Performance pressure and mental health among finance workers in Korea: a cross-sectional study.

Objectives: While issues related to mental health, including suicide, have been frequently reported among finance workers, no formal investigation has been undertaken. This study was conducted to analyze correlations between indicators of performance pressure, which is a characteristic of the finance sector, and mental health. Methods: An online survey was administered to 1,181 participants. Brief questionnaires were employed to ask general questions about participant characteristics, work environment, and the presence of performance pressure, suicidal thoughts/plans/attempts, depression (indicated by the Patient Health Questionnaire-9), and anxiety (measured with the Generalized Anxiety Disorder-7). Frequency analysis, chi-square testing, and multivariate logistic regression analysis were performed. Results: Of the 1,181 respondents, 797 (83.54%) reported feeling pressure to perform at work, while 252 (26.42%) admitted to occasional willingness to achieve results even through illegal activities. Multivariate logarithmic regression analysis was employed to examine the correlation between performance pressure and mental health. This analysis revealed that those expressing willingness to achieve. Results: through illegal activities exhibited higher levels of suicidal ideation (adjusted odds ratio [aOR], 1.63; 99% confidence interval [CI], 1.04-2.55), plans (aOR, 1.75; 99% CI, 1.01-3.01), and attempts (aOR, 2.72; 99% CI, 1.06-6.98). Additionally, these individuals demonstrated higher levels of depression (aOR, 2.02; 99% CI, 1.34-3.06) and anxiety (aOR, 2.84; 99% CI, 1.81-4.46). Conclusion: Performance pressure is prevalent within the finance industry. This pressure serves as a major source of stress for employees and is evident in 3 representative indicators of mental health: suicide, depression, and anxiety.

Development of algorithm for work intensity evaluation using excess overwork index of construction workers with real-time heart rate measurement device.

Background: The construction workers are vulnerable to fatigue due to high physical workload. This study aimed to investigate the relationship between overwork and heart rate in construction workers and propose a scheme to prevent overwork in advance. Methods: We measured the heart rates of construction workers at a construction site of a residential and commercial complex in Seoul from August to October 2021 and develop an index that monitors overwork in real-time. A total of 66 Korean workers participated in the study, wearing real-time heart rate monitoring equipment. The relative heart rate (RHR) was calculated using the minimum and maximum heart rates, and the maximum acceptable working time (MAWT) was estimated using RHR to calculate the workload. The overwork index (OI) was defined as the cumulative workload evaluated with the MAWT. An appropriate scenario line (PSL) was set as an index that can be compared to the OI to evaluate the degree of overwork in real-time. The excess overwork index (EOI) was evaluated in real-time during work performance using the difference between the OI and the PSL. The EOI value was used to perform receiver operating characteristic (ROC) curve analysis to find the optimal cut-off value for classification of overwork state. Results: Of the 60 participants analyzed, 28 (46.7%) were classified as the overwork group based on their RHR. ROC curve analysis showed that the EOI was a good predictor of overwork, with an area under the curve of 0.824. The optimal cut-off values ranged from 21.8% to 24.0% depending on the method used to determine the cut-off point. Conclusion: The EOI showed promising results as a predictive tool to assess overwork in real-time using heart rate monitoring and calculation through MAWT. Further research is needed to assess physical workload accurately and determine cut-off values across industries.

Case-Control Study of Occupational Acute Myeloid Leukemia in the Republic of Korea.

Background: We conducted a case-control study to identify high-risk occupations and exposure to occupational hazards for acute myeloid leukemia (AML). Methods: When patients with AML admitted to the Department of Hematology in the study hospital for the first time are referred to the Department of Occupational and Environmental Medicine, data on occupation are collected by investigators to evaluate work-relatedness. Community-based controls were recruited through an online survey agency, and four controls per case were matched. Occupational information was estimated using structured questionnaires covering 27 specific occupations and 32 exposure agents. Conditional logistic regression analysis was performed by pairing cases and controls. Results: In the analysis of the risk of AML according to occupational classification, a significant association was found in paint manufacturing or painting work (OR = 2.22, 95% CI: 1.03-4.81) and aircrew (OR = 6.00, 95% CI: 1.00-35.91) in males, and in pesticide industry (OR = 6.89, 95% CI: 1.69-28.07) and cokes and steel industry (OR = 2.00, 95% CI: 1.18-22.06) in ≥60 years old. Moreover, the risk of AML increased significantly as the cumulative exposure to thinners increased. In the analyses stratified by sex and age, the association between pesticide exposure and AML was significant in males (OR = 3.28, 95% CI: 1.10-9.77) and in ≥60 years old (OR = 6.22, 95% CI: 1.48-26.08). Conclusion: This case-control study identified high-risk occupational groups in the Republic of Korea including paint manufacturers and painters, aircrew, and those who are occupationally exposed to pesticides or paint thinners.

Association between presenteeism and mental health among logistic center workers.

Background: Workers in logistics centers are always pressed for time to collect and pack products. They also participate in high-intensity manual labor in which various musculoskeletal hazards exist. In the case of logistic center labor, it is estimated that there is a high risk of presenteeism due to the above characteristics which can cause deterioration of workers' mental health. However, there is insufficient research on this topic. Methods: Workers in a logistic center were surveyed using an Internet questionnaire. The survey items included demographic characteristics, labor intensity and work-related factors, and mental health aspects such as depression and anxiety. The survey was conducted for about a month from July 26, 2021 and a total of 353 people were analyzed. Through the χ2 test and t-test, the characteristics of workers who experienced presenteeism were examined and the prevalence ratios (PRs) of depression and anxiety experiences were calculated by multivariable Poisson regression. Afterwards, stratification analysis considering gender, the type of contract, and labor intensity was implemented. Results: In the group that experienced presenteeism, the number of working days per week was higher and fixed-term workers, high labor intensity, and sleep deprivation were more common. In the multi-Poisson regression analysis conducted by adjusting the demographic characteristics, working hours, and work-related factors, the PRs of depression and anxiety were 1.98 (95% confidence interval: 1.24-3.18) and 1.81 (1.22-2.68), respectively. In particular, the p-value for interactions was significant when stratified with the type of contract. Conclusions: As a result of the study, presenteeism and mental health were associated in logistic center workers. To prevent mental health issues of logistic center workers, management of presenteeism is necessary and a prospective study is needed.

Long working hours and the risk of hypothyroidism in healthy Korean workers: a cohort study.

OBJECTIVES: Long working hours have been reported to cause various health problems, but are currently practiced in many countries. Building upon a previous cross-sectional study, the authors aimed to elucidate the causal relationship between long working hours and hypothyroidism through a longitudinal study. METHODS: Data were collected at baseline from 45,259 participants without thyroid disease and with consistent weekly working hours (36-40, 41-52, 53-60, and >60 hours) during the follow-up period. Hypothyroidism was defined using the reference limits of serum thyroid-stimulating hormone and free thyroxine levels. By estimating hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox proportional hazards regression analysis, the risk of incident hypothyroidism was evaluated with 36-40 hours of work per week as the reference. RESULTS: During 138,261.7 person-years of follow-up, 2,914 participants developed hypothyroidism (incidence density, 2.11/102 person-years). The multivariable-adjusted HRs of incident hypothyroidism for 41-52 hours, 53-60 hours, and >60 hours of work per week were 1.13 (95% CI, 1.03 to 1.24), 2.53 (95% CI, 2.17 to 2.95), and 2.57 (95% CI, 2.09 to 3.15), respectively. In dose-response analyses, long working hours had an approximately linear relationship with hypothyroidism incidence. The risk of incident hypothyroidism in those who worked 53-60 hours and >60 hours per week compared with the reference group was significantly higher among the older age group (≥36 years, stratified by median age), men, and daytime workers. CONCLUSIONS: This large-scale cohort study demonstrated the association between long working hours and an increased risk of incident hypothyroidism with a dose-response relationship.

The Relationship between Hospital Selection by Employer and Disabilities in Occupational Accidents in Korea.

Background: In the event of an industrial accident, the appropriate choice of hospital is important for worker health and prognosis. This study investigates whether the choice of hospital by the employer in the case of industrial accidents affects the prognosis of injured employees. Methods: Data from the 2018 Panel Study of Workers' Compensation Insurance in Korea were used in an unmatched case-controlled study. The exposure variable is "hospital selection by an employer," and the outcome variable is 'worker's disability." Odds ratios (ORs) were estimated by modified Poisson regression and adjusted for age, gender, underlying disease, injury severity, and workplace size and stratified by industrial classification. The group at increased risk was analyzed and stratified by age, gender, and area. Results: In the construction industry, hospital selection by the employer was significantly associated with increased risk of disability (adjusted OR 1.26; 95% confidence interval [CI]: 1.20-1.32) and severe disability (adjusted OR 1.38; 95% CI: 1.08-1.76) among the injured. Female and younger workers not living in the Seoul capital area were more at risk of disability and severe disability than those living in the Seoul capital area. Conclusions: Hospital selection by employers affects the prognosis of workers injured in an industrial accident. For protecting workers' health and safety, workplace emergency medical systems should be improved, and the selection of appropriate hospitals to supply treatment should be reviewed.

Two Semiconductor Companies' Financial Support Compensation (FSC) Programs for Semiconductor Workers with Suspected Work-Related Diseases (WRDs).

This study described two companies' financial compensation programs for semiconductor workers with suspected work-related diseases (WRDs) and discussed the major related issues. The key contents of the programs found on the websites opened by two semiconductor companies (Samsung and SK Hynix) were cited. In order to select the suspected WRDs for the FSC, all available epidemiologic studies related to health problems conducted in the semiconductor industry were reviewed. Most program contents are similar, although the amount of financial compensation and a few types of disease available for compensation differ between the companies. The group of cancer, rare disease, childhood rare disease among children born to semiconductor workers (hereafter selected diseases among offspring), and fetal loss, including spontaneous abortion (SAB) and stillbirth, were considered for compensation. An employment duration of longer than one year on a semiconductor production line is required for FSC for cancer or rare disease. The FSC for SAB and offspring disease require a period of employment longer than one month, either before three months prior to conception or between conception and childbirth. The maximum amount of compensation per type of cancer and rare disease was fixed based on the medical treatment fee. The FSC programs of the two companies have been operated successfully to date. These programs are arguably considered to contribute to resolving the conflict between companies and workers with WRDs.

Association between long working hours and liver enzymes: evidence from the Korea National Health and Nutrition Examination Survey, 2007-2017.

Background: Long working hours causes several health risks, but little is known about its effects on the liver. This study aimed to examine the correlation between working hours and abnormal liver enzyme levels. Methods: We used data from the Korea National Health and Nutrition Examination Survey IV-VII. For the final 15,316 study participant, the information on working hours was obtained through questionnaires, and liver enzyme levels, consisting of serum levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT), through blood tests. The relationship between weekly working hours and abnormal levels of liver enzymes was analyzed using multiple logistic regression, and a trend test was also conducted. Results: In male, working ≥ 61 hours per week was significantly associated with elevated AST and ALT levels compared with working 35-52 hours per week. Even after adjusting for covariates, the odds ratios (ORs) of abnormal AST and ALT increased by 1.51 (95% confidence interval: 1.20-2.05) and 1.25 (1.03-1.52), respectively, and a dose-response relationship was observed. This association was more prominent among the high-risk group, such as those aged > 40 years, obese individuals, worker on non-standard work schedule, pink-collar workers, or temporary worker. No correlation was observed in female. Conclusions: Long working hours are associated with abnormal liver function test results in male. Strict adherence to statutory working hours is necessary to protect workers' liver health.

The Association Between Long Working Hours of Parents and Dyslipidemia in Their Children.

The purpose of our study is to examine the association between children's low-density lipoprotein cholesterol (LDL-C) levels and their parents' working hours. We used data from the 2010-2018 Korea National Health and Nutrition Examination Survey in which lipid profile samples of 3,799 children were eligible. Logistic regression analyses were used with an outcome variable of the dichotomous LDL-C group and an exposure variable of the father's and mother's working hours, respectively. In logistic regression models adjusted for age, sex, household income, education level of children and parents, and working hours of the parents, mothers' working hours more than 52 h per week were significantly associated with their children's dyslipidemia [OR 2.14, 95% confidence interval (CI) 1.33-3.47] compared to working 40 h or less, whereas fathers' working hours did not show statistical significance (OR 1.08, 95% CI 0.71-1.66) in the same manner. The association was greatest for elementary school students for mothers working more than 52 h per week (OR 3.42, 95% CI 1.64-7.14) compared to those working hours 40 h per week or less. Mothers' long working hours were associated with a higher prevalence of dyslipidemia in their children. The association was strongest for elementary school students. Proper working time of parents is required for their children's health.

Poor worker's long working hours paradox: evidence from the Korea National Health and Nutrition Examination Survey, 2013-2018.

Background: Because income and working hours are closely related, the health impact of working hours can vary according to economic status. This study aimed to investigate the relationship between working hours and the risk of poor self-rated health according to household income level. Methods: We used the data from the Korea National Health and Nutrition Examination Survey VI and VII. The information on working hours and self-rated health was obtained from the questionnaire. After stratifying by household income level, the risk of poor self-rated health for long working hour group (≥ 52 hours a week), compared to the 35-51 working hour group as a reference, were calculated using multiple logistic regression. Results: Long working hours increased the risk of poor self-rated health in the group with the highest income, but not in the group with the lowest income. On the other hand, the overall weighted prevalence of poor self-rated health was higher in the low-income group. Conclusions: The relationship between long working hours and the risk of poor self-rated health varied by household income level. This phenomenon, in which the health effects of long working hours appear to diminish in low-income households can be referred to as the 'poor worker's long working hours paradox'. Our findings suggest that the recent working hour restriction policy implemented by the Korean government should be promoted, together with a basic wage preservation to improve workers' general health and well-being.

Working for Long Hours Is Associated With Dietary Fiber Insufficiency.

It has been suggested that long working hours are associated with various diseases through dietary patterns. However, few studies have reported the association between working hours and dietary habits. Thus, the objective of this cross-sectional study was to explore the difference in dietary fiber intake by working hours. Data of a total of 10,760 workers in South Korea who participated in the Korea National Health and Nutrition Survey (KNHANES), a nation-wide survey, were analyzed to determine different distributions of dietary fiber insufficiency using multiple logistic regression models. Fiber insufficiency proportion was different from working hour groups. 70.1% of the total population eat fiber insufficiently. Working <40 h group showed 66.8% of fiber insufficiency. But working more than 52 h group marked 73.2% of fiber insufficiency. Logistic regression analysis of 10,760 nation-wide study participants revealed that working for 41-52 h a week (OR: 1.32, 95% CI: 1.18-1.47) and working for over 52 h a week (OR: 1.42, 95% CI: 1.25-1.62) were significantly associated with insufficient fiber intake compared to workers with standard working hours (30-40 h a week). These associations were still robust in an adjusted model, with working for 41-52 h a week (OR: 1.13, 95% CI: 1.01-1.27) and working for over 52 h (OR: 1.26, 95% CI: 1.09-1.45) showing high associations with dietary fiber insufficiency. Those with long working hours tend to have insufficient intake of dietary fiber. To promote desirable dietary habits, intervention programs on working conditions should be considered.

Comparative analyses of occupational injuries among temporary agency worker and direct contract workers: Findings from the Korea Health Panel 2009-2018.

OBJECTIVES: Several studies have reported health or safety risk of temporary agency workers (TAW). Since most of the studies are just cross-sectional studies, we intended to identify the risk of occupational injury in TAW, using longitudinal study design. METHODS: The Korea Health Panel 2009-2018 data were used in the study. For the statistical analysis of this study, we used a panel logit model to identify the risk of occupational injury in TAW compared to direct contract workers (DCW). RESULTS: There was no significant difference in risk of occupational injury between TAW and DCW among the overall population (adjusted OR 0.920, 95% CI 0.600-1.411). However, there was a significant increase in occupational injury in women (adjusted OR 2.134, 95% CI 1.092-4.170) and the "19-34" age group (adjusted OR 2.744, 95% CI 1.103-6.825) of TAW. CONCLUSIONS: This study provides evidence for vulnerable groups such as women and younger age groups in the relationship between TAW and occupational injury.

Cross-Sectional Association of Urinary Bisphenol A and Vaccine-Induced Immunity against Hepatitis B Virus: Data from the 2003-2014 National Health and Nutrition Examination Survey.

Hepatitis B virus (HBV) infection poses a serious health burden; bisphenol A (BPA), a commonly used plasticizer for consumer products, is a potential immune disruptor. However, epidemiologic studies revealing the association between BPA exposure and immunity are limited. This study investigates the association between environmental BPA exposure and immune response following HBV vaccination in a nationally representative sample population. Using National Health and Nutrition Examination Survey data from six cycles, we analyzed the data of 6134 participants, classified as susceptible to HBV infection (n = 3086) or as having vaccine-induced immunity (n = 3048). Associations between BPA level and HBV susceptibility were assessed using multivariable logistic regression and expressed as odds ratios (ORs) of the pooled data and data for each cycle. There was a significant association in the pooled data after adjusting for potential confounders (adjusted OR (aOR): 1.14, 95% confidence interval (CI): 1.05-1.23). However, the associations between BPA concentration and HBV susceptibility were inconsistent across the survey cycles and tended to decrease in more recent cycles. Although this study preliminarily suggests that BPA attenuates the immune response to hepatitis B vaccination, further prospective studies are warranted to elucidate the discrepancies observed.

The Association Between Organizational Justice and Health-Related Productivity Loss Among Korean Employees.

OBJECTIVES: To investigate the association between organizational justice (OJ) and health-related productivity loss (HRPL) among Korean employees. METHODS: From January 6, 2020 to February 18, 2020, data were collected using a web-based questionnaire. This study measured HRPL using the Work Productivity and Activity Impairment Questionnaire: General Health version. Procedural and interactional justice were measured using the Korean organizational justice questionnaire. Generalized linear models were used for estimating productivity loss based on tertiles of OJ levels, while the productivity loss of employees in low OJ categories was used as a reference group. RESULTS: The nonparametric associations between the OJ levels and the overall HRPL level were observed. High levels of OJ significantly reduced HRPL. CONCLUSIONS: Our results support the hypothesis that high OJ is associated with improved labor productivity.

Association of sedentary work with colon and rectal cancer: systematic review and meta-analysis.

OBJECTIVES: There has been no research on sedentary behaviour in the occupational domain that occupies a large portion of the daily life. METHODS: We conducted a meta-analysis to investigate the association between sedentary work and colorectal cancer. We searched PubMed, Embase and Cochrane databases up to 12 August 2020 for peer-reviewed journal articles that assessed the association between sedentary work and colon or rectal cancer. Pooled estimates of ORs were obtained using random effects models. Statistical tests for publication bias, heterogeneity and sensitivity analysis were applied. RESULTS: Of the 5 381 studies initially identified, 23 studies with 64 reports were eligible for inclusion. Sedentary work significantly increased the risk of colon cancer (pooled OR=1.21, 95% CI 1.11 to 1.31, p value ≤0.0001) and rectal cancer (pooled OR=1.08, 95% CI 1.00 to 1.16, p value=0.0395). The adjustment for leisure time physical activity attenuated the association and made the risk estimates non-significant for sedentary behaviour, but the association was independent of sex, control of body mass index and assessment of sedentary behaviour. CONCLUSIONS: We found evidence of association between sedentary work and the risk of colon or rectal cancer. Limiting excessive sedentary work could be an important means of preventing colon and rectal cancer.

Long Working Hours and Risk of Depression by Household Income Level: Findings From the Korea National Health and Nutrition Examination Survey (KNHANES).

OBJECTIVES: To investigate the relationship between working hours and the risk of depression according to household income level. METHODS: We used the data from the Korea National Health and Nutrition Examination Survey. The information on working hours was obtained from the questionnaire, and depression was assessed by The Patient Health Questionnaire-9. After stratifying by household income level, the risk of depression for long working hour group (more than or equal to 52 hours a week), compared with the 30 to 51 working hour group as a reference, were calculated using multiple logistic regression. RESULTS: It was found that long working hours associated with high risk for depression in the group with the highest income, but not in the group with the lowest income. CONCLUSIONS: The relationship between long working hours and the risk of depression varied by household income level.

Differential impact of working hours on unmet medical needs by income level: a longitudinal study of Korean workers.

OBJECTIVES: Unmet medical need is defined as the perceived need for medical service that is not received. Although the association between unmet medical needs and working hours has been explored before, the combined effect of household income has not been investigated thus far. This study, therefore, aimed to examine the differential association between working hours and the risk of unmet medical needs according to household income. METHODS: A total of 7047 participants enrolled in the Korea Health Panel data 2011-2014 were considered. The analytical method used in this study was a generalized estimating equation model that accounted for repeated measured participants. By controlling for time-invariant individual-fixed effects, we identified the relationship between long working hours and the risk of unmet medical needs. RESULTS: The association between long working hours and the risk of unmet medical needs differed according to household income. In the highest quintile of household income, the risk of unmet medical needs was 1.58-fold higher among those who worked >52 hours per week than among those who worked 30-52 hours per week. However, this association was not significant in the lowest quintile group. CONCLUSIONS: The current study implies that financial hardship might be a more fundamental health hazard than working longer hours among the low-income group. Future policies should consider not only limiting working hours but also compensating workers' income to adequately protect low-income workers from the health risks associated with long working hours.

The relationship between working hours and lifestyle behaviors: Evidence from a population-based panel study in Korea.

OBJECTIVES: This study aimed to investigate the relationship between working hours and lifestyle behaviors using data from a large nationally representative panel survey. METHODS: We used the Korea Health Panel Study (KHPS) data from 2011 to 2014. Weekly working hours and lifestyle risk factors were assessed by questionnaires. Comparing to the reference group, the weekly working hours were 40 h per week, odds ratios and 95% confidence intervals for smoking status, alcohol consumption status, and regular exercise status of other weekly working hours groups (<40, 40, 41-52, and >52) were calculated, using generalized estimating equation models considering repeated measures. RESULTS: Our findings clearly showed a relationship between long working hours and unhealthy lifestyles, such as cigarette smoking, alcohol consumption, physical inactivity, and insufficient sleep. Additionally, weekly working hours are positively associated with the amount of smoking and drinking, and inversely associated with sleep duration among those who worked 40 h or more per week. CONCLUSION: Long working hours are associated with unhealthy lifestyles, such as cigarette smoking, alcohol consumption, physical inactivity, and insufficient sleep.

Interaction between occupational physical burdens and low job control on musculoskeletal pain: Analysis of the 5th Korean Working Environment Survey.

OBJECTIVE: This study aimed to investigate the interactive impacts between occupational physical burdens and psychological job demand or control on musculoskeletal pain (MSP) using nationally representative data for Korean workers. METHODS: Using 5th Korean Working Conditions Survey (KWCS), we explored the interaction between occupational physical burdens and levels of psychological job demand or control on risk of MSP in 49 572 eligible participants. For quantitative evaluation of the interaction, relative excess risk due to interaction (RERI) was calculated. RESULTS: In a group with low job control and at least one occupational physical burden, odds ratio (OR) for neck and upper extremity pain was 2.44 (95% CI, 2.24-2.66) compared with a group with high job control and no physical burden (a reference group: lowest risk), which was the highest value among the four groups, and the RERI was 0.35 (95% CI, 0.19-0.51). Similarly, OR for lower extremity pain was 2.15 (95% CI, 1.95-2.37) and RERI was 0.26 (95% CI, 0.07-0.45). However, the RERI was not significant in the case of psychological job demand. CONCLUSION: This study revealed significant interactions between occupational physical burdens and low job control on MSP.

A Longitudinal Study of the Relationship between Shift Work and Prostate-Specific Antigen in Healthy Male Workers.

As shift work has become prevalent globally, it is important to evaluate the health effects of shift work on employees. Several studies have demonstrated a positive association between shift work and prostate cancer. Therefore, we aimed to further examine the relationship between shift work and elevated prostate-specific antigen (PSA). Our study collected data from 66,817 male participants at baseline and followed up for about 6 years. We categorized shift worker status and shift schedule types. To evaluate the risk of elevated PSA on shift workers, we estimated hazard ratios using the Cox proportional hazards regression analyses. During a median follow-up of 4.1 years, 1030 participants developed elevated PSA. The multivariable-adjusted hazard ratio (HR) of elevated PSA for shift workers compared with daytime workers was 1.37 (1.04-1.80). Among shift workers, rotating shift workers (HR = 1.47, 95% CI 1.06-2.03) showed a significantly increased risk of elevated PSA compared with daytime workers. Our longitudinal study provides evidence for an association between shift work, especially rotating shift work, and elevations of PSA.