Characteristics of Workplace Injuries among Nineteen Thousand Korean Firefighters.

To determine the actual firefighter injury statistics in Korea, we conducted a survey on the nature of on-duty injuries among all male firefighters in Korea. We distributed questionnaires to all Korean male firefighters via email, and data from the 19,119 workers that responded were used for data analysis. The job types were categorized into fire suppression, emergency medical service (EMS) and officers. As estimated of age standardized injury prevalence per one thousand workers, 354 fire extinguishing personnel, 533 EMS workers, and 228 officers experienced one or more injuries during the previous 12 months. The odds ratio (95% confidence interval) of injuries was 1.86 (1.61-2.15) for fire suppression and 2.93 (2.51-3.42) for EMS personnel compared to officers after adjusting for age, marital status, smoking habit and career period. Age standardized absence days from work due to injuries per one thousand workers were 1,120, 1,337, and 676 for fire suppression, EMS and officers, respectively. Car accident (24.5%) was the most common cause and wound (42.3%) was the most common type of injuries. Our nationwide representative study showed that fire suppression and EMS workers are at greater risk of on-duty injuries compared to officers. We observed different injury characteristics compared to those reported in other countries.

Association between job-related stress and experience of presenteeism among Korean workers stratified on the presence of depression.

BACKGROUND: Presenteeism refers to the phenomenon of working while sick. Its development can be attributed to not only somatic symptoms but also underlying social agreements and workplace atmosphere. In this study, we analyzed presenteeism among workers from various industries, focusing on job-related stress with stratification on the presence of depression. METHODS: We conducted the study with data from questionnaires filled in by different enterprises enrolled in the Federation of Korean Trade Unions. Workers' depressive symptoms were investigated using the Patient Health Questionnaire-2, while questions on job-related stress and presenteeism were derived from the short form of the Korean Occupational Stress Scale and the official Korean version of the Work-Productivity and Activity Impairment Questionnaire-General Health, respectively. Multilevel logistic analysis was conducted to determine the statistical differences derived from the differences between companies. RESULTS: In total, 930 participants (753 men and 177 women) from 59 enterprises participated in the research. We conducted multilevel logistic regression to determine the association between the variables and presenteeism, with stratification by the presence of depression. Higher job demands and higher interpersonal conflict showed significantly elevated odds ratios (ORs) in univariate models and in the multivariate multilevel model. In the final model of total population, fully adjusted by general and work-related characteristics, higher job demands (OR: 3.29, 95% confidence interval [CI]: 2.08-5.21) and interpersonal conflict (OR: 1.87, 95% CI: 1.29-2.71) had significantly higher ORs-a tendency that remained in participants without depression. CONCLUSIONS: This study reflected the factors associated with presenteeism among workers from various enterprises. The findings revealed that job-related stress was closely related to presenteeism in both the total population and in the population without depression. Thus, it emphasized interventions for managing job stress among workers to reduce presenteeism in general workers' population.

The cumulative incidence and trends of rare diseases in South Korea: a nationwide study of the administrative data from the National Health Insurance Service database from 2011-2015.

BACKGROUND: The burden of rare diseases on society and patients' families has increased in Korea. However, because of the infrequency of rare diseases, there is a lack of resources and information to address these cases and inadequate funding for the management of these patients. We investigated the average annual cumulative incidence of rare diseases and the trends in annual cumulative incidence from 2011 to 2015 in Korea by using nationwide administrative data from the Korean National Health Insurance Service (NHIS) database for patients registered with the co-payment assistance policy for rare and incurable diseases. Annual cumulative incidence per 10,000,000 was calculated as the total number of newly enrolled patients with the Korean Standard Classification of Diseases (KCD)-7 code in the register, divided by the number of residents with health insurance coverage during each year. We employed simple linear regression analysis to evaluate the trends in annual cumulative incidence/10,000,000 population per year for each rare disease. RESULTS: Overall, national support was provided for patients with 415 KCD codes listed among the targeted rare diseases. The total number of newly enrolled patients with rare diseases was 53,831 in 2011, 52,658 in 2012, 52,955 in 2013, 71,530 in 2014, and 70,559 in 2015. The number of rare diseases with an average annual cumulative incidence of 100/10,000,000 and above was 22 (5.30%), while there were 227 (54.70%) and 148 (35.66%) with an average cumulative incidence between 1/10,000,000 and 100/10,000,000 and less than 1/10,000,000, respectively. The trends in the annual cumulative incidence for 43 rare diseases were statistically significant (p-value < 0.05). The rare diseases for which the incremental trend per year was statistically significant were sarcoidosis (D86, D86.0, D86.1, D86.2, D86.3, D86.8, D86.9), Parkinson's disease (G20), Guillain-Barré syndrome (G61.0), primary biliary cirrhosis (K74.3) and Sjogren's syndrome (M35.0). CONCLUSIONS: The number of rare diseases showing an increasing trend in annual cumulative incidence was higher than the number of diseases showing a decreasing trend in annual cumulative incidence. Given that the definition and diagnosis vary based on country and that there is difficulty in identifying valid cases, further detection strategies are needed to establish the incidence of each rare disease considering the importance of establishing a health policy based on the actual incidence of the targeted diseases.

Differences in the performance of health officers at the workplace according to their qualifications.

BACKGROUND: Health officers are an integral part of the occupational health service, and there have been studies to identify and improve the role of health officers in the workplace in order to improve the level of health care in the workplace. This study aimed to determine the contribution of health officers to the role of a health officer as prescribed by law and the percentage of health management work performed during work according to their qualifications. METHODS: Questionnaires were distributed to a total of 4584 workplaces where health officers were hired, and a total of 806 copies (17.58%) were returned. Of these, 336 questionnaires were finally analyzed, after excluding questionnaires missing the main variables. Using the data, the difference of role contributions and the percentage of health care work performed during the whole day according to the qualification of the health officer was analyzed. RESULTS: Nurses were highly rated in the field of medical care, and industrial hygienists and air environmental engineers were highly rated in terms of chemicals and risk factor management. The percentage of health care work performed during the whole day differed according to the size of the workplace and industrial classification, but it was generally the lowest among air environmental engineers. CONCLUSIONS: Health officers play a very different role in the workplace depending on their qualification, and they need support for areas of other qualification. In order to effectively manage the health of the staff at a workplace, it is necessary to consider the development of a support system for small- and medium-sized enterprises and adjust the conditions of employment of the health officer according to the law.

The relationship between occupational noise and vibration exposure and headache/eyestrain, based on the fourth Korean Working Condition Survey (KWCS).

INTRODUCTION: The individual and combined effect of occupational noise and vibration exposures, on workers' health has not been thoroughly investigated. In order to find better ways to prevent and manage workers' headache, this study aimed to investigate the effects of occupational noise and vibration exposure on headache/eyestrain. METHODS: We used data from the fourth Korean Working Condition Survey (2014). After applying inclusion and exclusion criteria, 25,751 workers were included. Occupational noise and vibration exposure and the prevalence of headache/eyestrain were investigated by self-reported survey. Chi-square tests were used to compare differences in baseline characteristics between the group with headache/eyestrain and the group without. Odds ratios and 95% confidence intervals were estimated using a logistic regression model adjusted for several covariates. Area under the receiver operating characteristics curve (AUROC) analysis was used to evaluate the effect of occupational noise and/or vibration exposure. RESULTS: Among the 25,751 study subjects, 4,903 had experienced headache/eyestrain in the preceding year. There were significant differences in age, education level, household income, occupational classification, shift work, occupational vibration exposure, and occupational noise exposure between the two groups (all p<0.05). The odds ratios between each exposure and headache/eyestrain increased proportionally with the level of exposure, increasing from 1.08 to 1.26 with increasing vibration exposure, and from 1.25 to 1.41 with increasing noise exposure. According to the AUROC analysis, the predictive power of each exposure was significant, and increased when the two exposures were considered in combination. DISCUSSION: The findings of this study show that both occupational noise and vibration exposures are associated with headache/eyestrain; noise exposure more strongly so. However, when the two exposures are considered in combination, the explanatory power for headache/eyestrain is increased. Therefore, efforts aimed at reducing and managing occupational noise and vibration exposure are crucial to maintaining workers' health.

Relationship Between Exposure to Second-Hand Smoke in the Workplace and Occupational Injury in the Republic of Korea.

Background: Most studies in the field of smoking exposure in the workplace linked to occupational safety have only focused on active smoking. Few studies have reported that exposure to second-hand smoke in the workplace is a possible factor increasing the risk of occupational injury without considering occupational characteristics. The aim of this study was to determine the association between occupational injury and level of exposure to second-hand smoke at the workplace among Korean workers, after taking into account occupational characteristics. Method: Using data from the third Korean Working Conditions Survey, levels of exposure to second-hand smoke were categorized as none, moderate, and high. We investigated the influence of exposure to second-hand smoke on occupational injury using logistic regression analysis with stratification by sex, smoking status, smoke-free policy in the workplace, and occupational characteristics. Occupational characteristics (occupational classification, working schedule, length of working day, and co-exposure to occupational hazards in the workplace) were stratified and analyzed using logistic regression models to estimate the risk of occupational injury linked to exposure to second-hand smoke. Results: Among all participants, there was a significant dose-dependent association between risk of occupational injury and level of exposure level to second-hand smoke. After stratification by sex and smoking status, there was a significant association between risk of occupational injury and exposure level to second-hand smoke. Moreover, there was a significant relationship between exposure to second-hand smoke in the workplace and occupational injury, depending on the smoking-free policy at workplace (odds ratio [OR] in completely non-smoking workplace, 4.23; OR in non-smoking workplace with separate smoking area, 2.98; OR in smoking workplace 2.84). Additionally, there was a significant relationship between risk of occupational injury and exposure to second-hand smoke after stratification by occupational classification, working schedule, long working hours, and co-exposure to hazards in the workplace. Discussion: There was a dose-response relationship between occupational injury and exposure to second-hand smoke, even after stratification to reduce the impact of various potential confounders and after taking into account occupational characteristics. These findings provide greater insight into the effects of exposure to second-hand smoke on the working population and may direct further research and policy-making in this field.

The association between subjective socioeconomic status and health inequity in victims of occupational accidents in Korea.

OBJECTIVES: We aimed to investigate the health inequity of victims of occupational accidents through the association between socioeconomic status and unmet healthcare need. METHODS: Data from the first and second Panel Study of Workers' Compensation Insurance were used, which included 1,803 participants. The odds ratio and 95% confidence intervals for the unmet healthcare needs of participants with a lower socioeconomic status and other socioeconomic statuses were investigated using multivariate regression analysis. RESULTS: Among all participants, 103 had unmet healthcare needs, whereas 1,700 did not. After adjusting for sex, age, smoking, alcohol, chronic disease, recuperation duration, accident type, disability, and economic participation, the odds ratio of unmet healthcare needs in participants with a lower socioeconomic status was 2.04 (95% confidence interval 1.32-3.15) compared to participants with other socioeconomic statuses. CONCLUSIONS: The victims of occupational accidents who have a lower socioeconomic status are more likely to have unmet healthcare needs in comparison to those with other socioeconomic statuses.

Association between job stress and occupational injuries among Korean firefighters: a nationwide cross-sectional study.

OBJECTIVE: We aimed to assess the nature of association between job stress and occupational injuries among firefighters in Korea. DESIGN: Cross-sectional study. SETTING: We conducted a nationwide survey using self-reported questionnaires in South Korea. PARTICIPANTS: A survey was conducted among 30 630 firefighters; 25 616 (83.6%) responded. Our study included firefighters who were 20-59 years old. Individuals with <12 months of current job experience and those with missing data were excluded; ultimately, 14 991 firefighters were analysed. RESULTS: Among fire suppression personnel, high job demands (OR=1.49, 95% CI 1.25 to 1.77), high interpersonal conflicts (OR=1.18, 95% CI 1.02 to 1.37), a poor organisational system (OR=1.33, 95% CI 1.14 to 1.55), and a negative workplace environment (OR=1.41, 95% CI 1.21 to 1.64) were associated with the occurrence of occupational injury; high job demands (OR=1.22, 95% CI 1.01 to 1.47) were also associated with the frequency of injuries. Among emergency medical services personnel, high job demands (OR=1.26, 95% CI 1.03 to 1.54), high interpersonal conflicts (OR=1.40, 95% CI 1.19 to 1.66), a poor organisational system (OR=1.55, 95% CI 1.30 to 1.85), lack of reward (OR=1.43, 95% CI 1.21 to 1.69) and a negative workplace environment (OR=1.30, 95% CI 1.10 to 1.54) were associated with the occurrence of occupational injury; low job control (OR=1.20, 95% CI 1.04 to 1.38), high interpersonal conflicts (OR=1.18, 95% CI 1.03 to 1.36), lack of reward (OR=1.17, 95% CI 1.02 to 1.35) and a negative workplace climate (OR=1.16, 95% CI 1.01 to 1.34) were also associated with a greater number of injuries. Among officers, high job demands (OR=1.96, 95% CI 1.35 to 2.85) and a negative workplace environment (OR=1.54, 95% CI 1.13 to 2.10) were associated with the occurrence of occupational injuries; however, there was no significant correlation between job stress and the number of injuries. CONCLUSIONS: High job stress among firefighters was associated with both the occurrence of occupational injury, and also with an increased frequency of injuries. Therefore, job stress should be addressed to prevent occupational injuries among firefighters.

The Association Between Blood Mercury Levels and Risk for Overweight in a General Adult Population: Results from the Korean National Health and Nutrition Examination Survey.

The primary objective of this study was to estimate the association between blood mercury levels and overweight in Korean adults. We analyzed cross-sectional data from 9228 participants (4283 men and 4945 women) who completed the Korean National Health and Nutrition Examination Survey (KNHANES), 2007-2013. The population was divided into two groups according to the body mass index (BMI) and waist circumference (WC). Blood mercury levels were analyzed using a gold amalgam method with a DMA-80 instrument, categorized into quartiles, and stratified by sex. After adjusting for all covariates, blood mercury was significantly associated with overweight in all subjects. According to the BMI criteria, the adjusted odds ratio of being in the highest blood mercury quartile was 1.75 (95 % confidence interval [CI], 1.53-2.01) overall, 2.09 (95 % CI, 1.71-2.55) in men, and 1.58 (95 % CI, 1.32-1.89) in women. According to the WC criteria, the adjusted odds ratio of being in the highest blood mercury quartile was 1.85 (95 % CI, 1.49-2.30) in men and 1.96 (95 % CI, 1.62-2.36) in women compared to the lowest quartile. Additionally, a trend in overweight across increasing blood mercury levels was observed by the p for trend test in the multiple diagnostic criteria.

A dose-response relationship between long working hours and unmet need for access to hospital facilities.

OBJECTIVES: Lack of access to hospital facilities, indicating unmet healthcare need, plays an important role in health inequity in the workplace. We aimed to investigate the association between long working hours and unmet healthcare need. METHODS: We used data from the Korea National Health and Nutrition Examination Surveys collected during 2007-2012, which included 8369 participants (4765 males, 3604 females) aged 20-54 years, who were paid workers. We used a logistic regression model with gender stratification to investigate the association between working hours and unmet healthcare need. RESULTS: Of the 8369 participants, 855 males (17.94%) and 981 females (27.22%) experienced unmet healthcare need. After adjusting for covariates, and compared to 30-39 working hours per week, the odds ratios (OR) of unmet healthcare need were 1.07 [(95% confidence interval (95% CI) 0.76-1.51], 1.46 (95% CI 1.03-2.07), and 1.57 (95% CI 1.11-2.23) in males, and 1.13 (95% CI 0.92-1.40), 1.30 (95% CI 0.99-1.69), and 1.60 (95% CI 1.21-2.10) in females, for 40-49, 50-59, and ≥ 60 work hours per week, respectively. There was a dose-response relationship between working hours per week and unmet healthcare need in both genders. CONCLUSIONS: Those who work long hours are more likely to have unmet healthcare needs, the cause of which seems to be lack of time.

Factors related to the physician and the employer influencing successful return to work in Korea: results from the first panel study of workers' compensation insurance (PSWCI).

OBJECTIVES: This study aims to investigate associated factors including the physician and the employer of successful return to work (RTW) in occupationally injured workers. METHODS: This study is based on the first panel study of workers' compensation insurance (PSWCI), published in June 2014. The PSWCI is a sample survey of occupationally injured workers who completed medical care in 2012 (89,921 people). A total of 2000 subjects were sampled based on sex, age, nine metropolitan-based regions, disability ratings, duration of rehabilitation, and whether vocational rehabilitation service was used. We divided the study population into two groups: return to work (RTW) group (job retention, reemployment, unpaid family worker, and self-employment), and non-RTW group (joblessness and economical inactivity). The odds ratios (ORs) and 95 % confidence intervals (CI) related to differences in basic characteristics, part of physician and employer-related factors between those who succeeded to RTW and those who did not were measured using multivariable logistic regression model. RESULTS: The success of RTW is 70.6 % (n = 1412) among participants. The ORs (95 % CI) of the participants belonging to RTW who received periodic recovery assessment from the medical care institution and the physician are 1.51 (1.07-2.13). The ORs (95 % CI) are 1.68 (1.05-2.69) for the RTW group who received work ability assessment and referral for vocational return. When the employer maintains the relationship with the occupationally injured worker, the worker has 1.39 times higher odds (95 % CI: 1.41-2.26) of the RTW group compared to the non-RTW group. CONCLUSIONS: The physician and the employer have a significant impact on the RTW.