Annals of Occupational and Environmental Medicine

Original Article

Development of criteria for health examination of high-risk occupational groups and application to female fishers: Delphi study: Hye-min Kim, Jungwon Kim, Kunhyung Kim, Hansoo Song; Ann Occup Environ Med 2026;38:e2. Published online January 8, 2026; DOI: https://doi.org/10.35371/aoem.2026.38.e2

Abstract Abstract in Korean PDF Supplementary Material: Background
The objective of this study was to establish criteria for designing health examination programs and selecting appropriate examination items for high-risk occupational groups and to apply these criteria specifically to female fishers.
Methods
The first Delphi survey comprised five domains and 15 specific criteria for identifying relevant health screening items for high-risk occupations. The second survey included open-ended questions addressing inconsistencies identified in the first survey and sought suggestions for additional items. In the third Delphi survey, specific health screening items were proposed for female fishers, and experts directly evaluated these items according to the finalized selection criteria.
Results
Twenty-eight experts participated in this study. The first and second Delphi rounds facilitated the finalization of selection criteria for health screening items, consisting of five domains: Domain 1, Priority of target disease; Domain 2, Applicability of early detection and intervention; Domain 3, Scientific evidence of medical test method; Domain 4, Acceptability of medical test method; and Domain 5, Effectiveness of examination. Content validity ratios for these criteria ranged between 0.429 and 1.000. Based on the established criteria, experts evaluated eight proposed screening items for female fishers in the third round of the Delphi survey. Bone density, bioelectrical impedance analysis, cardiovascular disease risk factors, and fundoscopy were evaluated as appropriate; however, no agreement was reached on the early detection and intervention areas for degenerative lumbar disease, knee osteoarthritis, and upper extremity disease, as well as on the effectiveness for upper extremity disease and chronic obstructive pulmonary disease.
Conclusion
This study successfully established comprehensive criteria for selecting diseases targeted by health examinations in high-risk occupational groups. The practical application of these criteria proved effective in assessing the appropriateness of specific health screening items.; 고위험 직업군 건강검진 기준 개발 및 여성 어업종사자에의 적용: 델파이 조사
배경
본 연구의 목적은 고위험 직업군을 위한 건강검진 프로그램 설계 기준과 적절한 검사 항목을 선정하는 기준을 수립하고, 이를 여성 어업종사자에게 구체적으로 적용하는 것이었다.
방법
첫 번째 델파이 조사에서는 고위험 직업군의 건강검진 항목을 선정하기 위한 5개 영역과 15개의 기준을 설정하였다. 두 번째 조사에서는 첫 번째 조사에서 발견된 불일치를 해소하고 추가 항목에 대한 제안을 받기 위해 개방형 질문을 포함하였다. 세 번째 델파이 조사에서는 여성 어업종사자에게 적용할 건강검진 항목을 제안하고, 전문가들이 최종 선정 기준에 따라 해당 항목을 평가하였다.
결과
본 연구에는 28명의 전문가가 참여하였다. 첫 번째와 두 번째 델파이 조사에서는 건강검진 항목 선정 기준이 확정되었으며, 이 기준은 다음의 5개 영역으로 구성되었다: <영역 1: 대상 질병의 우선순위>, <영역 2: 조기 발견 및 개입의 적용 가능성>, <영역 3: 의학적 검사 방법에 대한 과학적 근거>, <영역 4: 의학적 검사 방법의 수용 가능성>, <영역 5: 검사의 효과성>. 각 기준의 내용 타당도 비율은 0.429에서 1.000 사이였다. 확립된 기준에 따라, 세 번째 델파이 조사에서 여성 어업종사자를 위한 8개 건강검진 항목이 평가되었으며, 골밀도, 생체 전기 저항 분석, 심혈관 질환 위험 인자, 안저 검사는 적절한 항목으로 평가되었으나, 퇴행성 요추 질환, 무릎 골관절염, 상지 질환 및 만성 폐쇄성 폐질환의 조기 발견 및 개입 영역과 상지 질환과 만성 폐쇄성 폐질환의 효과성에 대해서는 전문가들 간의 합의가 이루어지지 않았다.
결론
본 연구는 고위험 직업군의 건강검진을 위한 질병 선정 기준을 성공적으로 확립하였다. 이 기준을 실제로 적용함으로써 특정 건강검진 항목의 적절성을 평가하는 데 효과적임을 확인하였다.

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Original Article

Sex difference in musculoskeletal disabilities among Korean fishers: a cross-sectional study: Hye-min Kim, Soo Hyeong Park, Bong Gyun Joo, Ki-Soo Park, Jeong Ho Kim, Hansoo Song; Ann Occup Environ Med 2025;37:e18. Published online July 7, 2025; DOI: https://doi.org/10.35371/aoem.2025.37.e18

Background
Fishing is a physically demanding occupation with a high risk of musculoskeletal disabilities (MSDs). Although previous studies have focused on ergonomic risk factors, little attention has been paid to sex differences in the prevalence of MSDs among fishers. This study aimed to assess whether female fishers experience a higher prevalence of MSDs than male fishers and to examine whether this difference persists after adjusting for socioeconomic and occupational factors.
Methods
We analyzed cross-sectional data from 898 Korean fishers (513 men and 385 women) who participated in the 2021–2022 Fisher Health Survey. MSDs in the upper extremities, lower back, and knees were defined as scores in the top 25% of the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), Oswestry Disability Index, and Western Ontario and McMaster Universities Arthritis Index Short Form (WOMAC-SF), respectively. Modified Poisson regression was used to calculate the prevalence ratios (PRs) by sex, with stepwise adjustments for age, socioeconomic factors, and occupational factors.
Results
Female fishers had significantly higher MSD risk than male fishers across all body regions (fully adjusted PRs: upper extremity, 1.59; lower back, 1.63; knee, 1.44). Sex disparities were most pronounced among those under 60 years of age and remained significant even in older age groups.
Conclusions
The elevated MSD risk among female fishers persisted despite adjusting for conventional risk factors, suggesting the influence of additional factors such as biological susceptibility, domestic labor, and gendered health reporting. Therefore, MSD prevention strategies should include sex-sensitive multidimensional approaches beyond ergonomic interventions.

한국 어업인에서의 근골격계 장애의 성별 차이: 단면 연구
목적
어업은 육체적으로 힘든 직업으로 근골격계 장애의 위험이 높다. 기존 연구들은 주로 인간공학적 위험요인에 집중해 왔으나, 어업인의 근골격계 장애 유병률에 대한 성별 차이는 상대적으로 덜 주목 받아 왔다. 본 연구는 여성 어업인이 남성 어업인보다 근골격계 장애 유병률이 더 높은지를 평가하고, 이러한 차이가 사회경제적 및 직업적 요인을 보정한 후에도 지속되는지를 살펴보았다.
방법
2021–2022년 어업인 건강조사에 참여한 한국 어업인 898명(남성 513명, 여성 385명)의 단면 자료를 분석하였다. 상지, 요추, 무릎의 근골격계 장애는 각각 QuickDASH, ODI, WOMAC-SF 점수 상위 25%에 해당할 경우로 정의하였다. 수정된 포아송 회귀(modified Poisson regression)를 사용하여 성별에 따른 유병비를 산출하였으며, 연령, 사회경제적 요인, 직업적 요인 순으로 단계적으로 보정하였다.
결과
여성 어업인은 남성 어업인보다 모든 신체 부위에서 근골격계 장애의 위험이 유의하게 높았다(보정 유병비: 상지 1.59, 요추 1.63, 무릎 1.44). 성별 격차는 60세 미만 집단에서 가장 두드러졌으며, 고령 집단에서도 유의한 차이가 지속되었다.
결론
여성 어업인의 높은 근골격계 장애의 위험은 잘 알려진 위험요인을 보정한 후에도 유지되었으며, 이는 생물학적 취약성, 가사노동, 성별에 따른 건강보고 차이 등의 추가적인 요인이 작용했을 가능성을 시사한다. 따라서 근골격계 장애 예방 전략은 인간공학적 개입을 넘어 성 감수성을 가져야 하며, 다차원적으로 접근해야 한다.

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Development of criteria for health examination of high-risk occupational groups and application to female fishers: Delphi study
Hye-min Kim, Jungwon Kim, Kunhyung Kim, Hansoo Song
Annals of Occupational and Environmental Medicine.2026; 38: e2. CrossRef

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Original Article

Population attributable fraction of indicators for musculoskeletal diseases: a cross-sectional study of fishers in Korea: Jaehoo Lee, Bohyun Sim, Bonggyun Ju, Chul Gab Lee, Ki-Soo Park, Mi-Ji Kim, Jeong Ho Kim, Kunhyung Kim, Hansoo Song; Ann Occup Environ Med 2022;34:e23. Published online September 7, 2022; DOI: https://doi.org/10.35371/aoem.2022.34.e23

Abstract Abstract in Korean PDF Supplementary Material

Background

The musculoskeletal disease (MSD) burden is an important health problem among Korean fishers. We aimed to investigate the indicators of the prevalence of MSD and contributions of significant indicators to MSD in Korean fishers.

Methods

This cross-section study included 927 fishers (male, 371; female, 556) aged 40 to 79 years who were enrolled from 3 fishery safety and health centers. The outcome variable was one-year prevalence of MSD in 5 body parts (the neck, shoulder, hand, back, and knee). Independent variables were sex, age, educational attainment, household income, job classification, employment xlink:type, hazardous working environment (cold, heat, and noise), ergonomic risk by the 5 body parts, anxiety disorder, depression, hypertension, diabetes, and hyperlipidemia. The adjusted odds ratio of MSDs by the 5 body parts were calculated using multiple logistic regression analysis. We computed the population attributable fraction (PAF) for each indicators of MSDs using binary regression models.

Results

The one-year prevalence of MSD in the neck, shoulder, hand, back, and knee was 7.8%, 17.8%, 7.8%, 27.2%, and 16.2% in males vs. 16.4%, 28.1%, 23.0%, 38.7%, and 30.0% in females, respectively. The ergonomic risk PAF according to the body parts ranged from 22.8%–59.6% in males and 22.8%–50.3% in female. Mental diseases showed a significant PAF for all body parts only among female (PAF 9.1%–21.4%). Cold exposure showed a significant PAF for the neck, shoulder, and hand MSD only among female (25.6%–26.8%). Age was not a significant indicator except for the knee MSD among female.

Conclusions

Ergonomic risk contributed majorly as indicators of MSDs in both sexes of fishers. Mental disease and cold exposure were indicators of MSDs only among female fishers. This information may be important for determining priority risk groups for the prevention of work-related MSD among Korean fishers.

어업인의 근골격계질환 관련인자의 인구집단 기여위험분율에 관한 단면연구
목적
한국 어업인들의 근골격계질환 유병률에 대한 관련인자의 인구집단 기여위험도를 조사하는 것이다.
방법
본 연구의 대상은 3개 어업안전보건센터에 소속된 40-79세 어업인 927명(남성 371명, 여성 556명)이다. 결과 변수는 구조화된 설문지에 따른 5개 신체 부위(목, 어깨, 손, 허리, 무릎)의 근골격계질환 1년 유병률이다. 독립변수는 성별, 연령, 최종학력, 가구소득, 고용형태, 세부업종, 유해 작업환경(추위, 더위, 소음), 신체부담작업수준, 불안장애, 우울증, 고혈압, 당뇨, 고지혈증이다. 다중 로지스틱 회귀분석을 사용하여5개 신체부위별 근골격계질환의 오즈비를 산출하였다. 이를 이용하여 근골격계질환에 대한 각 변수별로 인구집단 기여위험분율(PAF)를 계산하였다.
결과
남성에서 근골격계질환 1년 유병률은 목7.8%, 어깨17.8%, 손7.8%, 허리27.2%, 무릎16.2% 이다. 여성의 1년 근골격계질환 1년유병률은 목 16.4%, 어깨 28.1%, 손 23.0%, 등 38.7%, 무릎 30.0% 이다. 신체 부위에 따른 신체부담작업의 기여위험분율은 남성 22.8-59.6%, 여성 22.8-50.3%이다. 정신질환은 여성에서만 모든 신체부위에서 유의한 기여위험분율을 보였다(9.1%-21.4%). 추위 노출은 여성에서만 목, 어깨, 손 근골격계질환에 대해 유의미한 기여위험분율을 보였다(25.6%-26.8%). 나이는 여성에서 무릎을 제외하고는 유의한 인자가 아니다.
결론
신체부담작업은 남성, 여성 모두에서 근골격계질환에 대한 주요 기여 변수이다. 정신 질환과 추위 노출은 여성 어업인에서만 근골격계질환에 기여를 한다. 본 연구는 어업인들의 업무관련성 근골격계질환 예방을 위한 우선순위 판단에 정보를 제공할 것이다.

Citations

Citations to this article as recorded by

Development of criteria for health examination of high-risk occupational groups and application to female fishers: Delphi study
Hye-min Kim, Jungwon Kim, Kunhyung Kim, Hansoo Song
Annals of Occupational and Environmental Medicine.2026; 38: e2. CrossRef
Sex difference in musculoskeletal disabilities among Korean fishers: a cross-sectional study
Hye-min Kim, Soo Hyeong Park, Bong Gyun Joo, Ki-Soo Park, Jeong Ho Kim, Hansoo Song
Annals of Occupational and Environmental Medicine.2025; 37: e18. CrossRef

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14 Download
3 Web of Science
2 Crossref

Research Article

Characteristics of lumbar disc degeneration and risk factors for collapsed lumbar disc in Korean farmers and fishers: Chaeyoung Hong, Chul Gab Lee, Hansoo Song; Ann Occup Environ Med 2021;33:e16. Published online May 14, 2021; DOI: https://doi.org/10.35371/aoem.2021.33.e16

Abstract Abstract in Korean PDF Supplementary Material

Background

Few studies have investigated the risk factors for lumbar intervertebral disc degeneration among hard physical workers involved in heavy lifting. In this study, we aimed to identify the characteristics of lumbar intervertebral disc degeneration and evaluate the relationship between collapsed lumbar disc and potential risk factors in farmers and fishers.

Methods

This study included 203 farmers (103 men and 100 women) and 166 fishers (95 men and 71 women) aged 40–69 years who had undergone lumbar magnetic resonance imaging and were enrolled in the Korea Farmer's Knee Cohort and the Jeonnam Fishers' Cohort. We evaluated each of the 5 lumbar discs using the Pfirrmann grading system and classified collapsed lumbar intervertebral disc (cLD) as a case with ≥ 1 grade 5 at any disc level. We investigated potential risk factors, such as gender, age, body mass index (BMI), working hours per day, working months per year, and cumulative heavy lifting working time (CLWT). The odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) were calculated.

Results

The prevalence of cLD was 19.8% (23.7% among fishers, 21.2% among fishers with farming, and 17.2% among farmers). cLD correlated with factors such as age and occupation. Gender, CLWT and the working time matrix were not significantly associated with cLD. The OR of cLD adjusted by gender, age, BMI, and working time matrix was 1.26 (95% CI: 0.69–2.30) for ≥ 5,000 hours CLWT compared to that for < 2,000 hours CLWT. The OR of cLD adjusted by gender, age, BMI, CLWT, and working time matrix was 2.08 (95% CI: 1.06–4.06) for fishers compared to that for farmers.

Conclusions

Heavy lifting did not show a significant association with cLD in farmers and fishers. However, there is possibility that fishers are at a higher risk of lumbar disc collapse than farmers.

한국 농어업인의 요추추간판 퇴행성변화의 특징과 요추추간판붕괴의 위험요인
목적
중량물을 운반하는 육체노동자들의 요추추간판 퇴행성변화의 위험인자에 관한 연구는 많지 않다. 본 연구에서는 농어업인의 요추추간판의 퇴행성변화의 특성을 파악하고, 요추추간판붕괴의 위험 요인을 알아보고자 하였다.
방법
본 연구는 한국농업인무릎관절염코호트에 등록된 농업인과 전남어업인코호트에 등록된 어업인 중 요추 자기공명영상을 촬영하였던 40-69세를 대상으로 하였다. 본 연구대상자수는 농업인 203명 (남성 103명, 여성 100명)과 어업인 166명 (남성 95명, 여성 71명)이다. 연구자들은 Pfirrmann 등급 체계를 사용하여 5개의 요추 디스크를 각각 평가하고 모든 디스크 레벨에서 Pfirrmann 등급 5이상인 경우를 ‘요추추간판붕괴’(디스크간격이 50%미만으로 감소)로 분류했다. 성별, 연령, 체질량지수, 일일 근로 시간, 연간 근로 개월 수, 생애누적들기작업시간과 같은 위험요인을 조사하였고, 이를 보정한 오즈비와 95 % 신뢰구간을 산출하였다.
결과
요추추간판붕괴의 유병률은 19.8%(어업인 23.7%, 농업을 겸업하는 어업인 21.2%, 농업인 17.2%)였다. 요추추간판붕괴는 연령 및 직업과 상관관계가 있었다. 반면, 성별, 생애누적들기작업시간, 일일근로시간과 연간근로개월수로 구성된 근무시간요인은 요추추간판붕괴와 유의한 관련성을 보이지 않았다. 보정된 요추추간판붕괴의 오즈비는 생애누적들기작업시간이 2,000시간 미만인 경우에 비해 5,000시간 이상인 경우 어업인의 경우 1.26 (95 % CI 0.69–2.30)이었다. 반면, 보정된 요추추간판붕괴의 오즈비는 농업인에 비해 어업인의 경우 2.08 (95 % CI 1.06–4.06)이었다.
결론
본 연구에서 중량물들기작업시간은 요추추간판의 붕괴와 유의한 연관성을 보이지 않았다. 그러나 어업인의 경우 농업인보다 요추추간판붕괴가 유의하게 많았다.

Citations

Citations to this article as recorded by

Development of criteria for health examination of high-risk occupational groups and application to female fishers: Delphi study
Hye-min Kim, Jungwon Kim, Kunhyung Kim, Hansoo Song
Annals of Occupational and Environmental Medicine.2026; 38: e2. CrossRef
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Revista de la Sociedad Española del Dolor.2025;[Epub] CrossRef
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Original Article

Occupational Diseases among Agricultural, Forestry and Fishery Workers Approved by Korea Labor Welfare Corporation: Yeon Soon Ahn, Hyun Sul Lim; Korean Journal of Occupational and Environmental Medicine 2007;19(1):1-16. Published online March 31, 2007; DOI: https://doi.org/10.35371/kjoem.2007.19.1.1

Abstract PDF

OBJECTIVES
To analyze the characteristics of occupational diseases among agricultural, forestry and fishery workers compensated under the Industrial Accident Compensation Insurance that is operated by the Korea Labor Welfare Corporation (KLWC).
METHODS
Using the KLWC database, we collected 667 cases of occupational disease compensated during the 8 years between 1 January 1998 and 31 December 2005. We analyzed the characteristics of occupational diseases using the KLWC electronic data and the data investigated by the Korea Occupational Safety and Health Agency.
RESULTS
KLWC approved 667 cases, including 69 deaths (10.3%). Men accounted for 76.0%of the approved cases. The most common age group was 50~59 years of age (37.3%). The most common size of enterprise was 5 to 49 workers (47.5%). The proportion of occupational diseases was 54.1%, of which 45.9% was work-related. Among occupational diseases, the most common was skin diseases (147 cases, 40.7%), followed by infectious diseases (131 cases, 36.3%), including scrub typhus (123 cases) and intoxication (40 cases, 11.1%). The causal hazardous agents were biological (320 cases, 88.6%), chemical (29 cases, 8.0%), and physical (11 cases, 3.0%). The major type of industry and occupation were forestry (445 cases, 66.7%) and elementary (151 among 235 cases, 89.3%), respectively.
CONCLUSIONS
Major compensated occupational diseases were infectious diseases, including scrubtyphus, skin diseases and toxic disease, which occurred among workers who were older, and had short tenure and elementary occupation, and these workers were out of the occupational health policy. A management policy must be established to prevent occupational diseases occurring in such vulnerable workers.

Citations

Citations to this article as recorded by

Survey of the knowledge, safety climate, and compliance with hospital infection standard precautions among dental hygienists
Ho Jin Jeong, Jung Hwa Lee
Journal of Korean Academy of Oral Health.2017; 41(4): 237. CrossRef
Compensation for Occupational Injuries and Diseases in Special Populations: Farmers and Soldiers
Young-Jun Kwon, Soo-Jin Lee
Journal of Korean Medical Science.2014; 29(Suppl): S24. CrossRef
Work-related diseases of agricultural workers in South Korea
Sangchul Roh
Journal of the Korean Medical Association.2012; 55(11): 1063. CrossRef
Work-related hazards among farmers
Soon Chan Kwon, Soo-Jin Lee, Mihye Jeong
Journal of the Korean Medical Association.2012; 55(11): 1046. CrossRef
Comparison of the Awareness and Knowledge of Scrub Typhus between Case and Control Groups
Kwan Lee, Byeong-Chan Park, Hyun-Sul Lim, Sun-Seog Kweon, Jin-Su Choi, Jang-Rak Kim, Keon-Yeop Kim, So-Yeon Ryu
Journal of agricultural medicine and community health.2012; 37(1): 1. CrossRef
Occupational Infection in Korea
Yun Kyung Chung, Yeon-Soon Ahn, Jae Sim Jeong
Journal of Korean Medical Science.2010; 25(Suppl): S53. CrossRef
Disease Prevalence and Mortality among Agricultural Workers in Korea
Won Jin Lee, Eun Shil Cha, Eun Kyeong Moon
Journal of Korean Medical Science.2010; 25(Suppl): S112. CrossRef

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Original Article

The Effect of Breath Hold Diving on Bone Mineral Density of Women Fishery Diver: Hwan Sik Hwang, Hyun Rim Choi; Korean Journal of Occupational and Environmental Medicine 2003;15(4):411-421. Published online December 31, 2003; DOI: https://doi.org/10.35371/kjoem.2003.15.4.411

Abstract PDF: OBJECTIVES
The aim of this study was to determine the effect of breathhold diving on female diver's bone mineral density (BMD).
METHODS
A cross-sectional observational study was carried out utilizing a health checkup of divers and controls at a hospital in Jeju city, Korea. Female divers (n=61) were matched with non-diver controls (n=61) by age, weight and postmenopausal year. BMD of the proximal femur(femoral neck, trochanter and Ward's triangle) was assessed by dual-energy X-ray absorptiometry (DEXA).
RESULTS
The average diving duration of the female divers was 34+/-13 years. The BMD of the divers was higher than that of the controls in the femur neck and trochanter (p<0.05). On correlations analysis, the status of menopause, age, body weight and age at menarche were significantly correlated with proximal femur BMD in the divers (p<0.05). On multiple regression analysis, age and body weight were predictors of proximal femur BMD in the divers. On linear regression analysis of proximal femur BMD according to age in the divers and controls, regression coefficients of the divers were lower in all 3 areas of the proximal femur than the controls.
CONCLUSIONS
BMD of the divers was higher than that of the controls in the femur neck and trochanter. There was a tendency for BMD of the divers to decrease faster than that of the controls with increasing age.

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