Annals of Occupational and Environmental Medicine

Original Article

Korean occupational and environmental medicine specialists: demand-supply projections: Hee-Tae Kang, Hye-Eun Lee, Mo-Yeol Kang, Chungwon Kang, Kyong sok Shin, Hyeon-Taek Heo, Yong Lim Won, Jungwon Kim; Ann Occup Environ Med 2026;e34. Published online July 27, 2026; DOI: https://doi.org/10.35371/aoem.2026.38.e34 [Accepted]

Abstract PDF: Background
Korea has experienced changes in the balance between the demand for and supply of occupational and environmental medicine (OEM) specialists due to recent policy and environmental shifts. This study projected demand and supply for these specialists for 2025–2035, focusing on those working in special health examination institutions and occupational health management agencies.
Methods
Demand was estimated by applying 2024 average workloads per OEM specialist to projected volumes of special health examinations and outsourced occupational health management for 2025–2035 under four scenarios that varied growth in outsourced management and the share of OEM specialists among participating physicians. Supply was projected using registration and official statistics for 1,010 specialists certified by 2025, combined with detailed residency cohort data, assumptions on future quotas, completion, and age at certification, and age-specific proportions working in the two institution types.
Results
Average workloads in 2024 were 4,793 workers per OEM specialist for special health examinations and 9,193 workers per physician for outsourced occupational health management. The number of OEM specialists younger than 90 years is projected to increase from 968 in 2025 to 1,244 in 2035, with those working in the two institution types increasing from 697 to 910. Depending on the scenario, demand in 2035 ranges from 838 to 943 specialists, with supply exceeding demand in three scenarios but remaining 33 specialists short in the most expansionary scenario.
Conclusions
Short‑term shortages of OEM specialists are likely but remain highly manageable, after which surplus capacity is expected. Policy efforts should therefore stabilize OEM residency pipelines and prepare institutional mechanisms to deploy surplus specialists beyond special health examinations and outsourced occupational health management.

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Brief Communication

Workers' opinions on working time regulations: results from the 5th Korean Work, Sleep, and Health Study (KWSHS): Jeong Woo Park, Seong-Sik Cho, Mo-Yeol Kang, Min Choi, Jongwoo Lee; Ann Occup Environ Med 2026;e32. Published online July 21, 2026; DOI: https://doi.org/10.35371/aoem.2026.38.e32 [Accepted]

Abstract PDF: Although South Korea's average annual working hours have declined over recent decades, the country continues to rank higher among Organisation for Economic Co-operation and Development countries. Despite ongoing policy debates on working time reform, public perspectives on specific regulatory measures among Korean workers remain underexplored. This study analyzed data from the 5th wave of the Korean Work, Sleep, and Health Study (KWSHS). The survey was conducted in September 2024 via an online platform. A total of 5,783 working adults aged 19–70 years were included. Participants were asked about their opinions on five working time regulatory measures, including the current weekly hour cap, extending regulations to small companies and exempt industries, introducing a daily working hours limit, regulating non-essential night work, and restricting weekend work for large supermarkets. A majority of respondents supported all five proposed regulatory measures. Support was highest for introducing a daily working hours cap (72.1% agree or strongly agree), followed by regulating non-essential night work (63.2%), extending the cap to small companies (60.1%), restricting weekend work for large supermarkets (60.7%), and introducing the weekly cap for exempt industries (52.8%). While 34.7% favored reducing the current weekly maximum, 36.5% preferred maintaining the current limit. The survey respondents generally support strengthening working-time regulations. These findings provide workers’ opinions on working-time regulations, although they should be interpreted within the study's limitations (a sample with a higher proportion of office workers).

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Original Article

The relations among workplace verbal abuse, job stress, and good self-rated health among Korean wage workers: Evidence from the 7th Korean Working Conditions Survey (KWCS): Youngdo Kim, Jung Wook Kim, Jung Ho Yang; Ann Occup Environ Med 2026;e29. Published online July 14, 2026; DOI: https://doi.org/10.35371/aoem.2026.38.e29 [Accepted]

Abstract PDF: Background
Workplace verbal abuse has increasingly been recognized as a psychosocial hazard affecting employees’ health. Although its direct psychological consequences have been well documented, the mechanisms through which verbal abuse shapes employees’ self-rated health have been less thoroughly examined. In particular, limited empirical attention has been given to the mediating role of job stress in this relationship. The association between workplace verbal abuse and good self-rated health among Korean wage workers was investigated, and the mediating role of job stress in this relationship was further examined.
Methods
Data were drawn from the 7th Korean Working Conditions Survey (KWCS), which included a nationally representative sample of 26,427 wage workers aged 20 years or older. Verbal abuse, job stress, and good self-rated health were assessed using structured self-report items. Multivariable logistic regression analyses were performed to evaluate associations among verbal abuse, job stress, and good self-rated health, with adjustments made for individual- and occupational/workplace-related covariates.
Results
Workplace verbal abuse was significantly associated with higher odds of job stress (odds ratio [OR]: 1.527; 95% confidence interval [CI]: 1.300–1.803; p < 0.001) and lower odds of good self-rated health (OR: 0.641; 95% CI: 0.566–0.726; p < 0.001). Mediation analysis indicated that job stress partially mediated the relationship between verbal abuse and good self-rated health, accounting for 2.38% of the total effect (indirect effect: –0.0021; p < 0.001), while the direct effect of verbal abuse remained significant.
Conclusion
Workplace verbal abuse was associated with poorer good self-rated health, both directly and indirectly through job stress. These findings highlight the need for organizational interventions and policy-level strategies aimed at reducing verbal aggression and mitigating occupational stress.

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Case Report

Sinonasal hemangiosarcoma following juvenile occupational exposure to formaldehyde when breeding farm animals: Daniela Napolitano, Stefania Massacesi, Roberto Calisti; Ann Occup Environ Med 2026;e27. Published online July 13, 2026; DOI: https://doi.org/10.35371/aoem.2026.38.e27 [Accepted]

Abstract PDF: Background
Hemangiosarcomas are heterogeneous malignancies possibly originating in any part of the body, rare in humans. The web of causation of human hemangiosarcomas remains poorly understood, to date, except for subsets of cases which have been recognized in a well-defined causal correlation to vinyl chloride or to ionizing radiation. In 2005, the International Agency for Research on Cancer ranked formaldehyde as a human carcinogen, causally related to both nasopharyngeal cancers and acute non-lymphocytic leukemias; at the time, the evidence in favor of a causal relationship of formaldehyde to sinonasal cancers was stated as “limited”. In 2024, an umbrella review reported a significantly increased risk for sinonasal cancers among formaldehyde-exposed workers.
Case presentation
A sinonasal hemangiosarcoma affecting an Italian male born in 1957, diagnosed in 2022, was reported to the Italian National Registry of Sino-Nasal Cancers (ReNaTuNS); the patient’s occupational history revealed a remote exposure to formaldehyde, used as a disinfectant, when breeding farm animals, from 1967 to 1976. No previous reporting has been found about a possible association between formaldehyde and sinonasal non-epithelial cancers.
Conclusions
Formaldehyde is, in our opinion, a suitable candidate to be considered for playing a causal role in the causation of the neoplasm; formal studies are required to test the hypothesis.

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Original Article

Association between shift work patterns and the incidence of prediabetes and diabetes among night shift workers: a retrospective cohort study: Hyundong Lee, Changil Shin, Minsun Kang, Jae Bum Park, Inchul Jeong, Jaehyuk Jung; Ann Occup Environ Med 2026;e26. Published online July 9, 2026; DOI: https://doi.org/10.35371/aoem.2026.38.e26 [Accepted]

Abstract PDF: Background
Prediabetes and diabetes represent major public health challenges, and shift work has been identified as a significant occupational risk factor. While two-shift systems are gaining preference over conventional three-shift systems, evidence comparing their risks for diabetes and prediabetes remains limited. We aimed to evaluate the risk of developing prediabetes and diabetes according to shift work patterns among night shift workers. Methods: This retrospective cohort study analyzed 14,879 night shift workers at a tertiary hospital in Korea (2016–2022). Participants were classified into two- and three-shift patterns. Incident diabetes and prediabetes were identified based on fasting blood glucose and hemoglobin A1c levels, diagnosis, or medication use. Data were censored at shift change, diagnosis, loss to follow-up, or the end of the study. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for demographics, lifestyle, body mass index, and occupational characteristics including working hours, consecutive night shifts, quick returns, and shift duration. Results: The two-shift group showed significantly higher incidence rates of diabetes and prediabetes than the three-shift group. After adjusting for covariates, two-shift work remained an independent risk factor for diabetes (adjusted HR: 1.43; 95% CI: 1.10–1.87) and prediabetes (adjusted HR: 1.34; 95% CI: 1.20–1.48). Stratified analyses indicated that the increased risk of diabetes associated with two-shift work was prominent in participants working 40 hours and 41–51 hours per week, whereas the association was not significant in those working ≥52 hours. Conclusions: Two-shift work was associated with a significantly higher risk of diabetes and prediabetes compared with three-shift work. Our findings highlight the need to consider specific shift schedules and their potential health effects when designing or selecting workforce systems, rather than focusing solely on productivity or preference.

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Case Report

Recurrent laryngeal leukoplakia in a cook occupationally exposed to cooking oil fumes: a case report: Kyung-Eun Lee, Seong Won Ma, Jiwoon Kwon, Young Shin Lee, Shinhee Ye; Ann Occup Environ Med 2026;e24. Published online July 1, 2026; DOI: https://doi.org/10.35371/aoem.2026.38.e24 [Accepted]

Abstract PDF: Background
This study reports a case of recurrent laryngeal leukoplakia, a precancerous lesion, in a female cook with long-term occupational exposure to cooking oil fumes. In 2022, the Korean Epidemiological Investigation Evaluation Committee determined that substantial scientific evidence supported the work-relatedness of the case.
Case presentation
A 55-year-old woman working as a cook in group-catering facilities in long-term care hospitals and general hospitals was referred to an otolaryngology clinic after an abnormal laryngeal finding was incidentally detected during routine upper gastrointestinal endoscopy in April 2018. Subsequent laryngoscopy revealed granulation tissue of the left vocal fold. Histopathological examination following laryngeal microsurgery confirmed high-grade dysplasia, leading to a diagnosis of left vocal fold leukoplakia, and the lesion was excised. During follow-up, persistent voice changes and recurrence of the lesion were identified, and repeat excision again demonstrated low- and high-grade dysplasia. The patient had worked as a cook for approximately 14.6 years and routinely performed oil-intensive cooking tasks, including frying, grilling, stir-frying, and battered-dish preparation, for approximately 2–4.5 hours per day. She reported insufficient ventilation during heavy fume generation. She had no history of smoking, passive smoking from her spouse, alcohol consumption, vocal abuse, gastroesophageal reflux disease, or mechanical trauma to the larynx.
Conclusions
This case suggests a possible occupational contribution of repeated intermittent exposure to cooking oil fumes and irritant aldehydes to recurrent laryngeal precancerous lesions among cooks. However, because direct historical exposure measurements were unavailable and this is a single case report, definitive causality cannot be established. Improvement of workplace ventilation and other exposure-control measures should be considered, and further studies with direct exposure assessment are needed.

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Original Article

Current status and demand projections for occupational and environmental medicine specialists: focus on special health examinations and outsourced occupational health management services: Hye-Eun Lee, Hee-Tae Kang, Mo-Yeol Kang, Chungwon Kang, Kyong Sok Shin, Hyeon-Taek Heo, Yong Lim Won, Jungwon Kim; Ann Occup Environ Med 2026;e23. Published online July 1, 2026; DOI: https://doi.org/10.35371/aoem.2026.38.e23 [Accepted]

Abstract PDF: Background
Occupational and environmental medicine (OEM) specialists are key personnel within the occupational health system. Recent developments, such as the introduction of the Serious Accidents Punishment Act and the expansion of occupational health policies targeting vulnerable workers, have highlighted the need to broaden the role of OEM specialists. This study analyzed the current workload of OEM specialists and projected their medium- to long-term demand.
Methods
The demand for OEM specialists was defined as the actual observed service utilization volume under the current legal, institutional, and policy environment. Key work areas were categorized as special health examinations and outsourced occupational health management services. Data sources included administrative records from the Korea Occupational Safety and Health Agency (KOSHA) and the Ministry of Employment and Labor (MoEL), statistics on worker health examination results, and evaluation data from specialized agencies for occupational health management. Demand through 2035 was projected by applying the observed historical growth trend in service utilization. The required number of specialists was calculated by applying the average workload per specialist in the base year.
Results
As of 2025, 577 OEM specialists were working at 255 special health examination institutions. Among the 153 occupational health management agencies, 265 physicians were employed, including 133 OEM specialists. The number of workers requiring services from OEM specialists is predicted to continue growing. Applying the current average workload per physician, an additional 132 special health examination physicians and 92 occupational health management agency physicians will be needed by 2035.
Conclusions
Actual workforce demand may differ from the projections presented in this study depending on changes in policies, industrial structure, service delivery models, and work efficiency. Future studies should incorporate need-based estimates that reflect the diverse roles of OEM specialists and use integrated workforce data to provide more refined projections.

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Original Article

Occupational differences in benzene-related biomarker levels beyond traditional industrial settings: findings from the Korean National Environmental Health Survey, 2015–2023: Chul Gab Lee; Ann Occup Environ Med 2026;38:e19. Published online June 15, 2026; DOI: https://doi.org/10.35371/aoem.2026.38.e19

Abstract PDF Supplementary Material: Background
Benzene is a group 1 carcinogen, and urinary trans,trans-muconic acid is a key biomarker of benzene exposure. Whether specific occupational groups in Korea have higher benzene body burdens beyond environmental levels has not been systematically evaluated using national biomonitoring data with smoking-adjusted biomarkers.
Methods
We pooled adult data from three cycles (3rd–5th) of the Korean National Environmental Health Survey (KoNEHS, 2015–2023; n = 10,786). Creatinine-adjusted urinary trans,trans-muconic acid (UttMACr) was analyzed across nine occupation groups using complex-samples general linear models with nested covariates. Sampling weights were rescaled within each cycle to harmonize weight scales across waves. Smoking was controlled using questionnaire-based variables and five-level creatinine-adjusted urinary cotinine (COTCr). Variance decomposition quantified predictors' contributions, and sensitivity analyses included COTCr-stratified models and analyses limited to the economically active population.
Results
Although population geometric mean UttMACr declined by 51% from the 3rd to 5th cycle, occupation remained a significant independent predictor after adjusting for temporal trends, smoking, demographic, and lifestyle covariates (ΔR² = 0.0018, p = 0.003). Cleaning/guard/elementary workers showed the highest elevation in the geometric mean ratio (GMR: 1.13; p < 0.001), followed by food/textile/other manufacturing (GMR: 1.12; p < 0.05) and chemical/metal/machinery manufacturing workers (GMR: 1.08; p < 0.05). COTCr-stratified analyses revealed occupation-specific patterns attenuated in pooled models: among participants with COTCr ≤ 1.0 μg/g creatinine, construction/mining (GMR: 1.62; p < 0.001) and agriculture/fishery (GMR: 1.41; p < 0.01) showed marked elevations.
Conclusions
Population UttMACr levels in Korea declined over time, but occupation-specific differences persisted after adjustment for trends, smoking, and sociodemographic factors. These findings suggest occupational benzene exposures may extend beyond traditionally recognized industrial settings and support more targeted biomonitoring, particularly for worker groups not routinely prioritized in current surveillance programs.

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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

Abstract Abstract 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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Case Report

Reactive airways dysfunction syndrome following acute lithium hydroxide dust exposure at a battery material production plant: a case series of 16 workers: Chul Gab Lee, Soo Hyeong Park, Jeong Joon Park, Han Soo Song, Hyeon Kyeong Ko, Sung Ho Yoon; Ann Occup Environ Med 2026;38:e17. Published online June 4, 2026; DOI: https://doi.org/10.35371/aoem.2026.38.e17

Abstract Abstract in Korean PDF: Background
Reactive airways dysfunction syndrome (RADS) is an acute-onset form of irritant-induced asthma that occurs after a single high-concentration exposure to irritants. Although RADS has been documented for chlorine, ammonia, and acid fumes, no published case series has attributed RADS to lithium hydroxide (LiOH) dust inhalation. We report the clinical features, diagnostic evaluation, and longitudinal management of 16 workers with persistent respiratory symptoms following acute occupational LiOH exposure at a battery cathode material production facility.
Case presentation
In March 2024, a silicone connector failure resulted in the leakage of approximately 50–100 kg of LiOH powder at a facility in Korea, exposing over 500 workers. Sixteen workers (15 men, 1 woman; mean age 53.4 years) with persistent respiratory symptoms were evaluated at the Department of Occupational and Environmental Medicine. Most patients presented with cough and sputum production; 56.3% (9/16) exhibited nocturnal or early-morning exacerbation. Methacholine challenge testing was performed in 10 patients, with positive results in three patients (PC20 [provocative concentration causing a 20% decline in forced expiratory volume in 1 second]: 1.36–6.74 mg/mL). By the Brooks 1985 criteria, one case was classified as definite RADS, four as probable, six as possible, and five as unlikely; American College of Chest Physicians 2008 cross-validation yielded identical classifications. Workers' compensation recipients had significantly longer follow-up (18–23 months) compared to non-recipients (1–3 months). Pharmacological management was symptom-directed, combining leukotriene receptor antagonists, mucolytics, antihistamines, and acid-suppressive therapy.
Conclusions
Acute high-concentration LiOH dust inhalation may induce RADS characterized by persistent respiratory symptoms and bronchial hyperresponsiveness. The extreme alkalinity, high water solubility, and exothermic dissolution of LiOH provide a plausible mechanistic framework for airway injury. Clinicians should consider RADS in workers presenting with persistent respiratory symptoms after alkaline dust exposure, even when routine investigations are unremarkable. Attention should also be given to the psychological burden associated with prolonged, poorly recognized symptoms.; 배터리 소재 생산 공장에서 수산화리튬 분진에 급성 노출된 후 발생한 반응성 기도 기능장애증후군(RADS): 16명 사례
배경
(Background): 반응성 기도 기능장애 증후군(reactive airways dysfunction syndrome, RADS)은 자극 물질에 단 한 번 고농도로 노출된 직후 급성으로 발현하는 자극유발천식(irritant-induced asthma, IIA)의 한 형태이다. 염소(chlorine)나 암모니아(ammonia), 산성 증기에 의한 RADS는 이미 보고되어 왔으나, 수산화리튬(lithium hydroxide, LiOH) 분진 흡입에 의한 RADS 사례는 현재까지 보고된 적이 없다. 본 연구에서는 배터리 양극재 생산시설에서 LiOH에 직업적으로 급성 노출된 후 호흡기 증상이 지속된 16명 노동자의 임상 양상, 진단 평가, 그리고 장기 관리 경과를 보고한다.
증례
(Case Presentation): 2024년 3월, 국내 한 시설에서 실리콘 커넥터의 파손으로 인해 약 50–100 kg의 LiOH 분말이 누출되어 500명 이상의 노동자가 노출되었다. 이 가운데 호흡기 증상이 지속된 16명(남자 15명, 여자 1명; 평균 연령 53.4세)이 직업환경의학(OEMD)에서 치료받았다. 대부분의 환자에서 기침과 객담 증상이 확인되었고, 56.3%(9/16명)에서 야간 또는 새벽 시간대 증상 악화가 관찰되었다. 메타콜린기관지유발검사(methacholine challenge test, MCT)는 10명에서 시행되었으며, 이 중 3명이 양성 소견(PC20 1.36–6.74 mg/mL)을 보였다. Brooks의 1985년 진단 기준을 적용했을 때 확정(definite) RADS 1명, 가능성 높음(probable) 4명, 가능성 있음(possible) 6명, 가능성 낮음(unlikely) 5명으로 분류되었고, ACCP(미국흉부내과학회) 2008 기준을 이용한 교차 평가에서도 동일한 분류 결과가 얻어졌다. 산업재해 보상(workers' compensation, WC) 승인을 받은 환자들은 18–23개월 동안 추적 관찰된 반면, 신청하지 않은 환자들은 1–3개월에 그쳐 추적 기간에 뚜렷한 차이를 보였다. 약물치료는 증상 완화를 목표로 류코트리엔 수용체길항제 (leukotriene-receptor antagonist), 거담제(mucolytics), 항히스타민제 (antihistamines), 위산분비 억제제(acid-suppressive therapy)를 병용하는 방식으로 처방되었다.
결론
(Conclusions): 고농도의 LiOH 분진을 급성으로 흡입할 경우 지속적인 호흡기 증상과 기관지 과민성(bronchial hyperresponsiveness)을 특징으로 하는 RADS가 유발될 수 있다. LiOH의 극단적인 알칼리성, 높은 수용성, 그리고 용해 시의 발열 반응은 기도 손상을 설명할 수 있는 병태생리학적 기전을 뒷받침한다. 따라서 임상의는 알칼리성 분진에 노출된 후 지속적인 호흡기 증상을 호소하는 노동자에 대해 통상적인 검사 소견이 정상이더라도 RADS 가능성을 염두에 두어야 한다. 더불어 장기간 지속되면서 충분히 인정받지 못하는 증상으로 인해 발생하는 심리적 부담에도 주의를 기울여야 한다.

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Original Article

Evaluating the efficacy of prednisolone for silicosis with progressive massive fibrosis in Australia: an observational pilot study: Hayley Barnes, David P. Nadebaum, Daniel Niewodowski, J. K. Khoo, Yuan Z. Lim, Bradley Gardiner, Tiffany Lin, Martin Cherk, Miranda Siemienowicz, Jyotika D. Prasad, Ryan Hoy; Ann Occup Environ Med 2026;e16. Published online June 4, 2026; DOI: https://doi.org/10.35371/aoem.2026.38.e16 [Accepted]

Abstract PDF: Background
There has been a resurgence of silicosis, particularly related to artificial stone. There are currently no treatments for silicosis beyond lung transplantation for end-stage disease. To evaluate the efficacy of prednisolone in people with artificial stone-associated silicosis–progressive massive fibrosis (PMF).
Methods
This was a pilot prospective observational clinical trial, assessing 3 months of prednisolone in adults with artificial stone–associated silicosis with PMF. Outcomes were assessed at 3 and 12 months.
Results
Seven participants completed the study. Baseline positron emission tomography (PET) scans demonstrated increased fluorine-18 fluorodeoxyglucose (18F-FDG) uptake in areas of PMF in all participants. All participants had a significant reduction in maximum standardized uptake value (SUVmax) following prednisolone at 3 months (pre-treatment mean SUVmax 6.7 [standard deviation (SD): 2.6], post-treatment mean SUVmax 4.2 [SD: 1.0], p = 0.01). There was also a non-significant reduction in the % of total lung parenchyma with SUV >1 (49.7% [SD: 36.4] to 45.8% [SD: 28.4], p = 0.52) and a significant reduction in SUV >2.5 (7.0% [SD: 6.3] to 2.4% [SD: 2.2], p = 0.03). There was a non-significant reduction in computed tomography ICOERD well-defined opacity profusion scores and large opacities. There was no significant difference in lung function or St. George's Respiratory Questionnaire. There were no serious adverse events.
Conclusions
There are high levels of inflammation in silicosis-PMF as evidenced by 18F-FDG PET. Short-term prednisolone reduced 18F-FDG PET activity. This suggests a possible therapeutic pathway for people with silicosis-associated PMF in a population with no current treatments. Further research is required to determine the most appropriate immunosuppressive strategy and further assess longer-term outcomes.

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Original Article

Relationship between obstructive sleep apnea risk and low back pain among shift workers in a tire manufacturing factory: Sunjin Jung, Seunghyeon Cho, Suwhan Kim, Kyung Wook Kang, JiHwan Kim, Won-Ju Park; Ann Occup Environ Med 2026;38:e15. Published online May 12, 2026; DOI: https://doi.org/10.35371/aoem.2026.38.e15

Abstract Abstract in Korean PDF: Background
Low back pain (LBP) is highly prevalent among industrial workers, and obstructive sleep apnea (OSA) has been increasingly recognized as a factor influencing pain modulation. This study evaluated the association between OSA risk, assessed by the STOP-Bang questionnaire, and LBP among shift workers in a tire manufacturing factory.
Methods
A total of 976 male shift workers from a tire manufacturing factory were analyzed. OSA risk was assessed using the STOP-Bang questionnaire and classified as low, moderate, or high. LBP and musculoskeletal pain were defined as self-reported symptoms occurring within the preceding 6 months. Multivariable logistic regression analyses were performed to estimate odds ratios (ORs) and 95% confidence intervals (CIs).
Results
Compared with workers at low OSA risk, those at moderate and high risk had significantly higher odds of LBP (OR: 1.50; 95% CI: 1.02–2.20; p = 0.038; and OR: 1.75; 95% CI: 1.20–2.55; p = 0.004, respectively). Similarly, moderate and high OSA risk were independently associated with increased odds of musculoskeletal pain (OR: 1.86; 95% CI: 1.26–2.73; p = 0.002; and OR: 1.84; 95% CI: 1.26–2.68; p = 0.002, respectively).
Conclusions
Among male shift workers, elevated OSA risk is independently associated with a higher prevalence of LBP and musculoskeletal pain. Systematic workplace screening for OSA risk using the STOP-Bang questionnaire may support occupational health assessments by identifying shift workers with elevated OSA risk who are more likely to report pain-related morbidity.; 타이어 제조공장 교대근무 근로자에서 폐쇄성 수면무호흡증 위험과 요통 및 근골격계 통증 간의 연관성
배경
요통은 산업 근로자 사이에서 흔히 나타나는 증상이며, 폐쇄성 수면무호흡증은 통증 조절에 영향을 미치는 요인으로 알려져 있다. 본 연구는 타이어 제조공장에서 야간교대근무를 수행하는 근로자를 대상으로 수면무호흡증 위험도와 요통 간의 연관성을 평가하고자 하였다.
방법
타이어 제조공장에서 근무하는 남성 생산직 교대근무자 976명을 대상으로 분석을 수행하였다. 폐쇄성 수면무호흡증 위험도는 STOP-Bang 설문지를 이용하여 낮음, 중간, 높음의 세 집단으로 분류하였다. 요통 및 요통 외 근골격계 통증은 최근 6개월 이내 증상의 경험 여부를 기준으로 정의하였다. 다변량 로지스틱 회귀분석을 통해 교차비와 95% 신뢰구간을 산출하였다.
결과
폐쇄성 수면무호흡증 위험도가 중간 또는 높은 군은 낮은 군에 비해 요통 발생 위험이 유의하게 높았다(중간 위험군: OR 1.50, 95% CI: 1.02–2.20, p = 0.038; 고위험군: OR 1.75, 95% CI: 1.20–2.55, p = 0.004). 요통 외 근골격계 통증 역시 중간 및 고위험군에서 유의한 연관성이 관찰되었다(중간 위험군: OR 1.86, 95% CI: 1.26–2.73, p = 0.002; 고위험군: OR 1.84, 95% CI: 1.26–2.68, p = 0.002).
결론
남성 생산직 교대근무자에서 폐쇄성 수면무호흡증 위험도가 높을수록 요통 및 근골격계 통증의 유병률이 독립적으로 증가하는 것으로 나타났다. 직장 내 수면 관련 질환에 대한 체계적인 관리를 통한 교대근무자의 통증 부담을 경감에 관한 추가적인 연구가 필요하다.

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Original Article

Association between relative handgrip strength and glycemic control among male automobile manufacturing workers using vibration tools in South Korea: Dong-Jae Seo, Hyun Joong Kim, Yongjin Kim, Jaewon Mun, Jong-Han Leem, Shin-Goo Park, Dong-Wook Lee, Hwan-Cheol Kim; Ann Occup Environ Med 2026;38:e14. Published online April 8, 2026; DOI: https://doi.org/10.35371/aoem.2026.38.e14

Abstract Abstract in Korean PDF Supplementary Material: Background
Although the association between handgrip strength and glycemic control has been reported, studies conducted exclusively within specific occupational groups remain limited. To explore the association between handgrip strength and metabolic health in industrial settings, this study examined the relationship between relative handgrip strength and glycated hemoglobin (HbA1c) among male automobile manufacturing workers using vibration tools in South Korea.
Methods
Using 66,212 occupational health examination records collected at Inha University Hospital between January 2024 and April 2025, a total of 3,365 workers with HbA1c and handgrip strength measurements were identified. After excluding duplicates (n = 1,536), female workers (n = 2), and records without Hb and estimated glomerular filtration rate, 1,823 male participants were included in the final analysis. Relative handgrip strength was calculated as the maximum value of bilateral grip strength divided by body mass index. Multiple linear regression analyses were conducted to assess the association between relative handgrip strength and HbA1c, adjusting for age, smoking status, alcohol consumption, current hypertension, current dyslipidemia, current hypoglycemic-agents use, family diabetes history, leisure-time physical activity, and resistance exercise.
Results
Relative handgrip strength was inversely associated with HbA1c levels (B: –0.060; 95% confidence interval [CI]: −0.081 to −0.039; p < 0.001). The association was strongest among normoglycemic participants (B: −0.185; 95% CI: −0.305 to −0.065; p = 0.003). Effect size was reduced but significantly associated among individuals with prediabetes (B: −0.115; 95% CI: −0.180 to −0.050; p < 0.001) and further attenuated to a borderline significance in individuals with diabetes (B: −0.023; 95% CI: −0.050 to 0.003; p = 0.082). These findings indicate that greater muscle strength relative to body size is related to better glycemic control.
Conclusions
Handgrip strength was associated with HbA1c levels in industrial workers. This study suggests that handgrip strength may provide complementary information on metabolic health in occupational settings.; 상대악력과 당화혈색소 간의 관계: 진동 공구를 사용하는 한국 자동차제조업 남성 근로자를 대상으로한 연구
목적
악력과 혈당조절 간의 관계는 선행연구에서 보고된 바 있으나, 특정직업군 내에서 수행된 연구는 제한적이다. 본 연구는 진동 공구를 사용하는 한국 자동차제조업 남성 근로자를 대상으로 상대악력과 당화혈색소간의 관계를 조사하였으며, 산업환경에서의 악력이 대사건강에 대한 보조적 정보를 제공할 수 있는 지 살펴보고자 하였다.
방법
2024년 1월부터 2025년 4월까지 인하대병원에서 수집된 66,212건의 건강검진기록을 바탕으로, 당화혈색소와 악력측정, 혈색소와 추정사구체여과율(eGFR) 결과가 모두 포함된 1,823명의 남성근로자를 대상으로 하였다. 상대악력은 양손악력 중 최대값을 체질량지수로 나누어 계산하였다. 연령, 혈색소, eGFR, 흡연여부, 음주여부, 고혈압, 고지혈증, 당뇨가족력, 여가시간 유산소운동, 근력운동을 보정한 후 다중선형회귀분석을 수행하여 상대악력과 당화혈색소간의 관계를 평가했다.
결과
상대악력은 당화혈색소 수치와 음의 상관관계를 보였으며 (B= -0.060, 95% CI -0.081 to -0.039 p < 0.001), 이 관계는 정상군에서 가장 강하게 나타났다 (B = -0.185, 95% CI -0.305 to -0.065, p=0.003). 전당뇨군에서는 효과크기는 줄어들었으나, 통계적으로 유의미한 악력 감소(B = -0.115, 95% CI -0.180 to -0.050 p<0.001)를 보였고, 당뇨군에서는 관계성이 낮아졌고, 경계적 유의성을 보였다 (-0.023, 95% CI -0.050 to 0.003, p=0.082). 이 결과는 높은 악력이 좋은 혈당조절과 관련이 있음을 시사한다.
결론
악력은 간단하고 저비용이며 비침습적인 생체지표로, 산업근로자에서 상대악력이 낮을수록 당화혈색소가 높은 경향을 보였다.

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Original Article

Occupational Diseases in Mongolia: A Retrospective Analysis (1975–2023) with a 30-Year Trend Study: Sansartsetseg Tsendjav, Myagmarchuluun Sainnyambuu, Otgonbayar Damdinbazar, Ulzii-Orshikh Ragchaabazar, Gantugs Yundendorj; Ann Occup Environ Med 2026;38:e12. Published online March 24, 2026; DOI: https://doi.org/10.35371/aoem.2026.38.e12

Abstract PDF Supplementary Material: Background
Occupational diseases represent a significant global public health challenge, yet reliable data from transitioning economies remain limited. This study aimed to analyze newly confirmed occupational disease cases in Mongolia over a 50-year period (1975–2023), identifying long-term trends and the prevalence of leading disease categories.
Methods
A retrospective, record-based study was conducted using quantitative data from 10,233 officially confirmed and compensated cases of occupational diseases resulting in an officially certified loss of labor capacity. Incidence rates per 100,000 workers were calculated for the 1992–2023 period. Leading diseases were classified by organ system, with focused analyses on respiratory diseases, occupational poisonings, and neurological disorders.
Results
Dust- and particulate-induced respiratory diseases accounted for the largest proportion of cases (57.4%), followed by occupational neurological disorders (16.2%) and occupational poisonings (8.0%). From 1992 to 2023, incidence rates among male workers were consistently 3–7 times higher than those among female workers. Analysis of exposure duration showed mean durations of 13.6 ± 4.9 years for silicosis (J62) and 20.7 ± 10.7 years for inorganic substance poisoning (T57). While respiratory diseases were predominant historically, occupational neurological diseases demonstrated an increasing trend after 2015.
Conclusions
Occupational neurological disorders are showing an increasing trend in Mongolia, reflecting a shift in the national occupational disease pattern. However, as the registry is based on the national compensation framework, these findings likely reflect recognized cases rather than the true epidemiological incidence, suggesting potential underreporting. Strengthening surveillance beyond the compensation system and improving diagnostic capacity for a broader range of work-related conditions are essential for effective prevention and policy development.

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Case Report

Severe bilateral hydrocarbon pneumonitis requiring surgical drainage following accidental aspiration of industrial cleaning solvent in a seafarer: a case report: Sang-Heon Cho, Jong Gill Jeong; Ann Occup Environ Med 2026;38:e8. Published online March 11, 2026; DOI: https://doi.org/10.35371/aoem.2026.38.e8

Abstract Abstract in Korean PDF: Background
Hydrocarbon pneumonitis is typically self-limiting, and severe complications, such as lung abscesses, are rare. Here, we report the case of a seafarer who developed bilateral lung abscesses after aspirating an industrial cleaning solvent, highlighting the aggravating role of delayed medical care and improper first-aid measures in a maritime setting.
Case presentation
A 46-year-old seafarer presented with dyspnea, 3 days after accidentally ingesting a hydrocarbon-based solvent that he mistook for water. Although he immediately spat out the fluid, he aspirated a small amount. His condition rapidly deteriorated to necrotizing pneumonia with bilateral lung abscesses, as confirmed by chest computed tomography. Despite empirical antibiotic therapy, the abscess worsened, necessitating a video-assisted thoracic surgery for drainage. The patient recovered after surgery and underwent a prolonged course of antibiotic therapy.
Conclusions
This case underscores the potential for life-threatening complications from industrial solvent aspiration, exacerbated by delayed medical care and forceful spitting. Strict workplace safety protocols, including the prohibition of storing chemicals in food containers to avoid confusion, and awareness about not inducing vomiting after ingestion, are essential to prevent such severe occupational injuries.; 산업용 세척 용제를 우발적으로 흡인한 선원에서 발생한 수술적 배액술이 필요했던 중증 양측성 탄화수소 폐렴에 대한 증례보고
배경
탄화수소에 의한 폐렴은 일반적으로 자연 치유되는 경과를 보이며, 폐농양과 같은 심각한 합병증은 드물다. 본 증례에서는 산업용 세척 용제를 흡인한 후 양측성 폐농양으로 발전한 선원의 사례를 보고하며, 특히 해상 환경에서의 지연된 의료 처치와 부적절한 응급처치가 병세를 악화시키는 요인임을 강조하고자 한다.
증례
46세 선원이 탄화수소 계열의 용제를 물로 오인하여 우발적으로 섭취한 지 3일 후 호흡곤란을 주소로 내원하였다. 환자는 즉시 액체를 뱉어냈으나, 그 과정에서 소량을 흡인하였다. 환자의 상태는 급격히 악화되어 괴사성 폐렴 및 양측성 폐농양으로 진행되었으며, 이는 흉부 컴퓨터단층촬영을 통해 확인되었다. 경험적 항생제 치료에도 불구하고 농양은 악화되었고, 결국 배농을 위한 비디오 흉강경 수술을 시행하였다. 환자는 수술 후 회복되었으며, 장기간의 항생제 치료를 받았다.
결론
본 증례는 산업용 용제 흡인이 생명을 위협하는 합병증을 유발할 수 있음을 보여주며, 이러한 위험은 의료 처치의 지연과 흡인 위험을 높이는 강하게 뱉어내는 행위로 인해 더욱 악화될 수 있음을 시사한다. 혼동을 방지하기 위해 식품 용기에 화학물질 보관을 금지하는 등의 엄격한 작업장 안전 수칙 준수와, 섭취 후 억지로 구토를 유발하지 않아야 한다는 점에 대한 인식 제고는 이러한 심각한 직업성 손상을 예방하는 데 필수적이다.

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Case Report

Multiple chemical sensitivity triggered by an automobile mechanic's indirect exposure to volatile organic compounds in the Republic of Korea: a case report: Dong-Hoon Cheon, Yoon-Ji Kim, Dongmug Kang, Youngki Kim, Eun-Soo Lee, Ki-Hun Kim, Se-Yeong Kim; Ann Occup Environ Med 2026;38:e7. Published online February 26, 2026; DOI: https://doi.org/10.35371/aoem.2026.38.e7

Abstract Abstract in Korean PDF: Background
Multiple chemical sensitivity (MCS) lacks definitive biomarkers, making differential diagnosis reliant on exclusion and symptom reproducibility. In automobile repair shops, volatile organic compounds (VOCs) from cleaning agents pose risks not only to primary users but also to co-workers via indirect exposure. We report a case of MCS suspected to be triggered solely by bystander VOC exposure, highlighting the clinical significance of uncaptured peak exposures in Korea.
Case presentation
A 23-year-old mechanic experienced recurrent headaches, throat irritation, and nausea immediately after co-workers used aerosolized cleaners in a poorly ventilated workspace. Symptoms consistently improved when he was away from work. Routine clinical evaluations were unremarkable. Although the patient underwent surgery for chronic rhinosinusitis, the symptoms persisted specifically upon re-exposure, effectively ruling out structural otorhinolaryngologic causes. Mental health screening indicated only mild depressive symptoms, insufficient to account for the severity of the physical symptoms. The Quick Environmental Exposure and Sensitivity Inventory (QEESI) scores were in the "suggestive" range for MCS. While routine workplace monitoring (8-hour time-weighted average [TWA]) showed non-detectable solvent levels, the nature of aerosol application suggested uncaptured short-term peak exposures. Based on the distinct temporal relationship, the patient was placed under medical observation and assessed as fit for work with restrictions on solvent exposure.
Conclusions
This case highlights the role of indirect VOC exposure as a trigger for MCS symptoms even when routine TWA monitoring indicates minimal concentrations. The discrepancy likely stems from the brief peak exposures triggering central sensitization, underscoring the limitations of standard monitoring. Management strategies must focus on peak-exposure control and fitness-for-work assessments that mandate strict avoidance of organic solvents, regardless of average ambient concentrations.; 국내 자동차 정비사의 휘발성 유기화합물 간접 노출에 의해 유발된 다중화학물질과민증: 증례 보고
배경
다중화학물질과민증(Multiple Chemical Sensitivity, MCS)은 명확한 바이오마커가 부족하여 배제 진단과 증상의 재현성에 의존하여 진단된다. 자동차 정비 현장에서 발생하는 휘발성 유기화합물(VOCs)은 직접 사용자뿐만 아니라 간접 노출되는 주변 작업자에게도 건강상의 위험을 초래한다. 본 저자들은 한국의 일반적인 작업환경측정 체계에서 포착되지 않는 단기 피크 노출(peak exposure)의 임상적 중요성을 강조하며, 간접 노출에 의해 유발된 MCS 사례를 보고하고자 한다.
증례
보고: 23세 남성 정비사가 환기가 불충분한 작업장에서 동료들이 에어로졸 세정제를 사용할 때마다 반복적인 두통, 인후 자극 및 오심을 경험하였다. 증상은 작업장을 벗어났을 때 일관되게 호전되는 양상을 보였다. 일반적인 임상 검사 결과는 정상 범위였으며, 만성 비부비동염 수술 후에도 유기용제 재노출 시 증상이 지속되어 이비인후과적 구조적 원인은 배제되었다. 정신건강 스크리닝 결과는 경미한 우울 증상만을 보였으며, 이는 신체 증상의 심각성을 설명하기에 불충분하였다. 한국판 QEESI(Quick Environmental Exposure and Sensitivity Inventory) 설문 결과 MCS '시사(Suggestive)' 범위에 해당하였다. 작업환경측정 결과(8시간 시간가중평균, TWA)는 유기용제 불검출 수준이었으나, 에어로졸 사용 특성상 측정되지 않은 단기 피크 노출이 의심되었다. 뚜렷한 시간적 인과관계를 바탕으로 환자는 의학적 관찰 대상이 되었으며, 유기용제 노출 제한을 조건으로 '조건부 작업 적합' 판정을 받았다.
결론
본 증례는 통상적인 TWA 측정치가 낮음에도 불구하고 간접적인 VOC 노출이 MCS 증상의 트리거가 될 수 있음을 시사한다. 이러한 불일치는 단기 피크 노출이 중추 감작(central sensitization)을 유발하기 때문으로 보이며, 이는 표준 측정 방식의 한계를 보여준다. MCS의 관리는 평균 노출 농도와 관계없이 피크 노출 제어 및 엄격한 유기용제 노출 회피를 포함하는 업무적합성 평가에 초점을 맞추어야 한다.

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Original Article

Acute health effects of accidental exposure to lithium hydroxide at a battery material production plant: Chul Gab Lee, Soo Hyeong Park, Ji Won Kang, Si Woo Hwang, Hyeo Na Kim, Hyeon Kyeong Ko; Ann Occup Environ Med 2026;38:e6. Published online February 9, 2026; DOI: https://doi.org/10.35371/aoem.2026.38.e6

Abstract Abstract in Korean PDF

Background
Lithium hydroxide (LiOH) is increasingly used in electric vehicle battery production; however, its health effects in the work environment remain underreported. This study characterizes the acute health effects on workers following accidental occupational exposure to LiOH at a Korean lithium plant in March 2024.
Methods
We analyzed health effects from two LiOH exposure accidents on March 6 and 9, 2024, involving 50–100 kg powder spills. Two datasets were examined: acute symptoms from 115 workers who visited hospitals immediately after exposure, and a symptom severity survey from 474 workers conducted 2 weeks post-exposure. Workers were stratified by distance from the leak source (<10 m, 10–20 m, >20 m) and respirator use. Univariate general linear modeling was applied to analyze the relationship between symptom occurrence and both the distance from the exposure source and respirator use.
Results
Among workers visiting hospitals immediately, local irritation symptoms predominated: sore throat (58.3%), cough (28.7%), and skin dermatoses (17.4%). Systemic symptoms included headache (45.2%), nausea (18.3%), chest tightness (12.2%), and dizziness (9.6%). Two-week follow-up revealed overall symptom improvement; severe cough decreased from 22.2% to 10.1%. However, despite general improvement, a significant portion of workers reported persistent respiratory issues, including cough (28.7%) and sputum production (31.0%). Symptom severity showed a significant dose-response relationship with proximity to the source (p < 0.001). While respirator use offered initial protection (p = 0.021), this effect was not statistically significant after 2 weeks.
Conclusions
Occupational LiOH exposure caused acute irritation and systemic symptoms, demonstrating immediate tissue damage consistent with its alkalinity and systemic toxicity upon absorption. As lithium battery production expands globally, these results emphasize the necessity for developing specific occupational exposure limits and medical surveillance guidelines for lithium compounds.

수산화리튬 누출 사고에 따른 급성 건강영향
배경
수산화리튬((LiOH)은 전기차 배터리 생산에 필수적인 소재이나, 직업환경의학 영역에서 건강영향에 대한 문헌은 부족하다. 본 연구는 2024년 3월 수산화리튬 생산공장에서 발생한 두 차례의 사고에 따른 노동자의 급성 건강 영향에 대해 조사 결과이다.
방법
2024. 3. 6일과 9일 두 차례에 걸쳐 수산화리튬 생산설비 시운전 중 실리콘 연결부 파열로 50~100kg의 분말이 누출되어 발생한 급성건강 영향의 2개의 데이터를 분석하였다. 하나는 누출사고 당시 한 병원 방문자 115명의 증상이며, 다른 하나는 노출 2주후에 474명을 대상으로 한 설문조사 결과이다. 국소증상과 전신증상 호소율을 기록하고, 이들 증상이 노출원과의 거리(<10m, 10~20m, >20m) 및 호흡 보호구를 착용 유무에 따른 심각도에 차이가 있는지 단변량 일반 선형 모델링을 적용하여 분석하였다.
결과
사고 직후 병원을 방문한 노동자에서 국소 자극 증상이 가장 흔하게 나타났으며, 인후통(58.3%), 기침(28.7%), 피부 질환(17.4%) 등이었다. 전신 증상으로는 두통(45.2%), 메스꺼움(18.3%), 가슴 답답함(12.2%), 어지럼증(9.6%) 등이 있었다. 2주 후 추적 관찰 결과에서 전반적인 증상 호전이 있었는데, 심한 기침은 22.2%에서 10.1%로 감소했다. 그러나 전반적인 증상 개선에도 불구하고, 상당수의 노동자는 기침(28.7%)과 가래(31.0%)를 포함한 호흡기 문제를 지속적으로 호소했다. 증상 심각도는 노출원과 거리에 따라 의미한 상관관계를 보였으며(p<0.001), 호흡기 보호구 착용은 초기에는 보호 효과를 제공했지만(p=0.021), 2주 후에는 통계적으로 유의미한 효과가 나타나지 않았다.
결론
수산화리튬에 누출 사고에 노출된 노동자에서 국소적인 자극 및 전신 증상을 유발했으며, 이는 수산화리튬의 알칼리성과 흡수 시 전신 독성에 부합하는 즉각적인 조직 손상으로 추정된다. 리튬 배터리 생산이 전 세계적으로 확대됨에 따라, 수산화리튬에 대한 구체적인 직업적 노출 한계와 의학적 감시 지침을 개발해야 한다.

Citations

Citations to this article as recorded by

Sustainable Working Life Within the Production and Recycling of Lithium-Ion Batteries for Electric Vehicles (GreenWorkLiB)
Klara Midander, Anneli Julander, Erik Rosengren, Sandra Johannesson, Florencia Harari
Batteries.2026; 12(6): 203. CrossRef
Reactive airways dysfunction syndrome following acute lithium hydroxide dust exposure at a battery material production plant: a case series of 16 workers
Chul Gab Lee, Soo Hyeong Park, Jeong Joon Park, Han Soo Song, Hyeon Kyeong Ko, Sung Ho Yoon
Annals of Occupational and Environmental Medicine.2026; 38: e17. CrossRef

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Case Report

Case series: from ventilation failure to substitution success in occupational lead poisoning at a Korean indoor firing range: Chul Gab Lee, Soo Hyeong Park; Ann Occup Environ Med 2026;38:e5. Published online February 9, 2026; DOI: https://doi.org/10.35371/aoem.2026.38.e5

Abstract Abstract in Korean PDF: Background
Indoor firing ranges are globally recognized as high-risk settings for occupational and recreational lead exposure due to the use of lead-based ammunition and frequently inadequate ventilation systems. In Korea, however, public health surveillance and regulatory oversight have remained limited. This case series empirically demonstrates that in high-emission settings like indoor firing ranges, ventilation upgrades are insufficient. Source substitution with lead-free primer ammunition proved to be the only definitive intervention.
Case presentation
In late 2023, an index case presenting with abdominal pain was found to have a blood lead level (BLL) of 55 μg/dL, prompting a government-mandated investigation. Nine male shooting instructors (tenure: 4–65 months) were subsequently identified with BLLs ranging from 38.2–73.2 μg/dL, while airborne lead concentrations (ALC) reached 0.51 mg/m³—10 times the occupational exposure limit (OEL: 0.05 mg/m³). During a 3-month closure to upgrade ventilation, workers received chelation therapy (CaNa₂EDTA and D-penicillamine), which reduced their BLLs to 3.2–25.7 μg/dL. However, 2 months after reopening, post-intervention ALC remained elevated at 0.0797 mg/m³, still exceeding the OEL, and BLLs rebounded to 16.2–53.3 μg/dL. A substitution strategy was then implemented, replacing lead-based ammunition with copper-clad, lead-free primer rounds. This intervention decreased ALC to <0.003 mg/m³ and lowered BLLs to 4.9–23.1 μg/dL. Despite the reduced airborne concentrations, several workers continued to exhibit BLLs around 20 μg/dL, suggesting subtle ongoing exposure and mobilization of bone-stored lead.
Conclusions
This cluster demonstrates that in environments where hazardous agents are continuously generated, such as indoor firing ranges, engineering controls alone, such as improved ventilation, may not provide adequate protection. Substitution—the most effective intervention within the hierarchy of controls—was essential for eliminating exposure. Furthermore, the toxicokinetics of bone lead in chronically exposed adults highlight the need for ongoing monitoring and cautious decision-making regarding treatment and return-to-work planning.; 한국의 한 실내사격장에서 발생한 직업성 납중독: 개입위계 체계의 실패와 성공 사례보고
배경
실내 사격장은 납 기반 탄약의 사용과 불충분한 환기 시스템으로 인해, 직업적 및 레저 활동 시 납 노출 위험이 높은 환경으로 전 세계적으로 알려져 있다. 그러나 한국에서는 이에 대한 공중 보건학적 감시나 규제적인 감독이 없었다. 본 증례 보고는 국내 한 실내 사격장 노동자(사격 코치)에서 발생한 집단 중증 납 중독 사례를 분석하여, 고농도 노출 환경에서 환기 개선과 같은 공학적 대책의 한계를 살펴보고, 유해 물질 대체(substitution)를 통한 근본적 해결의 중요성을 강조하고자 한다.
증례
2023년 말, 심한 복통을 호소한 지표 환자(index case)의 혈중 납 농도(BLL)가 55 µg/dL로 확인되면서 정부 주도의 역학 조사가 실시되었다. 해당 사격장의 사격 코치 9명(근무 기간: 4~65개월)의 혈중 납 농도(Blood lead level, BLL)은 38.2~73.2 µg/dL 범위였으며, 작업환경측정에 의한 사격장 실내 납 농도(Airborne lead concentration, ALC)는 0.51 mg/m³로 노출 기준(Occupational exposure limit, OEL: 0.05 mg/m³)의 10배를 초과했다. 환기 설비 개선을 위한 3개월간 폐쇄 기간 동안 킬레이션 요법(CaNa₂EDTA 및 D-penicillamine)을 시행하여 BLL이 3.2~25.7 µg/dL로 감소했다. 그러나 환기 시스템을 대폭 개선하여 재가동했음에도 불구하고, 2개월 후 ALC는 0.0797 mg/m³로 여전히 기준치를 초과했고, 복귀한 근로자들의 BLL은 16.2~53.3 µg/dL로 급격히 재상승했다. 이에 따라 납 기반 탄약을 구리 피복 및 무연 뇌관(lead-free primer) 탄약으로 전면 교체하는 대체 전략이 시행되었다. 그 결과 ALC는 0.003 mg/m³ 미만으로 감소하였고, BLL 또한 4.9~23.1 µg/dL로 감소하여 안정화되었다. 다만, ALC의 획기적 감소에도 불구하고 일부 노동자의 BLL이 20 µg/dL 수준을 유지한 것은 뼈에 축적된 납의 재분배(mobilization) 영향으로 추정된다.
결론
본 사례는 실내 사격장과 같이 유해 인자가 지속적으로 발생하는 환경에서는 환기 개선 등의 공학적 대책만으로는 근로자를 충분히 보호할 수 없음을 시사한다. 따라서 산업안전보건의 ‘위험성 관리의 위계(Hierarchy of Controls)’ 중 가장 효과적인 조치인 ‘대체(substitution)’를 통해 오염원을 원천적으로 제거하는 것이 필수적이다. 아울러 만성 고농도 노출 근로자의 경우, 체내 축적된 납의 독성동태학적 특성을 고려하여 치료 및 업무 복귀 결정 시 장기적인 모니터링과 신중한 접근이 요구된다.

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Review

Impacts of heat on sleep quality among heat-exposed workers: a systematic review: Maarthi Raja, Vidhya Venugopal, D. C. Mathangi, Suvarna Jyothi Kantipudi, K. Mahesh Kumar, Somnath Panda, Latha Perumal Kamalakkannan; Ann Occup Environ Med 2026;38:e3. Published online January 8, 2026; DOI: https://doi.org/10.35371/aoem.2026.38.e3

Abstract PDF Supplementary Material

Climate change is intensifying occupational heat exposure, posing risks not only for heat-related illness but also for sleep, which is essential for recovery, safety, and productivity. Heat-exposed workers are highly vulnerable due to prolonged exposure, limited access to cooling, and poor housing. This systematic review aimed to synthesise global evidence on how occupational heat exposure affects sleep quality among workers across different occupations and settings. A systematic review was conducted following Synthesis without Meta-Analysis (SWiM) guidelines. PubMed, Scopus, and Google Scholar were searched (2000–2025) for studies involving adult workers (≥18 years) reporting both heat exposure and sleep outcomes. The review was registered with PROSPERO (ID: CRD420251125735). Of 7,108 records screened, 11 studies met the inclusion criteria. Studies spanned Asia, Australia, North America, and global cohorts. Heat exposure consistently impaired sleep quality and duration. Using Pittsburgh Sleep Quality Index, Actigraphy, and self-reports, common complaints included difficulty falling asleep (64%), restlessness (54%), non-restorative sleep (54%), night sweats (36%), and reduced total sleep time (45%). Night-time temperatures above 25°C and high workplace wet bulb globe temperature values were strongly linked with reduced sleep efficiency and delayed sleep onset. Vulnerable groups included shift workers, petrochemical and steel labourers, women, older adults, and low-income workers in urban heat islands and poorly ventilated housing. Occupational heat exposure disrupts sleep, compounding daytime strain and creating a dual burden for workers. Integrating sleep into heat stress management through cooling interventions, better housing, and revised work–rest schedules is critical for workers well-being in a warming climate.

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Citations to this article as recorded by

Climate heatwaves and mental health in Asia: Exemplars and insights from the Philippines
Rowalt Alibudbud
Geopsychiatry.2026; 4: 100114. CrossRef

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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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Brief Communication

Physical performance metrics of police officers in northeastern Mexico according to age groups and sex: Luis E. Carranza-Garcia, Isaac Garcia-Flores, Ricardo Navarro-Orocio, Jose O. Lagunes-Carrasco, Ricardo Lopez-Garcia, Maria C. Enriquez-Reyna; Ann Occup Environ Med 2025;37:e34. Published online November 17, 2025; DOI: https://doi.org/10.35371/aoem.2025.37.e34

Abstract PDF: Normative values for the physical fitness of Mexican police officers (POs) by sex and age are scarce. This study describes physical performance percentiles by sex and age group and developed percentile values for POs of northeastern Mexico. A retrospective analysis was conducted on database of 7,519 men and 1,050 women aged 20–59 years. Fitness assessments included anthropometric measures, handgrip strength, Abalakov vertical jump, agility circuit, and 1,000-m run. Officers aged 20–29 outperformed other groups in all tests, except for grip strength, which peaked in the 30–39 group. In both sexes, fitness declined with age. Percentile tables by sex and age offer benchmarks to support performance standards, guide targeted physical activity programs and inform future research on Mexican POs.

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Original Article

Association between sudden work recall and psychological health issues: a cross-sectional analysis of the 6th Korean Working Conditions Survey: Dong-Woo Kim, June-Hee Lee, In-Ho Lee, Kyung-Jae Lee; Ann Occup Environ Med 2025;37:e33. Published online September 8, 2025; DOI: https://doi.org/10.35371/aoem.2025.37.e33

Abstract Abstract in Korean PDF: Background
The impact of global integration has led to an increase in non-standard work patterns, threatening workers' health. Psychological health problems, such as anxiety and fatigue, negatively affect workers' health and safety. Sudden work recall, a situation where workers are asked to return to work under unpredictable circumstances, is associated with uncertainty. Research on the relationship between sudden work recall and anxiety and fatigue is limited, and this study aims to investigate this relationship among Korean workers.
Methods
The study used data from the 6th Korean Working Conditions Survey. To analyze the pure effects of sudden work recall, the final sample was limited to 15,702 non-shift workers with a ‘good’ subjective health status. The presence of sudden work recall was categorized into three frequency groups: “several times a month,” “rarely,” and “never.” Anxiety and fatigue were each categorized into "yes" or "no" responses. Multiple logistic regression analysis was performed.
Results
After adjusting for demographic and occupational characteristics, the odds ratio (OR) for anxiety in the 'several times a month' group was 4.066 (95% confidence interval [CI]: 2.787–5.931), indicating a significantly higher risk. Conversely, the OR for the 'rarely' group was 1.363 (95% CI: 0.921–2.017), which was not statistically significant. A similar pattern was observed for fatigue: the 'several times a month' group had a significantly higher risk (OR: 1.875; 95% CI: 1.490–2.359), but the 'rarely' group (OR: 0.955; 95% CI: 0.750–1.215) did not.
Conclusions
The relationship between sudden work recall and psychological health may not be a simple linear one. The results suggest that only a high frequency of sudden work recall is associated with an increased risk of anxiety and fatigue. Therefore, it is necessary to establish appropriate measures and to conduct additional research in this area.; 돌발적 업무 복귀 요청과 심리적 건강 문제의 연관성: 제 6차 근로환경조사를 이용한 단면 분석
목적
세계화로 인한 비정형적 근무 형태의 증가는 노동자의 건강을 위협하고 있다. 특히 불안과 피로와 같은 심리적 건강 문제는 삶의 질과 안전에 부정적인 영향을 미친다. 본 연구는 예측 불가능한 상황에서 갑자기 업무에 복귀하라는 요청을 받는 ‘돌발적 업무 복귀 요청’이 한국 노동자의 불안 및 피로와 어떤 연관성을 가지는지 조사하고자 한다.
방법
본 연구는 제6차 근로환경조사 자료를 활용했으며, 돌발적 업무 복귀 요청의 순수한 영향을 분석하기 위해 교대 근무자와 주관적 건강 상태가 ‘보통’ 이하인 근로자를 제외한 총 15,702명을 최종 분석 대상으로 선정했다. 돌발적 업무 복귀 요청의 빈도에 따라 ‘없음’, ‘드물게’, ‘한 달에 여러 번’으로 범주를 나누었으며, 다중 로지스틱 회귀분석을 통해 돌발적 업무 복귀 요청과 불안 및 피로 간의 연관성을 분석했다.
결과
인구통계학적 및 직업적 특성을 보정한 후, ‘한 달에 여러 번’ 돌발적 업무 복귀를 경험한 그룹은 불안(OR: 4.066, 95% CI: 2.787–5.931)과 피로(OR: 1.875, 95% CI: 1.490–2.359)의 위험이 유의미하게 높았다. 반면, ‘드물게’ 경험한 그룹은 불안(OR: 1.363, 95% CI: 0.921–2.017)과 피로(OR: 0.955, 95% CI: 0.750–1.215) 모두에서 통계적으로 유의미한 연관성이 나타나지 않았다.
결론
돌발적 업무 복귀 요구와 불안 및 피로의 관계는 단순히 선형적이지 않으며, 높은 빈도로 경험할 때만 유의미한 위험 증가와 관련이 있음을 시사한다. 돌발적인 업무 복귀 요청이 신체적 및 정신적 장애를 유발할 수 있는 가능성에 대한 연구는 제한적이며, 이러한 문제를 예방하기 위한 대책이 충분히 발전되지 않았다. 따라서 돌발적 업무 복귀와 관련된 근로자 건강 보호 및 예측 가능한 근무 환경 조성 분야에서 적절한 대책을 수립하고 추가적인 연구를 수행할 필요가 있다.

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Cohort Profile

Occupational and Environmental Health Screening Cohort of Yangsan Korea (OEC-YK): 2012–2023: Dongmug Kang, Eun-Soo Lee, Se-Yeong Kim, Youngki Kim, Youn Hyang Lee, Yoon-Ji Kim; Ann Occup Environ Med 2025;37:e32. Published online September 5, 2025; DOI: https://doi.org/10.35371/aoem.2025.37.e32

Abstract Abstract in Korean PDF: The Occupational and Environmental Health Screening Cohort of Yangsan Korea (OEC-YK) was established to monitor long-term health outcomes in workers and environmental high-risk citizens through systematic periodic health examinations. The cohort integrates 623,402 examination instances from 105,768 participants at Pusan National University Yangsan Hospital (2012–2023), encompassing general health checkups, occupational exposure surveillance, cancer screenings, and others including asbestos-related surveillance. Examination types included general health examination (32.4%), cancer screening (20.6%), special health examination (16.2%), night-shift work examination (16.0%), chronic disease screening (4.8%), pre-placement examinations (2.1%), and asbestos-related surveillance (3.6%). At baseline, 59.0% were male and 75.5% were aged between 20 and 59 years. Follow-up rates reached 35.0% at 1 year, 31.9% at 2 years, and 3.2% at 11 years. Notably, the inclusion of systematic asbestos examinations, combined with a national asbestos job exposure matrix, allows detailed study of long-latency occupational diseases. This large-scale longitudinal dataset supports exposure-disease linkage analysis, job-exposure integration, and time-series modeling of worker health trajectories in Korea.; 양산 지역 직업 환경 건강검진 코호트(OEC-YK) : 2012-2023년
양산 지역 직업환경건강검진 코호트(Occupational and Environmental Health Screening Cohort of Yangsan Korea, OEC-YK)는 체계적이고 주기적인 건강검진을 통해 근로자와 환경적 고위험군 시민의 장기적인 건강 영향을 모니터링하기 위해 구축되었다. 본 코호트는 2012년부터 2023년까지 양산부산대학교병원에서 수행한 105,768명의 수검자로부터 수집한 623,402건의 검진 자료를 통합하였으며, 여기에는 일반건강검진, 직업적 노출 감시, 암 검진과 석면 관련 감시를 포함한 기타 사항이 포함되었다. 검진 유형으로는 일반건강검진(32.4%), 암검진(20.6%), 특수건강검단(16.2%), 야간 교대근무 작업자 건강진단(16.0%), 만성질환 검진(4.8%), 배치 전 건강진단(2.1%), 석면 관련 건강검진(3.6%) 등이 포함되었다. 기초 조사 시점에서 남성이 59.0%였고, 20세에서 59세 사이의 연령대가 75.5%를 차지하였다. 추적 관찰률은 1년 시점 35.0%, 2년 시점 31.9%, 11년 시점 3.2%에 도달하였다. 특히, 국가 단위 석면 직업 노출 매트릭스(Job Exposure Matrix)와 연계된 체계적인 석면 건강검진의 도입은 잠복기가 긴 직업성 질환에 관한 정밀한 연구를 가능하게 한다. 이러한 대규모 종단자료는 한국에서의 직업성 노출과 질병 간의 연관성 분석, 직업-노출 정보 통합, 근로자의 건강 경과에 대한 시계열 분석 등을 수행할 수 있는 유용한 자원을 제공한다.

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Original Article

Factors affecting heat-related illness symptoms among school food service workers: a cross-sectional study in Korea: Nahyun Kim, Dongwhan Suh, Jia Ryu, Woo Chul Jeong, Yun-Keun Lee, Jinwoo Lee, Hyunjoo Kim; Ann Occup Environ Med 2025;37:e30. Published online September 2, 2025; DOI: https://doi.org/10.35371/aoem.2025.37.e30

Abstract Abstract in Korean PDF Supplementary Material: Background
School food service workers are highly likely to develop heat-related illnesses because of their work environment. However, studies that have examined the risk of heat-related illnesses among them are limited. The purpose of this study was to investigate the status of heat exposure, implementation of heat wave countermeasures, and prevalence of heat-related illness symptoms among school food service workers in Korea, and to explore the relationship between them.
Methods
A cross-sectional study was conducted through an online survey of school food service workers from May 25 to June 12, 2023, via three labor unions. We analyzed 6,244 valid responses. We assessed general characteristics, heat-related illness symptoms (heat rash, heat cramps, heat edema, heat exhaustion, heat syncope), duration of heat exposure during heat waves, and heat wave preventive measures. Multiple logistic regression analyses were performed, with adjustments for age, occupation, hypertension, diabetes, and school type.
Results
More than one-third of school food service workers reported heat exposure between May and September exceeding 4 hours daily, and 94.6% experienced at least one heat-related illness symptom during the last year. A dose-response relationship was observed between heat exposure duration and heat-related illness symptoms (p for trend < 0.001). School food service workers who did not have increased rest periods or did not reduce high-heat prepared foods showed significantly higher odds ratios for heat-related illness symptoms.
Conclusions
School food service workers experience substantial heat exposure and a high prevalence of heat-related illness symptoms. The risk of heat-related illness symptoms was associated with extended duration of heat exposure. Increasing rest periods and reducing high-heat food preparation were effective preventive measures. These findings underscore the need for improved heat exposure management and implementation of effective preventive measures to protect the health of school food service workers, with particular attention to appropriate rest periods.; 학교 급식 종사자의 온열질환 증상 위험요인
목적
학교 급식 종사자는 다수의 열원이 존재하는 협소한 공간에서 근무하기 때문에 온열질환 발생 가능성이 높다. 학교 급식 종사자의 작업 중 열 노출 현황, 폭염 대응책 시행, 온열질환 증상 유병률을 조사하고 이들의 관계를 탐구하고자 하였다.
방법
2023. 5. 25- 6. 12까지 학교 급식 관련 3개 노동조합을 통해 온라인 설문조사를 실시해 6,244개의 유효한 응답을 얻었다. 일반적 특성과 온열질환 증상 경험, 폭염 시 근무 중 고온노출 시간, 폭염피해 예방 조치 경험을 조사했다. 온열질환 증상 경험에 관련된 요인을 확인하기 위해 연령, 직종, 고혈압, 당뇨병, 학교 유형을 보정한 다중 로지스틱 회귀분석을 수행했다.
결과
학교 급식 종사자의 3분의 1 이상이 5월부터 9월 사이 일일 4시간을 초과하는 열 노출을 보고했으며, 94.6%가 지난 1년 동안 적어도 하나의 온열질환 질환 증상을 경험했다. 하루 중 고온 노출 시간에 따라 온열질환 증상 경험의 위험은 양반응 관계로 증가했다(P for trend<0.001). 폭염 피해 예방 조치를 경험한 것에 비해 그렇지 않은 경우 온열질환 증상 경험의 위험은 휴게시간 증가(OR=1.86), 고열 제조 반찬 줄임(OR=1.59)에서 통계적으로 유의하게 증가했다.
결론
학교 급식 종사자들은 상당한 열 노출과 높은 온열질환 증상 유병률을 보였다. 온열질환 증상의 위험은 고온 노출이 심할수록 증가하는 것으로 확인되었다. 휴식시간 증가와 고열 제조 음식 조리 감소가 효과적인 예방 조치였다. 이러한 결과는 학교 급식 종사자들의 건강을 보호하기 위한 개선된 열 노출 관리와 효과적인 예방 조치 시행의 필요성을 강조하며, 특히 적절한 휴식시간에 특별한 주의를 기울여야 함을 시사한다.

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Original Article

Occupational skin diseases among cathode material workers in the Korean lithium-ion battery industry: a descriptive case series: Hwa-Yeon Lee, Dong-Hee Koh, Junhyeok Choi, Yong Lim Won; Ann Occup Environ Med 2025;37:e29. Published online September 2, 2025; DOI: https://doi.org/10.35371/aoem.2025.37.e29

Abstract Abstract in Korean PDF

Background
Occupational skin diseases are common in industrial settings; however, few studies have examined workers involved in the production of lithium-ion battery cathode-active materials. This study aimed to investigate the patterns and factors associated with skin diseases in these workers.
Methods
Overall, 37 workers with a history of skin disease were recruited from two cathode-active material manufacturing companies. Onsite investigations, semi-structured interviews, and workplace observations were conducted. Information on skin symptoms, affected areas, symptom frequency, and aggravating factors was collected.
Results
The most commonly reported symptoms were pruritus (27.5%), erythema (20.3%), and chemical burns (15.9%). The most commonly affected areas were the hands and forearms (67.6%), whereas 27.0% of workers reported symptoms in unexposed areas, such as the thighs. The symptoms tended to worsen on workdays and improved during holidays. Less-experienced workers reported more frequent symptoms.
Conclusions
Skin diseases during cathode material production appear to be primarily caused by irritants and allergic contact dermatitis, as well as chemical burns caused by exposure to metal dust, such as lithium, nickel, and cobalt. An urgent need exists for appropriate personal protective equipment, improved work environments, and targeted education for new workers.

한국 리튬이온 배터리 산업의 양극재 제조업 근로자에서 발생한 직업성 피부질환: 단면 연구
목적
산업 현장에서 직업성 피부질환은 흔하지만, 리튬이온 배터리 양극활물질 제조공정에 종사하는 근로자를 대상으로 한 피부질환 연구는 거의 없다. 본 연구는 해당 공정 근로자에서의 피부질환 양상과 관련 요인을 파악하고자 하였다.
방법
양극활물질 제조업체 2곳에서 피부질환 경험이 있는 근로자 37명을 대상으로 현장조사, 반구조화 면담, 작업환경 관찰을 실시하였다. 피부 증상, 노출 부위, 증상 빈도 및 악화 요인 등을 조사하였다.
결과
조사 참여 근로자의 주요 증상은 소양감(27.5%), 홍반(20.3%), 화학적 화상(15.9%)이었다. 증상은 손과 팔에 가장 흔하게 나타났으며(47.2%), 18.9%는 허벅지 등 비노출 부위에도 증상을 보고하였다. 근무일에 증상이 악화되고 휴일에 호전되는 경향이 있었다. 경력이 짧은 근로자일수록 증상이 빈번하였다.
결론
양극활물질 제조업에서 확인한 피부질환은 리튬, 니켈, 코발트 등의 금속 분진에 의한 자극성 및 알레르기성 접촉피부염, 화학화상이 주요 원인으로 추정된다. 적절한 보호구 지급과 환경개선, 신입 근로자 대상 교육 체계가 필요하다.

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Dong-Hee Koh, Yong Lim Won, Hwa Yeon Lee, Sang-Gil Lee
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Original Article

Injury rates and work-related diseases following workforce reduction among South Korean on-site workers in basic local governments between 2016 and 2018: Dongwhan Suh, Nahyun Kim, Han-Na Jung, Woo Chul Jeong, Hyunjoo Kim; Ann Occup Environ Med 2025;37:e17. Published online July 28, 2025; DOI: https://doi.org/10.35371/aoem.2025.37.e17

Abstract Abstract in Korean PDF Supplementary Material

Background
South Korean on-site workers in the public sector, fully covered by the Occupational Safety and Health Act, often perform hazardous tasks. However, their status and injury rates remain poorly documented. This study aimed to analyze changes in injury rates and the proportion of work-related diseases (WRDs) among on-site workers in basic local governments (BLGs) following workforce reductions between 2016 and 2018.
Methods
Data from two sources provided by the Ministry of Employment and Labor were analyzed: organizational data on the number of on-site workers, and cases of injuries, deaths, and diseases among on-site workers in 226 BLGs from 2016 to 2018; and workers’ compensation claims data (individual data) for on-site workers in BLGs during the same period. Injury, mortality, and disease incidence rates were calculated and compared between BLGs with increased and decreased workforce. The proportion of WRDs among all the injuries was also examined.
Results
The total number of on-site workers in BLGs decreased by 18.1% in 2018 compared with 2016. The injury rate increased from 0.46% in 2016 to 0.62% in 2018. BLGs with workforce reductions showed higher injury rates, particularly in those with fewer than 1,000 on-site workers. The proportion of WRDs among all injuries increased by 1.34 times in 2018 compared with 2016.
Conclusions
Workforce reductions among on-site workers in BLGs are associated with higher injury rates and a great proportion of WRDs. These findings highlight the need for improved occupational safety and health practices within the public sector and serve as an important basis for establishing workforce management and injury prevention policies. However, limitations in the available data made it challenging to identify worker groups particularly vulnerable to WRDs. Further research is needed, as it is critical for the development of effective occupational safety and health policies.

한국 기초자치단체 현업업무 종사자의 인력감소에 따른 재해율 및 작업관련질병 구성비 변화: 2016 - 2018년 산업재해 승인 자료 분석
목적
산업안전보건법의 전면 적용 대상인 공공행정 기관의 현업업무 종사자들은 종종 위험한 업무를 수행하고 있으나, 이들의 현황과 이들이 겪는 재해에 대해서는 잘 알려져 있지 않다. 본 연구는 2016년부터 2018년까지 기초자치단체 현업업무 종사자에서의 인력 감소 이후 재해율 및 작업관련질병 구성비의 변화를 분석하고자 하였다.
방법
고용노동부에서 제공한 2가지 자료를 분석하였다: (1) 2016년부터 2018년까지 226개 기초자치단체 현업업무 종사자 수, 재해자 수, 사망자 수, 질병 이환자 수를 포함한 조직 수준 자료, (2) 2016년부터 2018년까지 기초자치단체 현업업무 종사자의 산업재해 승인 자료 (개별 수준 자료). 이를 통해 재해율, 사망률, 질병 이환율을 산출하고, 전년 대비 근로자 수 증감에 따라 기초자치단체를 구분하여 두 집단 간 이러한 수치를 비교하였다. 또한, 전체 산업재해 중 작업관련질병의 구성비도 분석하였다.
결과
2018년 기초자치단체 현업업무 종사자 수는 2016년 대비 18.1% 감소하였다. 재해율은 2016년 0.46%에서 2018년 0.62%로 증가하였다. 전년 대비 현업업무 종사자 수가 감소한 기초자치단체에서의 재해율은 전년 대비 증가한 기초자치단체에서의 재해율보다 더 높았으며, 이는 현업업무 종사자 수가 1,000명 미만인 기초자치단체에서 더 두드러졌다. 전체 산업재해 중 작업관련질병의 구성비는 2016년에 비해 2018년에 1.34배 증가하였다.
결론
기초자치단체의 현업업무 종사자 수 감소는 재해율 및 작업관련질병 구성비 증가와 관련이 있다. 본 연구 결과는 공공부문 현업업무 종사자의 산업안전보건에 대한 인식을 제고하고, 향후 인력관리 및 재해 예방 정책 수립을 위한 기초자료로 활용될 수 있다. 다만, 원 자료의 한계로 인해 작업관련질병에 특히 취약한 근로자 집단을 구체적으로 파악하는 데는 어려움이 있었다. 이는 산업안전보건 정책 수립 시 중요한 문제이므로 향후 추가적인 연구가 필요하다.

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Early Effects of the Serious Accidents Punishment Act on Occupational Health Outcomes in Korea: A Nationwide Difference‐in‐Differences Study (2017–2023)
Hyewon Park, Misong Woo, Wanhyung Lee
American Journal of Industrial Medicine.2026; 69(8): 657. CrossRef

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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

Abstract Abstract in Korean PDF

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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287 Download
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Case Report

Unveiling a hidden hazard: lead poisoning from hobbyist activities and its long-term impact: Chiara Pucci, Luca Tomassini, Marco dell’Omo, Alessandra Deini, Daniele Lillacci, Cristiana Gambelunghe, Mauro Zampolini, Nicola Murgia, Angela Gambelunghe; Ann Occup Environ Med 2025;37:e15. Published online May 26, 2025; DOI: https://doi.org/10.35371/aoem.2025.37.e15

Abstract PDF: Background
Lead poisoning is a serious public health issue that can arise from various sources, including nonoccupational exposure. This can make it challenging to manage, as lead poisoning can arise from unexpected sources. This case study examined lead poisoning in a 52-year-old man linked to hobbyist activities involving lead pellets, highlighting the diagnostic and therapeutic challenges associated with this uncommon source of exposure.
Case presentation
A 52-year-old man with a history of sports fishing presented with confusion, balance disorders, and memory loss. The initial medical evaluation revealed anemia and elevated lead levels. Further investigations, including imaging and blood tests, confirmed the presence of ingested lead pellets. The patient underwent chelation therapy, which led to a reduction in blood lead levels and improvement in symptoms. Follow-up over 46 months showed a gradual decrease in lead levels and partial recovery of cognitive function, although a few lead-related effects persisted.
Conclusions
This case underscores the need for awareness of non-traditional sources of lead exposure, such as hobbyist activities. Effective diagnosis and treatment, including chelation therapy, can significantly alleviate the effects of lead poisoning. Ongoing monitoring is essential to manage long-term health outcomes related to chronic lead exposure.

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308 Download

[Special Collection] Psychosocial stress measurement tools

Special Article

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; Ann Occup Environ Med 2025;37:e12. Published online May 7, 2025; DOI: https://doi.org/10.35371/aoem.2025.37.e12

Abstract Abstract in Korean PDF Supplementary Material

Background
The Korean Occupational Stress Scale (KOSS) was developed in 2004. During this time, industrial structures have evolved, and societal awareness of occupational stress has changed. This study aims to develop and validate a revised version of the Korean Occupational Stress Scale (KOSS®19), tailored for workers, reflecting these changes.
Methods
The KOSS®19 was developed based on the 26-item KOSS–short form (SF) through a review by eight experts. A survey was conducted including 359 service industry workers, comprising the KOSS®19, Burnout, and Depression scales. The KOSS®19 subscales were restructured, and their reliability and validity were evaluated.
Results
The KOSS®19 composed of eight subscales: hazardous physical environment (2 items), high job demand (3 items), insufficient job control (2 items), low social support (2 items), job insecurity (2 items), organizational injustice (4 items), lack of reward (2 items), and work-life imbalance (2 items). The reliability and validity of the KOSS®19 were found to be satisfactory.
Conclusions
The KOSS®19 is a suitable tool for assessing occupational stress, effectively replacing the original KOSS and KOSS-SF.

직무 스트레스: 한국적 맥락에서의 척도 개발 및 타당화
목적
한국형 직무스트레스 척도(KOSS)가 2004년에 개발된 이후 산업 구조가 변화하고 직무 스트레스에 대한 사회적 인식도 달라졌다. 본 연구는 이러한 변화를 반영하여 한국형 직무스트레스 척도 개정판(KOSS®19)을 개발하고 타당성을 검증하는 것을 목적으로 한다.
방법
KOSS®19는 기존의 26문항 KOSS-SF를 기반으로 8명의 전문가 검토를 거쳐 개발되었다. 서비스업 종사자 359명을 대상으로 KOSS®19, 소진(Burnout) 척도, 우울 척도를 포함한 설문조사를 실시하였으며, KOSS®19의 요인을 재구성하고 신뢰도 및 타당도를 평가하였다.
결과
KOSS®19는 8개 요인으로 구성되었다: 위해물리환경(2문항), 높은직무요구 (3문항), 직무자율성결여(2문항), 낮은사회적지지(2문항), 직업불안정(2문항), 조직불공정(4문항), 보상부적절(2문항), 일-삶의불균형 (2문항). KOSS®19의 신뢰도 및 타당도는 만족할 만한 수준으로 확인되었다.
결론
KOSS®19는 직무 스트레스를 평가하는 데 적절한 도구로, 기존 KOSS 및 KOSS-SF를 효과적으로 대체할 수 있다.

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Ganguk Lee, Chunhui Suh, Jungwook Kim, Norito Kawakami, Sarah Wright
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Jungwon Jang, Inah Kim
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Jeonghyun Kim, Yugyeong Jung, Junmo Lee, Kwangyoung Lee, Hwajung Hong, Uichin Lee
Proceedings of the ACM on Interactive, Mobile, Wearable and Ubiquitous Technologies.2026; 10(2): 1. CrossRef
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Case Report

Challenges in diagnosing occupational allergic contact dermatitis: a case report: Jun Fai Yap, Kim Sui Wan, Muhammad Fadhli Mohd Yusoff, Yin Cheng Lim, Rama Krishna Supramanian; Ann Occup Environ Med 2025;37:e7. Published online March 24, 2025; DOI: https://doi.org/10.35371/aoem.2025.37.e7

Abstract PDF

Background
In Malaysia, occupational allergic contact dermatitis (ACD) is often under-reported. This case report describes a chemical engineer who developed possible ACD, likely due to workplace allergen exposure.
Case presentation
He presented with a 4-month history of intensely itchy rashes on both hands, which improved during work breaks. A dermatological examination revealed lichenified, pruritic papules with well-defined borders on the palmar surfaces of both hands. A skin patch test identified reactions to five allergens, including ‘fragrance mix,’ ‘methyldibromo glutaronitrile,’ ‘clioquinol,’ ‘epoxy resin,’ and ‘textile dye mix.’ However, among these, only ‘bisphenol A diglycidyl ether,’ a component of ‘epoxy resin,’ was listed in the safety data sheet as a confirmed occupational exposure. In accordance with local regulations, this case was reported as ‘occupational dermatitis’ to the Department of Occupational Safety and Health. The patient was prescribed symptomatic topical treatments, including emollients and topical corticosteroids. Additionally, he was advised to switch to hypoallergenic products. On follow-up, his chronic inflammatory skin lesions showed improvement.
Conclusions
Thorough occupational history-taking and patch testing are essential for diagnosing ACD. Personalized health education and regular follow-ups, is crucial in monitoring lesion resolution and evaluating the effectiveness of preventive measures in workplace settings.

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Ann Lurati
The Journal for Nurse Practitioners.2026; 22(7): 105871. CrossRef

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Original Article

Occupational disease issues in high-tech industries of South Korea: analysis of governmental data on the semiconductor and display industries: Chungsik Yoon, Jinjoo Chung, Jongran Lee, Kwonchul Ha, Joseph DiGangi, Jeong-Ok Kong; Ann Occup Environ Med 2025;37:e6. Published online March 24, 2025; DOI: https://doi.org/10.35371/aoem.2025.37.e6

Abstract Abstract in Korean PDF: Background
This study analyzed occupational diseases compensated through the government system in the Korean electronics industry and observed changes in the rationale for compensation.
Methods
Data from the Korea Workers’ Compensation and Welfare Service (KWCWS) from 2012 to 2023 were analyzed to examine occupational disease issues in South Korea's semiconductor and display industries.
Results
KWCWS received 174 occupational disease claims between 2012 and 2023, with 88 (50.6%) approved. The case of a 22-year-old semiconductor worker who died from leukemia has raised awareness and appears to be leading to more claims and higher approval rates. Cancer-related claims, particularly for breast and blood cancers, were the most common. Since 2018, the approval rate for occupational diseases has increased to 60%, which may have been influenced by the Supreme Court's Principle of Presumption of Occupational Diseases and the government’s reduction of the burden of proof. However, approval rates remain lower in small- and medium-sized enterprises (38.0%) compared to large corporations (55.6%), likely because of better documentation and unionization in the latter. The semiconductor industry had more claims and approvals than the LCD industry, primarily due to its longer operational history and greater chemical exposure.
Conclusions
In South Korea, the increasing approval rate of occupational diseases in the electronics industry from 2012 to 2023 appears to reflect changes in how causal relationships and occupational health policies have been implemented and this is likely due to stakeholder involvement and relevant legal decisions.; 반도체 및 디스플레이 산업의 정부자료 분석으로 본 한국 첨단 산업에서의 직업병 이슈
목적
본 연구는 한국 전자산업에서 산재보험 보상 승인된 직업병을 분석하고 보상 근거의 변화를 관찰하였다.
방법
2012년부터 2023년까지 근로복지공단의 데이터를 분석하여 한국의 반도체 및 디스플레이 산업에서 직업병의 신청과 승인을 연도별, 업종별, 규모별로 분석하였다.
결과
2012년부터 2023년까지 근로복지공단에 접수된 직업병 산재보상 신청은 174건이고 이 중 88건(51%)이 승인되었다. 2007년 한 반도체 노동자의 백혈병 사망을 계기로 직업병에 대한 인식이 높아져, 산재보상 신청 건수가 증가하고 승인률도 높아진 것으로 추정된다. 신청 상병은 암, 특히 유방암과 혈액암이 가장 많았다. 대법원이 직업병 추정 원칙을 판시하고 정부가 입증 부담을 완화한 것이 2018년 이후 직업병 승인률을 60%까지 증가하는데 기여하였다. 그러나 중소기업(38%)의 승인률은 대기업(56%)에 비해 여전히 낮은데, 이는 대기업에서 기록을 더 잘 보관하고 노조 조직률도 더 높은 것이 영향을 주었을 것이다. 반도체 산업은 LCD 산업보다 산재 신청 건수와 승인 건수가 더 많은데, 이는 반도체 산업의 역사가 더 길며 화학물질 노출이 더 크기 때문으로 추정된다.
결론
연구 기간 동안 전자업체에서의 대부분 직업병은 혈액암과 유방암과 같은 암이었고 직업병 산재 승인의 증가는 이해관계자의 참여와 사회 이슈화, 유연해진 법원 판결, 산재보험제도 등이 큰 영향을 미쳤을 것이다.

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Data Profile

Data profile: Korean Work, Sleep, and Health Study (KWSHS): Seong-Sik Cho, Jeehee Min, Heejoo Ko, Mo-Yeol Kang; Ann Occup Environ Med 2025;37:e3. Published online February 19, 2025; DOI: https://doi.org/10.35371/aoem.2025.37.e3

Abstract Abstract in Korean PDF

The Korean Work, Sleep, and Health Study (KWSHS) was launched in 2022 as a longitudinal panel study to examine the interactions between work conditions, sleep health, and labour market performance among the Korean workforce. Baseline data were collected from 5,517 participants aged 19 to 70, encompassing diverse occupations. Follow-up surveys occur biannually, accommodating seasonal variations in sleep and health dynamics. To ensure stability, refreshment samples were integrated in later waves, maintaining a cohort size of 5,783 participants in wave 5. Key data include socio-demographics, employment characteristics, sleep patterns, health outcomes, and workplace performance. Early findings highlight critical associations, such as the adverse effects of occupational physical activity on productivity, the impact of emotional labour on health-related productivity loss, and the significance of sleep disruptions on mental health. The cohort’s design enables detailed analyses of longitudinal and cross-sectional trends, offering insights into how changing work environments influence health and productivity. The KWSHS could serve as a vital resource for evidence-based interventions aimed at improving occupational health and productivity in Korea's evolving labour landscape. Data access is available through the study’s principal investigator upon request.

한국 직업, 수면 및 건강 연구(KWSHS)
한국 직업, 수면 및 건강 연구(KWSHS)는 한국 노동자의 근로 조건, 수면 건강, 노동 시장 성과 간 상호작용을 조사하기 위해 2022년에 시작된 종단적 패널 연구이다. 기초 자료는 다양한 직업군을 포함하여 19세에서 70세까지의 5,517명을 대상으로 수집하였다. 후속 설문조사는 수면 및 건강 역학의 계절적 변동성을 고려하여 2년마다 실시하며, 코호트의 안정성을 유지하기 위해 후속 조사에서는 보충 표본을 추가하여 5차 웨이브에서는 총 5,783명의 코호트 규모를 유지하였다. 주요 자료에는 사회인구학적 정보, 고용 특성, 수면 패턴, 건강 결과 및 직장 성과 등이 포함된다. 초기 연구 결과는 직업적 신체활동이 생산성에 미치는 부정적 영향, 감정 노동이 건강 관련 생산성 손실에 미치는 영향, 그리고 수면 장애가 정신 건강에 미치는 중요성을 포함한 주요 연관성을 강조하고 있다. 본 코호트의 설계는 종단적 및 횡단적 추세에 대한 세부적인 분석을 가능하게 하여 변화하는 근로 환경이 건강 및 생산성에 미치는 영향을 심층적으로 이해할 수 있게 한다. KWSHS는 한국의 변화하는 노동 환경 속에서 직업 건강 및 생산성을 향상시키기 위한 근거 기반 개입을 위한 중요한 자원이 될 수 있다. 데이터 접근은 연구 책임자에게 요청을 통해 가능하다.

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Heejoo Ko, Seong‐Sik Cho, Dong‐Wook Lee, Jaesung Choi, Min‐Seok Kim, Mo‐Yeol Kang
Journal of Sleep Research.2026;[Epub] CrossRef
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Association of Working Time Control With Health-Related Productivity Loss and Work Engagement
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Structural variation of the pineal gland in shift workers from neuroimaging evidence
Youjin Kim, Heeju Son, Chae Jung Park, Joon Yul Choi, Wanhyung Lee
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Association of unmet healthcare needs with health-related productivity loss, work ability, and work engagement
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Work ability and health-related productivity loss by chronotype: Results from population-based panel study
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Association between psychosocial safety climate and depression risk among Korean workers
Soo Kyung Cho, Seong-Sik Cho, Maureen F. Dollard, May Young Loh, Mo-Yeol Kang
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Review

List of occupational diseases among farmers in Korea: a literature review: Hansoo Song, Seok-Ju Yoo, Won-Ju Park, Seunghyeon Cho, Ki Soo Park, Joo Hyun Sung, Sang Jin Park, Seong-yong Yoon, Kyeongsoo Kim, Dong-phil Choi, Hye-min Kim, Bounggyun Ju, Kanwoo Youn; Ann Occup Environ Med 2025;37:e2. Published online February 19, 2025; DOI: https://doi.org/10.35371/aoem.2025.37.e2; Correction in: Ann Occup Environ Med 2025;37(0):e16

Abstract Abstract in Korean PDF Supplementary Material

A comprehensive list of occupational diseases among farmers is crucial for both compensation and prevention efforts. In Korea, most farmers are self-employed, and some occupational diseases are compensated through farmer safety insurance. However, it is not harmonized with industrial accident compensation insurance and does not adequately reflect the true burden of occupational diseases among farmers. To address this gap, the authors compiled a list of occupational diseases tailored to Korean farmers by reviewing the International Labor Organization’s list of occupational diseases, the Korean Industrial Accident Compensation Insurance List, the occupational disease lists of other countries, and relevant literature on farmers’ work-related diseases.

한국 농업인의 직업성 질병 목록: 문헌고찰
농업인의 직업병에 대한 포괄적인 목록은 질병보상과 예방을 위해 중요하다. 한국에서 농업인의 대부분은 자영업자로 근로자에게 적용되는 산업재해보상보험의 적용을 받지 못하고 일부 직업성질환에 대해서만 정책보험인 농업인안전보험을 통해 보상되고 있다. 그러나 이러한 보상은 산업재해보상보험과 조화를 이루지 못하고 있으며, 농업인에게 실제 부담을 주고 있는 직업성 질병을 반영하지 못하고 있다. 이러한 문제를 개선하기 위해 저자들은 국제노동지구의 직업병 목록, 한국의 산업재해보상보험법 상 업무관련성 질병 목록, 다른 국가들의 직업병 목록 및 농업인의 업무관련성 질병에 대한 문헌을 검토하여, 한국 농업인에게 적합한 직업병 목록을 작성하였다.

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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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Hyunjoo Oh, Yeajoo Kim, Hipyo Ahn, Dong-gwi Lee
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1 Web of Science
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Original Article

Effect of psychosocial safety climate on work-family conflict and psychological health among working couples: Nurfazreen Aina Muhamad Nasharudin, Zhao Rui; Ann Occup Environ Med 2024;36:e27. Published online October 25, 2024; DOI: https://doi.org/10.35371/aoem.2024.36.e27

Abstract PDF Supplementary Material

Background
The purpose of the study was to look into how work-family conflict (WFC), family-work conflict (FWC), and psychological health are affected by the psychosocial safety climate (PSC). First, the study suggested that for both husband and wife, PSC moderates the relationship between job demands and WFC. Second, the study predicted FWC mediates the relationship between WFC and depressive symptoms through the “crossover” process.
Methods
The study design used a multi-source sample that involved 350 teachers and their working spouses (n = 700). The analysis of mediation and moderation among job demands, WFC, FWC, PSC, and depressive symptoms was conducted using SPSS and structural equation modeling AMOS software.
Results
For the teacher’s sample, based on behavioral (β = 0.166, p < 0.05) and strain-based (β = 0.170, p < 0.05) aspects, the hierarchical regression analysis revealed that the PSC moderates the relationship between physical demand and WFC. The results also showed that the relationship between time-based WFC and emotional demand is moderated by PSC (β = 0.103, p < 0.05). Next, the analysis found that PSC moderates the association between cognitive demand and WFC of strain-based (β = 0.179, p < 0.05). For the spouse’s sample, according to the analysis, PSC moderates the relationship between strain-based WFC and physical demand (β = 0.091, p < 0.05). The study also revealed that FWC serves as a mediator in the relationship between WFC and depressive symptoms in both husbands (β = 0.233, p < 0.01) and wives (β = 0.135, p < 0.001).
Conclusions
Overall, this study contributes significant insights to the current literature by examining the impact of PSC on the psychological well-being of individuals and others through the crossover process.

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Family health as a mediator between work–family conflict and depression in working parents: a cross-sectional study
Min Yang, Chaochan Su, Meng Yang, Qiuxia Huang
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Original Article

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. Published online September 6, 2024; DOI: https://doi.org/10.35371/aoem.2024.36.e25

Abstract Abstract in Korean PDF

Background
The rise in single-person households is a global phenomenon with well-documented implications for both physical and mental well-being. However, there remains a scarcity of studies focusing specifically on the health impacts of single-person households on workers. This study aims to address this gap by comparing insomnia symptoms between single- and multi-person household workers, shedding light on the health implications of household composition.
Methods
This study utilized data from the Sixth Korean Working Conditions Survey. Insomnia symptoms were categorized into normal sleep and insomnia symptom groups utilizing the 3-item Minimal Insomnia Symptom Scale. Multiple logistic regression analysis was employed to examine the association between single-person household wage workers and insomnia symptoms.
Results
In comparison to wage workers from multi-person households, those from single-person households exhibited heightened risks of reporting insomnia symptoms. In the fully adjusted model, the odds ratios for symptoms of insomnia among single-person household wage workers was 1.173 (95% confidence interval: 1.020–1.349).
Conclusions
This study underscores that single-person household wage workers in Korea face an elevated risk of insomnia symptoms compared to their counterparts in multi-person households.

한국 1인 가구 임금근로자와 불면증 증상들의 연관성: 제6차 한국근로환경조사 (KWCS)
목적
기존 연구에 의하면 1인 가구와 건강 문제는 부정적인 연관성을 보이는 것으로 알려져 있으나 1인 가구 임금 근로자들에 대한 연구는 부족해 보인다. 이에 임금 근로자들을 대상으로 1인 가구의 불면증 증상의 실태를 파악하고 다인 가구 임금 근로자들과 비교하여 1인 가구 근로자가 건강에 어떠한 영향을 미치는지 연구해보고자 한다.
방법
이 연구는 제6차 근로환경조사의 원시자료를 이용한 단면 연구이다. 불면증 증상의 경우 Minimal Insomnia Symptom Scale (MISS)를 사용하여 평가되었다. 다인 가구 임금 근로자군과 비교했을 때 1인 가구 임금 근로자군과 불면증 증상 간의 연관성을 연구하기 위해 다중 로지스틱 회귀분석을 실시하였다.
결과
다인 가구 임금 근로자군과 비교했을 때 1인 가구 임금 근로자군의 불면증 증상에 대한 교차비(OR)은 1.173 (95% confidence interval [CI]: 1.020-1.349)로 나타났다.
결론
연구 결과 한국의 1인 가구 임금 근로자는 다인 가구 임금 근로자에 비해 불면증 증상을 보일 위험이 높은 것으로 나타났다. 1인 가구 근로자의 증가 추세는 근로자의 건강에 영향을 미치는 요인으로서 관심이 필요할 것으로 생각된다.

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Original Article

Burnout, stress, and their correlates among bank employees of South India: a cross-sectional study: Guruprasad Vinod, Srikant Ambatipudi; Ann Occup Environ Med 2024;36:e22. Published online August 28, 2024; DOI: https://doi.org/10.35371/aoem.2024.36.e22

Abstract PDF Supplementary Material

Background
The banking sector is one of the job sectors that experience high stress, workload, complex interpersonal relationships, and job burnout as it involves interaction with the public and financial responsibilities, which leads to high burnout and stress. The present study was conducted to assess the prevalence of burnout and stress among bank employees and to find the associated factors.
Methods
This cross-sectional survey was conducted among 282 bank employees of Kollam district, Kerala, India. Data was collected using a self-administered questionnaire related to the socio-demographic and professional details. We used the Oldenburg Burnout Inventory (OLBI) to screen for burnout levels. Depression Anxiety Stress Scale (DASS 21) to screen for the levels of depression, anxiety, and stress among study participants. Descriptive statistics were used to summarize the data, and logistic regression was used to identify the factors associated with the levels of burnout and stress.
Results
Of 282 study participants, moderate to high levels of burnout were observed in 232 participants (82.2%), and 74 participants (26.2%) had mild to extremely severe levels of stress. Daily average working duration showed an association with higher levels of burnout (adjusted odds ratio [ORAdj]: 2.391; 95% confidence interval [CI]: 1.12–5.10) and stress (ORAdj: 3.37; 95% CI: 1.58–7.16).
Conclusions
A high prevalence of burnout and stress was observed in the present study. The duration of working hours was associated with both burnout and stress. Therefore, regulating the working hours may help adequately manage stress and burnout, thereby improving the mental health of bank employees.

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Case Report

Glioblastoma in a paper industry worker exposed to high concentrations of formaldehyde: a case report: Youngshin Lee, Jiwoon Kwon, Miyeon Jang, Seongwon Ma, Kyo Yeon Jun, Minjoo Yoon, Shinhee Ye; Ann Occup Environ Med 2024;36:e17. Published online July 5, 2024; DOI: https://doi.org/10.35371/aoem.2024.36.e17

Abstract Abstract in Korean PDF Supplementary Material: Background
Formaldehyde was classified as a Group I Carcinogen by the International Agency for Research on Cancer (IARC) in 2006. While the IARC has stated that there is a lack of evidence that formaldehyde causes brain cancer, three meta-analyses have consistently reported a significantly higher risk of brain cancer in workers exposed to high levels of formaldehyde. Therefore, we report a case of a worker who was diagnosed with glioblastoma after being exposed to high concentrations of formaldehyde while working with formaldehyde resin in the paper industry.
Case presentation
A 40-year-old male patient joined an impregnated paper manufacturer and performed impregnation work using formaldehyde resin for 10 years and 2 months. In 2017, the patient experienced a severe headache and visited the hospital for brain magnetic resonance imaging, which revealed a mass. In the same year, the patient underwent a craniotomy for brain tumor resection and was diagnosed with glioblastoma of the temporal lobe. In 2019, a craniotomy was performed owing to the recurrence of the brain tumor, but he died in 2020. An exposure assessment of the work environment determined that the patient was exposed to formaldehyde above the exposure threshold of 0.3 ppm continuously for more than 10 years and that he had high respiratory and dermal exposure through performing work without wearing a respirator or protective gloves.
Conclusions
This case report represents the first instance where the epidemiological investigation and evaluation committee of the Occupational Safety and Health Research Institute in Korea recognized the scientific evidence of work-related brain tumors due to long-term exposure to high concentrations of formaldehyde during impregnated paperwork. This case highlights the importance of proper workplace management, informing workers that prolonged exposure to formaldehyde in impregnation work can cause brain tumors and minimizing exposure in similar processes.; 고농도 포름알데히드에 노출된 제지 산업 근로자에서 발생한 교모세포종: 사례보고
배경
포름알데히드는 2006년 국제암연구소(IARC)에서 1군 발암 물질로 분류되었다. IARC는 포름알데히드가 뇌종양을 유발한다는 증거가 부족하다고 밝혔지만, 세 건의 메타 분석에서 고농도의 포름알데히드에 노출된 근로자의 뇌종양 위험도가 상당히 높다고 일관되게 보고했다. 이에 포름알데히드 수지를 사용하는 제지 산업에서 근무하던 중 고농도의 포름알데히드에 노출되어 교모세포종 진단을 받은 근로자의 사례를 보고하고자 한다.
증례
40세 남성 환자는 함침지 제조업체에 입사하여 10년 2개월 동안 포름알데히드 수지를 사용한 함침 작업을 수행했다. 2017년 9월, 환자는 심한 두통을 느껴 병원을 방문하여 촬영한 뇌 자기공명영상(MRI)의 결과에서 종양이 발견되었다. 같은 해에 환자는 뇌종양 절제를 위해 개두술을 시행하였고 측두엽의 교모세포종을 진단받았다. 2019년 뇌종양 재발로 개두술을 시행하였지만 치료에도 불구하고 2020년 사망하였다. 환자의 작업환경 노출 평가 결과, 10년 이상 지속적으로 노출 기준치인 0.3ppm 이상의 포름알데히드에 노출되었고, 호흡기나 보호 장갑을 착용하지 않고 작업을 수행해 호흡기 및 피부 노출이 높았던 것으로 확인되었다.
고찰
본 사례는 국내 산업안전보건연구원 역학조사평가위원회가 함침 작업 중 고농도 포름알데히드에 장기간 노출되어 업무상 뇌종양이 발생하였다는 과학적 근거를 인정한 첫 사례이다. 이 사례를 통해 함침 작업에서 포름알데히드에 장기간 노출되면 뇌종양이 발생할 수 있음을 근로자에게 알리고 유사한 공정에서 노출을 최소화하는 등 적절한 작업환경관리의 필요성을 강조한다.

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Original Article

Telecommuting during the COVID-19: the role of job demand and control on health outcomes: Seung-Woo Ryoo, Jin-Young Min, Seok-Yoon Son, Baek-Yong Choi, Juho Choi, Kyoung-Bok Min; Ann Occup Environ Med 2024;36:e14. Published online June 14, 2024; DOI: https://doi.org/10.35371/aoem.2024.36.e14

Abstract Abstract in Korean PDF Supplementary Material

Background

The coronavirus disease 2019 (COVID-19) pandemic drastically modified the occupational system wherein telecommuting has risen as the major form of work. Few studies have incorporated Karasek’s job demand-control (JDC) model into explaining the health effects of telecommuting. This study aimed to investigate the health risk in South Korean telecommuters during the pandemic, and its distribution according to the job stress-related factors.

Methods

A nationwide population-based cross-sectional study of South Korean laborers was conducted, utilizing the 6th Korean Working Conditions Survey (2020–2021). Following the previously described concept of telecommuting, 14,478 white-collar employees were eligible study participants. Telecommuting, job demand, job control, and various health indicators were measured by the responses to the survey. Participants were stratified into 4 job profiles classified by the JDC model. We conducted multiple logistic regression analyses between telecommuting and health-related outcomes to estimate the odds ratio (OR) with a 95% confidence interval (CI).

Results

One hundred forty-six low-strain, 223 active, 69 passive, and 148 high-strain workers were screened as telecommuters. Compared to office workers, telecommuters had a higher proportion in high job control groups. Subgroup analysis demonstrated different relationships between telecommuting and health, where only active telecommuters showed a higher prevalence of depression (OR: 1.980, 95% CI: 1.126–3.481), and high-strain telecommuters were affected in most outcomes including insomnia (OR: 2.555, 95% CI: 1.473–4.433), musculoskeletal pain (OR: 2.786, 95% CI: 1.719–4.517), headache/eye strain (OR: 3.074, 95% CI: 1.992–4.745) and presenteeism (OR: 1.932, 95% CI: 1.193–3.131).

Conclusions

This study revealed significantly increased odds of multiple health outcomes among South Korean telecommuters during the COVID-19 pandemic era. High-strain job holders were prominently susceptible to the negative health impacts of telecommuting. Occupational health management towards telecommuters should approach mitigating high job demand and low job control.

코로나19 시기 재택근무: 건강 결과에 대한 직무 요구와 직무 재량의 역할
목적
코로나19 팬데믹으로 인해 재택근무는 직무 체계에서 주요한 업무 형태로 떠올랐다. 재택근무가 노동자의 건강에 미치는 영향을 설명하는데 있어 직무 요구-재량 모델을 도입한 연구가 부족하다. 본 연구는 팬데믹 기간 동안 한국 재택근무자들의 건강 위험과 상기 직무 스트레스 관련 요인에 따른 분포를 조사하는 것을 목표로 했다.
방법
본 연구는 제6차 근로환경조사(2020~2021년)를 활용하여 한국 노동자에 대한 전국 인구 기반 횡단면 연구를 실시했다. 이전 연구에서 확립한 재택근무 개념에 따라 14,478명의 화이트 칼라 피고용인 노동자들을 적격집단으로 선정했다. 설문조사 응답 결과를 토대로 재택근무, 직무 요구, 직무 재량 및 다양한 건강 지표를 측정했다. 연구대상자들을 직무 요구-재량 모델에 따라 분류된 네 가지 직무 유형으로 구분하였고, 다중 로지스틱 회귀분석을 시행하여 재택근무 여부에 따른 건강 변수의 오즈비(OR)와 95% 신뢰구간(CI)을 측정하였다.
결과
저-긴장 노동자 146명, 능동적 노동자 223명, 수동적 노동자 69명, 고-긴장 노동자148명이 재택근무자로 분류되었다. 통근근무자와 비교했을 때, 재택근무자들은 직무 재량이 높은 군에서 그 비중이 높았다. 층화분석 결과 재택근무와 건강 사이의 연관성은 군별로 상이하였는데, 오직 능동적 재택근무자들만이 통근근무자들보다 높은 우울증 유병률을 보였고 (OR 1.980, 95% CI 1.126-3.481) 고-긴장 재택근무자들이 가장 많은 결과 변수에서 유의한 오즈비를 보였다; 불면증 (OR 2.555, 95% CI 1.473-4.433), 근골격계 통증 (OR 2.786, 95% CI 1.719-4.517), 두통/안구 피로 (OR 3.074, 95% CI 1.992-4.745), 상병 시 근무 (OR 1.932, 95% CI 1.193-3.131).
결론
본 연구에 따르면 코로나19 팬데믹 기간 동안 한국 재택근무자들에서 다수의 건강 문제가 발생할 오즈가 유의하게 증가하였다. 그중 고-긴장 업무에 종사하는 노동자들은 재택근무가 건강에 미치는 부정적인 영향에 가장 취약하였다. 따라서 재택근무자들에 대한 산업보건 관리는 높은 직무 요구와 낮은 직무 재량을 완화하는 방향으로 접근해야 할 것이다.

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Original Article

The impact of long working hours on daily sodium intake: Kyungho Ju, Yangwoo Kim, Seung Hee Woo, Juhyeong Kim, Inah Kim, Jaechul Song, Soo-Jin Lee, Jeehee Min; Ann Occup Environ Med 2024;36:e9. Published online April 1, 2024; DOI: https://doi.org/10.35371/aoem.2024.36.e9

Abstract Abstract in Korean PDF

Background

Long working hours are associated with an increased risk of cardiovascular disease, yet the underlying mechanism(s) remain unclear. The study examines how occupational factors like working hours, shift work, and employment status correlate with dietary choices and sodium intake, impacting hypertension risk.

Methods

This study used data from the Korea National Health and Nutrition Examination Survey conducted between 2013 and 2020. The dataset included 8,471 respondents, all of whom were wage workers aged 20 or older and reported working at least 36 hours per week. Individuals who have been previously diagnosed with or are currently diagnosed with hypertension, diabetes, or dyslipidemia were excluded. The average daily sodium intake was assessed via a 24-hour dietary recall method. Average weekly working hours were categorized into 3 groups: 36–40 hours, 41–52 hours, and over 52 hours. Multiple logistic regression models were used.

Results

Study findings revealed that 83.7% of participants exceeded the recommended daily sodium intake of 2 g set by the World Health Organization. After adjusting for confounding factors, a positive correlation was observed between average working hours and daily sodium intake. Among males, statistical significance was found in the group with average weekly working hours of 41–52 hours (prevalence ratio [PR]: 1.17; 95% confidence interval [CI]: 1.05–1.30) and the group exceeding 52 hours (PR: 1.22; 95% CI: 1.09–1.38) when comparing the fourth quartile of daily sodium intake to the combined quartiles of Q1, Q2, and Q3. Among females, no significance was noted.

Conclusions

Long working hours were associated with increased sodium intake, primarily among male workers. This connection is likely attributed to having less time for home-cooked meals, resulting in higher fast food consumption and dining out. A workplace intervention promoting healthy eating and reducing stress is essential to lower sodium consumption and mitigate hypertension risk.

장시간 근무가 일일 소듐 섭취량에 미치는 영향
목적
장시간 근무는 심혈관 질환의 증가와 관련이 있다고 알려져 있지만, 그 메커니즘은 명확히 알려져 있지 않다. 본 연구는 주당 평균 근로시간, 교대근무 및 고용 형태 등의 직업적 요인과 식습관 변화 간의 관계를 확인하고, 특히 고혈압의 알려진 위험 요인인 과다한 소듐 섭취와의 관련성을 조사하였다.
방법
본 연구는 2013년부터 2020년까지 실시된 대한민국 국민건강영양조사의 데이터를 사용하였다. 연구대상자는 20세 이상의 임금 근로자, 주당 최소 36시간 이상 근무하는 자로 선정하였다. 이 외에도 다양한 인구학적, 직업 변수가 설문 조사를 통해 수집되었으며, 평균 일일 소듐 섭취량은 24시간 회상법을 통해 조사되었다. 주당 평균 근무 시간은 36-40시간, 41-52시간 및 52시간 이상의 세 집단으로 분류되었다. 다중 로지스틱 회귀 모델이 분석에 사용되었다.
결과
연구대상자 중 83.7%가 세계보건기구(WHO)에서 권장한 일일 나트륨 섭취량인 2g을 초과한 것이 확인되었다. 교란변수 보정 후에도 주당 평균 근로시간과 일일 소듐 섭취 간의 통계적 유의성이 확인되었다. 남성에 대하여, 주당 평균 근무 시간이 41-52시간인 그룹 (PR: 1.17, 95% CI: 1.05-1.30)과 52시간을 초과한 그룹 (PR: 1.22, 95% CI: 1.09-1.38)이 일일 소듐 섭취량 4분위에서 1, 2, 3분위를 포함한 그룹과와 비교하여 통계적으로 유의미한 관련이 있었다. 여성에 대하여는 통계적으로 유의미하지 않았다.
결론
장시간 근무는 주로 남성 근로자에서 소듐 섭취 증가와 관련이 있었다. 이는 가정에서 조리하는 시간이 줄어들어 패스트 푸드 및 외식 소비가 증가하는 것에 기인한 것으로 생각된다. 과량의 소듐 섭취는 고혈압의 알려진 위험 요인이므로, 직장에서의 적극적인 개입을 통해, 더 건강한 식습관과 개선된 근무 환경을 통해 소듐 섭취를 줄이는 것이 필요하다.

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Original Article

Differences of nutritional intake habits and Dietary Inflammatory Index score between occupational classifications in the Korean working population: Seung Hee Woo, Yangwoo Kim, Kyungho Ju, Juhyeong Kim, Jaechul Song, Soo-Jin Lee, Jeehee Min; Ann Occup Environ Med 2024;36:e5. Published online March 18, 2024; DOI: https://doi.org/10.35371/aoem.2024.36.e5

Abstract Abstract in Korean PDF Supplementary Material

Background

Human nutrient intake is closely related to the conditions of their workplace.

Methods

This study used data from the Korean National Health and Nutritional Examination Survey (KNHANES) conducted between 2016 and 2020. The study population comprised individuals aged 19 to 65 years who were engaged in paid work, excluding soldiers (total = 12,201, male = 5,872, female = 6,329). The primary outcome of interest was the Dietary Inflammatory Index (DII) score, which was calculated using dietary intake data. Generalized linear models were used for statistical analyses.

Results

Pink-collar workers had higher DII scores, indicating a potentially higher inflammatory diet than white-collar workers (mean: 2.18 vs. 1.89, p < 0.001). Green and blue-collar workers displayed lower levels of dietary inflammation (green: 1.64 vs. 1.89, p = 0.019, blue: 1.79 vs. 1.89, p = 0.022). After adjusting for sex, age, income, education, and energy intake, the sole trend that persisted was the comparison between white-collar and pink-collar workers.

Conclusions

DII scores and dietary patterns differed among occupational groups and genders.

한국 직장 인구의 직업 분류별 영양 섭취 습관과 식이 염증 지수 차이
목적
직장인의 영양 섭취는 그들의 직장 환경과 밀접한 관련이 있다.
방법
본 연구는 2016년부터 2020년까지 실시된 대한민국 국립건강영양조사(KNHANES) 자료를 사용하였다. 연구 대상은 19세에서 65세까지의 직장인으로, 군인은 제외되었다.(전체 = 12,201명, 남성 = 5,872명, 여성 = 6,329명) 주요 관심 대상은 식이 염증 지수(DII)로, 식품 섭취 정보를 사용하여 계산하였다. 통계 분석에는 일반화된 선형 모델을 사용하였다.
결과
핑크 칼라 직종 근로자들은 DII 점수가 더 높았으며, 이는 화이트 칼라 직종 근로자들보다 잠재적으로 염증성 식습관이 높을 수 있음을 나타낸다.(평균: 2.18 대 1.89, p < 0.001) 그린과 블루 칼라 직종 근로자들은 DII 점수가 낮았다.(그린: 1.64 대 1.89, p = 0.019, 블루: 1.79 대 1.89, p = 0.022) 핑크 칼라와 화이트 칼라 직종 근로자에서 DII 점수의 차이는 성별, 연령, 소득, 교육 및 에너지 섭취량에 대한 보정 후에도 지속되었다.
결론
DII 점수와 식습관은 직업군과 성별에 따라 다르게 나타났다.

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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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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

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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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.

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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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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

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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Associations between exposure to polycyclic aromatic hydrocarbons and biomarkers of acute kidney injury among Chilean agricultural workers
Grant D. Tore, Melissa DeSantiago, Heather M. Stapleton, Wassim Obeid, Chirag R. Parikh, Jordan R. Kuiper, Margarita Valenzuela, Catterina Ferreccio, Louis Fazen, Aisha S. Dickerson, Sandra Cortés, Lesliam Quirós-Alcalá
International Journal of Hygiene and Environmental Health.2026; 274: 114791. CrossRef
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Original Article

Occupational factors affecting the decline in pulmonary function among male farmers using occupational pesticide in Gyeonggi-do, South Korea: Sooyeon Lee, Jiyoung Han, Seung Hee Woo, Soo-Jin Lee; Ann Occup Environ Med 2022;34:e42. Published online December 8, 2022; DOI: https://doi.org/10.35371/aoem.2022.34.e42

Abstract Abstract in Korean PDF

Background

Occupational pesticide exposure is a potential risk for respiratory health effects. Most clinical studies on pesticide exposure were related to acute exposure, and only a few studies on chronic exposure have been conducted. This study investigated the chronic respiratory health status and the chronic effects of occupational pesticide exposures of farmers in Gyeonggi-do.

Methods

Surveys and pulmonary function tests were conducted on 1,697 farmers in 16 regions of Gyeonggi-do. The structured questionnaire included demographic characteristics, medical history, recent respiratory symptoms and diseases, and work-related conditions, and was conducted through one-on-one interviews. The prevalence of respiratory diseases was compared by the odds ratios (ORs) at 95% confidence intervals (CIs) estimated by logistic regression analysis. Additional multivariate logistic regression analysis was also conducted.

Results

Pesticide work groups showed significant association with an obstructive pattern in the lung function test (unadjusted OR, 2.38; 95% CI, 1.17–5.52). Selected work-related variables of pesticide exposure were ‘start age,’ ‘cumulative duration,’ ‘mixing pesticides,’ and ‘protection(goggle).’ The obstructive pattern of lung function test showed significant associations with mixing pesticides (OR, 2.30; 95% CI,1.07–5.46), and protection (goggle) use (OR, 0.34; 95% CI, 0.12–0.79).

Conclusions

Mixing two or more pesticides showed a significant association. Wearing goggles can be seen as an indicator of awareness of the protective equipment and proper wearing of protective equipment, and loss of pulmonary function can be prevented when appropriate protection is worn.

한국 경기도 지역의 남성 농업인 폐기능 감소에 영향을 주는 직업적요인들
목적
직업적 농약노출은 호흡기 건강영향에 대해 잠재적인 위험을 갖고 있다. 과거 농약노출에 대한 임상연구는 대부분 급성 농약노출에 대한 것이었다. 이번 연구에서는 농약의 직업적 노출에 대한 만성적 호흡기 건강영향을 조사하며, 농약사용에 있어서 어떤 작업변수가 실제 영향을 미치는지 조사한다.
방법
2013년부터 2015년까지 경기도 16개 지역에서 농작업을 하는 농업인 1697명을 대상으로, 농작업현황과 인구학적 정보를 포함한 구조화된 설문조사를 일대일 대면 인터뷰형태로 실시했으며, 동시에 폐기능검사를 실시하였다. 통계적분석방법은 로지스틱 회귀분석으로 95% 신뢰구간에 대하여 폐기능검사에서의 폐쇄성형태, 제한성형태와 최근 6개월의 호흡기증상의 유병률을 오즈비를 구하여 비교하였다. 농약작업과의 세부관계성을 밝히기 위하여 추가적인 다변량-로지스틱회귀분석을 수행하였다.
결과
농약 작업군에서 폐쇄성패턴과 유의한 연관성을 보였다(오즈비: 2.38, 1.17-5.52). 다변량-로지스틱회귀분석 결과, 농약 사용패턴 중 유의미한 변수는 '누적노출년도', '농약작업 시작나이', '농약 혼합', '보호구착용(고글)'로 나타났으며, 폐쇄성패턴과 농약혼합행태, 보호구착용이 유의한 연관성을 보여주었다.
결론
농약에 노출된 농업인은 폐기능감소에 있어 유의한 기능감소를 보여주었다. 농약관련 변수 중에는 양적인 변수들이 유의한 관련성이 있었으며, 고글착용은 적절한 보호구착용의 지표로 볼 수 있으며, 보호효과가 있었다.

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