Journal of Preventive Medicine and Public Health

Cohort Profile

Etiome Study Using Molecular Epigenetic Markers and Lung Organoid in Korean School Meal Service Workers (Etiome Study in S-meal Workers): Study Protocol: Sungji Moon, Soseul Sung, Sue K. Park; J Prev Med Public Health. 2025;58(3):231-240. Published online April 10, 2025; DOI: https://doi.org/10.3961/jpmph.25.020

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Abstract Summary PDF Supplementary Material: School meal service workers may face an increased risk of lung cancer due to the nature of their work. This study aims to assess environmental exposure levels during occupational cooking among these workers in Seoul, Korea, and to examine the associations with carcinogen-associated biomarkers. Additionally, the study seeks to verify lung carcinogenesis through experiments using lung organoids treated with carcinogens, such as polycyclic aromatic hydrocarbons (PAHs) and particulate matter. Here, we introduce the study protocol and outline our research strategies. This etiome study employs molecular epidemiological approaches involving at least 200 school meal service workers from 25-30 school cafeterias in Seoul, as well as in vitro lung organoid experiments. The study includes a questionnaire survey to analyze workers’ occupational environments, focusing on exposure to hazardous substances such as cooking oil fumes and assessing the use of personal protective equipment (e.g., masks) and the presence of ventilation systems. We measure molecular epigenomic biomarkers, including PAH adducts and metabolites along with methylation markers, in the exposure and control groups. Additionally, lung organoid experiments are performed to investigate the potential for lung cancer development due to respiratory carcinogen exposure in cooks. This study is expected to contribute to health risk assessments and the establishment of preventive strategies for meal service workers.; Summary

Korean summary
조리업 종사자의 폐암 발생 위험도가 높다고 보고되지만 실제 발암 물질에 어느정도 노출되어 있는지 전 세계적으로 아직까지 밝혀진 바 없습니다. 본 연구는 서울시내 학교 조리업 종사자 모집과 발암물질 노출 마커 측정 대한 방법론적인 논문이며 향후 추적 관찰할 수 있는 코호트 연구에 대한 초석 역할을 합니다.

Key Message
Although previous studies have reported an increased risk of lung cancer among cooking workers, the extent of their exposure to carcinogens has not yet been well characterized globally. This study presents the methodology for recruiting school cooking workers in Seoul and measuring biomarkers of carcinogen exposure. It serves as a foundational step toward establishing a prospective cohort for long-term follow-up.

Scoping Review

Is Farming a Risk Occupation for Cardio-cerebrovascular Diseases? A Scoping Review on Cardio-cerebrovascular Disease Risk in Farmers: Hyeonjun Kim, Wongeon Jung, Sunjin Jung, Seunghyeon Cho, Inho Jung, Hansoo Song, Ki-Soo Park, Seong-Yong Yoon, Joo Hyun Sung, Seok-Ju Yoo, Won-Ju Park; J Prev Med Public Health. 2024;57(6):521-529. Published online August 23, 2024; DOI: https://doi.org/10.3961/jpmph.24.302

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Abstract Summary PDF Supplementary Material

Objectives
In Korea, cardio-cerebrovascular disease (CCVD) is recognized as an occupational disease when sufficient evidence of a work-related burden exists. In 2021, approximately 26.8% of the payments from occupational disease insurance under the Industrial Accident Compensation Insurance Act were allocated to CCVDs. However, due to the specific nature of insurance policies for farmers, CCVD is not acknowledged as an occupational disease in their case.
Methods
We reviewed studies on the differences in the incidence, prevalence, and mortality rates of CCVDs between farmers and the general population or other occupations and described the exposure of farmers to risk factors for CCVDs.
Results
Several studies showed that farming is a high-risk occupation for CCVDs, with the following risk factors: long working hours, night work, lack of holidays, and strenuous physical labor; physical factors (noise, cold, heat, humidity, and vibration); exposure to hazardous gases (diesel exhaust, carbon monoxide, hydrogen sulfide, carbon disulfide, nitrogen oxides, and polycyclic aromatic hydrocarbons), pesticides, and dust (particulate matter, silica, and organic dust); exposure to a hypoxic environment; and job-related stress. Social isolation and lack of accessible medical facilities also function as additional risk factors by preventing farmers from receiving early interventions.
Conclusions
Farmers are exposed to various risk factors for CCVDs and are an occupation at risk for CCVDs. More studies are needed in the future to elucidate this relationship. This study lays the groundwork for future research to develop guidelines for approving CCVDs as occupational diseases among farmers.

Summary

Korean summary
이 연구는 농업이 뇌심혈관질환과 연관된 고위험 직업임을 입증하는 근거를 검토하였습니다. 농업인은 긴 근무 시간, 격렬한 신체 노동, 유해 가스 및 살충제 노출 등 다양한 위험 요인과 더불어 의료 접근성 부족과 같은 문제에 직면해 있습니다. 이는 뇌심혈관질환을 농업인의 업무 관련 질병으로 인정하기 위한 가이드라인 개발에 중요한 기초를 제공합니다.

Key Message
This study reviewed evidence supporting that farming is a high-risk occupation associated with cardio-cerebrovascular diseases. Farmers face various risk factors, including long working hours, strenuous physical labor, exposure to hazardous gases and pesticides, and challenges such as limited access to medical care. This provides an essential foundation for developing guidelines to recognize cardio-cerebrovascular diseases as work-related illnesses among farmers.

Citations

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Labour-type physical activity, alcohol use and hypertension in rural older adults in Northeast China
Yongheng Zhao, Gaixia Hou, Yimeng Gu, Zhuangzhuang Guo, Dehui Zhang, Xuefeng Xi, Limeng Liu, Lizhen Ning
Frontiers in Public Health.2026;[Epub] CrossRef
Leveraging Administrative Health Databases to Address Health Challenges in Farming Populations: Scoping Review and Bibliometric Analysis (1975-2024)
Pascal Petit, Nicolas Vuillerme
JMIR Public Health and Surveillance.2025; 11: e62939. CrossRef

Original Articles

Workstation Risk Factors for Work-related Musculoskeletal Disorders Among IT Professionals in Indonesia: Tofan Agung Eka Prasetya, Nurul Izzah Abdul Samad, Aisy Rahmania, Dian Afif Arifah, Ratih Andhika Akbar Rahma, Abdullah Al Mamun; J Prev Med Public Health. 2024;57(5):451-460. Published online July 25, 2024; DOI: https://doi.org/10.3961/jpmph.24.214

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Abstract Summary PDF

Objectives
This study aimed to identify workstation factors influencing work-related musculoskeletal disorders (WMSDs) among information technology (IT) professionals in Indonesia.
Methods
A cross-sectional study was conducted among 150 IT workers at small-enterprise companies who were randomly selected across East Java, Indonesia. The data were modeled using multiple linear regression, with a 95% level of confidence for determining statistical significance.
Results
The respondents reported that the neck had the highest level of discomfort and was the most at risk of WMSDs, followed by the lower back, right shoulder, and upper back. Screen use duration (p=0.040) was associated with whole-body WMSDs, along with seat width (p=0.059), armrest (p=0.027), monitor (p=0.046), and a combined telephone and monitor score (p=0.028). Meanwhile, the factors significantly related to the risk of WMSDs in the hands and wrist were working period (p=0.039), night shift (p=0.024), backrest (p=0.008), and mouse score (p=0.032).
Conclusions
Occupational safety authorities, standards-setting departments, and policymakers should prioritize addressing the risk factors for WMSDs among IT professionals.

Summary

Key Message
This study investigates workstation risk factors contributing to work-related musculoskeletal disorders (WMSDs) among IT professionals in Indonesia. Findings indicate that neck discomfort is the most prevalent, with significant associations identified between WMSDs and factors such as screen use duration, seating arrangements, and work conditions. The results underscore the need for ergonomic improvements and targeted preventive measures to enhance occupational health and safety for IT workers.

Citations

Citations to this article as recorded by

Evaluation of working posture and neck pain among IT professionals – an observational study
Amita Aggarwal, Tushar J. Palekar
International Journal of Occupational Safety and Ergonomics.2026; : 1. CrossRef
Work-related musculoskeletal disorders and digitalization: past adoption, current utilization, and future concerns
Young-Mee Kim, Sung-il Cho
BMC Public Health.2025;[Epub] CrossRef

Reliability of a Newly Developed Tool to Assess and Classify Work-related Stress (TAWS-16) for Indian Workforce: Gautham Melur Sukumar, Runalika Roy, Mariamma Philip, Gururaj Gopalkrishna; J Prev Med Public Health. 2023;56(5):407-412. Published online August 19, 2023; DOI: https://doi.org/10.3961/jpmph.23.219

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Abstract Summary PDF: Objectives
Work stress is associated with non-communicable diseases, increased healthcare costs, and decreased work productivity among employees in the information technology sector. There is a need for regular work-stress screening among employees using valid and reliable tools. The Tool to Assess and Classify Work Stress (TAWS-16) was developed to overcome limitations in existing stress assessment tools in India. This study aimed to test the reliability of TAWS-16 in a sample of managerial-supervisory employees.
Methods
This observational reliability study included data from 62 employees. Test-retest and inter-method reliability were investigated using a TAWS-16 web application and interview by telephone, respectively. Kappa values and intra-class correlation coefficients were calculated. Internal consistency was assessed through Cronbach’s alpha.
Results
For both test-retest and inter-method reliability, the agreement for both work-related factors and symptoms suggestive of work stress exceeded 80%, and all kappa values were 0.40 or higher. Cronbach’s alpha for test-retest and inter-method reliability was 0.983 and 0.941, respectively.
Conclusions
TAWS-16 demonstrated acceptable reliability. It measured stressors, coping abilities, and psychosomatic symptoms associated with work stress. We recommend using TAWS-16 to holistically identify work stress among employees during periodical health check-ups in India.; Summary

Key Message
The study assessed test-retest and inter-method reliability of Tool to Assess Work Stress (TAWS – 16) developed by Centre for Public Health, National Institute of Mental Health and Neurosciences (NIMHANS) on 62 employees in Bengaluru, India. Kappa statistics, Intra-class correlation coefficient (ICC) and Cronbach’s alpha were calculated. TAWS – 16 demonstrated acceptable reliability, good internal consistency and can be used to identify work stress among employees during periodical health check-ups in Indian setting.

Analysis of Differences in Preterm Birth Rates According to Household Occupation in Japan From 2007 to 2019: Tasuku Okui, Naoki Nakashima; J Prev Med Public Health. 2022;55(4):371-378. Published online June 20, 2022; DOI: https://doi.org/10.3961/jpmph.22.178

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Abstract PDF

Objectives
No studies have examined the association between preterm birth rates and socioeconomic factors in Japan using nationwide statistical data. We analyzed the association between preterm birth rates and household occupation using Vital Statistics data.
Methods
Aggregated Vital Statistics data from Japan from 2007 to 2019 were obtained from the Ministry of Health, Labour and Welfare. From the data, the number of births according to year, age group, gestational period, number of pregnancies, and household occupation were used in this study. Crude preterm birth rates and preterm birth rates adjusted by maternal age according to household occupation were calculated for each year. Poisson regression analysis was conducted to evaluate the association between household occupation and preterm births.
Results
Unemployed households had the highest preterm birth rate, and households with an occupation classification of “full-time worker 2” (an employee at a large company, civil servant, or board member) had the lowest preterm birth rate throughout each period. Poisson regression analysis revealed that unemployed households were statistically significantly associated with a high preterm birth risk. In contrast, the preterm birth rate adjusted by maternal age remained stable throughout each period regardless of household occupation, and preterm birth rates were found not to have increased in recent years in Japan.
Conclusions
Unemployed households had higher preterm birth rates than other household occupations. Further studies investigating the characteristics of unemployed households are needed to identify the reasons for this disparity.

Summary

Citations

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Maternal occupation and risk of adverse fetal outcomes in Tanzania: A hospital-based cross-sectional study
Baldwina Tita Olirk, Aiwerasia Vera Ngowi, Furaha August, Ezra Jonathan Mrema, Jovine Bachwenkizi, Simon Henry Mamuya, Kahsu Gebrekidan
PLOS ONE.2025; 20(3): e0319653. CrossRef
Shotgun metagenomics of the vaginal microbiome in cervical shortening and preterm birth risk
Keun-Young Lee, Seung-Ho Shin, Goeun Park, Shin-Hae Kang, Hyun-Jung Kang, Jiye Kim, Jae Jun Lee, Ga-Hyun Son, Ji Young Hong
Scientific Reports.2025;[Epub] CrossRef
Establishment and validation of clinical prediction models for preterm birth in patients with intrahepatic cholestasis of pregnancy: Single-center retrospective observational study
Min Wen, Wenfei Zheng, Mengmeng Yu
Medicine.2025; 104(52): e46848. CrossRef
Analysis of an Association between Preterm Birth and Parental Educational Level in Japan Using National Data
Tasuku Okui
Children.2023; 10(2): 342. CrossRef
Association of maternal nationality with preterm birth and low birth weight rates: analysis of nationwide data in Japan from 2016 to 2020
Tasuku Okui, Yoko Sato, Seiichi Morokuma, Naoki Nakashima
Maternal Health, Neonatology and Perinatology.2023;[Epub] CrossRef
Does the father’s job matter? Parental occupation and preterm birth in Korea
Taemi Kim, Eunseon Gwak, Bolormaa Erdenetuya, Jeong-Won Oh, Jung-won Yoon, Myoung-Hee Kim, Jia Ryu, Seung-Ah Choe
Epidemiology and Health.2023; 45: e2023078. CrossRef

The Role of CYP2B6*6 Gene Polymorphisms in 3,5,6-Trichloro-2-pyridinol Levels as a Biomarker of Chlorpyrifos Toxicity Among Indonesian Farmers: Jen Fuk Liem, Dwi A. Suryandari, Safarina G. Malik, Muchtaruddin Mansyur, Dewi S. Soemarko, Aria Kekalih, Imam Subekti, Franciscus D. Suyatna, Bertha Pangaribuan; J Prev Med Public Health. 2022;55(3):280-288. Published online May 16, 2022; DOI: https://doi.org/10.3961/jpmph.21.641

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Abstract PDF Supplementary Material

Objectives
One of the most widely used pesticides today is chlorpyrifos (CPF). Cytochrome P450 (CYP)2B6, the most prominent catalyst in CPF bioactivation, is highly polymorphic. The objective of our study was to evaluate the role of CYP2B6*6, which contains both 516G>T and 785A>G polymorphisms, in CPF toxicity, as represented by the concentration of 3,5,6-trichloro-2-pyridinol (TCPy), among vegetable farmers in Central Java, Indonesia, where CPF has been commonly used.
Methods
A cross-sectional study was conducted among 132 vegetable farmers. Individual socio-demographic and occupational characteristics, as determinants of TCPy levels, were obtained using a structured interviewer-administered questionnaire and subsequently used to estimate the cumulative exposure level (CEL). TCPy levels were detected with liquid chromatography-mass spectrometry. CYP2B6*6 gene polymorphisms were analyzed using a TaqMan® SNP Genotyping Assay and Sanger sequencing. Linear regression analysis was performed to analyze the association between TCPy, as a biomarker of CPF exposure, and its determinants.
Results
The prevalence of CYP2B6*6 polymorphisms was 31% for *1/*1, 51% for *1/*6, and 18% for *6/*6. TCPy concentrations were higher among participants with CYP2B6*1/*1 than among those with *1/*6 or *6/*6 genotypes. CYP2B6*6 gene polymorphisms, smoking, CEL, body mass index, and spraying time were retained in the final linear regression model as determinants of TCPy.
Conclusions
The results suggest that CYP2B6*6 gene polymorphisms may play an important role in influencing susceptibility to CPF exposure. CYP2B6*6 gene polymorphisms together with CEL, smoking habits, body mass index, and spraying time were the determinants of urinary TCPy concentrations, as a biomarker of CPF toxicity.

Summary

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Aplicaciones de la xenometabolómica para la identificación de biomarcadores de toxicidad: una revisión del tema
Juan Pablo Betancourt Arango, Alejandro Patiño Ospina, Gonzalo Taborda Ocampo, Jhon Alexander Fiscal Ladino
Biosalud.2025; 19(1): 7. CrossRef
Pesticide metabolite 3, 5, 6-trichloro-2-pyridinol causes massive damage to the cochlea resulting in hearing loss in adult mice
Mao Huang, Shuangshuang Mao, Yunfei Pan, Ziying Zhang, Fei Gui, Xiaohua Tan, Yu Hong, Rong Chen
Environmental Pollution.2024; 360: 124691. CrossRef
Human CYP2C19 Substrate and Inhibitor Characterization of Organophosphate Pesticides
Patricia A. Vignaux, Pratik Shriwas, Andre Revnew, Garima Agarwal, Thomas R. Lane, Craig A. McElroy, Sean Ekins
Chemical Research in Toxicology.2023; 36(9): 1451. CrossRef
The determinants of thyroid function among vegetable farmers with primary exposure to chlorpyrifos: A cross-sectional study in Central Java, Indonesia
Jen Fuk Liem, Imam Subekti, Muchtaruddin Mansyur, Dewi S. Soemarko, Aria Kekalih, Franciscus D. Suyatna, Dwi A. Suryandari, Safarina G. Malik, Bertha Pangaribuan
Heliyon.2023; 9(6): e16435. CrossRef

Individual and Occupational Factors Associated With Low Back Pain: The First-ever Occupational Health Study Among Bangladeshi Online Professionals: Mosharop Hossian, Mohammad Hayatun Nabi, Ahmed Hossain, Mohammad Delwer Hossain Hawlader, Nadira Sultana Kakoly; J Prev Med Public Health. 2022;55(1):98-105. Published online January 12, 2022; DOI: https://doi.org/10.3961/jpmph.21.565

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Abstract PDF

Objectives
Low back pain (LBP) is a common chronic condition among sedentary workers that causes long-term productivity loss. This study aimed to identify the relationships of individual and occupational factors with LBP among Bangladeshi online professionals.
Methods
We conducted a cross-sectional study involving 468 full-time online professionals who usually worked in a sitting position. One-month LBP complaints were assessed using a musculoskeletal subscale of subjective health complaints. The chi-square test was used to measure associations between categorical predictors and LBP, and multivariable logistic regression was conducted to identify the variables significantly associated with LBP.
Results
LBP within the last month was reported by 65.6% of participants. Multivariable logistic regression analysis indicated that age >30 years (adjusted odds ratio [aOR], 0.40; 95% confidence interval [CI], 0.23 to 0.70) and being married (aOR, 0.59; 95% CI, 0.36 to 0.97) had significant negative associations with LBP. Significant positive associations were found for spending >50 hours weekly on average working in a sitting position (aOR, 1.61; 95% CI, 1.05 to 2.49), being overweight and obese (aOR, 1.87; 95% CI, 1.16 to 2.99), sleeping on a soft mattress (aOR, 2.01; 95% CI, 1.06 to 3.80), and ex-smoking status (aOR, 3.33; 95% CI, 1.41 to 7.87).
Conclusions
A high prevalence of LBP was found among full-time online professionals. Long working hours in a sitting position showed a significant association with developing LBP. Smoking history, body mass index, and sleeping arrangements should also be considered while considering solutions for LBP prevalence among online professionals.

Summary

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Low back pain and sitting time, posture and behavior in office workers: A scoping review
Nuray Alaca, Ali Ömer Acar, Sergen Öztürk
Journal of Back and Musculoskeletal Rehabilitation.2025; 38(5): 919. CrossRef
Effects of mattress firmness and usage duration on low back pain: a hospital-based study from Lahore
Alveena Mobeen, Hafiz Muhammad Kazim, Nimra Ijaz
Journal of Social & Health Sciences.2024; 2: 34. CrossRef
Pay-for-performance and low back pain with interaction of overwork: findings from the cross-sectional Korean working conditions survey
Julia D. Hur, Jongin Lee
Frontiers in Public Health.2024;[Epub] CrossRef

Public Sector Workers’ Mental Health in Argentina: Comparative Psychometrics of the Perceived Stress Scale: Agustín Ramiro Miranda, Ana Veronica Scotta, Ana Lucía Méndez, Silvana Valeria Serra, Elio Andrés Soria; J Prev Med Public Health. 2020;53(6):429-438. Published online October 5, 2020; DOI: https://doi.org/10.3961/jpmph.20.229

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Abstract PDF

Objectives
Given that Argentinian public-sector workers are highly exposed to stressful conditions, and that the psychometric properties of the widely used Perceived Stress Scale (PSS) should be evaluated in different settings, this work aimed to compare the psychometric properties of the Latin American Spanish PSS-10 and PSS-4 and to identify the optimal scale for stress assessment.
Methods
A sample of 535 participants was randomly divided into 2 groups to evaluate dimensionality by exploratory and confirmatory factor analyses. The reliability of both scales was also evaluated. Convergent validity was estimated using the Executive Complaints Questionnaire, the average variance extracted, and the composite reliability. Discriminant validity was based on the correlation with the Utrecht Work Engagement Scale and the phi-square correlation between the components.
Results
The factor analyses supported bidimensionality of the PSS-10 (stress and coping), which showed a better fit than the PSS-4. Moreover, the reliability of the PSS-10 was higher, whereas the PSS-4 did not achieve adequate values of internal consistency. The PSS-10 was also correlated significantly with all validation scales, and presented proper internal convergent and divergent validity.
Conclusions
The PSS-10 is a reliable and structurally valid instrument to measure perceived stress and coping in a Latin American Spanish-speaking population with high work demands, and the findings of this study expand our knowledge on the geographical and sociocultural applicability of the PSS.

Summary

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Henrik Pedersen, Tatiana Skliarova, Stian Lydersen, Hege Hafstad, Audun Havnen, Mariela Loreto Lara‐Cabrera
Scandinavian Journal of Psychology.2026; 67(1): 230. CrossRef
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Ecopsychology.2026;[Epub] CrossRef
Two-years mothering into the pandemic: Impact of the three COVID-19 waves in the Argentinian postpartum women’s mental health
Agustín Ramiro Miranda, Ana Veronica Scotta, Mariela Valentina Cortez, Elio Andrés Soria, Pracheth Raghuveer
PLOS ONE.2025; 20(3): e0294220. CrossRef
Understanding work engagement in public administration: A comprehensive bibliometric and systematic review of the past decade
Iqbal Saffariz Santosa, Erwan Agus Purwanto, Sumaryono Sumaryono, Puguh Prasetya Utomo
Social Sciences & Humanities Open.2025; 11: 101479. CrossRef
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Cogent Psychology.2025;[Epub] CrossRef
Co-Development and Content Validity of an Instrument to Collect Integratively the Social Determinants of Health in Postpartum Lactating People
Paula Eugenia Barral, Agustín Ramiro Miranda, Elio Andrés Soria
World.2025; 6(3): 120. CrossRef
Perceived stress, negative life events, and adiposity among Puerto Rican young adults in the South Bronx, New York, and San Juan, Puerto Rico
Jorge A. Gonzalez-Mejia, Andrea A. López-Cepero, Natishkah Knox, Hector R. Bird, Glorisa J. Canino, Cristiane S. Duarte, Shakira F. Suglia
Journal of Health Psychology.2025;[Epub] CrossRef
Psychometric properties of the Perceived Stress Scale (PSS-10) in silica-exposed workers from diverse cultural and linguistic backgrounds
Fiona Hore-Lacy, StellaMay Gwini, Deborah C. Glass, Christina Dimitriadis, Javier Jimenez-Martin, Ryan F. Hoy, Malcolm R. Sim, Karen Walker-Bone, Jane Fisher
BMC Psychiatry.2024;[Epub] CrossRef
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Agustín R. Miranda, Mariela V. Cortez, Ana V. Scotta, Elio A. Soria
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Effects of Socio-demographic Factors on the Decreasing Trend in the Sex Ratio at Birth in Korea, 1997-2017: Jisuk Bae; J Prev Med Public Health. 2020;53(5):371-380. Published online August 7, 2020; DOI: https://doi.org/10.3961/jpmph.20.282

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Abstract PDF Supplementary Material: Objectives
This study investigated the effects of socio-demographic factors on the decreasing trend in the sex ratio at birth from 1997 to 2017 in Korea.
Methods
Data from 10 349 602 live births registered with Statistics Korea from 1997 to 2017 were analyzed. The secondary sex ratio (SSR), defined as the ratio of male to female live births, during the study period (1997-1999 [phase I], 2000-2002 [phase II], 2003-2005 [phase III], 2006-2008 [phase IV], 2009-2011 [phase V], 2012-2014 [phase VI], and 2015-2017 [phase VII]) was calculated according to selected socio-demographic factors, such as parental age, education, occupation, and birth order. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals for a male birth after adjusting for potential confounders.
Results
The SSR gradually decreased from 1.10 (in 1998-2000 and 2002) to 1.05 (in 2013-2016). While a decreasing trend in the SSR was not noted among first births, male-biased sex ratios were prominent among third and higher-order births, for which the highest SSR was 1.46 in 1998. Higher birth order was significantly associated with an excess of male births in phases I-VI (≥third vs. first, OR range, 1.03 to 1.35). Advanced maternal age was significantly associated with an excess of female births in phases II, III, and V (≥40 vs. 20-24 years, OR range, 0.92 to 0.95).
Conclusions
This study demonstrated that advanced maternal age and reduction of the artificially-biased SSR among third and higher-order births may partially explain the decreasing trend in the SSR from 1997 to 2017 in Korea.; Summary

Effect of Burnout on Post-traumatic Stress Disorder Symptoms Among Firefighters in Korea: Data From the Firefighter Research on Enhancement of Safety & Health (FRESH): Woojin Kim, Munjoo Bae, Sei-Jin Chang, Jin-Ha Yoon, Da Yee Jeong, Dae-Sung Hyun, Hye-Yoon Ryu, Ki-Soo Park, Mi-Ji Kim, Changsoo Kim; J Prev Med Public Health. 2019;52(6):345-354. Published online October 24, 2019; DOI: https://doi.org/10.3961/jpmph.19.116

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Abstract Summary PDF Supplementary Material

Objectives
It is well-known that post-traumatic stress disorder (PTSD) among firefighters contributes to their job-related stress. However, the relationship between burnout and PTSD in firefighters has rarely been studied. This study therefore explored the association between burnout and its related factors, such as trauma and violence, and PTSD symptoms among firefighters in Korea.
Methods
A total of 535 firefighters participated in the Firefighter Research on Enhancement of Safety & Health study at 3 university hospitals from 2016 to 2017. The 535 participants received a baseline health examination, including questionnaires assessing their mental health. A Web-based survey was also conducted to collect data on job-related stress, history of exposure to violence, burnout, and trauma experience. The associations among burnout, its related factors, and PTSD symptoms were investigated using structural equation modeling.
Results
Job demands (β=0.411, p<0.001) and effort-reward balance (β=-0.290, p<0.001) were significantly related to burnout. Burnout (β=0.237, p<0.001) and violence (β=0.123, p=0.014) were significantly related to PTSD risk. Trauma (β=0.131, p=0.001) was significantly related to burnout; however, trauma was not directly associated with PTSD scores (β=0.085, p=0.081).
Conclusions
Our results show that burnout and psychological, sexual, and physical violence at the hands of clients directly affected participants’ PTSD symptoms. Burnout mediated the relationship between trauma experience and PTSD.

Summary

Korean summary
535명의 현직소방관을 대상으로 소방공무원에서 업무관련스트레스, 폭력노출, 외상노출, 소진(번아웃), 외상후 스트레스 장애(PTSD) 증상 설문을 시행하였고, 구조방정식 통해 업무스트레스에 의한 소진이 PTSD에 주는 영향과 다른 요인간의 연관성을 분석하였다. 그 결과, 업무 환경에서의 높은 직무요구수준과 낮은 노력-보상 균형은 소진을 증가시키며, 업무스트레스에 의한 소진과 근무 중 겪게 되는 폭력노출 경험은 PTSD 점수와 양의 연관관계를 보였다. 반면, 업무 도중 외상사건 경험은 PTSD 점수와 직접적으로 유의한 연관관계를 보이지 않았으나, 소진을 통한 간접적으로 영향을 주는 것을 확인하였다.

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Brief Report

Background and Activities of the Samsung Ombudsperson Commission in Korea: Cheolsoo Lee, Seong-Kyu Kang, Hyunwook Kim, Inhee Kim; J Prev Med Public Health. 2019;52(4):265-271. Published online July 3, 2019; DOI: https://doi.org/10.3961/jpmph.19.033

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Abstract Summary PDF Supplementary Material

Objectives
The Samsung Ombudsperson Commission was launched as an independent third-party institution following an agreement among Samsung Electronics, Supporters for Health and Right of People in Semiconductor Industry (Banolim in Korean, an independent NGO), and the Family Compensation Committee, in accordance with the industry accident prevention measure required by the settlement committee to address the issues related to employees who allegedly died from leukemia and other diseases as a result of working at Samsung’s semiconductor production facilities.
Methods
The Commission has carried out a comprehensive range of activities to review and evaluate the status of the company’s occupational accidents management system, as well as occupational safety and health risk management within its facilities.
Results
Based on the results of this review, termed a comprehensive diagnosis, the Commission presented action plans for improvement to strengthen the company’s existing safety and health management system and to effectively address uncertain risks in this area going forward.
Conclusions
The Commission will monitor the execution of the suggested tasks and provide advice and guidance to ensure that Samsung’s semiconductor and liquid crystal display production lines are safer.

Summary

Korean summary
삼성옴부즈만위원회는 ‘삼성전자 반도체 사업장에서의 백혈병 등 질환 발병과 관련된 문제 해결을 위한 조정위원회’의 조정권고안 중 재해예방대책 부분에 대하여 삼성전자, 반올림, 가족대책위원회 등 3자 간에 조정합의가 성립함에 따라 출범한 외부의 독립기구로서, 삼성전자 내부의 재해관리시스템 운영 상황을 비롯하여 사업장 내 산업안전보건관리 현황 등에 관하여 필요한 정보를 삼성전자로부터 제출받아 이를 검토·평가하고 필요한 경우 개선을 권고하는 종합진단 활동을 수행하였다. 종합진단 결과, 삼성옴부즈만위원회는 현재의 안전보건관리 체계를 보다 강화하고 안전보건관리 영역에서 미래의 불확실한 위험을 효과적으로 해소하기 위해 개선권고사항을 제시하였으며, 앞으로 개선권고사항의 이행점검활동을 통해 삼성전자 반도체 및 LCD사업장이 보다 안전한 사업장이 될 수 있도록 지도 및 조언할 예정이다.

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Original Articles

Transformational Leadership and Depressive Symptoms in Germany: Validation of a Short Transformational Leadership Scale: Max Leonhard Seegel, Raphael M. Herr, Michael Schneider, Burkhard Schmidt, Joachim E. Fischer; J Prev Med Public Health. 2019;52(3):161-169. Published online May 12, 2019; DOI: https://doi.org/10.3961/jpmph.19.002

8,079 View
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Abstract PDF

Objectives
The objective of the present study was to validate a shortened transformational leadership (TL) scale (12 items) comprising core TL behaviour and to test the associations of this shortened TL scale with depressive symptoms.
Methods
The study used cross-sectional data from 1632 employees of the overall workforce of a middle-sized German company (51.6% men; mean age, 41.35 years; standard deviation, 9.4 years). TL was assessed with the German version of the Transformational Leadership Inventory and depressive symptoms with the Hospital Anxiety and Depression Scale (HADS). The structural validity of the core TL scale was assessed with confirmatory factor analysis. Associations with depressive symptoms were estimated with structural equation modelling and adjusted logistic regression.
Results
Confirmatory factor analysis and structural equation modelling showed better model fit for the core TL than for the full TL score. Logistic regression revealed 3.61-fold (95% confidence interval [CI], 2.20 to 5.93: women) to 4.46-fold (95% CI, 2.86 to 6.95: men) increased odds of reporting depressive symptoms (HADS score >8) for those in the lowest tertile of reported core TL.
Conclusions
The shortened core TL seems to be a valid instrument for research and training purposes in the context of TL and depressive symptoms in employees. Of particular note, men reporting poor TL were more likely to report depressive symptoms.

Summary

Citations

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Associations between key job resources, job demands, and affective organizational commitment among nursing professionals in German hospitals: a cross-sectional study
Lucas Fehr, Clemens Koob
BMC Nursing.2025;[Epub] CrossRef
Investigating the Association Between Transformational Leadership and Job Satisfaction: The Role of Gratitude Towards the Organization in the Peruvian Context
Edgardo Muguerza-Florián, Elizabeth Emperatriz García-Salirrosas, Miluska Villar-Guevara, Israel Fernández-Mallma
Administrative Sciences.2025; 15(9): 349. CrossRef

Reconstruction of Radiation Dose Received by Diagnostic Radiologic Technologists in Korea: Yeongchull Choi, Jaeyoung Kim, Jung Jeung Lee, Jae Kwan Jun, Won Jin Lee; J Prev Med Public Health. 2016;49(5):288-300. Published online August 23, 2016; DOI: https://doi.org/10.3961/jpmph.16.064

11,046 View
152 Download
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Abstract PDF Supplementary Material

Objectives
Diagnostic medical radiation workers in Korea have been officially monitored for their occupational radiation doses since 1996. The purpose of this study was to design models for reconstructing unknown individual radiation doses to which diagnostic radiation technologists were exposed before 1996.
Methods
Radiation dose reconstruction models were developed by using cross-sectional survey data and the personal badge doses of 8167 radiologic technologists. The models included calendar year and age as predictors, and the participants were grouped into six categories according to their sex and facility type. The annual doses between 1971 and 1995 for those who were employed before 1996 were estimated using these models.
Results
The calendar year and age were inversely related to the estimated radiation doses in the models of all six groups. The annual median estimated doses decreased from 9.45 mSv in 1971 to 1.26 mSv in 1995, and the associated dose variation also decreased with time. The estimated median badge doses from 1996 (1.22 mSv) to 2011 (0.30 mSv) were similar to the measured doses (1.68 mSv to 0.21 mSv) for the same years. Similar results were observed for all six groups.
Conclusions
The reconstruction models developed in this study may be useful for estimating historical occupational radiation doses received by medical radiologic technologists in Korea.

Summary

Citations

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Trends in Occupational Radiation Doses for U.S. Radiologic Technologists Performing General Radiologic and Nuclear Medicine Procedures, 1980–2015
Daphnée Villoing, David Borrego, Dale L. Preston, Bruce H. Alexander, André Rose, Mark Salasky, Martha S. Linet, Choonsik Lee, Cari M. Kitahara
Radiology.2021; 300(3): 605. CrossRef
Estimation of the historical radiation dose of Korean radiation workers, 1961–1983
Dalnim Lee, Won Jin Lee, Young Woo Jin, Jiyeong Kim, Soojin Park, Sunhoo Park, Songwon Seo
Journal of Radiological Protection.2021; 41(4): 1005. CrossRef
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Jiyeong Kim, Songwon Seo, Dal Nim Lee, Soojin Park, Ki-Jung Im, Sunhoo Park, Young Woo Jin
Radiation Protection Dosimetry.2020; 189(1): 106. CrossRef
Thyroid cancer risks among medical radiation workers in South Korea, 1996–2015
Won Jin Lee, Dale L. Preston, Eun Shil Cha, Seulki Ko, Hyeyeun Lim
Environmental Health.2019;[Epub] CrossRef
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Yeongchull Choi, Eun Shil Cha, Ye Jin Bang, Seulki Ko, Mina Ha, Choonsik Lee, Won Jin Lee
Radiation Protection Dosimetry.2018; 179(2): 142. CrossRef
Projected lifetime cancer risks from occupational radiation exposure among diagnostic medical radiation workers in South Korea
Won Jin Lee, Yeongchull Choi, Seulki Ko, Eun Shil Cha, Jaeyoung Kim, Young Min Kim, Kyoung Ae Kong, Songwon Seo, Ye Jin Bang, Yae Won Ha
BMC Cancer.2018;[Epub] CrossRef
Assessing the health effects associated with occupational radiation exposure in Korean radiation workers: protocol for a prospective cohort study
Songwon Seo, Wan Young Lim, Dal Nim Lee, Jung Un Kim, Eun Shil Cha, Ye Jin Bang, Won Jin Lee, Sunhoo Park, Young Woo Jin
BMJ Open.2018; 8(3): e017359. CrossRef
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Assessment of Occupational Symptoms and Chemical Exposures for Nail Salon Technicians in Daegu City, Korea: Sung-Ae Park, Sugyeong Gwak, Sangjun Choi; J Prev Med Public Health. 2014;47(3):169-176. Published online May 30, 2014; DOI: https://doi.org/10.3961/jpmph.2014.47.3.169

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Abstract PDF

Objectives

This study aimed to evaluate occupational symptoms and chemical exposures of nail salon technicians.

Methods

Work-related symptoms of nail salon technicians in Daegu City were surveyed using a researcher-administered questionnaire, and responses were compared to those of non-exposed office workers as controls. Personal exposure level of airborne volatile organic compounds was also monitored using passive samplers.

Results

A total of 159 subjects in 120 salons were interviewed. Average work-shift concentrations of 13 chemicals were measured for 50 workers from 30 salons using personal passive samplers. The most frequently reported respiratory or neurologic symptoms by nail shop technicians compared to controls were nose irritation (odds ratio [OR], 54.0; confidence interval [CI], 21.6 to 134.8), followed by headache (OR, 9.3; CI, 4.7 to 18), and throat irritation (OR, 4.3; CI, 2.2 to 8.5). For eyes and skin, 92% of respondents complained eye irritation (OR, 13.1; CI, 5.7 to 30.1). In musculoskeletal symptoms, workers reported pain or discomfort in shoulders (OR, 20.3; CI, 7.7 to 54) and neck (OR, 19.7; CI, 8.9 to 43.6). From personal measurements, the proportion of exceeding the Korean Occupational Exposure Limit was the highest for acetone with 64%, followed by toluene (50%), butyl acetate (46%), and methyl methacrylate (12%). However, the service was being provided without a proper ventilation system in most surveyed shops.

Conclusions

Based on these findings, it is warranted to have appropriate local exhaust ventilation place to ensure adequate health protection of nail shop technicians as well as customers. At the same time, greater policy interests are warranted in nail care business to protect health of both workers and customers.

Summary

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Research Support, Non-U.S. Gov't

Changes in Labor Regulations During Economic Crises: Does Deregulation Favor Health and Safety?.: Won Gi Jhang; J Prev Med Public Health. 2011;44(1):14-21.; DOI: https://doi.org/10.3961/jpmph.2011.44.1.14

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OBJECTIVES
The regulatory changes in Korea during the national economic crisis 10 years ago and in the current global recession were analyzed to understand the characteristics of deregulation in labor policies. METHODS: Data for this study were derived from the Korean government's official database for administrative regulations and a government document reporting deregulation. RESULTS: A great deal of business-friendly deregulation took place during both economic crises. Occupational health and safety were the main targets of deregulation in both periods, and the regulation of employment promotion and vocational training was preserved relatively intact. The sector having to do with working conditions and the on-site welfare of workers was also deregulated greatly during the former economic crisis, but not in the current global recession. CONCLUSIONS: Among the three main areas of labor policy, occupational health and safety was most vulnerable to the deregulation in economic crisis of Korea. A probable reason for this is that the impact of deregulation on the health and safety of workers would not be immediately disclosed after the policy change.

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The Vulnerability of Occupational Health and Safety to Deregulation: The Weakening of Information Regulations during the Economic Crisis in Korea
Won Gi Jhang
NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy.2018; 28(1): 151. CrossRef
The association between nonstandard work and occupational injury in Korea
Hyoung‐June Im, Dae‐gyu Oh, Young‐Su Ju, Young‐Jun Kwon, Tae‐Won Jang, Jun Yim
American Journal of Industrial Medicine.2012; 55(10): 876. CrossRef

English Abstracts

Reliability of Self-Reported Information by Farmers on Pesticide Use.: Yo Han Lee, Eun Shil Cha, Eun Kyeong Moon, Kyoung Ae Kong, Sang Baek Koh, Yun Keun Lee, Won Jin Lee; J Prev Med Public Health. 2010;43(6):535-542.; DOI: https://doi.org/10.3961/jpmph.2010.43.6.535

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OBJECTIVES
Exposure assessment is a major challenge faced by studies that evaluate the association between pesticide exposure and adverse health outcomes. The objective of this study was to investigate the reliability of information that farmers self-report regarding their pesticide use. METHODS: Twenty five items based upon existing questionnaires were designed to focus on pesticide exposure. In 2009 a self-administrated survey was conducted on two occasions four weeks apart among 205 farmers residing in Gyeonggi and Gangwon provinces. For a reliability measure, we calculated the percentage agreement, the kappa statistics and the intraclass correlation coefficient (ICC) between the two reports according to the characteristics of the subjects. RESULTS: Agreement for ever-never use of any pesticide was 96.4% (kappa 0.61). For both 'years used' and 'age at the first use' of overall pesticides, high agreement was obtained (ICC: 0.88 and, 0.78, respectively), whereas those of 'days used' and 'hours used' were relatively low (ICC: 0.42 and, 0.66, respectively). The kappa value for the use of personal protective equipment ranged from 0.46 to 0.59, and hygiene activities came out at 0.19 to 0.37. The agreement for individual pesticide use ranged widely and there was relatively low agreement due to the low response rates. The reliability scores did not significantly vary according to gender, age, the education level, the types of crop or the years of farming. CONCLUSIONS: Our results support that carefully designed, self-reported information on ever-never pesticide use among farmers is reliable. However, the reliability of data on individual pesticide exposure may be unstable due to low response rates and needs to be refined.

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William Mueller, Aggrey Atuhaire, Ruth Mubeezi, Iris van den Brenk, Hans Kromhout, Ioannis Basinas, Kate Jones, Andrew Povey, Martie van Tongeren, Anne-Helen Harding, Karen S. Galea, Samuel Fuhrimann
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Recall of exposure in UK farmers and pesticide applicators: trends with follow-up time
William Mueller, Kate Jones, Hani Mohamed, Neil Bennett, Anne-Helen Harding, Gillian Frost, Andrew Povey, Ioannis Basinas, Hans Kromhout, Martie van Tongeren, Samuel Fuhrimann, Karen S Galea
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NeuroToxicology.2019; 70: 12. CrossRef
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Symptom Prevalence and Work-related Risk Factors of Acute Pesticide Poisoning among Korean Farmers in Gyeong-gi Province
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Crisis Intervention for Workers in Severely Stressful Situations After Massive Layoffs and Labor Disputes.: Jong Min Woo, Jeong Ho Chae, Soo Chan Choi; J Prev Med Public Health. 2010;43(3):265-273.; DOI: https://doi.org/10.3961/jpmph.2010.43.3.265

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OBJECTIVES
Due to the economic crisis and globalization, many workers have been suffering from severe occupational stress due to job insecurity and struggles related to downsizing and restructuring. This study aims to assess the stress levels among workers involved in fierce labor disputes and massive layoffs and to evaluate their specific needs and satisfaction with counseling services set up to help workers cope with severely stressful situations? METHODS: The authors provided crisis intervention to workers in traumatic situations to compare the differential level of stress responses and needs among the workers remaining employed in a large auto factory, those laid off by it, and those laid off by other companies in the same region (Pyeongtaek, Gyeonggi Province). We measured stress levels using the worker's stress response inventory (WSRI) and heart rate variability (HRV), and assessed workers' satisfaction with the counseling services. RESULTS: 502 workers participated in the program. Fifty-seven percent of them consulted with occupational problems. The mean WSRI score of the workers remaining employed in the automobile factory was higher than that of the unemployed (employed: 39.8+/-19.9, unemployed: 29.3+/-18.8). Ninety-five percent of workers responded that they were satisfied or very satisfied with the counseling services. CONCLUSIONS: This study suggests the urgent need for the establishment of a national crisis intervention program dedicated to supporting workers in severely stressful situations.

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Employment and Married Women's Health in Korea; Beneficial or Harmful?.: Il Ho Kim, Heeran Chun; J Prev Med Public Health. 2009;42(5):323-330.; DOI: https://doi.org/10.3961/jpmph.2009.42.5.323

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OBJECTIVES
The aim of this study was to investigate whether working married women in different occupational classes affected diverse health outcomes. METHODS: We used data for married women aged 25-59 (N=2,273) from the 2005 National Health and Nutritional Examination Survey. Outcome measures included physical/mental and subjective/objective indicators (self-rated poor health, chronic diseases, depression, and suicidal ideation from reported results; metabolic syndrome and dyslipidemia from health examination results). Age-standardized prevalence and logistic regression were employed to assess health status according to three types of working groups (housewives, married women in manual jobs, married women in non-manual jobs). Sociodemographic factors (age, numbers of children under 7, education, household income) and health behaviors (health examination, sleep, rest, exercise, smoking, drinking) and a psychological factor (stress) were considered as covariates. RESULTS: Non-manual married female workers in Korea showed better health status in all five health outcomes than housewives. The positive health effect for the non-manual group persisted in absolute (age-adjusted prevalence) and relative (odds ratio) measures, but multivariate analyses showed an insignificant association of the non-manual group with dyslipidemia. Manual female workers showed significantly higher age-adjusted prevalence of almost all health outcomes than housewives except chronic disease, but the associations disappeared after further adjustment for covariates regarding sleep, rest, and stress. CONCLUSIONS: Our results suggest that examining the health impact of work on married women requires the consideration of occupational class.

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Original Article

Psychological Distress and Occupational Injury: Findings from the National Health Interview Survey 2000-2003.: Jaeyoung Kim; J Prev Med Public Health. 2008;41(3):200-207.; DOI: https://doi.org/10.3961/jpmph.2008.41.3.200

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OBJECTIVES
This study examined whether serious psychological distress (SPD) is associated with occupational injury among US employees. METHODS: The employed population aged 18-64 years was examined (n=101,855) using data from the National Health Interview Survey (NHIS) 2000-2003. SPD was measured using the Kessler 6-item Psychological Distress Scale (K-6), a screening scale designed to identify persons with serious mental illness. The predicted marginal prevalence of psychological distress and occupational injury with the adjusted odds ratio were estimated using multiple logistic regression analyses. RESULTS: The age-adjusted 3-month prevalence of occupational injury was 0.80+/-0.12% in workers with SPD, which was 37% greater than in workers without SPD (0.58+/-0.03%). The odds of occupational injury in workers with SPD were higher compared to workers without SPD (OR=1.34, 95% CI=0.93-1.92), after controlling for sex, age, race, education, occupation, and activity limitation by at least one medical condition. Male, service and blue collar occupation, and activity limiation by co-morbidity showed significantly higher odds of occupational injury for workers with SPD. CONCLUSIONS: The findings suggest that SPD accounts for an increased likelihood of occupational injury among US employees. A further longitudinal study is needed to differentiate the mechanism or causal pathways linking individual injury risk at the workplace, SPD, and socioeconomic factors.

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Review

A Review on Socioeconomic Position Indicators in Health Inequality Research.: Yong Jun Choi, Baek Geun Jeong, Sung Il Cho, Kyunghee Jung-Choi, Soong Nang Jang, Minah Kang, Young Ho Khang; J Prev Med Public Health. 2007;40(6):475-486.; DOI: https://doi.org/10.3961/jpmph.2007.40.6.475

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OBJECTIVES
Socioeconomic position (SEP) refers to the socioeconomic factors that influence which position an individual or group of people will hold within the structure of a society. In this study, we provide a comprehensive review of various indicators of SEP, including education level, occupation-based SEP, income and wealth, area SEP, lifecourse SEP, and SEP indicators for women, elderly and youth. METHODS AND RESULTS: This report provides a brief theoretical background and discusses the measurement, interpretation issues, advantages and limitations associated with the use of each SEP indicator. We also describe some problems that arise when selecting SEP indicators and highlight the indicators that appear to be appropriate for health inequality research. Some practical information for use in health inequality research in South Korea is also presented. CONCLUSIONS: Investigation into the associations between various SEP indicators and health outcomes can provide a more complete understanding of mechanisms between SEP and health. The relationship between specific SEP indicators and specific health outcomes can vary by country due to the differences in the historical, socioeconomic, and cultural contexts of the SEP indicators.

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English Abstract

The Proportional Mortality Ratios of Specific-cause Mortality by Occupation and Education among Men Aged 20-64 in Korea (1993-2004).: Ki Hye Kim, Kyung Hak Lee, Sang Min Lee, Seung Yeon Lee, Ye Seung Lee, Kyoung Ree Lim, Jee Eun Chang, Sang Won Cho, Eun Hye Choi, Sung Tae Chung, Eunjeong Jin, Mia Son; J Prev Med Public Health. 2007;40(1):7-15.; DOI: https://doi.org/10.3961/jpmph.2007.40.1.7

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OBJECTIVES
This study investigated the relationship of occupational class and educational background with proportional mortality ratios in Korea. METHODS: Mortality was investigated using the entire registered death data from 1993 to 2004, obtained from the Korean National Statistics Office. Proportional mortality ratios (PMRs) for specific diseases were calculated according to the occupational class and educational background of men aged 20-64. RESULTS: Manual workers were found to have higher PMRs for liver disease and traffic accidents, as did the lower educated group. Especially, this study showed trends of an increasing of the wide gap between lower and higher socioeconomic stati for liver disease, traffic accidents, diabetes mellitus and cerebral vascular disease. The mortality for cerebrovascular disease, diabetes mellitus, heart disease, traffic accident and liver disease showed increasing trends according to the calendar year for the lower than the higher social class. CONCLUSIONS: The specific conditions that had higher PMRs in the Korean lower social class were liver disease and traffic accidents. Especially, there was an increasing trend for a widening of the gap between manual and nonmanual groups in relation to mortality from liver disease, diabetes mellitus and traffic accidents.

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Chi-Young Lee, Yong-Hwan Lee
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Original Articles

Application Status and Its Affecting Factors of Double Standard for Multinational Corporations in Korea.: Myung Ki, Jaewook Choi, Juneyoung Lee, Heechan Park, Seokjoon Yoon, Namhoon Kim, Jungyeon Heo; J Prev Med Public Health. 2004;37(1):17-25.

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Abstract PDF: OBJECTIVE
We intended to evaluate the double standard status and to identify factors of determining double standard criteria in multinational corporations of Korea, and specifically those in the occupational health and safety area. METHODS: A postal questionnaire had been sent, between August 2002 and September 2002, to multinational corporations in Korea. A double standard company was defined as those who answered in more than one item as adopting a different standard among the five items regarding double standard identification. By comparing double standard companies with equivalent standard companies, determinants for double standards were then identified using logistic regression analysis. RESULTS: Of multinational corporations, 45.1% had adopted a double standard. Based on the question naire's scale level, the factor of 'characteristic and size of multinational corporation' was found to have the most potent impact on increasing double standard risk. On the variable level, factors of 'number of affiliated companies' and 'existence of an auditing system with the parent company' showed a strong negative impact on double standard risk. CONCLUSION: : Our study suggests that a distinctive approach is needed to manage the occupational safety and health for multinational corporations. This approach should be focused on the specific level of a corporation, not on a country level.; Summary

The Relationships of Occupational Class, Educational Level and Deprivation with Mortality in Korea.: Mia Son; Korean J Prev Med. 2002;35(1):76-82.

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Abstract PDF: OBJECTIVE
To investigate the relationships of occupational class, educational level and deprivation with mortality in Korea. METHODS: This study used existing South Korean national data on occupation, educational level, and deprivation and death. Mortality was investigated using registered death data from 1993 to 1997 obtained from the Korean National Statistics Office (NSO) with denominators drawn from the 1995 Census. Statistical analysis consisted of poisson regression modeling and multilevel analysis. RESULTS: The lower occupational class (manual workers) group had a higher mortality rate than the higher occupational class (non-manual workers) group. Educational level, and deprivation were both inversely related withand mortality. Occupation was strongly associated with education. Area-based deprivation indicators and individual indices for social class made an independent contribution to the mortality risk. CONCLUSIONS: The findings of this study suggests that the relationships of occupational class, educational level and deprivation with mortality appears to be stronger in Korea than in European countries.; Summary

Transient Effects on the Risk of Occupational Injuries as an Acute Events: a Case-crossover Study.: Seon A Jeong, Jong Tae Lee, Jong Uk Won, Jaehoon Roh; Korean J Prev Med. 2001;34(1):35-40.

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Abstract PDF: OBJECTIVES
To elucidate the transient effects on the risk of occupational injuries as acute events and establish an alternative proposal. METHODS: The study population comprised a total of 302 workers randomly selected from applications for occupational injury compensation reported to the Inchon local labor office from January 1, 1999 to December 31. A case-crossover design, where each case serves its own control, was applied to this study. Through a telephone interview, workers provided useful data concerning five job related stressful events such as company transfer, work load change, overtime work, exchange duty, and work-part transfer. They were asked whether there were stressful events within a week of the occurrence of injury and the degree of stress. Exposure status from one year prior was used as control information. In the end, the data provided by 158 of selected persons was used for the analysis based on the quality of the data provided by the participants. A conditional logistic regression was used to discover the transient effects on the risk of occupational injuries as acute events. RESULTS: The effect of a company transfer and work load change on occupational injury was statistically significant on the risk of occupational injuries as an acute event(RR=5.5, 95% CI=2.501-12.428; RR=3.1, 95% CI=1.963-5.017, respectively). Other stressful events were found to elevate the risk factor for the occurrence of occupational injury, but were not significant. CONCLUSIONS: Our results suggested that transient stressful events elevated the risk factor for the occurrence of occupational injury.; Summary

Epidemiologic Survey on Outbreak of Dermatosis Associated with Ants, Pachycondyla chinensis.: Geun Ryang Bae, Hyun Sul Lim, Byung Jin Kim; Korean J Prev Med. 1999;32(3):421-426.

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Abstract PDF: OBJECTIVES
An outbreak of dermatosis occurred at a city gas manufacturing factory in Pohang in Aug, 1998. The authors conducted a study to find the cause and prevent the dermatosis. METHODS: We conducted a questionnaire survey of 73 workers in the factory twice, once on Aug. 14th and then Sept. 11th, 1998. Also, a dermatologist examined their skin lesions. We suspected ants as the cause, so we collected them for identification. RESULTS: Twelve cases of dermatosis were identified with an attack rate of 16.4%. The attack rates were not different by age, educational level or tenures. The attack rates were 66.6% among production workers, 2.0% among clerical workers, 16.7% among tank trailer drivers and 0% among guards. The attack rate among production workers was significantly higher than that of the others (p<0.01). There were no histories of the same dermatosis for the past one year. Histories of other skin diseases and allergies were very rare in both cases with skin diseases and control. Multiple, pruritic, rice-grained to bean sized erythematous macules or papules with a central biting point could be found after initial severe itching occurred. Three cases showed signs of dermatosis with an allergic nature. The onset of dermatosis was between July 30 and Aug 12 and the durations varied from 5 days to over a month. The most frequent sites of skin lesions were the chest and abdomen (66.6%), and they were also observed on the neck (33.3%), arms (33.3%), shoulders (16.7%) and back (16.7%). Over 10 ants with their wings were collected in the work place and identified as Pachycondyla chinensis, subfamily Ponerinae. CONCLUSIONS: We thought that the outbreak of dermatosis was brought about by the ants flying into the work place through the open windows. Further studies on the factors contributing to the prosperity of the ants in this area are needed.; Summary

Characteristics of Occupational Skin Disease Reported by Surveillance System.: Yeon Soon Ahn, Hyoung Ok Kim, Jun Young Lee, Ho Keun Jung; Korean J Prev Med. 1999;32(2):130-140.

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Abstract PDF: OBJECTIVES
This study was carried out to estimate the magnitude of skin disease related to occupation and to find out the characteristics of it. METHODS: We collected and analyzed the cases of occupational skin disease reported by surveillance system composed of doctors and nurses in 150 enterprises with dispensary or attached hospital and physicians in 92 specific health examination institutes and 150 dermatologists from May to November, 1998. RESULTS: Among members of surveillance system, 66 enterprises and 47 specific health examination institutes and 55 dermatologists reported 571 cases of occupational skin disease in 512 workers. Excepting 81 cases reported by dermatologists, We analyzed 490 cases reported by enterprises and specific health examination institutes. Among 490 cases, contact dermatitis was most common(368 cases, 75.1%) and the second was hyper or hypopigmentation(36 cases, 7.3%). When we analyzed the characteristics of workers with occupational contact dermatitis, male workers were 281(79.2%) and female were 74(20.8%). 165 workers(64.5%) had chronic skin disease with repeated cure and relapse. 245 workers(72.5%) answered positively that their coworkers had similar skin disease. 27 workers(8.7%) experienced absence due to contact dermatitis related to occupation. To analyze the type of industries of workers with occupational contact dermatitis, automobile and trailer manufacturing industry was most common(105 cases, 29.6%) and the second was manufacturing industry for image, sound and communication equipment(55 cases, 15.5%). Organic solvent(183 cases, 46.7%) was the most common treating material of workers with contact dermatitis and the second was various kinds of chemicals(59cases, 15.1%). CONCLUSIONS: This is the first study using nationwide surveillance system to collect data of occupational skin disease. We found that many workers had skin disease related to occupation and characteristics of occupational skin disease were chronic and clustering. Therefore, we had to establish counterplan to manage occupational skin disease and to operate surveillance system to identify trends of occupational skin disease, continuously.; Summary

A Survey for Computerized Information System of Occupational Health Management at Worksite.: Heui Sug Jo, Eun Hee Ha, Yun Chul Hong, Chul Hwan Kim, Kyung Ja June, Hye Sook Park; Korean J Prev Med. 1998;31(2):215-227.

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Abstract PDF: In order to develop the computerized information system of occupational health management at worksite, we surveyed actual states of computer use at worksites. We used a self-administrative questionnaire to the members of Korean Association of Occupational Health Nursing(KAOHN) from July 4 to August 21 in 1997. Among the members of KAOHN, 147 members answered. The worksites where they, were employed were very diverse in aspect of jobs, locations, and size. Occupational health computerized system was used at 30(20.4%) worksites among 147 respondents. When they first introduced the computerized system the most difficult problem was the lack of support of manager. The programs that they have used mainly consist of drug management, health examination management, disease management, but the program of worksite environment management have been rarely used. Most users felt that the computerized system was effective, but there were problems in connection within programs. Many worksites have plans to take or expand the computerized information system within several years. It is necessary to develop the effective and integrated occupational health computerized system.; Summary

Study of repuirements and conditions to be improved for voluntary occupational health program in worksite.: Jae Seok Song, Jong Uk Won, Myong Sei Son, Bong Suk Cha, Jae Hoon Roh; Korean J Prev Med. 1997;30(4):840-851.

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Abstract PDF: To perform voluntary occupational health program in worksites, regulational supports are necessary. The regulational supports include assessment of current occupational health program and appropriate incentives. The purpose of this study is to find out the requirements of voluntary occupational health program and conditions to be improved. Study population was industrial health managers of both industries with less than 300 workers and over 300 workers, and the member of labor union who is responsible for safety and health in worksite. Two different questionnaire were used to find out the requirements and conditions to be improved respectively. The results were; 1. The category which prevalence rate of occupational injuries and occupational disease should be lower than national average was most important in health managers employed in industries over 300 workers and followed by reporting system, education, worksite policy, work environment assessment, protective equipment, consequently. But those employed in industries less than 300 workers showed high importance in prevalence rate of occupational injuries and disease, reporting system, worksite policy, work environment assessment, protective equipment, education, consequently. 2. The members of labor union thought that worksite policy was most important and the next is education, reporting system, work environment assessment, protective equipment, prevalence rate of occupational injuries and disease. 3. There were difference in importance of education and worksite policy according to the size of industries. Reporting system, prevalence rate of occupational injuries and disease, and worksite policy had different importance between members of labor union and health managers. 4. In the results of questionnaire for conditions to be improved, the most important condition was top manager's willingness except personal protective equipments, and followed by financial support, legal support. The limitations of this study were the problems of representativeness of study population. but voluntary health program should be performed in worksites which have relatively good occupational health system. So, this selection bias could not disrupt our results.; Summary

Effects of Cigarette Smoking on Psychosicial Distress and Occupational Risks.: Bong Suk Cha, Sei Jin Chang, Jong Ku Park, Sang Baek Ko, Myung Guen Kang, Sang Yul Ko; Korean J Prev Med. 1997;30(3):540-554.

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Abstract PDF: The effects of cigarette smoking on the psychosocial distress, the absenteeism, the occupational injuries, and on the prevalence for the accidents were assessed in 795 male workers who had been employed since March 1994. The results show that the prevalence of current smokers were higher in young men, lower educational level, lower income, single men(unmarried or divorced), alcohol drinkers, and blue collar workers. In the bivariate analyses, the workers with the high job demand and low work control were more likely to smoke, although the relationship was not strong. Those who reported lower satisfaction on his job tended to smoke more. Mean scores of psychosocial well-being Index(PWI) were higher in current smokers than nonsmokers. For the hierarchical multiple regression analyses, interaction terms between cigarette smoking and job stressors(job demand and work control) were not significant. For smokers, the odds ratios for the occupational injuries, and the accidents were 1.40(95% confidence interval 0.77-2.57) and 1.96 (95% confidence interval 0.75-5.09), respectively. The mean absent day were 4.13 for smokers, 3.65 for nonsmokers, although the differences were not statistically significant. It seems that cigarette smoking had not caused any crucial effects on the psychosocial well-being status and the occupational risks. Some considerations for the further research on the relationship of cigarette smoking on the mental health status and the occupational risks were also discussed.; Summary

A study on dermatologic diseases of workers exposed to cutting oil.: Byung Chul Chun, Hee Ok Kim, Soon Duck Kim, Chil Hwan Oh, Yong Tae Yum; Korean J Prev Med. 1996;29(4):785-800.

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Abstract PDF: We investigated the 1,004 workers who worked in a automobile factory to study the epidemiologic characterist of dermatoses due to cutting oils. Among the workers, 667(66.4%) answered the questionnaire. They are belong to 5 departments of the factory-the Engine-Work(86), Power train Assembly(17). We measured the oil mist concentration in air of the departments and examined the workers who had dermatologic symptoms. The results were follows; 1) Oil mist concentration; Of all measured points(52), 9 points(17.2%) exceeded 5mg/m3-the time-weighed PEL- and one department had a upper confidence limit(95%) higher than 5mg/m3. 2) Dermatologists examined 213 workers. 172 of them complained any skin symptoms at that time-itching(32.5%), papule(21.6%), scale(15.7%), vesicle(12.5%) in order. The abnormal skin site found by dermatologist were palm(29.3%), finger & nail(24.6%), forearm(16.2%), back of hand(8.4%) in order. 3) As the result of physical examination, we found that 160 workers had skin diseases. Contact dermatitis was the most common; 69 workers had contact dermatitis alone(43.1%), 11 had contact dermatitis with acne(6.9%), 10 had contact dermatitis with folliculitis(6.3%), 1 had contact dermatitis with acne & folliculitis, and 1 had contact dermatitis with abnormal pigmentation. Others were folliculitis(9 workers, 5.6%), acne(8, 5.0%), folliculitis & acne(2, 1.2%), keratosis(1, 0.6%), abnormal pigmentation(1, 0.6%), and non-specific hand eczema(47, 29.3%). 4) The prevalence of any skin diseases was 34.0 per 100 in cutting oil users, and 13.3 per 100 in non-users. Especially, the prevalence of contact dermatitis was 23.0 per 100 in cutting oil users and 4.3 per 100 in non-users. 5) We tried patch test(standard series, oil series, organic solvents) on 49 patients to differentiate allergic contact dermatitis from irritant contact dermatitis and found 20 were positive. 6) In a multivariate analysis(independent=age, tenure, kinds of cutting oil), the risk of skin diseases was higher in the water-based cutting oil user and both oil user than non-user or neat oil user(odds ratio were 2.16 and 2.78, respectively). And the risk of contact dermatitis was much higher at the same groups(odds ratio were 5.16 and 6.82, respectively).; Summary

A Study on the Establishment of Management Methods about Occupational Dermatoses.: Hyun Sul Lim, Hae Kwan Cheong, Byung Soon Choi, Ji Yong Kim, Yeol Oh Sung, Yang Ho Kim; Korean J Prev Med. 1996;29(3):617-638.

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Abstract PDF: Occupational dermatosis is one of the most prevalent occupational disorders. However, the extent of the occupational dermatoses including incidences and prevalencies of each disease entity, and etiologic materials are not yet well stated in Korea. Authors reviewed the literatures on the statistic data and reports on the occupational dermatoses, and surveyed on the occupational dermatoses in two factories, and surveyed the physicians responsible to the occupational dermatoses with formed questionnaire. The results are as follows; 1. Among medical journals published since 1964, there were 31 articles on the occupational dermatoses. Of 31 articles, 18 were case reports and all others were review articles. Of 18 case reports, 9 were epidemiologic survey. The Workers' Periodic Health Examinations revealed that prevalence of the occupational dermatoses was highest(4.36 per 10,000 workers) in 1974, but number of the cases reported were decreased sharply since 1978 with some tendency to increase since 1987. There were 2,240 reported cases of occupational dermatoses between 1966 and 1992, which is 1.90% of all the reported occupational diseases. Skin infection and injuries due to chemicals were most frequent and there were 6 cases of skin cancer. 2. In an epidemiological survey on the dermatoses among 995 workers in a metal product manufacturing factory and 225 workers with acne, 130 workers with scar, 123 workers with deformity of toe nails. Scars, photosensitivity dermatitis, deformity of finger and toe nails, and acne were more prevalent in the metal product manufacturing factory(p<0.05). In the metal product manufacturing factory, workers treating organic solvents and oils had more dermatoses than those without treating the materials(p<0.05). On the skin patch performed on 16 workers in the metal product manufacturing factory, there were 8 cases of irritation dermatitis and 5 cases of contact dermatitis. Prevalence of contact dermatitis in the metal product manufacturing factory was 1.3%. 3. On the questionnaire survey, 34 dermatologists, 29 doctors of preventive medicine, and 22 family physician replied. The proportion of occupational etiology among all dermatoses assumed by the physicians were below 9%, and the most important occupational dermatosis in Korea was contact dermatitis. Main etiologic materials related to the occupational dermatosis were organic solvent, acid and alkali, and metals. The reason for the scarcity of report of occupational dermatoses were difficulty in diagnosis and physician's ignorance of the occupational etiology. They replied that to prevent the occupational dermatosis in the workplace, the use of protective devices was most important, and development of diagnostic criteria on the occupational dermatoses is urgent. Above results shows us that there is many workers with occupational dermatoses, but they are mostly unreported. Measures to prevent and manage the occupational dermatoses are not satisfactory at present. Hence, authors suggest measures for the precises diagnosis, report and prevention of the occupational dermatoses. a. Dernatikigustm orevebtuve physician, and industrial hygienist should work as a team to examine the high risk group and establish the preventive measures. b. Disease entities, diagnostic criteria of occupational dermatoses should be listed, criteria for the compensation and job fitting at recruitment should be established, and manual for the proper treatment and effective prevention of each occupational dermatosis should be developed. c. Patch test antigens against each occupational category should be developed and it should be available to any physicians responsible. d. To facilitate the diagnosis of occupational dermatoses by the doctors responsible for the Workers' Periodic Health Examination, development of standardized questionnaire, education on the techniques of the patch test, and cooperation with the dermatologist in diagnosis of occupational dermatoses is essential.; Summary

Knowledge, Attitude and Practice according to Types of Occupational Health Management.: Sung Hee Kim, Hae Ryeun Shin, Sang Woo Kim, Kuck Hyeun Woo, Wan Seoup Park, Jae Yong Park; Korean J Prev Med. 1996;29(3):579-596.

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Abstract PDF: The first purpose of this study was to compare the mean Knowledge, Attitude & Practice(KAP) scores concerning major occupational Health between two types of occupational health management in small & medium-scale textile factories. Sample number was 1,138 workers. In small & medium factories with 300 workers or less, they have two alternatives for occupational health management; Individual Health Management or Vicarious Health Management. The second purpose was to determine if there was a relationship between duration of Vicarious health management and mean kap scores for 694 workers from the Vicarious Health Management group. We used self-administered questionnaires for measuring KAP. The results of this study were; 1. There was significant difference concerning all socioeconomic & occupational variables(gender, age education level, marital status, Blue/White collar, working duration of present factory, working duration of total factories) except for shift. 2. There was no significant difference of mean scores of Knowledge and attitude between the Individual Health Management Group and the Vicarious Health Management. But, the mean score of Practice was significantly different. 3. According to multiple regression analysis, the mean score of Knowledge significantly increased with age, education level, working duration of all factories increased. The mean score of Attitude significantly increased with age, education level and married. The mean score of Practice significantly increased with age, education level, working duration of all factories, married and men. 4. In conclusion, The type of Health management did not significantly affect the mean KAP scores concerning major occupational Health problems. 5. But, the Duration of Vicarious Health management significantly increased the mean KAP scores.; Summary

Carpal Tunnel Syndrome among workers in a condom industry.: Joong Koo Kang, Do Myung Paek, Young Jung Lee, Hyeo Il Ma, Mi A Song, Hong Ki Lee, Jung Keun Choi; Korean J Prev Med. 1996;29(3):507-520.

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Abstract PDF: The objectives of this study are to investigate the prevalence of occupation related carpal tunnel syndrome(CTS) among workers in a condom industry; to analyse the sensitivity and specificity of clinical signs or symptoms such as hand diagram, Tinel's sign and Phalen's sign in carpal tunnel syndrome; and to test vibration threshold test using audiometry as a technically easy and noninvasive method in the diagnosis of carpal tunnel syndrome in stead of nerve conduction velocity(NCV). The study group was divided into exposed group(39 cases)and non-exposed group(48 cases) based on whether or not excessive use of wrist movements exist. 1. There are statistically significant differences in symptoms and signs of carpal tunnel syndrome such as hand diagram, Tinel's sign and Phalen's sign between exposed and non-exposed group(p<0.05). 2. Six cases(9 hands) were confirmed as carpal tunnel syndrome by NCV. Five cases(7 hands) belonged to exposed group, 1 case(2 hands) to nonexposed group. As there are significant differences in prevalence of carpal tunnel syndrome between two groups(p<0.05), excessive use of wrist in occupation is a risk factor of carpal tunnel syndrome. 3. When we use NCV as a gold standard in the diagnosis of carpal tunnel syndrome, sensitivity and specificity of hand diagram, Tinel's sign and Phalen's sign is as followed; hand diagram; sensitivity 88.9%, specificity 84.2%. Tinel's sign; sensitivity 55.6%, specificity 72.8%. Phalen's sign; sensitivity 14.3%, specificity 88.4%. Among above clinical signs and symptoms, hand diagram is the best clinical screening test. 4. The differences of vibration threshold between median and ulnar nerve at the same time are useful in the diagnosis of carpal tunnel syndrome but the time change of vibration threshold of median nerve over time are not sensitive enough. It is concluded that vibration threshold between median and ulnar nerve at the same time can be used as a supplementary or alternative criterion to indicate that the nerve dysfunction is located in the carpal tunnel.; Summary

An Epidemiologic Study on an Outbreak of Dermatosis Associated with Moths at a Factory.: Hyung Sul Lim, Cheol Jung, Doohie Kim, Yeol Oh Sung, Jung Ran Kim, Yoo Hang Shin; Korean J Prev Med. 1996;29(2):359-370.

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Abstract PDF: An outbreak of dermatosis occurred at a machinery manufacture factory in kyongju on Aug 1995. Authors conducted a questionnaire survey among 92 workers in the factory and a dermatologist examined their skin lesions. Authors also collected moths and identified them. The results are as follows; 1. Forty-two cases of dermatosis were identified with attack rate of 45.7%. Attack rate was not different by company, age, sex, educational level and duration of employment. Attack rate was 47.8% among productive workers, 25.0% among clerical workers and 100.0% among patrolmen. 2. Two cases among 42 dermatosis cases and three subjects among 50 non-cases had a history of same dermatosis last year. Four of dermatosis cases had a history of dermatosis among their family members. 3. skin lesions of the cases were scattered or grouped rice-sized erythematous papules or vesicles. Duration of dermatosis from the onset to the time of survey was from one day to more than 30 days. The most frequent site of skin lesion was the arms(81.0%), and it was also observed at the neck(47.6%), abdomen(45.2%), chest(42.9%), legs(38.1%) and back(35.7%). skin lesion was aggravated with sweating(31.0%), after shower(16.7%) and with scratching(l1.9%). 4. Moths were collected and identified as Euproetis subflava(Bremer). Many poisons stings were observed on their wngs which is harmful to human. 5. Contact with moths' wing droppings to two authors on their forearms for provocation resulted in severe immediate pain followed by prolonged pruritus. Erythematous macules quickly appeared and suoceeded by firm wheal-like red papules. Authors thought that the outbreak of dermatosis was brought about by Euproetix subflava(Bremer). Further studies on the factors contributing to the prosperity of the moths in this area are needed.; Summary

Cost-Benefit Analysis of Back School Program for Occupational Low Back pain Patients.: Yeong Su Ju, Mi Na Ha, Sang Hwan Han, Ho Jang Kwon, Soo Hun Cho, Chang Yup Kim, Sun Min Kim; Korean J Prev Med. 1996;29(2):347-358.

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Abstract PDF: Although occupational low back pain accounts for 20~40% of all occupational illness and injury, there are limited numbers of studies regarding the effectiveness of back school program. The objective of this study was to evaluate the economic benefit of back school program for early return to work of occupational low back pain patients in the current occupational injury compensation and management system. The cost-benefit analysis in this study was conducted to evaluate the relative magnitude of benefit to cost. The total cost was estimated by calculating the value of components in back school program according to governmental budget protocol. The back school program was consisted of three major approaches, pain center, work-hardening program and functional restoration program and each of components had various facilities and experts. The total amount of cost was estimated as 250,866,220 won per year. The most promising type of back school program were quite intensive (a 3 to 5-week stay in a specialized center), therefore, if we adopted the 5-week stay course, 10 courses could be held in a year. Following to the medical act, 20 patients per doctor could participate in a each course, ie, total 200 patients in a year. As a result, we could estimate the cost of 1,254,331 won a patient. we estimated the benefit by using data of a few local labor offices about average medical treatment beneficiary and off-duty beneficiary of 46 occupational low back pain patients in 1994. Ullman and Larsson(1977) mentioned that the group of chronic low back pain patients who participated in back school program needed less time to recover by 48.4% of beneficiary duration. And in the trying to estimate the benefit, we asked 10 rehabilitation board certificate doctors about reduction proportion of treatment cost by introducing back school program. The answered reduction proportions were in the range of 30~45%, average 39%. As a final result, we could see that the introduction of back school program in treatment of chronic occupational low back pain patients could produce the benefit to cost ratio as 3.90 and 6.28. And we could conclude that the introduction of back school program was beneficial to current occupational injury compensation and management system.; Summary

Trends of Study and Classification of Reference on Occupational Health Management in Korea after Liberation.: Eun Hee Ha, Hye Sook Park, Young Bok Kim, Hyun Jong Song; Korean J Prev Med. 1995;28(4):809-844.

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Abstract PDF: The purposes of this study are to define the scope of occupational health management and to classify occupational management by review of related journals from 1945 to 1994 in Korea. The steps of this study were as follows: (l)Search of secondary reference; (2) Collection and review of primary reference; (3) Survey; and (4) Analysis and discussion. The results were as follows; 1. Most of the respondents majored in occupational health(71.6%), and were working in university (68.3%), males and over the age 40. Seventy percent of the respondents agreed with the idea that classification of occupational health management is necessary, and 10% disagreed. 2. After integration of the idea of respondents, we reclassified the scope of occupational health management. It was defined 3parts, that is, occupational health system, occupational health service and others (such as assessment, epidemiology, cost-effectiveness analysis and so on). 3. The number of journals on occupational health management was 510. It was slightly increased from 1986 and abruptly increased after 1991. The kinds of journals related to occupational health management were The Korean Journal of occupational Medicine(18.2%), several kinds of Medical College Journal(17.0%), The Korean Journal occupational Health(15.l%), The Korean Journal of preventive Medicine(15.l%) and others(34.6%). As for the contents, the number of journals on occupational health management systems was 33(6.5%) and occupational health services 477(93.5%). Of the journals on occupational health management systems, the number of journals on the occupational health resource system was 15(45.5%), occupational finance system 8(24.2%), occupational health management system 6(l8.2%), occupational organization 3(9.1%) and occupational health delivery system l(3.0%). of the journals on occupational health services, the number of journals on disease management was 269(57.2%), health management 116(24.7%), working environmental management 85(18.1%). As for the subjects, the number of journals on general workers was l85(71.l%), followed by women worker, white color workers and so on. 4. Respondents made occupational health service(such as health management, working environmental management and health education) the first priority of occupational health management. Tied for the second are quality analysis(such as education, training and job contents of occupational health manager) and occupational health systems(such as the recommendation of systems of occupational and general disease and occupational health organization). 5. Thirty seven respondents suggested 48 ideas about the future research of occupational health management. The results were as follows: (l) study of occupational health service 40.5%; (2) Study of organization system 27.1%; (3) Study of occupational health system (e.g. information network) 8.3%; (4) Study of working condition 6.2%; and (5) Study of occupational health service analysis 4.2%.; Summary

Factors Relating to Quitting in the Small Industries in Incheon.: Yeon Soon Ahn, Jaehoon Roh, Kyoo Sang Kim; Korean J Prev Med. 1995;28(4):795-807.

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Abstract PDF: This study was carried out from 1993 to 1994 in the small industries in Incheon. The objectives of this study was in order to estimate the quitting rate, to identify its relating factors and to propose effective quitting management policy in the small industries. The results were as follows; 1. The quitting rate of 266 study workers was 42.1%(l12 workers). 2. Age, working duration, position, marital status were significant difference between the quitting group and the non-quitting group. 10 the quitting group, mean age was young, working duration was short, general employees and unmarried workers were many compared with the non-quitting group. 3. In the industry characteristics, total assets, total sales, sales per person, establishment duration and occupational health and safety status were significant difference between the quitting group and the non-quitting group. In the quitting group, total assets, total sales and sales per person were little, establishment duration of company was short and occupational health and safety status were poor compared with the non-quitting group. 4. In the quitting group, worker's response to employer's disposal about health and safety was more passive and the relation to employer with employee was significantly poor compared with the non-quitting group. 5. Multiple logistic regression analysis of quitting against family income per person, working duration, relation to employer with employee, occupational health and safety status in industry, worker`s response to employer's disposal about health and safety and sales per person was done. Working duration, occupational health and safety status, worker`s response to empolyer's disposal about health and safety were significant eiplainatory variables for quitting. Above results showed that the quitting rate was high and it was significant difference between the quitting group and non -quitting group according to characteristics of workers and of industries. Especially, it suggested that working duration, occupational health and safety status and worker's response to employers disposal about health and safety were significant quitting factor. Therefore, it should be reflected in the quitting management and the policy of steady employment.; Summary

Psychometric Charateristics of Occupational Low Back Pain Patients.: Mi Na Ha, Soo Hun Cho, Ho Jang Kweon, Sang Hwan Han, Young Soo Joo, Nam Jong Pack; Korean J Prev Med. 1995;28(3):715-725.

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Abstract PDF: This study was done for identifying the factors which affect psychologic symptoms of low back(LBP) patients. The study subjects were 43 work-related low back pain patients, 28 work-related non-low back pain patients and 47 general low back injury patients. The study material is SCL 90-R for checking psychologic symptoms and questionnaire for obtaining general information about the subjects. The data were analyzed by model of analysis of covariance adjusted by several variables such as gender, age, education and marital status and then compared the least square means of symptom score between groups. To identify the factors that affect psychologic symptom, duration of suspension, return to work and interaction factor of these two variables were analyzed by multivariate model and we calculated partial correlation coefficient of these variables. As a result, work-related LBP patients showed higher score of symptoms in somatization, depression and psychosis than work-related non-LBP and non-work-related LBP. Duration of suspension and return to work were significant explanatory variables for psychologic symptom score of work-related LBP. Then, we may conclude that the treatment and rehabilitation programe for work-related LBP should cover the strategy of early return to work.; Summary

An Analysis of Health Examination Outcome in the Special Health Examination Institute.: Yeon Soon Ahn, Sang Hyuk Jung, Dong Chun Shin, Jong Uk Won, Jae Hoon Roh; Korean J Prev Med. 1995;28(3):663-677.

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Abstract PDF: Special health examination institute has done periodic health examination for workers who have worked in the hazardous workplace. However, assessment on outcome in special health examination institute about detection ability of occupational disease has not been. In this circumstances, we studied on the differences of health examination outcome among special health examination institutes and identified related factors which affected outcome of special health examination in the special health examination institutes. The summary of the results were as follows. 1. 50 special health examination institutes were examined in this study. Among them, university institutes were 13 cases(26.0%), hospitals were 20 cases(40.0%), a corporation aggregates were 9 cases(18.0%) and an auxiliary organs of company were 8 cases(16.0%). There were 29(58.0%) institutes with a preventive medicine specialist, but 21 institutes(42.0%) were not. 2. Total workers examined in 50 institutes were 606,948 and workers diagnosed as occupational disease(D1) were 3,156. The rate of occupational disease was 6 workers per 1,000 examined workers. Workers needed for close observation(C) were 95,809 and the rate of workers needed for close observation was 141 per 1,000 examined workers. 3. The rate of occupational disease of university institutes was highest(11.3 per l,000 examined workers) and followed by hospitals(6.0 per 1,000 examined workers), a corporation aggregates(4.2 per 1,000 examined workers), and an auxiliary organs of company(l.2 per 1,000 examined workers.). The difference of the rate of occupational disease between university institutes and an auxiliary organs of company was statistically moderate significant(p<.1).The rate of occupational disease in special health examination institutes with establishment duration was more than 10 years was statistically higher than institutes with establishment duration was less than 10 years(p<0.l). 4. The results of multiple regression, R2 was 0.3394(adjusted R2 was 0.2109), F-value was 2, fi41ft(p<0.5), and statistically significant variables were establishment duration(p<0.1), number of examined workers per one doctor(p<.l), and auxiliary organs of company(p<0.l), which dependent variable was the rate of occupational disease and independent variables were number of examined workers per one doctor, classification of institute, the rate of working environment exceeding TLV, duration of institute establishment, presence of a preventive medicine specialist.; Summary

Study on activities of some occupational health nurses in Kyungnam area.: Young Sook Kim, Hae Sook Shon, Jeong Hak Kang, Chang Hee Lee, Chae Un Lee; Korean J Prev Med. 1995;28(3):576-587.

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Abstract PDF: Authors purposed to observe activities of occupational health nurses and it's related factors, and to suggest the way that induct better occupational health nurses' activities with questionnaire to 87 occupational health nurses who individually work as health manager in the plant. The questionnaire included type of plant and number of workers, general characteristics, work conditions, activities, etc. Major findings are as follows. 1. 82.8% of occupational health nurses were third decade 93.1% graduated junior college or college. And 82.8% were not married. 2. General work conditions: 40.2% were belonged to safety-health section, 98.85% were mere clerks. 60.9% worked less than weekly 44 hours, and an annual salary of 50.6% was between 10million and 14 million won. 3. work condition related to health manager work: there was separated health care room in 94. 3%, working period as health manager(occupational health nurse) was less than 5 years in 70.1%, 49.4% had the out-of-health manager work. In 87.4%, occupational physician was appointed, only 6.9% of them were full time, 52.9% of them worked little in the plants The problems related to workers' health were discussed with industrial nurses in 88.5%. 4. Attitude for their work: 88.5% were thought that their work is important for workers' health care, 57.5% satisfied to work as health manager. In 51.7%, motive to being industrial nurse were the appropriate aptitude. 5. Activities: General medical care in 100 % were carried out, in 97 7% works related to general health examination, in l00% works related to special health examination were carried. But works related to use of protective apparatus were carried out in 20.8%. 6. Factors related to level of activities: In cases who solved the health related problems by themselves, the level of activities was significantly higher than in others. In cases there w ere full time occupational physician, the level of activities was significantly lower. 7. Occupational health nurse's needs: 100% wanted regular education, 89.7% wanted the qualifying examination. As the results, author suggests that the right of self-control is given to occupational health nurses and the work of occupational physician is clearly defined for the induction of the better activities of occupational health nurses.; Summary

A Study on Safety Accidents Occurred for 5 Years at a Welding Material Manufacturing Factory.: Hyun Sul Lim; Korean J Prev Med. 1995;28(3):551-562.

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Abstract PDF: To assess the status of safety accidents, authors reviewed and analysed the records of safety accidents of a welding material manufacturing factory at pohang city from January 1989 to December 1993. The results are; 1. The total incidence of safety accidents was 295 spells for five years. 2. Average age of workers with accident was 35.7 years. Average duration of employment was 6.2 years and the duration of employment increased as the year increased. 3. There was no statistical significance on season, month, weekday and time by year in the incidence of safety accidents. The most frequent part of body injured was upper and the most frequent type of injury was abrasion. 4. Mean admission rate of safety accidents was 12.6% and the ratio of treated spells as occupational injury was 7.8%. 5. The most frequent cause of injury was worker's mistake and the most frequent action for the prevention of further accidents was safety education. 6. The incidence rate of safety accidents on 1993 was 116.2 spells per l,000 persons. Above results suggest that to prevent safety accidents, safety education should be done continuously, the environmental and human factors were controlled and more exact reporting system of safety accidents was needed.; Summary

Multiple Brain Calcification in Chronic Lead Poisoning.: Sung Ryul Kim, Byoung Gwon Kim, Young Seoub Hong, Do Won Dam, Soon Seob Choi, Kap Yull Jung, Joon Youn Kim; Korean J Prev Med. 1995;28(2):398-405.

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Abstract PDF: We experienced a case of occupational lead poisoning employed in a secondary lead smelting plant for 12 years. The patient was 39-year-old male and had been felt dizziness, recent memory impairment and intermittent severe abdominal pain for 2 years. On admission, blood lead level was 92.9 microgram/dl, urinary lead level was 19,9 microgram/l and zinc protoporphyrin level was 226.0 microgram/dl. On the blood test, hemoglobin was 10.6 g/dl and showed normocytic normochromic anemia. There were no abnormal findings in the biochemical and hormonal tests. Decrease of I.Q. and use of words in speaking were found in the psychiatric and psychologic examinations. We observed the finding of motor polyneuropathy in the nerve conduction velocity test. Computed tomographic finding showed calcification lesions in the basal ganglia, dentate nuclei, caudate nuclei, and especially characteristic multiple calcifications were located in the subcortical white matter.; Summary

An Epidemiologic Study on Occupational Dermatosis Associated with Mites.: Hyun Sul Lim, Ji Yong Kim, Hae Kwan Cheong, Yeol Oh Sung, Han Il Ree; Korean J Prev Med. 1995;28(1):13-26.

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Abstract PDF: An outbreak of dermatosis occurred in a livestock fodder factory at Kyongju in May 1994. Authors conducted a questionnaire survey on 60 workers in the factory and a dermatologist examined their skin lesion. Authors also collected mites and identified them. The obtained results were summarized as follows; 1. Twentyeight cases of dermatosis were identified with attack rate of 46.7%. Attack rate was not different by department, age, sex, educational level and employment duration. Attack rate was 67.5% in productive worker and 5.0% in clerical workers (p<0.01) but was not significantly different between departments among productive workers (p>0.05). 2. Three cases among 28 dermatosis cases and one subject among 32 non-cases had a history of same dermatosis last year. Only one of dermatosis cases had a history of dermatosis among family members. History of other skin lesion and allergy was very rare in both cases and non-cases. 3. Skin lesions of the cases were rice-sized erythematous papules or vesicles with a central biting point. Onset date of dermatosis was between May 1 and June 10. Duration was from one day to more than 30 days. Skin lesion was most frequent at the back(75.0%). and also observed at the arms(64.3%). abdomen(60.7%), legs(57.1%), chest(32.1%) and neck (25.0%). Skin lesion was aggravated while workers are sweeping the floor(35.7%), working at the workplace(21.4%) and in bed at night(28. 6%). 4. Total l,637 mites were collected and identified into 3 suborder, 7 families and 17 species. Dermafophagoides farinae was most frequent Nnd most of the species identified were blood sucking mites. Authors concluded that the outbreak of dermatosis was brought about by mite-bites and grain beetle parasitizing Acarophenax tribolii was the most suspected species. Further studies to identify the specific species causing dermatosis and route of import are needed.; Summary

Knowledge and AttitudeA;of the Workers and the Health Personnel on the Health Management in Kyung-In Area.: Seong Sil Chang, Se Hoon Lee; Korean J Prev Med. 1994;27(1):145-158.

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Abstract PDF: This study was performed to investigate the knowledge and attitude of workers in small scale industries on health management, and to provide the basic data for more effective service by the group occupational health service system. The knowledge and attitude of 247 workers and 46 health personnel in the industries scattered around Incheon were investigated from December 1992 to February 1993. The results were summarized as follows; 1. There were significant differences between the workers and the health personnel by age, sex, marriage status, job-position and education level. 2. The recognition level of the workers to contract work related disease was significantly higher than that of health personnel, and recognition level of the workers on environmental hazards and on the utility of measuring hazards were lower than that of health personnel. 3. The recognition level on the content of the group occupational health service system was significantly different between workers and health personnel, 72.6% of the responses from the workers answered that they did not know what the group occupational health service system was, but 82.2% of the responses from the health personnel answered that they knew well what it was. And 79.0% of all respondents thought it was necessary for worker's health. 4. seventy three percent of the respondents from the workers indicated that they had never taken health education. However, 93.0% of all respondents answered positively for the need of health education to promote their health. 5. current health service system was judged to be insufficient for the demand of workers for better health. Most of the respondents prefered a formal but flexible health service system and they wanted the periodic health examination to be followed up. It was revealed that despite of poor knowledge, the demand of workers for health service was higher than the current supply. Therefore, this study suggests that educating both health personnel and workers to obtain correct knowledge on the hazards to work environment and health management is needed for effective occupational health service.; Summary

Carpal Tunnel Syndrome among Packing Workers in A Rayon Manufacturing Factory.: Won Jin Lee, Eun Il Lee, Chul Whan Cha; Korean J Prev Med. 1992;25(1):26-33.

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Abstract PDF: The carpal tunnel syndromes is one of the most common peripheral nerve entrapment syndromes. The typical symptoms are pain, numbness and paresthesia in the median nerve territory of the hand. Recently, it is widely recognized that occupational factor is regarded as the important cause of the carpal tunnel syndrome. Clinical study is performed in the 42 female workers who is repetitively working at packing department in a rayon manufacturing factory from November 1991 till March 1992. The study included a questionnaire, physical examinations, and the neurophysiological test. The summary of the results obtained was as follows: 1. Among 42 packing workers, 9 workers(21.4%) were diagnosed as carpal tunnel syndrome by electromyography. The affected side was bilateral in 4 workers(9.5%), right in 4 workers(9.5%), and left in one worker(2.4%). 2. Among 42 subjects, 28 workers(66.7%) complained the clinical symptoms related to carpal tunnel syndrome, 11 workers(26.2%) showed positive Phalen sign, and 7 workers(16.7%) showed positive Tinel sign. 3. Researchers regard electromyographic finding as the gold standard for diagnosis of carpal tunnel syndrome. The sensitivity and specificity of the clinical symptoms to diagnose the carpal tunnel syndrome were 0.89, 0.39 respectively. If the carpal tunnel syndrome is diagnosed by the combination of the positive findings of the symptoms and the physical examinations, either Tinel of Phalen sign, the sensitivity and specificity were 0.67 and 0.76 respectively. Considering above results, though this small number of worker is not adequate for epidemiologic conclusions, carpal tunnel syndrome seems to be an important occupational disorder among packing workers in a rayon manufacturing factory.; Summary

Study on the workers' participation in industries.: Jae Wook Choi, Ok Ryun Moon; Korean J Prev Med. 1991;24(3):339-355.

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Abstract PDF: The concept of workers' participation in occupational health was introduced to Korea recently in relation to primary health care in occupational health. But there is confusion and debate about workers' participation concept. The purpose of this study was to review the concepts of workers' participation and to conduct evaluation the workers' participation status in occupational health and safety. 394 workers and 54 employers (5.6%) in north area of Kyunggi-Do, were selected and interviewed with a questionnaire by a trained interviewer from August to September 1990. In general, the concept of workers' participation is based on industrial democratization and Declaration of Human Rights which had been powerful ideologies in labor movement. Contrary to workers' participation, community participation is rooted in the Health Rights. So, it is necessary to consider concept of workers' participation to improve participation. The results of survey were as follows: 1. Most of companies (71.75) carried out occupational health education to workers in study area. 2. The Occupational Safety and Health Committee (OSHC) were set up in 24.1% among the study companies, and 72.7% of workers among respondents thought that OSHC was helpful to workers health. 3. The workers signed his name to personal health report in 43.1% and the rate of participation in occupational environment examination was 54.9%. 4. The workers prefer the OSHC (39.3%), owner (35.1%) and union (25.8%) as a occupation health organization, but owners prefer OSHC (54.5%), manager (43.2%) and union (2.3%). 5. Among the factors of the general characteristics, the existence of labor union was a major determinant of workers' attitude and level of workers' participation. As we have seen, most levels of workers' participation are low in occupational health. The variable of existence of labor union among the factors was a major determinant of workers attitude and level of workers' participation. Therefore, in order to promote workers health, it is necessary to ponder long deeply on occupational health care system under the viewpoint of workers' participation.; Summary

A literature review on the health status of Korean workers under the Japanese colonialism.: Chang Yeop Kim, Ok Ryun Moon; Korean J Prev Med. 1991;24(1):45-56.

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Abstract PDF: The history of occupational health in Korea has covered the era of the Republic of Korea after the Liberation from Japanese colonialism. But the number of Korean workers exceeded about 2 millions at the times of liberation in 1945, so that it is expected that many occupational health problems inflicted Korean workers under the Japanese colonialism. The authors reviewed medical literatures, administrative documents, and other available data which were published under the colonial state, and collected things which had reference to the health status of Korean workers. The results were as follows; 1. Nutritional status of Korean workers was supposed to be inferior to of general population, some students, and poor inhabitants in a remote moutain villages. 2. It was supposed that the constitution of Korean workers was near lower limit of average build of contemporary Koreans. 3. The accidents rate in mines was significantly high but decreasing year after year, and the most importance cause of accidents was the fall of roof in the mine. The medical facilities and equipments for miners were supposed to be not sufficient in the mines and workshops. 4. Some occupational disease including silicosis, noise-induced hearing impairment, and decompression disease were known. But, overall incidence or prevalence of these diseases could not be identified. 5. On the whole, the fatalities of acute infectious diseases of Korean workers were higher than those of Japanese inhabitants in Korea and Korean inhabitants. The prevalence of pulmonary tuberculosis of Korean workers was increasing with every passing year. 6. The medical personnels and facilities were so deficient that most Korean workers were out of adequate medical use. We discussed only a part of the health status of Korean workers under the Japanese colonialism, so it would be necessary to have a better grasp of details of occupational health policy and health status in the era of afflicting.; Summary

Health characteristics and symptom of workers in reactive dye industries.: Kyung Jong Lee, Young Hahn Moon, Jaehoon Roh, Hae Sim Park, Chein Soo Hong; Korean J Prev Med. 1990;23(3):338-344.

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Abstract PDF: This study investigated the symptoms, medical and occupational history of 424 workers of 5 reactive dye Industries in the Inchon area in Korea. The study was performed on March 6 and July 19, 1989. The tests applied to the subjects were: serum total IgE, skin prick test with 7 inhalatory antigens, pulmonary function test, chest X-ray, methacholine test, and bronchoprovocation test. The workers were classified according to these tests into 4 groups (healthy, realitively healthy, need careful medical observation, and occupational asthma), and were compared in terms of the group characteristics and the symptom prevalence. The prevalence of occupational asthma of workers in reactive dye was 5.9%. Significant differences were observed among the 4 groups. The groups were significantly different in the variables of sex and duration of smoking among their general characteristics ; asthma, bronchitis, and other respiratory diseases with respect to their past medical history. This study suggests that we should pay special attention to the workers exposed to the risk of occupational asthma.; Summary

Study of Cancer Cases by Industry in Kwangju-Chonnam Area: Based on Industrial Medical Insurance Record.: Yong Sik Kim, Won Moon Oh, Hyung Cheol Park, Jin Su Choi, In Hyun Song; Korean J Prev Med. 1990;23(2):207-215.

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Abstract PDF: In order to investigate the occurrence characteristics of cancer in terms of industry in Kwangju-Chonnam area, medical utilization records of industrial medical insurance corporations during the period of 1987 to 1988 were reviewed for the identification of neoplastic disease. The cases obtained from the medical records were followed up for the verification and to get additional information. Standardized incidence data were compared by occupational characteristics. Multiple logistic regression analysis was applied to analyze the difference of incidence or distribution of cancer as a whole or of some selected cancer. Total cases of cancer identified were 242 during the study period. Annual incidence rate was calculated as 123.1 per 100,000 person. The frequent types of cancer were cancers of stomach, liver, lung, colon and rectum, bladder and lymphoma in descending order. Employees of mine and other sand handling industries showed significantly higher risks for cancer of stomach and cancer as a whole. Employees of the transportation industry showed the higher risk for cancer of liver. Workers in small-sized industry (< or = 100) had a higher risk for cancer than who in large-sized industry (>100). These findings suggested the effect of occupational environmental exposure to cancer development.; Summary

Survival Analysis of Hospitalized Mesothelioma Patients.: Chun Bae Kim, Sang Hyuk Jung, Kyung Jong Lee, Jong Doo Kang; Korean J Prev Med. 1990;23(1):77-86.

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Abstract PDF: Between 1977 and 1987, 20 patients with mesothelioma were treated at Severance Hospital. Data was gathered from medical charts at the time of hospitalization of mesothelioma patients and from a follow-up questionnaire by mail or telephone. The results acquired were as follows: 1. Among the 20 patients, 11 men and 9 women with mesothelioma were identified. The mean age at hospitalization was 47 years and 11 mesothelioma patients were known or presumed to be dead during the different observation periods. 2. Only one mesothelioma patient had a definite history of occupational asbestos exposure. 3. The sites of orgin of mesothelioma were the pleura(13), peritoneum(2), pericardium(2), mediastinum(2), and pelvis(1). Common symptoms included dyspnea, chest pain, abdominal distension, etc. 4. Pathologically, mesotheliomas were divided into 14 malignant types and 6 benign types ; and histologically, 8 fibrous mesotheliomas and 3 epithelial mesotheliomas were shown. 5. There was a statistically significant difference in survival rate according to pathologic type and smoking status. In the groups with malignant mesothelioma, 50% survival time from first symptoms was 18 months and that from diagnosis was 11 months. Also, 75% survival time from diagnosis was 6 months in the smoking groups and 19 months in the non-smoking groups.; Summary

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