Annals of Occupational and Environmental Medicine最新文献

Background: Perfluoroalkyl substances (PFAS) are used in various products, and PFAS have been detected in outdoor clothing. PFAS can be absorbed into the human body via oral ingestion, inhalation, and dermal contact. In this study, we examined the association between the frequency of using outdoor clothing and serum PFAS concentrations in the Korean population using data from cycle 4 (2018-2020) of the Korean National Environmental Health Survey.

Methods: Data from 2,993 adult participants were analyzed. The participants were classified into low-concentration and high-concentration groups based on the 75th percentile concentration of serum PFAS. The use of outdoor clothing was categorized into three groups: non-use, <4 times a week, and ≥4 times a week. The odds ratio (OR) for serum PFAS levels associated with use of outdoor clothing was determined through logistic regression analysis, adjusted for demographic characteristics, health-related factors, PFAS-treated items, dietary factors, and ventilation time.

Results: ORs for high serum PFAS were higher in groups using outdoor clothing compared to the non-user group. In males, the adjusted ORs for the < 4 times a week and ≥ 4 times a week outdoor clothing usage group were as follows: perfluorooctanoic acid (PFOA), 1.26 (95% confidence interval [CI]: 1.10-1.44) and 1.70 (1.40-2.07); perfluorohexanesulfonic acid (PFHxS), 1.49 (1.16-1.92) and 1.70 (1.22-2.37); and perfluorononanoic acid (PFNA), 1.34 (1.19-1.51) and 1.68 (1.38-2.05), respectively. In females, the respective ORs were as follows: PFOA 1.32 (95% CI: 1.19-1.46) and 1.53 (1.01-2.32); PFHxS, 1.46 (1.08-1.96) and 2.63 (2.10-3.29); PFNA, 1.38 (1.22-1.55) and 1.45 (1.07-1.96).

Conclusions: In adults, elevated serum PFAS levels were associated with increased frequency of using outdoor clothing.

Background: This study investigated the relationship between work-life balance (WLB), effort-reward imbalance (ERI), and presenteeism among Korean wageworkers through two models used simultaneously.

Methods: Data from the 6th Korean Working Conditions Survey for 28,669 Korean workers, including 13,513 men and 15,156 women, were analyzed. All analyses were performed with pre-designed weight. Multiple logistic regression analysis was used to analyze the association between WLB, ERI, and presenteeism among Korean workers. The participants were classified into the following four groups: group 1, status of both WLB and ERI is "balanced"; group 2, WLB and ERI status are "imbalanced" and "balanced", respectively; group 3, WLB and ERI status are "balanced" and "imbalanced", respectively; group 4: status of both WLB and ERI is "imbalanced."

Results: We found that WLB and ERI were associated with presenteeism in both men and women. Depending on their WLB and ERI status, women generally had a higher tendency of presenteeism than men. Multiple logistic regression shows that, in most models and groups, there is an increased odds ratio (OR) for presenteeism in both men and women compared to the reference value. Moreover, the OR in both men and women gradually increased in groups 2, 3, and 4 compared with group 1. When considering both WLB and ERI status simultaneously, ERI had a greater impact on presenteeism than WLB. Furthermore, it was found that a synergistic effect of presenteeism manifests when both WLB and ERI are in a state of imbalance simultaneously.

Conclusions: Using the two models simultaneously, we found an association between WLB, ERI, and presenteeism according to sex with a synergistic effect among Korean workers. Our research suggests that active interventions targeting WLB and ERI are necessary to reduce presenteeism, which ultimately leads to decreased productivity.

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.

Background: Although weekend work makes up a significant part of work patterns in modern society, research on the health effects of weekend work is relatively limited compared to other types of nonstandard work. This study was conducted to examine the impact of weekend work on the health of Korean workers, aiming to provide evidence to support the development of welfare policies that promote workers' health.

Methods: This study was conducted using data from the 6th Korean Working Conditions Survey, targeting 35,957 Korean workers who met the research criteria. Based on the survey responses, information was collected on weekend work status and health outcomes, including general health, musculoskeletal pain, headaches or eye pain, fatigue, sleep disorders, depression, anxiety, absenteeism and presenteeism. To examine the association between weekend work and health outcome variables, logistic regression analysis was performed adjusting for sociodemographic and occupational characteristics, with additional stratified analyses conducted according to employment status.

Results: Among the final study population, 11,255 workers, accounting for 30.5% of the total, were weekend workers. After adjusting for sociodemographic and occupational characteristics, weekend work was found to be significantly associated with depression (odds ratio [OR]: 1.08; 95% confidence interval [CI]: 1.00-1.18), anxiety (OR: 1.35; 95% CI: 1.16-1.58), musculoskeletal pain (OR: 1.45; 95% CI: 1.34-1.58), fatigue (OR: 1.49; 95% CI: 1.36-1.62), absenteeism (OR: 1.70; 95% CI: 1.43-2.03), and presenteeism (OR: 1.82; 95% CI: 1.62-2.04). The health effects of weekend work differed between the self-employed and employees, as shown in the results of the stratified analysis.

Conclusions: Weekend work was found to increase the risk of both physical and mental health problems of Korean workers, and the effect varied according to employment status. There is a need to design a comprehensive occupational health policy that reflects the characteristics of different employment statuses.

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.

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.

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.

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.

Background: This study investigates the association between serum iron levels and frequency-specific hearing loss in Korean female population, a topic previously unexplored in auditory health research.

Methods: This study enrolled Korean female participants from the general population. Serum iron levels and hearing thresholds at low (1 kHz) and high (4 kHz) frequencies were assessed, adjusting for potential confounders. Participants were stratified into quartiles based on serum iron levels.

Results: The mean age of the study population was 51.1 ± 10.1 years. Among the 2,987 participants, 344 (11.5%) had abnormal low-frequency hearing thresholds, and 719 (24.1%) had abnormal high-frequency thresholds. Multiple linear regression analysis demonstrated a significant negative association between serum iron levels and low-frequency hearing thresholds (β = -0.012, p = 0.017), whereas no significant association was observed with high-frequency thresholds (β = -0.006, p = 0.352). In a stratified analysis using 50 years (the average menopausal age) as a cutoff, no statistically significant association was identified in participants younger than 50 years. However, in those aged 50 years and older, the negative association between serum iron levels and low-frequency hearing thresholds remained statistically significant.

Conclusions: This study is the first to identify an association between serum iron levels and low-frequency hearing loss in females aged 50 years and older, underscoring the potential role of iron in auditory function. These findings highlight the importance of further research in diverse populations to elucidate the underlying mechanisms and broader clinical implications.

Background: As South Korea experiences rapid population aging, preventing early retirement has become a critical concern. Ill health contributes to early retirement, and educational level moderates this relationship. Although well-studied in Europe, it remains less explored in Northeast Asia, where labor markets and educational attainment differ significantly. This study investigated the moderating role of education in the relationship between chronic diseases and labor force non-participation in South Korea, considering disease severity, type, and employment status.

Methods: Using data from the Korean Longitudinal Study of Elderly Employment, this study analyzed 5,758 individuals born between 1964 and 1976. Chronic diseases were categorized by severity and type. Labor force participation and retirement from lifetime primary occupation were measured. Education was categorized as low (≤high school) or high (≥college). Logistic regression analyses were conducted, adjusting for sociodemographic and lifestyle covariates, with stratification by education level, employment status, severity, and disease characteristics.

Results: Chronic diseases were significantly associated with labor market non-participation and early retirement, with stronger associations among individuals with lower educational levels. Educational disparities were particularly evident for severe and psychiatric disorders. Among wage workers, those with lower education were more likely to exit the labor market due to chronic diseases, whereas those with higher education generally maintained employment, except in cases of musculoskeletal diseases. Low-educated individuals with chronic diseases were also more likely to retire early from their lifetime primary occupations.

Conclusions: Education moderates the relationship between chronic diseases and labor non-participation, with greater disparities in severe or psychiatric illnesses and among wage workers. Low-educated workers are more vulnerable to early retirement due to ill health, highlighting the need for targeted policy interventions to support this group and prevent early exit from the workforce.