hours than in the population with regular working hours (OR: 1.43, 95% confidence interval [CI]: 1.29–1.58). Irregular and long (> 52 hours/week) working hours have the highest risk of work-related MSP in both genders (in men, OR: 3.48 [95% CI: 2.53–4.78]; in women, OR: 2.41 [95% CI: 1.46–4.00]).

Conclusions

Irregular working hours were associated with work-related MSP in Korea. The association was magnified with long working hours. Reform of the Korean Labor Standards Act leading to increase irregular working hours may induce adverse health outcome.

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[Special Collection] Working hours as a social determinants of workers' health

Brief Communication

The impacts of working time flexibilization on occupational safety and health: an expert survey: Daseul Moon, Hyunjoo Kim; Ann Occup Environ Med 2023;35:e20. Published online July 20, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e20

Abstract PDF Supplementary Material

The policy proposal by the current Korean government that proposes flexible overtime rules is causing social controversy. This study has explored the 612 experts’ opinions on the occupational safety and health impacts of the policy using an online self-report survey. They expected short-term overwork (87.25%), overwork inequality (86.44%), irregular working hours (84.31%), chronic overwork (84.15%), long working hours (83.66%), and unpredictability of working hours (81.86%) as a result of the policy change. They also responded that the policy change would increase industrial accident deaths (87.25%), mental illnesses (87.09%), deaths due to overwork or cardiovascular diseases (83.84%), and accidents (83.33%). They disagreed that the government’s flexibilization policy, while agreeing that the necessity of policies on regulating night work (94.77%), guaranteeing wages to eliminate overtime (90.36%), establishing working time regulations for the bogus self-employed (82.84%), and applying the 52-hour workweek system to all workplaces (76.47%). These expert opinions are consistent with previous research on the health effects of working hours.

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[Special Collection] Working hours as a social determinants of workers' health

Brief Communication

Working hours and the regulations for night shift workers: Tae-Won Jang; Ann Occup Environ Med 2023;35:e19. Published online July 5, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e19

Abstract PDF Supplementary Material

There are several types of shift work in Korea: rotating shift, 24-hour shift, day-night shift, fixed night work, and.so on. As a result of analyzing the 8th Korea National Health and Nutrition Examination Survey and the 6th Korean Working Condition Survey, Korean shift workers accounted for 11.6%–13.9% of wage workers. Weekly working hours of shift workers were 57.69 ± 1.73 (24-hours shift) and 49.97 ± 0.67 (fixed night shift), which were significantly longer than day workers. To prevent health consequences of night work, many countries regulate the working hours of night work not to exceed 7–9 hours a day. However, Korea does not regulate working hours for night work, and some occupations may work more hours than the prescribed overtime hours. To prevent health consequences and reduce working hours for Korean night shift workers, it is necessary to regulate the working hours of night shift workers by law.

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[Special Collection] Working hours as a social determinants of workers' health

Brief Communication

Working hours and the regulations in Korea: Inah Kim, Jeehee Min; Ann Occup Environ Med 2023;35:e18. Published online July 6, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e18

Abstract PDF Supplementary Material

South Korea has the highest policy priority for working hour regulations because it has longer annual working hours than other Organization for Economic Development Co-operation and Development countries and has fewer holidays. According to the results of the Working Conditions Surveys between 2006 and 2020, in 2020, 6% of wage earners worked for > 52 hours weekly. The percentage of workers exceeding 52 hours weekly has decreased over time; however, disparities exist based on age, industry, occupation, company type, and company size, particularly in service-, arts-, and culture-related occupations and workplaces with fewer than 5 employees. South Korea’s working hours system is greatly influenced by the 52-hour weekly maximum; sometimes, a maximum of 64–69 hours, including overtime, is theoretically possible. To ensure healthy working hours, it is important to actively protect workers who fall through the cracks, such as those in businesses with fewer than 5 employees.

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[Special Collection] Working hours as a social determinants of workers' health

Opinion

Statement by the Korean Society of Occupational and Environmental Medicine on the proposed reform of working hours in South Korea: Hee-Tae Kang, Chul-Ju Kim, Dong-Wook Lee, Seung-Gwon Park, Jinwoo Lee, Kanwoo Youn, Hwan-Cheol Kim, Kyoung Sook Jeong, Hansoo Song, Sung-Kyung Kim, Sang-Baek Koh; Ann Occup Environ Med 2023;35:e17. Published online July 5, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e17

Abstract PDF Supplementary Material

The current 52-hour workweek in South Korea consists of 40 hours of regular work and 12 hours of overtime. Although the average working hours in South Korea is declining, it is still 199 hours longer than the Organisation for Economic Co-operation and Development average of 1,716 hours per year. In view to this, the South Korean government has now proposed to reform the workweek, mainly intending to increase the workweek to 69 hours when the workload is heavy. This reform, by increasing the labor intensity due to long working hours, goes against the global trend of reducing work hours for a safe and healthy working environment. Long working hours can lead to increased cerebrovascular and cardiovascular diseases, industrial accidents, mental health problems, and safety accidents due to lack of concentration. In conclusion, the Korean government’s working hour reform plan can have a negative impact on workers’ health, and therefore it should be thoroughly reviewed and modified.

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[Special Collection] Working hours as a social determinants of workers' health

Editorial

Special Series I: Working hours as a social determinant of workers’ health: Kyunghee Jung-Choi, Tae-Won Jang, Mo-Yeol Kang, Jungwon Kim, Eun-A Kim; Ann Occup Environ Med 2023;35:e16. Published online July 6, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e16

PDF Supplementary Material

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Original Article

The relationship between shift work pattern and thyroid stimulating hormone in female workers: Hun Jeong, Chang Ho Chae, Jun Ho Lee, Hyo Won Chong; Ann Occup Environ Med 2023;35:e14. Published online June 22, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e14

Abstract Abstract in Korean PDF

Background

Shift work is known to cause changes in the circadian rhythm of the human body and adversely affect not only physical health but also mental health. Some studies have demonstrated the correlation between shift work and thyroid stimulating hormone (TSH), a hormone that changes according to the diurnal rhythm, but few studies have reported the different TSH levels according to the shift work type. This study aimed to investigate changes in TSH according to the shift work type.

Methods

This study included 1,318 female workers who had a medical checkup at a university hospital in Changwon from 2015 to 2019. Shift work types were classified as non-shift work, regular 2 shifts, and irregular three shifts, and a TSH ≥ 4.2 mIU/L was defined as abnormal. A general linear model (GLM) was used to compare the TSH levels and the risk of subclinical hypothyroidism in each year, and a binary logistic analysis was performed using a generalized estimation equation (GEE) to compare the risk of subclinical hypothyroidism over the 5-year period.

Results

Of the 1,318 participants included in this study, 363, 711, and 244 were non-shift, two-shift, and irregular three-shift workers, respectively. In the GEE analysis, after adjusting for age, body mass index, smoking, and alcohol consumption, the odds ratios (ORs) were 1.81 (95% confidence interval [CI]: 1.15–2.86; p = 0.011) in 2 shifts and 2.02 (95% CI: 1.23–3.32; p = 0.006) in irregular three shifts, compared to non-shift.

Conclusions

Our results showed that shift work had a higher risk of subclinical hypothyroidism than non-shift work and that there was a significant difference in the risk of subclinical hypothyroidism according to the shift work type. These findings suggest that the shift work type can be considered in future thyroid function tests and evaluations.

여성근로자에서 교대근무유형과 갑상선 자극 호르몬과의 연관성
목적
교대근무는 인체의 일중리듬에 변화를 일으키고 심혈관 질환, 소화기 질환 및 대사증후군과 같은 신체적 건강 뿐만 아니라 수면장애, 우울감 등을 포함한 정신건강에도 유해한 영향을 끼치는 것으로 알려져 있다. 일중리듬에 의해 변화하는 호르몬 중 하나인 갑상선 자극 호르몬(TSH)의 농도가 교대근무와의 연관성을 보여주는 연구들이 있으나 교대근무 유형에 따른 차이를 살펴본 연구는 부족한 실정이다. 본 연구는 교대근무의 유형에 따른 TSH의 변화를 알아보고자 하였다.
방법
2015년부터 2019년까지 창원의 일개 대학병원의 건강진단을 받은 1,318명의 여성근로자를 대상으로 연구를 진행하였다. 교대근무유형은 비교대근무, 규칙적 2교대 및 불규칙 3교대로 분류하였으며 TSH ≥ 4.2mIU/L인 경우 이상이 있는 것으로 정의하였다. 연도별로 TSH의 농도를 비교하기 위하여 일반선형모델을 사용하였으며 5년간의 불현성 갑상선기능저하증의 위험도를 비교하기 위하여 일반화추정방정식을 사용하여 이분형 로지스틱 분석을 시행하였다.
결과
연구 대상자 1,318명 중 비교대근무자는 총 363명, 2교대 근무자는 총 711명, 불규칙 3교대 근무자는 총 244명이었다. 연령, 체질량지수(BMI), 흡연, 음주를 보정하고 일반화추정방정식을 사용하여 이분형 로지스틱 분석을 시행한 결과, 비교대근무자를 기준으로 하였을 때, OR은 2교대 근무자에서 1.81(95% CI 1.15-2.86, P=0.011), 불규칙 3교대 근무자에서 2.02(95% CI 1.23-3.32, P=0.006)로 나왔다.
결론
본 연구의 결과는 교대근무가 비교대근무에 비해 불현성 갑상선기능저하증의 위험도가 높았으며 교대근무의 유형에 따른 불현성 갑상선기능저하증의 위험도에 있어 유의미한 차이를 보였다. 이는 이전 연구들의 결과를 뒷받침할 뿐만 아니라 향후 갑상선 기능 검사 및 평가에 있어 교대근무의 유형이 고려대상이 될 수 있을 것으로 생각된다.

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Environmental Research.2025; 276: 121503. CrossRef
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Case Report

Occupational asthma related to indoor air pollution in a worker at an indoor air gun shooting range: a case report: Kwang Min Lee, Seungho Lee, Yoon-Ji Kim, Seung-eun Lee, Youngki Kim, Dongmug Kang, Se-Yeong Kim; Ann Occup Environ Med 2023;35:e13. Published online June 19, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e13

Abstract Abstract in Korean PDF Supplementary Material

Background

Indoor air pollution can cause and exacerbate asthma. We report a previously undescribed case of occupational asthma related to indoor air pollution in a worker at an indoor air gun shooting range and highlight the potential risk of developing occupational asthma in this environment.

Case presentation

A 31-year-old man presented with dyspnea, cough, and sputum and was diagnosed with asthma complicated by pneumonia. Objective evidence of asthma was obtained by performing a methacholine bronchial provocation test. It was suspected that the patient had occupational asthma, which began one month after changing jobs to work within the indoor air gun shooting range. The highest peak expiratory flow (PEF) diurnal variability on working days was 15%, but the highest variation was 24%, with 4 days out of 4 weeks having a variation of over 20% related to workplace exposure. Conversely, the diurnal variability on the rest days was 7%, and no day showed a variation exceeding 20%. The difference in the average PEF between working and rest days was 52 L/min. PEF deterioration during working days and improvement on rest days were noted.

Conclusions

The results obtained from the in-depth analysis of the PEF were adequate to diagnose the patient with occupational asthma. Exposure to indoor air pollution and lead and the patient’s atopy and allergic rhinitis may have contributed to the development of occupational asthma.

실내 공기총 사격장 근로자의 실내공기오염관련 직업성 천식 증례보고
a배경: 실내공기오염은 천식을 유발하고 악화시킬 수 있다. 본 연구는 실내 공기총 사격장에서 일하는 근로자의 실내 공기 오염과 관련된 이전에 기술되지 않은 직업성 천식 사례를 보고하고, 이러한 환경에서 직업성 천식 발병의 잠재적 위험을 강조한다.
증례
31세 남자가 호흡곤란, 기침, 가래 증상이 나타나 내원하였고, 폐렴이 동반된 천식으로 진단되었다. 천식의 객관적인 증거는 메타콜린 기관지유발검사를 시행하여 획득하였다. 환자는 실내공기총 사격장에서 근무하기 위해 이직한지 한달만에 직업성 천식을 앓고 있는 것으로 의심되었다. 근무일의 최고호기유량(PEF) 주간 변동성은 15%였지만, 가장 높은 변동성은 24%였으며, 4주 중 4일은 작업장 노출과 관련하여 20% 이상의 변동성을 보였다. 반대로 쉬는 날의 일교차는 7%로 20%를 넘는 날은 없었다. 근무일과 휴식일 사이의 평균 최고호기유량(PEF) 차이는 52 L/min이었다. 근무일 동안 PEF 악화 및 휴식일의 개선이 주목되었다.
결론
최고호기유량(PEF)의 심층분석결과는 직업성 천식 환자를 진단하기에 적합하였다. 실내공기오염과 납 노출, 환자의 아토피와 알레르기성 비염이 직업성 천식 발병에 기여했을 가능성이 있다.

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Original Article

Relationship between job stress and impaired fasting glucose in male steel industry workers: a cross-sectional study: Hyun-Kyo Lee, Inho Lee, Jisuk Yun, Yong-Jin Lee, Eun-Chul Jang, Young-Sun Min, Soon-Chan Kwon; Ann Occup Environ Med 2023;35:e12. Published online June 2, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e12

Abstract Abstract in Korean PDF

Background

The purpose of this study is to investigate the relationship between job stress and impaired fasting glycemia (IFG) of male workers in a manufacturing industry.

Methods

Data were collected from 5,886 male workers in a manufacturing industry who participated in the medical examination from June 19 to August 14, 2020 through self-reported questionnaires. The general characteristics of the subjects, shift work, high blood pressure, dyslipidemia, and job stress were included. Job stress was measured using the Korean Occupational Stress Scale (KOSS) consisting of 8 items and 43 questions. Multivariable logistic regression analysis was used to investigate the IFG association with job stress.

Results

Among the various factors that can cause job stress, only high job demand was associated with a risk of IFG (odds ratio, 1.43; 95% confidence interval, 1.13–1.82) especially in non-shift worker. For all other factors, no statistically significant results were obtained.

Conclusions

In this study of male workers engaged in the Korean steel manufacturing industry, the 'job demand' item among job stress of non-shift worker was related to IFG.

철강 공장에 근무하는 남성 근로자의 직무 스트레스와 공복혈당장애와의 관계: 단면연구
목적
제2형 당뇨와 직무 스트레스와의 관계를 다룬 여러 연구가 있었으나 공복혈당장애와의 관계를 조사한 연구 결과는 존재하지 않았다. 본 연구는 단일 철강 사업장에서 직무스트레스와 공복혈당장애의 관련성을 확인하되 한국형 직무스트레스 각각 항목과의 연관성을 파악하고자 하였다.
방법
2020년 6월 19일부터 8월 14일까지 건강검진에 참여한 제조업 남성 근로자 5,886명을 대상으로 자체 보고 설문지를 통해 자료를 수집하였다. 변수로 대상자의 일반적인 특성 및 교대근무, 재직년수, 고혈압, 이상지질혈증, 직무스트레스 점수가 포함되었다. 직무스트레스는 8개 항목과 43개 질문으로 구성된 한국직업스트레스척도(KOSS)를 이용하여 측정되었다. 다중 로지스틱 회귀 분석을 사용하여 직무 스트레스와 IFG의 연관성을 조사하였다.
결과
직무스트레스를 유발할 수 있는 다양한 요인 중, 비 야간작업자의 높은 직무요구도만이 IFG(OR 1.43, 95% CI 1.13-1.82)의 위험 증가와 관련이 있었다. 다른 모든 요인의 경우 통계적으로 유의한 결과가 얻어지지 않았다.
결론
철강 제조업에 종사하는 남성 근로자들을 대상으로 한 본 연구에서 직무 스트레스 중 ‘직무 요구’ 항목은 비 야간작업자의 공복혈당장애와 관련이 있었다. 향후 다양한 직업군을 대상으로 한 후속 연구가 필요할 것이다.

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Prevalence and Risk Factors of Prediabetes: A Cross-Sectional Study
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BIO Web of Conferences.2025; 193: 00052. CrossRef

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Original Article

Organic solvent exposure for the chronic kidney disease: updated systematic review with meta-analysis: Chaeseong Lim, Hyeoncheol Oh; Ann Occup Environ Med 2023;35:e11. Published online May 17, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e11

Abstract Abstract in Korean PDF

Background

Studies on the relationship between organic solvent exposure and chronic kidney disease (CKD) have presented inconsistent results. Definition of CKD has changed in 2012, and other cohort studies have been newly published. Therefore, this study aimed to newly confirm the relationship between organic solvent exposure and CKD through an updated meta-analysis including additional studies.

Methods

This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The search was conducted on January 2, 2023 using Embase and MEDLINE databases. Case-control and cohort studies on the relationship between organic solvent exposure and CKD were included. Two authors independently reviewed full-text.

Results

Of 5,109 studies identified, a total of 19 studies (control studies: 14 and cohort studies: 5) were finally included in our meta-analysis. The pooled risk of CKD in the organic solvent exposed group was 2.44 (1.72–3.47). The risk of a low-level exposure group was 1.07 (0.77–1.49). The total risk of a high-level exposure group was 2.44 (1.19–5.00). The risk of glomerulonephritis was 2.69 (1.18–6.11). The risk was 1.46 (1.29–1.64) for worsening of renal function. The pooled risk was 2.41 (1.57–3.70) in case-control studies and 2.51 (1.34–4.70) in cohort studies. The risk of subgroup classified as ‘good’ by the Newcastle Ottawa scale score was 1.93 (1.43–2.61).

Conclusions

This study confirmed that the risk of CKD was significantly increased in workers exposed to mixed organic solvents. Further research is needed to determine the exact mechanisms and thresholds. Surveillance for kidney damage in the group exposed to high levels of organic solvents should be conducted.

Trial Registration

PROSPERO Identifier: CRD42022306521

유기용제와 만성 콩팥병 ; 갱신된 메타-분석
목적
유기용제는 많은 산업현장에서 널리 사용되고 있는 물질로, 산업현장 근로자들의 건강에 나쁜 영향을 초래하고 있다. U.Ravnskov et al, 2000 에서는 유기용제 노출과 만성 신부전에 대해 조사했던 환자-대조군 연구들을 모아 메타분석을 시행하였다. 해당 메타 분석이 발표된 이후 만성 신부전의 정의가 변경되었으며 새로운 코호트 연구들도 새로 발표되었다. 따라서 본 연구에서는 기존 메타 분석에서 포함되지 못한 연구들을 추가로 포함하여 업데이트된 메타 분석을 시행하였다.
방법
본 체계적 검토는 Preferred Reporting Items For Systematic Reviews and Meta-Analysis(PRISMA) guideline 에 의거하여 진행되었다. 검색은 Embase 와 MEDLINE 데이터베이스를 활용하여 2021년 11월 9일날 시행되었다. 유기용제 노출에 의한 만성 신부전에 대한 총 위험도와 더불어, 저도 노출, 중등도 노출, 고도 노출로 구분된 논문들을 모아 노출강도에 따른 하위그룹의 위험도 또한 분석하였다.
결과
유기용제 노출군은 비노출군에 비해 만성 신부전에 대한 총 위험도 (pooled risk) 는 2.44(1.72-3.47) 로 나왔다. 저도 노출의 경우 위험도 1.07(0.77-1.49) 로 나타났고 고도 노출군의 경우 총 위험도 2.44(1.19-5.00) 로 나타났다. 사구체 신염 발생의 경우 위험도가 2.69(1.18-6.11), 신기능 악화의 경우 1.46(1.29-1.64) 로 나타났다. 환자-대조군 연구들의 경우 2.41(1.57-3.70), 코호트 연구들의 경우 2.51(1.34-4.70) 으로 나타났다. Newcastle Ottawa scale 점수가 ‘좋음’으로 분류된 연구들의 경우 1.93(1.43-2.61)로 나타났다.
결론
선행 연구와 마찬가지로 혼합 유기용제 노출 근로자에서 만성 신부전의 위험성이 유의하게 증가한 것을 확인하였다. 이는 현재 석유 관련 제품 취급자, 도장공, 금속가공, 실험실 근로자 등 혼합 유기용제 고용량 노출군에 대한 특수건강진단 시 신기능 검사나 단백뇨 검사의 범위를 넓혀야 함을 시사할 수 있다.

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[Special Collection] Working hours as a social determinants of workers' health

Special Article

Problems and suggested improvement plans for occupational health service in Korea: Dongmug Kang; Ann Occup Environ Med 2023;35:e10. Published online May 11, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e10

Abstract Abstract in Korean PDF Supplementary Material

The purpose of this paper was to review the problems relating to Korea’s occupational health services and suggest ways to improve them. Korea can be classified as a welfare state type of conservative corporatism partially interwoven with liberalism. While experiencing compressed economic growth, the economic sectors of developed (excess areas) and developing (deficient areas) countries are interwoven. Therefore, it is necessary to perfect conservative corporatism along with a complementary reinforcement of liberal contents and to apply a multilayered approach focusing on complementing the deficient areas. It is essential to form a national representative indicator related to occupational health, and a strategy for selection and concentration is needed. The proposed central indicator is the occupational health coverage rate (OHCR), which is the number of workers who have applied for mandatory occupational health services under the Occupational Safety and Health Act in the numerator with the total working population in the denominator. This paper proposes ways to raise the OHCR, which is currently at the level of 25%–40%, to 70%–80%, which is the level of Japan, Germany, and France. To achieve this target, it is necessary to focus on small businesses and vulnerable workers. This is an area of market failure and requires the active input of community-oriented public resources. For access to larger workplaces, the marketability of services should be strengthened and personal intervention using digital health resources should be actively attempted. Taking a national perspective, work environment improvement committees with tripartite (labor, management, and government) participation for improvement of the working environment need to be established at the center and in the regions. Through this, prevention funds linked to industrial accident compensation and prevention could be used efficiently. A national chemical substance management system must be established to monitor the health of workers and the general public.

한국의 직업보건서비스의 문제점과 개선 방안
한국의 직업보건서비스의 문제점을 살펴보고 개선 방안을 제시하고자 하였다. 발간된 논문과 보고서 및 2022년의 산업보건환경 변화에 따른 대응방안 연구(정책포럼)1의 결과를 중심으로 조사하였다. 한국은 보수적조합주의를 근간으로 한 자유주의가 가미된 형태의 복지국가유형으로 분류할 수 있고, 압축적 경제성장을 경험하면서 선진국과 개발도상국의 영역이 섞여 있어 과잉과 결핍이 혼재되어 있다. 따라서 한국의 직업보건서비스의 발전을 위해서는 보수조합주의적 완성도를 높이면서 부수적으로 자유주의적 내용을 보완하여야 하며, 동일한 발전단계에 대한 단일한 접근법 보다는 결핍영역에 대한 보완을 중심으로 한 중층적 접근법이 필요하다. 직업보건관련 중심적 지표를 형성하고 이에 대한 선택과 집중전략이 필요하며, 중심지표로는 현재 25~40% 수준에 머물러 있는 직업보건 적용율을 독일, 프랑스, 일본 수준인 70~80% 수준으로 제고하는 것을 목표로 삼기를 제안한다. 이렇게 하기 위해서는 소규모 사업장과 취약한 노동자에 대해 집중하여야 하며, 이 영역은 시장실패영역으로서 지역중심의 공공자원의 적극적 투입이 필요한데, 전국 보건소 숫자인 256개 정도의 지역에 지역 직업보건 지원센터를 건립할 것을 제안한다. 중규모 이상의 사업장에 대한 접근으로는 서비스의 수요에 기반한 시장성을 강화하고 디지털헬스를 이용한 개인영역의 중재를 적극 시도하여야 한다. 전국적차원에서 사업장 작업환경개선과 중재를 위한 노사정이 참여하는 작업환경개선위원회를 중앙과 지역에 설치하고, 이를 통해 산재보상과 예방을 연계한 예방기금을 효율적으로 사용하도록 한다. 국가 차원의 화학물질 관리체계를 구축하고, 근로자와 일반국민의 건강을 모니터링할 수 있어야 한다

Citations

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Original Article

Correlation of commute time with the risk of subjective mental health problems: 6^th Korean Working Conditions Survey (KWCS): Hyo Choon Lee, Eun Hye Yang, Soonsu Shin, Seoung Ho Moon, Nan Song, Jae-Hong Ryoo; Ann Occup Environ Med 2023;35:e9. Published online May 11, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e9

Abstract Abstract in Korean PDF

Background

Studies conducted so far on the link between commute time and mental health among Koreans remain insufficient. In this study, we attempted to identify the relationship between commute time and subjective mental health using the 6^th Korean Working Conditions Survey (KWCS).

Methods

Self-reported commute time was divided into four groups: ≤ 30 (group 1), 30–60 (group 2), 60–120 (group 3), and > 120 minutes (group 4). Subjective depression was defined as a score of 50 points or less on the WHO-5 well-being index. Subjective anxiety and fatigue were defined as answering ‘yes’ to the questionnaire on whether they had experienced it over the past year. The analysis of variance, t-test, and χ² test was used to analyze the differences among the characteristics of the study participants according to commute time, depression, anxiety, and fatigue. Odds ratios (ORs) and 95% confidence intervals (CIs) for depression, anxiety, and fatigue according to commute time were calculated using multivariate logistic regression models adjusted for sex, age, monthly income, occupation, company size, weekly working hours, and shift work status.

Results

Long commute times showed increased ORs and graded increasing trends for depression, anxiety, and fatigue. The ORs for depression increased significantly in group 2 (1.06 [1.01–1.11]), group 3 (1.23 [1.13–1.33]), and group 4 (1.31 [1.09–1.57]) compared to group 1 (reference). The ORs for anxiety increased significantly in group 2 (1.17 [1.06–1.29]), group 3 (1.43 [1.23–1.65]) and group 4 (1.89 [1.42–2.53]). The ORs for fatigue increased significantly in group 2 (1.09 [1.04–1.15]), group 3 (1.32 [1.21–1.43]), and group 4 (1.51 [1.25–1.82]).

Conclusions

This study highlights that the risk of depression, anxiety, and fatigue increases with commute time.

통근 시간과 주관적 정신건강문제 위험의 상관관계 : 제6차 한국근로환경조사
목적
한국인들의 통근 시간과 정신 건강의 관계에 대해 지금까지 수행된 연구는 매우 부족하다. 본 연구에서는 제6차 한국근로환경조사 자료를 이용하여 통근 시간과 주관적 정신건강의 관계를 규명하고자 하였다.
방법
자가 보고된 통근 시간은 30분 이하(1군), 30분-60분(2군), 60분-120분(3군), 120분 초과(4군)의 4개 그룹으로 분류하였다. 주관적 우울은 WHO-5 웰빙 지수 50점 이하인 경우로 정의하였다. 주관적 불안과 피로는 지난 1년간 이러한 증상을 경험한 적이 있는지에 대한 설문지에 '그렇다'고 대답한 경우로 정의하였다. 분산분석, T-검정 및 카이-제곱 검정을 사용하여 출퇴근 시간, 우울, 불안, 피로에 따른 연구 참여자들의 특성 차이를 분석하였다. 성별, 연령, 월 소득, 직업, 회사 규모, 주당 근로 시간, 교대근무 상태를 보정한 다변량 로지스틱 회귀모형을 이용하여, 통근 시간에 따른 우울, 불안, 피로에 대한 오즈비와 95% 신뢰구간을 산출하였다.
결과
긴 통근 시간은 우울, 불안, 피로에 대한 오즈비 증가 및 점진적인 상승 추세를 보여주었다. 우울에 대한 오즈비는 2군(1.06[1.01-1.11]), 3군(1.23[1.13-1.33])과 4군(1.31[1.09-1.57])에서 1군(참조군)에 비해 유의하게 증가하였다. 불안에 대한 오즈비는 2군(1.17[1.06-1.29]), 3군(1.43[1.23-1.65])과 4군(1.89[1.42-2.53])에서 유의하게 증가했다. 피로에 대한 오즈비는 2군(1.09[1.04-1.15]), 3군(1.32[1.21-1.43])과 4군(1.51[1.25-1.82])에서 유의하게 증가했다.
결론
본 연구는 출퇴근 시간이 증가함에 따라 우울증, 불안, 피로의 위험이 증가한다는 것을 강조한다.

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Original Article

Relationship between visual display terminal working hours and headache/eyestrain in Korean wage workers during the COVID-19 pandemic: the sixth Korean Working Conditions Survey: Gayoung Kim, Seong-yong Cho, Jinseok Kim, Seongyong Yoon, Jisoo Kang, Si young Kim; Ann Occup Environ Med 2023;35:e8. Published online May 9, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e8

Abstract Abstract in Korean PDF

Background

Prolonged use of visual display terminal (VDT) can cause eyestrain, dry eyes, blurred vision, double vision, headache and musculoskeletal symptoms (neck, shoulder, and wrist pain). VDT working hours among workers have greatly increased during the coronavirus disease 2019 (COVID-19) pandemic. Therefore, this study aimed to investigate the relationship between VDT working hours and headache/eyestrain in wage workers using data from the sixth Korean Working Conditions Survey (KWCS) (2020–2021) conducted during the COVID-19 pandemic.

Methods

We analyzed the sixth KWCS data of 28,442 wage workers aged 15 years or older. The headache/eyestrain that occurred in the last year was assessed. The VDT work group included workers who use VDT always, almost always, and three-fourth of the working hours, while the non-VDT work group included workers who use VDT half of the working hours, one-fourth of the working hours, almost never, and never. To analyze the relationship between VDT working hours and headache/eyestrain, the odds ratios (ORs) and 95% confidence interval (CI) were calculated using logistic regression analysis.

Results

Among the non-VDT work group, 14.4% workers experienced headache/eyestrain, whereas 27.5% workers of the VDT work group experienced these symptoms. For headache/eyestrain, the VDT work group showed adjusted OR of 1.94 (95% CI: 1.80–2.09), compared with the non-VDT work group, and the group that always used VDT showed adjusted OR of 2.54 (95% CI: 2.26–2.86), compared with the group that never used VDT.

Conclusions

This study suggests that during the COVID-19 pandemic, as VDT working hours increased, the risk of headache/eyestrain increased for Korean wage workers.

코로나 19 유행 시기의 임금근로자에서 영상표시단말기(VDT) 작업시간과 두통/눈피로의 연관성: 제 6차 근로환경조사(KWCS)
목적
영상표시단말기(VDT)를 장시간 사용하면 눈의 피로, 안구 건조, 시야 흐림, 복시, 두통 및 근골격계 증상(목, 어깨 및 손목 통증)을 유발할 수 있다. 코로나19의 유행 동안 근로자들의 VDT 근로시간이 크게 증가했다. 본 연구는 코로나19 유행 시기에 실시된 제6차 KWCS(2020-2021) 자료를 활용하여 임금근로자의 VDT 근로시간과 두통/눈피로의 연관성을 조사하고자 하였다.
방법
본 연구는 15세 이상 임금근로자 28,442명을 대상으로 제6차 KWCS 자료를 분석하였다. 두통/눈피로는 지난 1년 동안 발생 여부로 확인하였다. 근무시간 내내, 거의 모든 근무시간, 근무시간 3/4 동안 VDT를 사용할 경우 VDT 작업군으로 분류하였고, 근무시간 절반, 근무시간 1/4, 거의 없음, 전혀 사용하지 않는 경우 VDT 비작업군으로 분류하였다. VDT 근무시간과 두통/눈피로의 관계를 분석하기 위해 로지스틱 회귀분석을 이용하여 승산비(OR)와 95% 신뢰구간(CI)을 계산하였다.
결과
본 연구는 15세 이상 임금근로자 28,442명을 대상으로 제6차 KWCS 자료를 분석하였다. 두통/눈피로는 지난 1년 동안 발생 여부로 확인하였다. 근무시간 내내, 거의 모든 근무시간, 근무시간 3/4 동안 VDT를 사용할 경우 VDT 작업군으로 분류하였고, 근무시간 절반, 근무시간 1/4, 거의 없음, 전혀 사용하지 않는 경우 VDT 비작업군으로 분류하였다. VDT 근무시간과 두통/눈피로의 관계를 분석하기 위해 로지스틱 회귀분석을 이용하여 승산비(OR)와 95% 신뢰구간(CI)을 계산하였다.
결론
본 연구는 코로나19 세계적 유행 기간 동안 VDT 근로시간이 증가함에 따라 한국 임금근로자의 두통/눈피로 위험이 증가함을 시사한다.

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Occupational exposure to video display terminals: a systematic review of ocular and visual health effects and associated risk factors
Eva Artime-Ríos, Mar Seguí-Crespo, Begoña Doménech-Amigot, Mar Sánchez-Brau, Ana Suárez-Sánchez, José María Ramada-Rodilla
Journal of Occupational Health.2026;[Epub] CrossRef

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Original Article

Developing a short standard questionnaire for assessing work organization hazards: the Healthy Work Survey (HWS): BongKyoo Choi, Youngju Seo; Ann Occup Environ Med 2023;35:e7. Published online April 27, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e7

Abstract PDF Supplementary Material

Background

At present, no short standard questionnaire exists for assessing and comparing major work organization hazards in the workplaces of the United States.

Methods

We conducted a series of psychometric tests (content validity, factor analysis, differential-item functioning analysis, reliability, and concurrent validity) to validate and identify core items and scales for major work organization hazards using the data from the 2002–2014 General Social Surveys (GSSs), including the Quality of Worklife (QWL) questionnaire. In addition, an extensive literature review was undertaken to find other major work organization hazards which were not addressed in the GSS.

Results

Although the overall validity of the GSS-QWL questionnaire was satisfactory in the psychometric tests, some GSS-QWL items of work-family conflict, psychological job demands, job insecurity, use of skills on the job, and safety climate scales appeared to be weak. In the end, 33 questions (31 GSS-QWL and 2 GSS) were chosen as the least, but best validated core questions and included in a new short standard questionnaire (called the Healthy Work Survey [HWS]). And their national norms were established for comparisons. Furthermore, based on the literature review, fifteen more questions for assessing other significant work organization hazards (e.g., lack of scheduling control, emotional demands, electronic surveillance, wage theft) were included in the new questionnaire. Thus, the HWS includes 48 questions in total for assessing traditional and emerging work organization hazards, which covers seven theoretical domains: work schedule/arrangement, control, support, reward, demands, safety, and justice.

Conclusions

The HWS is a short standard questionnaire for assessing work organization hazards which can be used as a first step toward the risk management of major work organization hazards in the workplaces of the US.

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Occupational stress(KOSS®19): scale development and validation in the Korean context
Hansoo Song, Hyoung Ryoul Kim, Inah Kim, Jin-Ha Yoon, Sang-Baek Koh, Sung-Soo Oh, Hee-Tae Kang, Da-Yee Jeung, Dae-Sung Hyun, Chunhui Suh, Sei-Jin Chang
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Journal of Occupational & Environmental Medicine.2025; 67(6): 404. CrossRef

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Original Article

Occupational exposure to polycyclic aromatic hydrocarbons in Korean adults: evaluation of urinary 1-hydroxypyrene, 2-naphthol, 1-hydroxyphenanthrene, and 2-hydroxyfluorene using Second Korean National Environmental Health Survey data: Dong Hyun Hong, Jongwon Jung, Jeong Hun Jo, Dae Hwan Kim, Ji Young Ryu; Ann Occup Environ Med 2023;35:e6. Published online March 24, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e6

Abstract Abstract in Korean PDF

Background

Polycyclic aromatic hydrocarbons (PAHs) are occupational and environmental pollutants generated by the incomplete combustion of organic matter. Exposure to PAHs can occur in various occupations. In this study, we compared PAH exposure levels among occupations based on 4 urinary PAH metabolites in a Korean adult population.

Methods

The evaluation of occupational exposure to PAHs was conducted using Second Korean National Environmental Health Survey data. The occupational groups were classified based on skill types. Four urinary PAH metabolites were used to evaluate PAH exposure: 1-hydroxypyrene (1-OHP), 2-naphthol (2-NAP), 1-hydroxyphenanthrene (1-OHPHE), and 2-hydroxyfluorene (2-OHFLU). The fraction exceeding the third quartile of urinary concentration for each PAH metabolite was assessed for each occupational group. Adjusted odds ratios (ORs) for exceeding the third quartile of urinary PAH metabolite concentration were calculated for each occupational group compared to the “business, administrative, clerical, financial, and insurance” group using multiple logistic regression analyses.

Results

The “guard and security” (OR: 2.949; 95% confidence interval [CI]: 1.300–6.691), “driving and transportation” (OR: 2.487; 95% CI: 1.418–4.364), “construction and mining” (OR: 2.683; 95% CI: 1.547–4.655), and “agriculture, forestry, and fisheries” (OR: 1.973; 95% CI: 1.220–3.191) groups had significantly higher ORs for 1-OHP compared to the reference group. No group showed significantly higher ORs than the reference group for 2-NAP. The groups with significantly higher ORs for 1-OHPHE than the reference group were “cooking and food service” (OR: 2.073; 95% CI: 1.208–3.556), “driving and transportation” (OR: 1.724; 95% CI: 1.059–2.808), and “printing, wood, and craft manufacturing” (OR: 2.255; 95% CI: 1.022–4.974). The OR for 2-OHFLU was significantly higher in the “printing, wood, and craft manufacturing” group (OR: 3.109; 95% CI: 1.335–7.241) than in the reference group.

Conclusions

The types and levels of PAH exposure differed among occupational groups in a Korean adult population.

한국 성인의 다환 방향족 탄화수소에 대한 직업적 노출: 제 2기 국민환경보건기초조사 자료를 이용한 요중 1-하이드록시피렌, 2-나프톨, 1-하이드록시페난트렌 및 2-하이드록시플루오렌 평가
목적
다환 방향족 탄화수소(Polycyclic Aromatic Hydrocarbons, PAHs)는 유기물의 불완전 연소로 인해 발생하는 직업 및 환경 오염 물질이다. PAHs에 대한 노출은 대표적으로 석탄 가스화 공정 등 특정 업무 및 직업과 관련하여 발생하는 것으로 알려져 있지만, 그 외 다양한 직업들에서도 노출이 일어날 수 있다. 본 연구는 제2기 국민환경보건기초조사(2012-2014) 자료의 4가지 요중 PAH 대사 산물들을 이용하여 한국 성인 인구에서 여러가지 직업들에서의 PAH 노출 수준을 비교하였다.
방법
제 2기 국민환경보건기초조사에 참여한 성인 남녀 6,478명을 대상으로 PAHs에 대한 직업적 노출을 평가하였다. 직업군은 직능 유형을 기준으로 분류하였다. PAHs 노출에 대한 평가를 위해 요중 PAH 대사산물인 1-하이드록시피렌, 2-나프톨, 1-하이드록시페난트렌, 그리고 2-하이드록시플루오렌을 사용하였다. 각 직업군에서 각각의 요중 PAH 대사산물 농도의 제 3사분위수를 초과하는 비율을 구하였다. 이후 로지스틱 회귀 분석을 사용하여 "비즈니스, 행정, 사무, 금융 및 보험" 그룹과 비교해 각 직업군에서 요중 PAH 대사산물 농도의 제 3사분위수를 초과하는 비율에 대한 보정된 교차비를 구하였다.
결과
1-하이드록시피렌의 경우, "경비 및 보안" (교차비: 2.949, 95% 신뢰구간: 1.300–6.691), "운전 및 운송" (교차비: 2.487, 95% 신뢰구간: 1.418–4.364), "건설 및 광업" (교차비: 2.683, 95% 신뢰구간: 1.547–4.655), 그리고 "농업, 임업 및 어업" (교차비: 1.973, 95% 신뢰구간: 1.220–3.191) 그룹에서 참조 그룹과 비교하여 유의하게 높은 교차비를 보였다. 2-나프톨의 경우, 참조 그룹보다 유의하게 높은 교차비를 보이는 직업군은 없었다. 1-하이드록시페난트렌의 경우, "요리 및 음식 서비스" (교차비: 2.073, 95% 신뢰구간: 1.208–3.556), "운전 및 운송" (교차비: 1.724, 95% 신뢰구간: 1.059-2.808), 그리고 "인쇄, 목재 및 공예품 제조"(OR: 2.255, 95% CI: 1.022–4.974) 그룹에서 참조그룹에 비해 유의하게 높은 교차비를 보였다. 2-하이드록시플루오렌의 경우, "인쇄, 목재 및 공예품 제조" (OR: 3.109, 95% CI: 1.335–7.241)그룹에서 참조 그룹에 비해 유의하게 높은 교차비를 보였다.
결론
한국 성인 인구에서 PAH 노출수준과 노출되는 PAH의 종류는 직업군에 따라 달랐으며, 그에 따른 추가적인 평가 및 보호조치가 필요하다.

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Original Article

The association of perfluoroalkyl substances (PFAS) exposure and kidney function in Korean adolescents using data from Korean National Environmental Health Survey (KoNEHS) cycle 4 (2018–2020): a cross-sectional study: Jisuk Yun, Eun-Chul Jang, Soon-Chan Kwon, Young-Sun Min, Yong-Jin Lee; Ann Occup Environ Med 2023;35:e5. Published online March 15, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e5

Abstract Abstract in Korean PDF

Background

Perfluoroalkyl substances (PFAS) are chemicals widely used in various products in everyday life. Due to its unique strong binding force, the half-life of PFAS is very long, so bioaccumulation and toxicity to the human body are long-standing concerns. In particular, effects on kidney function have recently emerged and there are no studies on the effect of PFAS on kidney function through epidemiological investigations in Korea. From 2018 to 2020, the Korean National Environmental Health Survey (KoNEHS) cycle 4, conducted an epidemiological investigation on the blood concentration of PFAS for the first time in Korea. Based on this data, the relationship between PFAS blood concentration and kidney function was analyzed for adolescents.

Methods

We investigated 5 types of PFAS and their total blood concentration in 811 middle and high school students, living in Korea and included in KoNEHS cycle 4, and tried to find changes in kidney function in relation to PFAS concentration. After dividing the concentration of each of the 5 PFAS and the total concentration into quartiles, multivariable linear regression was performed to assess the correlation with kidney function. The bedside Schwartz equation was used as an indicator of kidney function.

Results

As a result of multivariable linear regression, when observing a change in kidney function according to the increase in the concentration of each of the 5 PFAS and their total, a significant decrease in kidney function was confirmed in some or all quartiles.

Conclusions

In this cross-sectional study of Korean adolescents based on KoNEHS data, a negative correlation between serum PFAS concentration and kidney function was found. A well-designed longitudinal study and continuous follow-up are necessary.

제 4기 국민환경보건 기초조사(2018-2020) 자료를 바탕으로 한 대한민국 청소년의 과불화 화합물 노출과 신장기능과의 상관관계 연구
목적
과불화 화합물은 일상생활에서 다양한 제품에 널리 쓰이는 화학물질이다. 특유의 강한 결합력으로 인한 반감기가 매우 길기 때문에 이로 인한 생물농축과 인체에 끼치는 독성작용은 오랫동안 큰 관심사이다. 최근에는 특히 신기능에 미치는 영향이 주목받고 있으나 국내에서는 대규모 역학조사를 통한 PFAS가 신기능에 미치는 영향에 대한 조사가 전무한 실정이다. 2018년부터 2020년까지 실시된 국민환경보건 기초조사는 국내 최초로 과불화 화합물의 혈중농도에 대한 대규모 역학조사를 실시했다. 이 자료를 바탕으로 국내 최초로 청소년을 대상으로 하여 과불화 화합물의 혈중농도와 신장기능의 관계를 분석하였다.
방법
제 4기 국민환경보건 기초조사에 포함된 국내에 거주하는 중, 고등학생 828명을 대상으로 5종의 과불화 화합물의 혈중 농도를 조사하고 농도에 따른 신장기능의 변화를 알아보고자 하였다. 5종의 과불화 화합물 각각의 농도와 총 합의 농도를 사분위수로 나눈 후 다중선형회귀분석을 실시하여 신기능과의 상관관계를 분석하였다.
결과
다중선형회귀분석 결과 5종의 과불화 화합물 각각의 농도와 총 합의 농도 증가에 따라 일부 또는 전체 사분위수에서 통계적으로 유의한 신장기능의 감소가 확인되었다.
결론
제 4기 국민환경보건 기초조사 자료를 바탕으로 한국 청소년을 대상으로 한 이번 단면연구에서는 혈중 과불화 화합물의 농도와 신기능 사이에 음의 상관관계가 있음을 발견하였다. 잘 설계된 종단연구와 지속적인 추적관찰이 필요하다.

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Original Article

Association between shift work and serum homocysteine level in female electronic manufacturing services workers: Jae Won Lim, Chan Woo Kim, Hyoung Ouk Park, Eui Yup Chung, Changho Chae, JunSeok Son, Young Hoo Shin, Seung Hyun Park, Sang Moon Choi; Ann Occup Environ Med 2023;35:e4. Published online March 10, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e4

Abstract Abstract in Korean PDF Supplementary Material

Background

Shift work has been shown to increase the risk of cardiovascular disease (CVD) based on several evidences. The classic risk factors of CVD include age, hypertension, smoking, obesity and diabetes. Recently, the serum homocysteine level has been reported to be a valuable indicator of CVD risk. This study aimed to determine the variation in serum homocysteine level as a cardiovascular risk indicator among female workers according to shift work.

Methods

The data of regular health examination of workers at an electronic manufacturing services company in Yeongnam region, South Korea in 2019 were examined in this study. The investigation was based on a cross-sectional study conducted on 697 female workers (199 day workers and 498 shift workers). The sociodemographic and biochemical characteristics were compared between day workers and shift workers. Through a logistic regression analysis, the odds ratio (OR) of the increased serum homocysteine level in relation to shift work was determined.

Results

Compared to female day workers, female shift workers showed significantly higher level of serum homocysteine (8.85 ± 2.16 vs. 9.42 ± 2.04 μmol/mL; p = 0.001). The OR of day workers against shift workers was 1.81 (95% confidence interval [CI]: 1.25–2.63). With the adjustment of variables that may influence the level of serum homocysteine, the adjusted OR was 1.68 (95% CI: 1.09–2.60).

Conclusions

The serum homocysteine level was significantly higher in shift workers than in day workers. It is thus likely to be a useful predictor of CVD in shift workers.

전자제조서비스업 회사의 여성 근로자에서 교대근무와 혈청 호모시스테인 수준과의 연관성
목적
교대근무가 심혈관계질환의 발병위험도를 증가시킨다는 여러 증거들이 있다. 심혈관계질환의 고전적 위험인자로는 나이, 고혈압, 흡연, 비만, 이상지질, 당뇨병 등이 있으며, 최근 혈청 호모시스테인 수치는 심혈관계 질환의 위험도 지표로 유용한 것으로 알려지고 있다. 본 연구에서는 여성 근로자에서 교대근무 여부에 따라 심혈관계 질환의 위험도 지표인 혈청 호모시스테인의 수준 차이가 있는지를 알아보고자 하였다.
방법
본 연구는 2019년 영남지방의 한 전자제조서비스업회사 근로자의 정기건강검진 자료를 이용하여 수행하였다. 총 697명의 여성근로자(주간근무자 199명, 교대근무자 498명)의 데이터로 단면연구를 수행하였다. 주간 근무자와 교대근무자의 인구사회학적, 생화학적 특성을 비교하였다. 로지스틱 회귀분석을 사용하여 교대근무와 상승된 혈청 호모시스테인 수치의 교차비를 조사하였다.
결과
여성 주간 근로자와 비교하여 여성 교대근무자의 혈청 호모시스테인 수치가 통계적으로 유의하게 더 높았다. (8.85 ± 2.16 vs 9.42 ± 2.04 μmol/ml ; p=0.001). 교대근무자에 비해 주간 근무자의 교차비는 1.81(95% CI : 1.25-2.63) 였으며, 혈청 호모시스테인 수치에 영향을 미칠 수 있는 변수를 보정한 후, 수정된 OR은 1.68(95% CI : 1.09-2.60) 이었다.
결론
혈청 호모시스테인 수치는 주간 근무자에 비해 교대근무자에서 통계적으로 유의하게 높았다. 교대근로자의 심혈관계 질환 발병의 예측에 있어 혈청 호모시스테인 수치가 유용하겠다.

Citations

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Night shift work and indicators of cardiovascular risk: A systematic review and meta-analysis
Johanna Samulin Erdem, Mrinal K. Das, Evi De Ryck, Øivind Skare, Jenny-Anne S. Lie, Merete Bugge, Barbara Harding, Ingrid L. Jorgensen, Ingrid Sivesind Mehlum, Manolis Kogevinas, Karl-Christian Nordby, Shan Zienolddiny-Narui
Environmental Research.2025; 276: 121503. CrossRef
Analysis of serum homocysteine reference range value in a population of healthy young adults
Muhammad TAHIR, Liong B. KURNIAWAN, Uleng BAHRUN, Andi A. ZAINUDDIN, Nurahmi NURAHMI, Andi ARIYANDI
Gazzetta Medica Italiana Archivio per le Scienze Mediche.2025;[Epub] CrossRef
Dietary habits of night shift workers: A reason or an excuse for poor nutrition
Svetlana Anđelković, Maja Babić
Srpski medicinski casopis Lekarske komore.2024; 5(1): 75. CrossRef

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Original Article

Risk assessment of heavy metals in tuna from Japanese restaurants in the Republic of Korea: Seong-Jin Bae, Kyu-Sik Shin, Chulyong Park, Kiook Baek, So-Young Son, Joon Sakong; Ann Occup Environ Med 2023;35:e3. Published online February 9, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e3

Abstract Abstract in Korean PDF Supplementary Material

Background

Studies on the risk of mercury (Hg) in Korean fishery products focus primarily on total Hg levels as opposed to methylmercury (MeHg) levels. None of the few studies on MeHg in tuna investigated tuna from Japanese restaurants. Few have evaluated lead (Pb), cadmium (Cd) and arsenic (As) in tuna. Thus, this study aimed to conduct a risk assessment by evaluating heavy metal concentrations in tuna from Japanese restaurants.

Methods

Thirty-one tuna samples were collected from Japanese restaurants in the Republic of Korea. They were classified according to region and species. The concentration of heavy metals in the samples was analyzed using the Ministry of Food and Drug Safety Food Code method. The rate of exceedance of maximum residue levels (MRLs) and the risk compared to the provisional tolerable weekly intake (PTWI) set by the Joint Food and Agriculture Organization/World Health Organization Expert Committee on Food Additives (%PTWI) were evaluated for risk assessment.

Results

The mean of MeHg, Pb, Cd and As concentrations were 0.56 ± 1.47 mg/kg, 33.95 ± 3.74 μg/kg, 14.25 ± 2.19 μg/kg and 1.46 ± 1.89 mg/kg, respectively. No sample exceeded the MRLs of Pb and Cd, but 9.7% of the samples exceeded the MRL of MeHg. The %PTWIs of MeHg, Pb, Cd and As were 4.2037, 0.0162, 0.0244 and 1.1627, respectively. The %PTWI of MeHg by age group and sex was highest among men aged 19–29 years (10.6494), followed by men aged 30–49 years (7.2458) and women aged 19–29 years (4.8307).

Conclusions

We found that 3 out of 31 samples exceeded the MRL of MeHg. The %PTWI of MeHg showed significant differences based on age and sex, and the value was likely to exceed a safe level depending on individuals’ eating behaviors. Therefore, improved risk management for MeHg is required.

한국의 일식집 유통 참치의 중금속(4종) 위해성평가
목적
국내 수산물의 수은에 관한 위해성 연구는 주로 메틸수은이 아닌 총 수은을 대상으로 이루어졌다. 소수의 참치의 메틸수은에 대한 연구들 중 일식점 유통 참치에 대한 연구는 없었다. 참치의 납, 카드뮴 및 비소에 대한 연구도 거의 이루어지지 않았다. 따라서 본 연구에서는 일식점 유통 참치의 중금속 농도를 평가하여 위해성평가를 실시하고자 하였다.
방법
참치는 한국의 일식집에서 총 31개의 시료가 수집되었다. 지역과 참치의 종에 따라서 분류하였다. 시료의 중금속 농도는 식품의약품안전처의 식품공전에 따라 분석했다. 위해성평가를 위해서 식품의 잔류허용기준을 초과하는 비율과 FAO/WHO합동식품첨가물 전문가위원회가 설정한 잠정주간섭취허용과 비교한 위험도(%PTWI)를 산출하였다.
결과
메틸수은, 납, 카드뮴 및 비소 농도의 기하평균은 각각 0.56 ± 1.47 mg/kg, 33.95 ± 3.74 μg/kg, 14.25 ± 2.19 μg/kg 및 1.46 ± 1.89 mg/kg이었다. 납과 카드뮴의 경우 잔류허용기준을 초과하는 시료가 없었으나 메틸수은의 경우 시료의 9.7%가 초과했다. 메틸수은, 납, 카드뮴 및 비소의 %PTWI는 4.2037, 0.0162, 0.0244 및 1.1627이었다. 메틸수은의 %PTWI는 19-29세의 남성, 30-49세의 남성, 19-29세의 여성 순으로 높았으며, 그 값은 10.6494, 7.2458, 4.8307이었다.
결론
총 31개의 시료 중 3개에서 메틸수은의 잔류허용기준을 초과하는 것으로 나타났다. 메틸수은의 %PTWI는 연령과 성별에 따라 상당한 차이를 보였고, 그리고 그 값은 섭취행태에 따라서 안전 수준을 초과할 가능성을 보였다. 따라서, 메틸수은에 대한 개선된 안전성 관리 방안이 필요할 것으로 보인다.

Citations

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Association Between Heavy Metals Exposure and Elevated High-Sensitivity C-Reactive Protein: Mediating Role of Body Mass Index
Seong-Uk Baek, Jin-Ha Yoon
Biomolecules.2025; 15(11): 1491. CrossRef
Metal Load of Potentially Toxic Elements in Tuna (Thunnus albacares)—Food Safety Aspects
József Lehel, Zita Papp, András Bartha, Péter Palotás, Rita Szabó, Péter Budai, Miklós Süth
Foods.2023; 12(16): 3038. CrossRef

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