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Original Article
Occupational health risk assessment, exposure monitoring, and medical surveillance in the UK, EU, and US: a comparative analysis and implications for occupational disease prevention in Korea
Sangjun Choi, Kyong-Hui Lee, Kyung Ehi Zoh, Dong-Hee Koh, Won Kim, Kwonchul Ha, Dong-Uk Park
Ann Occup Environ Med 2026;38:e18.   Published online June 15, 2026
DOI: https://doi.org/10.35371/aoem.2026.38.e18
AbstractAbstract AbstractAbstract in Korean PDF
Background
Although most countries maintain occupational safety and health (OSH) legislation to prevent occupational diseases, the legal codification and integration of occupational health risk assessment (HRA), exposure monitoring, and medical surveillance vary substantially across jurisdictions; therefore, this study compared the legal frameworks of Korea, the United Kingdom (UK), the European Union (EU), and the United States (US) to examine the linkage among these elements, assess whether they support estimation of individual cumulative past exposure, and derive implications for improving occupational disease prevention in Korea.
Methods
This qualitative comparative legal analysis examined employer obligations related to quantitative exposure monitoring, HRA, and medical surveillance under the OSH systems of the UK, the EU, the US, and Korea. Primary statutes and subordinate regulations were systematically reviewed to assess how these elements are mandated, linked, and supported by record-keeping provisions enabling cumulative exposure estimation.
Results
The UK and the EU explicitly require HRA as a regulatory starting point and link exposure monitoring and medical surveillance to the outcomes of risk assessment, with targeted hazard-based provisions for intrinsically high-risk agents. The US adopts a hybrid approach, imposing mandatory monitoring and medical surveillance for high-hazard substances under 29 Code of Federal Regulations 1910 Subpart Z while relying on general statutory duties elsewhere. Korea applies broad list-based requirements for exposure monitoring and medical surveillance that are largely independent of HRA outcomes and do not include legally mandated variables necessary for systematic cumulative exposure estimation. In contrast, the UK, the EU, and partially the US provide legal mechanisms, including long-term record-keeping provisions, that enable reconstruction of individual cumulative occupational exposure.
Conclusions
Strengthening the integration of HRA, exposure monitoring, and medical surveillance—together with improved record-keeping structures that support cumulative exposure reconstruction—may contribute to more effective occupational disease prevention and long-term medical surveillance in Korea.
영국·EU·미국의 질병 위험성평가, 작업환경측정, 질병감시 제도 비교를 통한 한국 직업병 감시제도에 대한 시사점
배경
대부분 국가는 근로자 직업병 예방을 위해 산업안전보건법을 운영하고 있다. 이 중 근로자 질병 위험성평가(위험성평가), 정량적 노출평가(작업환경측정 등), 질병감시제도의 내용과 연계 구조는 다르다.
방법
본 연구는 영국, EU, 미국, 한국의 산업안전보건법 중 노출평가, 위험성평가, 질병감시제도에 대한 의무 내용을 비교하고 고찰했다. 질병 위험 지표인 근로자 개인 과거 누적 노출 추정이 가능한지 기록내용도 포함했다.
결과
영국과 EU는 위험성평가를 질병 감시체계의 출발점으로 명시하고 이를 근거로 정량적 측정과 질병 감시를 연계하고, 일부 고 독성 유해인자(암과 변이원성 물질)에 대해서는 제한적인 유해성 기반 측정과 검진 의무 규정을 두고 있다. 미국은 29 CFR 1910 Subpart Z에 따라 약 30여가지 고 독성 물질에 대해 노출측정과 건강감시를 의무화하고, 그 외 유해인자는 일반적 법적 의무에 기반한 혼합형 제도를 운영한다. 모두 근로자 개인 누적 노출 수준 추정이 가능하도록 노출변수 등이 기록은 물론 보존기한이 30년 이상으로 의무화되어 있다. 반면 한국은 유해성 중심 인자 목록(약 190여 종)을 대상으로 따라 노출과 상관없이 작업환경측정과 질병감시(특수건강검진)를 의무화하고 위험성평가 등 제도와의 연계가 제한적이다. 또한 개인 누적 노출을 추정하기 위한 항목(근무기간별 직무변화, 노출강도 등) 기록 의무도 없다.
결론
한국은 근로자 개인 누적 노출에 기반한 질병 위험을 평가하는 위험성평가, 작업환경측정, 특수건강검진 제도가 서로 연계되어 직업병 감시체계를 강화하는 제도 개선이 필요하다.
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Original Article
Usefulness of High Resolution Computed Tomography (HRCT) in the Diagnosis of Asbestos-Related Lung Diseases
Hyun Jae Lee, Ji Eun Son, Young Seoub Hong, Young Ill Lee, Byung Jin Yeah, Chang Hun You, Kap Yeol Jung, Sang Hoon Kim, Hyoung June Im, Eun Chul Jang, Jung Man Kim, Joon Youn Kim
Korean Journal of Occupational and Environmental Medicine 2006;18(2):112-122.   Published online June 30, 2006
DOI: https://doi.org/10.35371/kjoem.2006.18.2.112
AbstractAbstract PDF
OBJECTIVES
This study was carried out to improve the medical surveillance program of workers exposed to asbestos by examining the usefulness of High Resolution Computed Tomography (HRCT) in the diagnosis of asbestos-related lung disease.
METHODS
The study subjects comprised 162 workers in a ship-repairing yard, 68 of whom had been directly exposed to asbestos and 94 indirectly exposed. The 'Occupational Safety & Health Administration (OSHA) asbestos standard, medical surveillance program' and HRCT were conducted to analyze the aspects of the asbestos-related lung disease. The OSHA asbestos standard, medical surveillance program consists of simple chest x-ray, spirometry and medical questionnaire.
RESULTS
Seventeen (10.5%) of the 162 subjects, 10 (14.7%) directly exposed and 7 (7.4%) indirectly exposed, revealed asbestos-related lung disease on HRCT. The sensitivity and specificity of simple chest x-ray for asbestos-related lung disease were 70.6% and 98.6%, and the positive and negative predictive values were 85.7% and 96.6% respectively, as compared with HRCT. HRCT was an effective diagnostic tool especially to detect early asbestos-related lung disease. The study results indicated a relative significant association between the results of spirometry and HRCT. The variables significantly associated with asbestos-related lung disease on HRCT were work duration, smoking history (pack-years), past history of respiratory disease, cough and dyspnea.
CONCLUSIONS
In the diagnosis of asbestos-related lung disease, HRCT should be considered not only for workers with positive findings on simple chest x-ray, but also workers with specific findings on spirometry, occupational history, smoking history, and past history of respiratory disease, or with respiratory symptoms such as cough and dyspnea.

Citations

Citations to this article as recorded by  
  • Radiologic Diagnosis of Asbestos-Related Lung Cancer
    Yoon Kyung Kim, Jeung Sook Kim, Yookyung Kim
    Journal of the Korean Society of Radiology.2015; 73(6): 347.     CrossRef
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