Epidemiology of occupational injuries in construction workers between 2009 and 2018 in South Korea.

BACKGROUND: This study aimed to investigate the characteristics of occupational injuries based on fatality, sex, and classification of occupations among construction workers using workers' compensation (WC) insurance data in South Korea. METHODS: We collected WC insurance data from the Korea Workers' Compensation & Welfare Service for all construction workers between 2009 and 2018. Data from 158,947 accepted claims for occupational injury were extracted, and the demographic features, occupational injury types, and annual trends were analyzed for fatal and nonfatal cases. The annual incidence and mortality trends of occupational injury were estimated using negative binomial regression and Poisson regression models, for injury incidence and mortality respectively. RESULTS: Among a total of 158,947 occupational injury cases, there were 155,772 (98%) nonfatal injuries and 3175 (2%) fatal injuries. For all occupational injuries, Construction Elementary Workers (6th Korean Standard Classification of Occupations (KSCO) 910; 45.7%) was the most frequent occupation, followed by Construction-Related Technical Workers (6th KSCO 772; 39.2%). The most frequent injury type was a fracture, followed by ruptures or lacerations and contusions. The incidence of all occupational injuries increased from 700.36 per 100,000 persons in 2009 to 1,195.98 per 100,000 persons in 2018. Further, deaths from injuries at work followed a significantly increasing annual trend [mortality rate ratio 1.04 (95% CI: 1.03-1.05)] from 2009 to 2018. CONCLUSION: The over two-thirds increased incidence of occupational injuries and significantly increasing mortality trends for occupational injuries during the last 10 years indicate the need for aggressive intervention in occupational safety and health management within the Korean construction industry.

Deep-Learning-Driven Quantification of Interstitial Fibrosis in Digitized Kidney Biopsies.

Interstitial fibrosis and tubular atrophy (IFTA) on a renal biopsy are strong indicators of disease chronicity and prognosis. Techniques that are typically used for IFTA grading remain manual, leading to variability among pathologists. Accurate IFTA estimation using computational techniques can reduce this variability and provide quantitative assessment. Using trichrome-stained whole-slide images (WSIs) processed from human renal biopsies, we developed a deep-learning framework that captured finer pathologic structures at high resolution and overall context at the WSI level to predict IFTA grade. WSIs (n = 67) were obtained from The Ohio State University Wexner Medical Center. Five nephropathologists independently reviewed them and provided fibrosis scores that were converted to IFTA grades: ≤10% (none or minimal), 11% to 25% (mild), 26% to 50% (moderate), and >50% (severe). The model was developed by associating the WSIs with the IFTA grade determined by majority voting (reference estimate). Model performance was evaluated on WSIs (n = 28) obtained from the Kidney Precision Medicine Project. There was good agreement on the IFTA grading between the pathologists and the reference estimate (κ = 0.622 ± 0.071). The accuracy of the deep-learning model was 71.8% ± 5.3% on The Ohio State University Wexner Medical Center and 65.0% ± 4.2% on Kidney Precision Medicine Project data sets. Our approach to analyzing microscopic- and WSI-level changes in renal biopsies attempts to mimic the pathologist and provides a regional and contextual estimation of IFTA. Such methods can assist clinicopathologic diagnosis.

Association between ambient particulate matter levels and hypertension: results from the Korean Genome and Epidemiology Study.

Background: Recently, there has been increasing worldwide concern about outdoor air pollution, especially particulate matter (PM), which has been extensively researched for its harmful effects on the respiratory system. However, sufficient research on its effects on cardiovascular diseases, such as hypertension, remains lacking. In this study, we examine the associations between PM levels and hypertension and hypothesize that higher PM concentrations are associated with elevated blood pressure. Methods: A total of 133,935 adults aged ≥ 40 years who participated in the Korean Genome and Epidemiology Study were analyzed. Multiple linear regression analyses were conducted to investigate the short- (1-14 days), medium- (1 and 3 months), and long-term (1 and 2 years) impacts of PM on blood pressure. Logistic regression analyses were conducted to evaluate the medium- and long-term effects of PM on blood pressure elevation after adjusting for sex, age, body mass index, health-related lifestyle behaviors, and geographic areas. Results: Using multiple linear regression analyses, both crude and adjusted models generated positive estimates, indicating an association with increased blood pressure, with all results being statistically significant, with the exception of PM levels over the long-term period (1 and 2 years) in non-hypertensive participants. In the logistic regression analyses on non-hypertensive participants, moderate PM10 (particulate matter with diameters < 10 µm) and PM2.5 (particulate matter with diameters < 2.5 µm) levels over the long-term period and all high PM10 and PM2.5 levels were statistically significant after adjusting for various covariates. Notably, high PM2.5 levels of the 1 year exhibited the highest odds ratio of 1.23 (95% confidence interval: 1.19-1.28) after adjustment. Conclusions: These findings suggest that both short- and long-term exposure to PM is associated with blood pressure elevation.

The Effect of Change of Working Schedule on Health Behaviors: Evidence from the Korea Labor and Income Panel Study (2005-2019).

This study investigated whether changes in work schedule are associated with health behavior changes. We used data from the Korea Labor and Income Panel Survey from 2005 to 2019. A generalized estimating equation model was used to assess the association between changes of work schedules (day-day, day-shift, shift-day, and shift-shift) and health behaviors. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated after adjusting for general and socioeconomic characteristics. Fixed daytime work was observed for 25,716 person-years, and fixed shift work was observed for 2370 person-years out of the total 4046 participants during a 14 year period. Workers who changed their work schedule from fixed daytime to shift work and from shift to fixed daytime work contributed to 670 and 739 person-years, respectively. Considering continuous fixed daytime workers as a reference group, continuous exposure to shift work (aOR 1.11, CI 1.01-1.26) and changes from fixed daytime to shift work (aOR 1.18, CI 1.05-1.44) were significantly associated with an increased risk of changing either smoking or drinking behavior to unhealthy patterns. The results of our study suggest that workers who work irregular shift times, in contrast to those with more standard, regular work schedules, are at a higher risk of changing smoking and/or drinking behavior to unhealthy patterns.

Status of Workers' Health Behavior and the Association between Occupational Characteristics and Health Behavior.

This study investigated differences in unhealthy lifestyle behaviors (ULBs) between workers and nonworkers and demonstrated the association of ULBs with occupational characteristics among workers. This cross-sectional study used data from the Korea National Health and Nutrition Examination Survey from 2007 to 2019. For sociodemographic data, chi-squared tests were used to analyze categorical variables. Odds ratios (ORs) and 95% confidence intervals (CIs) for ULBs were estimated using Poisson regression models after adjusting for age, sex, educational level, and household income. The variables used were current smoking status, heavy drinking, and physical inactivity. Workers were associated with an increased risk of current smoking (adjusted OR (aOR) = 1.48, 95%CI = 1.41-1.56), heavy drinking (aOR = 1.79, 95%CI = 1.68-1.90), and physical inactivity (aOR = 1.07, 95%CI = 1.04-1.11) compared with nonworkers. Among workers, the differential risks of ULB according to occupational characteristics were as follows: skilled manual workers, self-employed workers, and workers working >40 h/week were at a higher risk of engaging in all ULBs than those in other occupational categories, paid workers, and workers working ≤40 h/week, respectively. Workers showed a higher risk of ULBs than nonworkers. The risk of ULBs differed according to occupational characteristics, highlighting the need for additional studies and detailed occupational health management.

Approval status and characteristics of work-related musculoskeletal disorders among Korean workers in 2020.

Background: This study aimed to investigate the characteristics of work-related musculoskeletal disorders (WRMSDs) in occupational disease claims and identify patterns of WRMSDs for each body part by industry and occupation. Methods: This study analyzed the raw data of occupational disease claims for musculoskeletal disorders deliberated by the Occupational Disease Decision Committee of the Korea Workers' Compensation & Welfare Service in 2020. The data was classified into 6 body parts with the highest numbers of occupational disease cases by using the complete enumeration data on principal diagnoses and 4 types of subdiagnoses in the raw data. The characteristics and approval rates of WRMSDs by body part, industry and occupation were examined and summarized. Results: A total of 13,015 occupational disease cases for WRMSDs were classified, and lumbar spinal (back) diseases accounted for the largest proportion of claimed diseases, followed by shoulder, elbow, wrist, knee, and neck diseases in a descending order. The occupations with the highest and second highest numbers of occupational disease cases by body part were found to be automobile assemblers and production-related elementary workers for the neck, school meal service workers and cooks for the back, construction frame mold carpenters and school meal service workers for the shoulder, elementary workers in mining and food service workers for the elbow, food service workers and automobile parts assemblers for the wrist, and ship welders and school meal service workers for the knee. Conclusions: This study examined the characteristics and approval status of WRMSDs by body part and occupation. Based on the study results, management strategies for the prevention of WRMSDs should be established regarding occupations with a high risk of WRMSDs for each body part.

Reconstruction of the Korean Asbestos Job Exposure Matrix.

BACKGROUND: A job-exposure matrix (JEM) is an important surrogate indicator to evaluate past exposure levels. Although a Korean asbestos JEM has been constructed previously, this JEM includes only a few industrial and occupational groups. This study aimed to reconstruct the JEM by integrating the latest organized data to improve its utility. METHODS: We used recent Korean standard industry and occupation codes and extracted 36 articles from a systematic literature review to initiate the reconstruction of the previous Korean asbestos JEM. The resulting data consisted of 141 combinations of industrial and occupational groups. Data from the Netherlands's JEM were also reviewed and categorized into 70 industrial and 117 occupational groups by matching with the Korean data. We also utilized Germany's data, which consisted of 10 industrial and 14 occupational groups. RESULTS: The reconstructed Korean asbestos JEM had 141 combinations of industries and occupations. The time periods are from the 1980s to the 2000s in 10-year intervals. Most of the data were distributed between the 1990s and the 2000s. Occupations with high exposure to asbestos included knitting and weaving machine operators, automobile mechanics or assemblers, ship mechanics or assemblers, mineral ore and stone products processing mechanics, and metal casting machine operators or mold makers. CONCLUSIONS: The reconstructed Korean asbestos JEM has expanded the type and duration of the occupational groups of the previous JEM and can serve as an important reference tool for evaluating asbestos exposure and designing compensation and prevention policies in Korea.

Distribution of working position among workers with varicose veins based on the National Health Insurance and National Employment Insurance data.

BACKGROUND: This study aimed to determine the effect of specific working postures on the development of varicose veins (VV). By using Korea's National Health Insurance (NHI) and National Employment Insurance (NEI) data, we analyzed the general characteristic and difference in proportions of VV cases according to occupational working posture. METHODS: From the NEI and NHI data, participant demographics, such as gender, age, body mass index, and number of workers in specific occupations or industries were obtained. We classified the 240 occupations into blue-collar (BC) and white-collar (WC) occupations and subdivided them into standing, sitting, and walking groups according to the dominant working posture. RESULTS: The number of VV patients per 100,000 individuals increased with age, with a higher number of women than men and a higher number of patients in the BC than WC groups. For the BC group, the proportion of VV cases was the highest in the standing group, followed by the walking and sitting groups, but there was no significant difference between standing and walking groups in man. For the WC group, the standing group had a higher proportion of VV cases than the sitting group, but there was no significant difference between the standing and sitting group in man. In the BC group, the proportion of VV cases was the highest among medical and welfare-related elementary workers, bakers and cookie makers, automobile assemblers, cleaning and guarding-related elemental workers, and nurses and dental hygienists. In the WC group, the proportion of VV cases was the highest among food/lodging/tourism/entertainment/sports-related managers, environment/cleaning/protective services-related managers, finance and insurance clerks, accounting book-keeping clerks, and social welfare and counseling professionals. CONCLUSIONS: This study was performed to determine the characteristics of VV with different working posture among Korean workers. It is expected to be the basis of further studies on occupational musculoskeletal diseases.