Annals of Occupational and Environmental Medicine

Opinion

Perspectives from the new president of the Korean Society of Occupational and Environmental Medicine: future strategies for occupational and environmental medicine: Sang Baek Ko; Ann Occup Environ Med 2025;37:e1. Published online February 19, 2025; DOI: https://doi.org/10.35371/aoem.2025.37.e1

Abstract Abstract in Korean PDF: Modern Korean society is experiencing fundamental transformations in industrial structures and working environments driven by complex factors, including demographic shifts, the Fourth Industrial Revolution, the coronavirus disease 2019 pandemic, and digital transformation. The evolving dynamics between the manufacturing and service industries, the emergence of technology-driven sectors, and the proliferation of new occupational categories are reshaping traditional employment models. This has directed the labor market toward nonstandard employment forms, including temporary, contract-based, and platform labor. Consequently, issues such as employment instability and reduced accessibility to workplace health programs, including occupational safety training, health examinations, and workplace health management, have become increasingly prominent. Although occupational and environmental medicine has subsequently gained significance, the current occupational health and safety framework inadequately addresses the nuances of emerging labor forms. Legal gaps persist, leaving vulnerable groups such as nonregular workers, platform laborers, and older workers insufficiently protected under existing systems. Furthermore, systemic issues are evident in the inadequate follow-up care during occupational health examinations, lacking continued adherence to hazard-centric approaches, and insufficient attention to chronic diseases and mental health challenges. This study proposes strategies that occupational and environmental medicine can address these issues. First, legal and institutional reforms must encompass new labor forms, accompanied by modernized safety and health guidelines. Second, state-of-the-art technologies should be leveraged to enhance predictive disease management and personalized healthcare for workers. Third, a preventive approach integrating chronic disease management, mental healthcare, and psychosocial risk factors must be established. Fourth, fostering interdisciplinary research collaboration across medicine, engineering, and psychology is essential for developing practical solutions to emerging challenges. In conclusion, occupational and environmental medicine in Korea must adapt to effectively address the evolving labor landscape. Through systematic innovation, integrated health-management approaches, technological advancements, and interdisciplinary cooperation, the health and safety of all workers in the rapidly changing world can be ensured.; 대한직업환경의학회 신임회장의 제언: 직업환경의학의 미래 전략
현대 한국 사회는 인구구조 변화, 4차 산업혁명, 팬데믹, 디지털 전환 등 복합적인 요인에 의해 산업 구조와 근로 환경에서 근본적인 변화를 경험하고 있다. 제조업과 서비스업 간의 역학 변화, 기술 중심 산업의 부상, 새로운 직업군의 확산은 전통적인 고용 모델을 재편하고 있다. 이에 따라 노동 시장은 비정규직, 계약직, 플랫폼 노동과 같은 비표준 고용 형태로 이동하고 있다. 그 결과, 고용 불안정과 직업 안전 교육, 건강검진, 작업장 건강관리 등 직업 건강 프로그램에 대한 접근성 저하 문제가 점점 더 부각되고 있다.
이러한 변화로 직업환경의학의 중요성이 증대되었으나, 현재의 직업 건강 및 안전 체계는 새로운 노동 형태의 특성을 충분히 반영하지 못하고 있다. 법적 공백이 여전히 존재하며, 비정규직 근로자, 플랫폼 노동자, 고령 노동자 등 취약 계층은 기존 제도 아래에서 충분히 보호받지 못하고 있다. 또한, 건강검진 후 사후관리의 미비, 유해 요인 중심 접근의 지속적 적용 부족, 만성 질환 및 정신 건강 문제에 대한 관심 부족 등 체계적 문제가 드러나고 있다.
본 연구는 직업환경의학이 이러한 문제를 해결하기 위한 전략을 제안한다. 첫째, 새로운 노동 형태를 포괄하는 법적·제도적 개혁과 현대화된 안전 및 건강 지침의 도입이 필요하다. 둘째, 최첨단 기술을 활용하여 예측적 질병 관리와 근로자 맞춤형 건강관리를 강화해야 한다. 셋째, 만성 질환 관리, 정신 건강 관리, 심리사회적 위험 요인을 통합하는 예방적 접근을 확립해야 한다. 넷째, 의학, 공학, 심리학 등 학제 간 연구 협력을 통해 새로운 과제에 대한 실질적 해결책을 모색해야 한다. 결론적으로, 한국의 직업환경의학은 변화하는 노동 환경에 효과적으로 대응하기 위해 적응해야 한다. 체계적 혁신, 통합적 건강 관리 접근법, 기술적 발전, 학제 간 협력을 통해 빠르게 변화하는 세계에서 모든 근로자의 건강과 안전을 보장할 수 있을 것이다.

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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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Perspectives from the new president of the Korean Society of Occupational and Environmental Medicine: future strategies for occupational and environmental medicine
Sang Baek Ko
Ann Occup Environ Med.2025; 37: e1. CrossRef
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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
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Epidemiology and Psychiatric Sciences.2024;[Epub] CrossRef
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Preventive Medicine.2023; 177: 107787. CrossRef

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