Recognition criteria for occupational cancers in relation to hepatitis B virus and hepatitis C virus in Korea.

The goal of this study was to review the scientific basis for the recognition of occupational cancer, in relation to hepatitis viral infections in Korea. Most Hepatitis B virus (HBV) infections in Korea occur as vertical infections, but these are decreasing rapidly due to vaccination. Hepatitis C virus (HCV) is known to be transmitted through parenteral routes, but the transmission route is often unclear. Most occupational infections of hepatitis virus involve accidental injuries of medical institution workers while using virus-contaminated medical devices. Many cohort studies and case-control studies have consistently reported that HBV and HCV infection increases the risk of hepatocellular carcinoma (HCC) and the strength of this association is high. Non-Hodgkin's lymphoma appears to be associated with HCV. Cholangiocarcinoma, pancreatic cancer, leukemia, and thyroid cancer are considered to be less related or unrelated to epidemiological causation. There are no uniform international specific criteria for occupational cancer caused through occupational exposure to a hepatitis virus. In establishing appropriate standards applicable to Korea, there should be sufficient consideration of latency, virus exposure levels and frequency, and other cancers, apart from HCC. In conclusion, we recommend keeping the current specific criteria. However, if a worker is injured at work when using a sharp medical device, and HBV and HCV viral infections are confirmed through serologic tests; if the worker is diagnosed as having a chronic HBV or HCV infection, a subsequent HCC (or Non-Hodgkin's lymphoma following chronic HCV infection) can then be considered highly related to the worker's occupation.

The effect of long working hours on cerebrovascular and cardiovascular disease; A case-crossover study.

BACKGROUND: This study investigated the relationship between weekly working hours and the occurrence of cerebro-cardiovascular diseases using a case-crossover study design. METHODS: We investigated average working hours during the 7 days before the onset of illness (hazard period) and average weekly working hours between 8 days and 3 months before the onset of cerebro-cardiovascular diseases (control period) for 1,042 cases from the workers' compensation database for 2009. RESULTS: Among all subjects, the odds ratio by conditional logistic regression for the risk of cerebro-cardiovascular diseases with a 10 hr increase in average weekly working hours was 1.45 (95% confidence interval [CI]: 1.22-1.72), a significant association. CONCLUSIONS: An increase in average weekly working hours may trigger the onset of cerebro-cardiovascular disease. Am. J. Ind. Med. 60:753-761, 2017. © 2017. Wiley Periodicals, Inc.

The work-relatedness at a case of acute lymphoblastic leukemia in a radiation oncologist.

BACKGROUND: Clinicians who perform radiation therapy (RT) are exposed to radiation, which may negatively affect their health. The present study reports a case of acute lymphoblastic leukemia in a healthcare provider who was exposed to radiation at work; we also present a literature review of this topic. CASE PRESENTATION: A 45-year-old patient, who had been a radiation oncologist and had been exposed to radiation while performing brachytherapy 10 years ago, complained of chest pain and was suspected of having leukemia based on the results of a blood test in an outpatient clinic. He was diagnosed with acute lymphoblastic leukemia, and subsequently underwent chemotherapy. However, the case died during treatment. Through epidemiological investigation, it was found that the case's cumulative exposure dose based on personal exposure and spatial dose measured during the work period was in the range of 6.08-12.15 mSv. CONCLUSIONS: Based on the following considerations, acute lymphoblastic leukemia was highly correlated with the level of radiation to which the case was exposed while performing brachytherapy on patients with cancer. Firstly, the latent period of acute lymphoblastic leukemia in the case closely matched the latency time reported in previous published studies (5-10 years). In addition, numerous studies have reported significantly higher relative risks of cancer among clinicians who perform RT compared with the general population. The case was also atypically exposed to radiation through his hands, despite wearing protective equipment. Lastly, the case's coworkers were also found to have been exposed to high levels of radiation. Investigation into the influence of radiation exposure through atypical routes during RT on the health of clinicians is recommended.

The effect of aircraft noise on sleep disturbance among the residents near a civilian airport: a cross-sectional study.

BACKGROUND: Aircraft noise is a major environmental noise problem. This study was conducted in order to investigate the relationship between sleep disturbance and exposure to aircraft noise on the residents who are living near an airport. METHODS: There were 3308 residents (1403 in the high exposure group, 1428 in the low exposure group, and 477 in the non-exposure group) selected as the subjects for this study. The Insomnia severity Index (ISI) and Epworth Sleepiness Scale (ESS) questionnaires were used to evaluate sleep disturbance. RESULTS: The mean ISI and ESS scores were 6.9 ± 6.4 and 5.5 ± 3.7, respectively, and the average scores were significantly greater in the aircraft noise exposure group, as compared to the non-exposure group. The percentage of the abnormal subjects, which were classified according to the results of the ISI and ESS, was also significantly greater in the noise exposure group, as compared to the control group. The odd ratios for insomnia and daytime hypersomnia were approximately 3 times higher in the noise exposure group, as compared to the control group. CONCLUSIONS: The prevalence of insomnia and daytime hypersomnia was higher in the aircraft noise exposure group, as compared to the control group. Further study is deemed necessary in order to clarify the causal relationship.

Effect of daily chlorhexidine bathing on the acquisition of methicillin-resistant Staphylococcus aureus in a medical intensive care unit with methicillin-resistant S aureus endemicity.

BACKGROUND: Universal decolonization is recommended in intensive care units (ICUs) that have unacceptably high rates of methicillin-resistant Staphylococcus aureus (MRSA) despite implementation of basic prevention strategies. METHODS: An interrupted time series study was performed to evaluate the effect of daily chlorhexidine bathing on the acquisition of MRSA in a medical ICU with MRSA endemicity. There was a 14-month control period and a 16-month chlorhexidine bathing period. Segmented Poisson regression analysis was performed to assess the impact of daily chlorhexidine bathing on the incidence density of MRSA. Also, chlorhexidine susceptibility testing with polymerase chain reaction for the qacA/B gene was performed on MRSA isolates collected during the chlorhexidine bathing period. RESULTS: There was a significant reduction in trend (-0.056; 95% confidence interval, -0.095 to -0.017; P = .005) of incidence density of MRSA despite a significant increase in both level and trend of MRSA prevalence rates during the chlorhexidine bathing period. However, there was no significant reduction in level of incidence density of MRSA during the interventional period. Minimum inhibitory concentration of chlorhexidine and the detection rates of the qacA/B gene for a total of 174 MRSA isolates did not increase during the chlorhexidine bathing period. CONCLUSIONS: Daily chlorhexidine bathing resulted in a significantly decreasing trend of MRSA acquisition rates irrespective of increased MRSA prevalence rates in the medical ICU. There was no shift of chlorhexidine-resistant MRSA strains.

Mortality rates by occupation in Korea: a nationwide, 13-year follow-up study.

OBJECTIVE: The present study sought to identify inequalities in cause-specific mortality across different occupational groups in Korea. METHODS: The cohort included Korean workers enrolled in the national employment insurance programme between 1995 and 2000. Mortality was determined by matching death between 1995 and 2009 according to a nationwide registry of the Korea National Statistical Office. The cohort was divided into nine occupational groups according to the Korean Standard Occupational Classification (KSOC). Age-standardised mortality rates of each subcohort were calculated. RESULTS: The highest age-standardised mortality rate was identified in KSOC 6 (agricultural, forestry and fishery workers; male (M): 563.0 per 100 000, female (F): 206.0 per 100 000), followed by KSOC 9 (elementary occupations; M: 499.0, F: 163.4) and KSOC 8 (plant, machine operators and assemblers; M: 380.3, F: 157.8). The lowest rate occurred in KSOC 2 (professionals and related workers; M: 209.1, F: 93.3). Differences in mortality rates between KSOC 2 and KSOC 9 (M: 289.9, F: 70.1) and the rate ratio of KSCO9 to KSCO2 (M: 2.39, F: 1.75) were higher in men. The most prominent mortality rate difference was observed in external causes of death (M: 96.9, F: 21.6) and liver disease in men (38.3 per 100 000). Mental disease showed the highest rate ratio (M: 6.31, F: 13.00). CONCLUSIONS: Substantial differences in mortality rates by occupation were identified. Main causes of death were injury, suicide and male liver disease. Development of policies to support occupations linked with a lower socioeconomic position should be prioritised.

Migraine and restless legs syndrome are associated in adults under age fifty but not in adults over fifty: a population-based study.

BACKGROUND: Recent studies have shown an association between migraine and restless legs syndrome (RLS). However, migraine prevalence peaks from the 20s to 40s whereas RLS prevalence peaks after the 50s. Despite this, reports on how migraine and RLS may be associated by age is limited. Therefore, the purpose of this study is to investigate the comorbidity between migraine and RLS according to age. METHODS: We selected a stratified random population sample of Koreans aged 19 to 69 years and evaluated them with a 60-item semi-structured interview designed to identify RLS, headache type, and clinical characteristics of migraine. To assess the association between migraine and RLS according to age, we divided participants into 5 age groups (19-29, 30-39, 40-49, 50-59, and 60-69 years) and analysed each group. RESULTS: Subjects with migraine showed an increased RLS prevalence in the 19-29 (Odds ratio [OR] = 6.6, 95 % confidence interval [CI] = 1.2-36.8) and 40-49 (OR = 6.7, 95 % CI = 1.5-33.5) age groups compared to non-headache controls but failed to showed a significant association in the 50-59 (OR = 1.1, 95 % CI = 0.2-5.6) and 60-69 (OR = 0.4, 95 % CI = 0.1-4.0) age groups. Migraineurs with 1-10 (12.5 %, OR = 2.0, 95 % CI = 1.3-3.2, p = 0.003) and >10 (12.5 %, OR = 2.5, 95 % CI = 1.0-5.6, p = 0.038) attacks per month showed an increased RLS prevalence compared to migraineurs with <1 attack per month (2.1 %). Subjects with non-migraine headaches showed an increased odds for RLS (OR = 1.8, 95 % CI = 1.3-2.7) compared to non-headache controls. There was no significant difference (9.1 % vs. 6.9 %, p = 0.339) in the RLS prevalence between migraineurs and non-migraine headache subjects. CONCLUSIONS: Our results suggest that migraine and RLS are differently associated according to age.

Effect of daily chlorhexidine bathing on acquisition of carbapenem-resistant Acinetobacter baumannii (CRAB) in the medical intensive care unit with CRAB endemicity.

BACKGROUND: There is insufficient evidence for daily chlorhexidine bathing to reduce nosocomial spread of carbapenem-resistant Acinetobacter baumannii (CRAB) in endemic situations. METHODS: An interrupted time series study was performed to evaluate the effect of daily chlorhexidine bathing on the acquisition of CRAB in a medical intensive care unit (ICU) with CRAB endemicity. There was a 14-month control period and 12-month chlorhexidine bathing period. Segmented Poisson regression analysis was performed to assess the impact of chlorhexidine bathing on the level and trend of the series of prevalence rates and incidence density. Also, chlorhexidine susceptibility testing was performed on CRAB isolates collected during the chlorhexidine bathing period. RESULTS: There was a 51.8% reduction of CRAB acquisition rates after an introduction of daily chlorhexidine bathing (44.0 vs 21.2 cases/1,000 at-risk patient days, P < .001). There was a significant reduction in the level (-0.604; 95% CI, -0.904 to -0.305; P < .001) of incidence density of CRAB, whereas there was no significant change in both level and trend of CRAB prevalence rates. Minimum inhibitory concentration of chlorhexidine against a total of 98 CRAB isolates ranged from 8-64 µg/mL. CONCLUSION: Daily chlorhexidine bathing significantly reduces the acquisition of CRAB in a medical ICU with CRAB endemicity.

Factors associated with disability and impact of tension-type headache: findings of the Korean headache survey.

BACKGROUND: Although mostly mild in symptom severity, tension-type headache (TTH) can cause disability. However, factors associated with disability of TTH have been rarely reported. This study sought to assess the factors associated with TTH-related disability and impact. METHODS: We analyzed data form the Korean Headache Survey, a nation-wide survey regarding headache in all Korean adults aged 19-69 years. TTH-related disability was measured by surveying actual disability and Headache Impact Test-6 (HIT-6). Actual disability was defined as having one or more days of activity restriction or missed activity due to headache in the last 3 months. The HIT-6 score ≥ 50 was regarded as significant headache impact associated with TTH. We assessed factors associated with TTH-related disability and impact using logistic regression analyses adjusting for sociodemographic variables and headache characteristics. RESULTS: Among 1507 individuals, the 1-year prevalence rate of TTH was 30.7% (n = 463), of which 4.8% reported actual disability and 21.3% had headache impact, respectively. In univariate analyses, sociodemographic variables were not associated with actual disability and headache impact, respectively. There were relationships between several headache characteristics and actual disability/headache impact. After adjustment of potential confounders, moderate headache intensity was correlated with actual disability (odds ratio [OR]: 4.41, 95% confidence interval [CI]: 1.46-13.27), while an inverse association was observed between no aggravation by routine activity and actual disability (OR: 0.32, 95% CI: 0.12-0.88). Multivariate analyses showed that ORs for headache impact were increased in those with higher headache frequency (OR: 2.54, 95% CI: 1.47-4.39 for 1-14 days/month; OR: 23.83, 95% CI: 5.46-104.03 for ≥ 15 days/month), longer headache time duration (OR: 1.84, 95% CI: 1.04-3.25 for ≥ 1 and < 4 hours; OR: 2.44 95% CI: 1.17-5.11 for ≥ 4 hours), and phonophobia (OR: 1.73, 95% CI: 1.02-2.95), whereas decreased in those with no aggravation by routine activity (OR: 0.32, 95% CI: 0.12-0.88). CONCLUSIONS: Several headache characteristics were associated with actual disability and headache impact among TTH individuals. Our findings suggest that there needs to be consideration careful of troublesome headache characteristics for TTH individuals suffering from disability and impact.

Carbon monoxide poisoning-induced cardiomyopathy from charcoal at a barbecue restaurant: a case report.

OBJECTIVE: Acute carbon monoxide poisoning has important clinical value because it can cause severe adverse cardiovascular effects and sudden death. Acute carbon monoxide poisoning due to charcoal is well reported worldwide, and increased use of charcoal in the restaurant industry raises concern for an increase in occupational health problems. We present a case of carbon monoxide poisoning induced cardiomyopathy in a 47-year-old restaurant worker. MATERIALS AND METHODS: A male patient was brought to the emergency department to syncope and complained of left chest pain. Cardiac angiography and electrocardiography were performed to rule out acute ischemic heart disease, and cardiac markers were checked. After relief of the symptoms and stabilization of the cardiac markers, the patient was discharged without any complications. RESULTS: Electrocardiography was normal, but cardiac angiography showed up to a 40% midsegmental stenosis of the right coronary artery with thrombotic plaque. The level of cardiac markers was elevated at least 5 to 10 times higher than the normal value, and the carboxyhemoglobin concentration was 35% measured at one hour after syncope. Following the diagnosis of acute carbon monoxide poisoning induced cardiomyopathy, the patient's medical history and work exposure history were examined. He was found to have been exposed to burning charcoal constantly during his work hours. CONCLUSIONS: Severe exposure to carbon monoxide was evident in the patient because of high carboxyhemoglobin concentration and highly elevated cardiac enzymes. We concluded that this exposure led to subsequent cardiac injury. He was diagnosed with acute carbon monoxide poisoning-induced cardiomyopathy due to an unsafe working environment. According to the results, the risk of exposure to noxious chemicals such as carbon monoxide by workers in the food service industry is potentially high, and workers in this sector should be educated and monitored by the occupational health service to prevent adverse effects.

The effect of organisational system on self-rated depression in a panel of male municipal firefighters.

OBJECTIVES: The present study evaluated the effects of job stress, including organisational system to self-rated depression through a panel study of male municipal firefighters in the Republic of Korea. METHODS: A panel of 186 municipal firefighters reported self-rated depressive symptoms according to the Beck Depression Inventory (BDI). The effects of job stress were evaluated using the Korea Occupational Stress Scale, taken one year earlier and classified by the median value. Panel members were classified into Depression or Control groups according to BDI scores, with a cut-off level of 'over mild depression' in a follow-up survey. RESULTS: The Depression group included 17 (9.1%) workers. Firefighters who scored high on occupational system had an 8.3 times greater risk of being assigned to the Depression group than those who had not (adjusted odds ratio [OR] = 8.03, 95% confidence interval (CI) = [1.73-37.22]). In contrast, job stress from a 'difficult physical environment' revealed negative risks related to being classified in the Depression group (AOR = 0.20, 95% CI = [0.04-0.92]). CONCLUSIONS: Although the healthy worker effect may be involved, job stress based on perceptions of organisational system was a strong risk factor for depression. A comprehensive approach should be considered that encompasses social issues when assessing or mental health in high-risk groups, as well as the practical issue of physiochemical hazards.

Combination of anxiety and depression is associated with an increased headache frequency in migraineurs: a population-based study.

BACKGROUND: Although anxiety and depression have been classified as distinct traits of affective disorders, previous studies have reported their co-occurrence in subjects with migraine. However, few reports are available on the clinical implications of this comorbidity. This study is to assess the comorbidity of anxiety and depression in subjects with migraine and its clinical implications in a population-based sample from Korea. METHODS: We selected Korean subjects aged 19-69 years by the stratified random sampling method, and evaluated them using a semi-structured interview, designed to identify headache type, anxiety, and depression. We used Goldberg Anxiety Scale questions and Patient Health Questionnnaire-9 for the diagnosis of anxiety and depression, respectively. RESULTS: Of the 2,762 participants who completed the interview, 147 subjects (5.4%) were classified as having a migraine during the previous year. Among these 147 subjects, 17 (11.6%) had anxiety and depression, 28 (19.0%) had anxiety alone, 9 (6.1%) had depression alone, and 93 (63.3%) had neither anxiety nor depression. Headache frequency per month was remarkably higher in subjects having migraine with anxiety and depression (median [25-75 percentile values], 8.0 [2.5-21.0]) than in those having migraine with anxiety alone (2.0 [1.0-5.0], p = 0.003), migraine with depression alone (1.0 [0.3-4.0], p = 0.001), and migraine without anxiety or depression (1.0 [0.3-3.0], p < 0.001). The migraine with anxiety alone (7.0 [6.0-8.0], p = 0.011) group and migraine with anxiety and depression (7.0 [5.0-9.0], p = 0.018) group showed higher Visual Analogue Scale scores for pain intensity compare to migraine without anxiety or depression (6.0 [5.0-7.0]) group. CONCLUSIONS: Approximately 1/3 of migraineurs with anxiety had depression and 2/3 of migraineurs with depression had anxiety. Combination of anxiety and depression was associated with an increased headache frequency. Anxiety was associated with exacerbation of headache intensity.

Long working hours and work-related cerebro-cardiovascular disease in Korea.

The aim of the present study was to determine a good discriminatory cutoff for long working hours as a surrogate of chronic overload at work, which is associated with the approval of workers' compensation claims for work-related cerebro-cardiovascular disease (WR-CVD) in Korea. We evaluated weekly working hours for four weeks prior to the onset of disease for all manufacturing industry claimants (N=319) of WR-CVD in 2010. The discrimination of long working hours in predicting approval of worker's compensation pertaining to WR-CVD was compared across cases. The cutoff was calculated with sensitivity, specificity, and the area under the curve with 95% CI using the receiver operating curve (ROC) method. The cutoff point was thus calculated to be 60.75 h (AUC=0.89, 95% CI [0.84-0.93]), showing a sensitivity value of 65% and specificity of 94%. This is the first study to report that long working hours could be a predictor with good discrimination and high specificity of approval of WR-CVD cases. In Korea, long working hours and widespread chronic overload at work are recognized as a social problem. Our study results suggest an appropriate cutoff for working hours as an indicator of chronic overload for the purpose of approving claims of WR-CVD. Furthermore, these results could contribute to improving the consistency of evaluation.

Prevalence, clinical characteristics and disability of migraine and probable migraine: a nationwide population-based survey in Korea.

BACKGROUND: Epidemiological data on probable migraine (PM) in Asia have rarely been reported. This study aimed to assess the prevalence, clinical characteristics, and disability of PM in comparison with strict migraine (SM) in Korea. METHODS: The Korean Headache Survey (KHS) is a nationwide interview survey that investigates the status of headache disorders among adults aged 19-69. We used data from the KHS. RESULTS: In a representative sample of 1507 individuals, the one-year prevalence of SM was 6.0%, and that of PM was 11.5%. Most PM sufferers missed the criterion of typical headache duration (82.0%). Multivariable regression analyses revealed that PM sufferers had an increased odds ratio (OR) for mild headache intensity (OR = 2.08; 95% confidence interval (CI): 1.11-3.90) and decreased ORs for living in a small city (OR = 0.50; 95% CI: 0.26-0.94), living in a rural area (OR = 0.36; 95% CI: 0.14-0.92) and headache frequency five to nine days per month (OR = 0.29; 95% CI: 0.11-0.78) compared to SM sufferers. Some SM and PM sufferers experienced decreased activity (26.4% in SM vs. 18.0% in PM) and missed activity (12.1% in SM vs. 14.4% in PM) due to headache. CONCLUSIONS: PM is a prevalent headache disorder in Korea. Some sociodemographic and clinical characteristics of PM are different from those of SM.

A case of hypersensitivity pneumonitis with giant cells in a female dental technician.

OBJECTIVES: Dental technicians are exposed to methyl methacrylate(MMA) and hard metal dusts while working, and several cases of hypersensitivity pneumonitis caused by the exposure have been reported. The authors experienced a case of hypersensitivity pneumonitis in a female dental technician who had 10 years' work experience and report the case with clinical evidence. METHOD: The patient's work, personal, social, and past and present medical histories were investigated based on patient questioning and medical records. Furthermore, the workplace conditions and tools and materials the patient worked with were also evaluated. Next, the pathophysiology and risk factors of pneumonitis were studied, and studies on the relationship between hypersensitivity pneumonitis and a dental technician's exposure to dust were reviewed. Any changes in the clinical course of her disease were noted for evaluation of the work-relatedness of the disease. RESULTS: The patient complained of cough and sputum for 1 year. In addition, while walking up the stairs, the patient was not able to ascend without resting due to dyspnea. She visited our emergency department due to epistaxis, and secondary hypertension was incidentally suspected. Laboratory tests including serologic, electrolyte, and endocrinologic tests and a simple chest radiograph showed no specific findings, but chest computed tomography revealed a centrilobular ground-glass pattern in both lung fields. A transbronchial biopsy was performed, and bronchoalveolar washing fluid was obtained. Among the findings of the laboratory tests, microcalcification, noncaseating granuloma containing foreign body-type giant cells, and metal particles within macrophages were identified histologically. Based on these results, hypersensitivity pneumonitis was diagnosed. The patient stopped working due to admission, and she completely quit her job within 2 months of restarting work due to reappearance of the symptoms. CONCLUSION: In this study, the patient did not have typical radiologic findings, but pathological evaluation of the lung biopsy from the bronchoscope led to the suspicion of pneumonitis. Under the microscope, the sample contained fibrotic changes in the lung, multinucleated giant cells, and particles in macrophages and was diagnosed as dental technician pneumoconiosis by the pathology. Working as a dental technician had directly exposed her to light metal dust and MMA, and her clinical symptoms and radiologic findings subsided after withdrawal from exposure to the workplace. These outcomes led to the diagnosis of hypersensitity pneumonitis due to MMA exposure and strong work-relatedness.

Anxiety, depression and quality of life in patients with irritable bowel syndrome.

BACKGROUND/AIMS: There have been few Asian studies regarding anxiety and depression associated with irritable bowel syndrome (IBS). The aim of this study was to evaluate the frequency and importance of anxiety and depression in Korean patients with IBS. METHODS: A total of 124 IBS patients and 91 healthy subjects were enrolled consecutively. All participants were asked to complete self-administered questionnaires: one addressing symptom severity, the Short Form 36, and the Hospital Anxiety and Depression Scale (HADS). The patients were also asked to complete the IBS-specifi c quality of life (IBS-QOL) questionnaire. RESULTS: Anxiety and depression were observed in 38.6% and 38.6% of IBS patients, respectively, and in 24.2% and 16.5% of healthy subjects, respectively (p<0.05 for both). The mean HADS scores for anxiety and depression in IBS patients were 6.8±4.5 and 7.1±4.4, respectively. Both anxiety and depression were associated with self-reported symptom severity (p<0.012 and p<0.001, respectively). As determined by multivariate analysis, symptom severity was the most important factor in the prediction of anxiety and depression. Self-reported symptom severity and depression were clearly and independently associated with the overall IBS-QOL score. CONCLUSIONS: Anxiety and depression were frequently observed in Korean IBS patients and were related to the severity of their symptoms and the impairment of the patient's QOL. Our data suggest that assessing anxiety and depression is important when evaluating IBS patients.

The Effects of Injury and Accidents on Self-rated Depression in Male Municipal Firefighters.

OBJECTIVES: The present study aims to determine the causal relationship between self-rated depression and experiences of injury and accidents in municipal firefighters. METHODS: A panel survey of 186 municipal firefighters measured with depressive symptoms according to the Beck's depression index (BDI) was conducted. The effects of job-related injuries and accidents were evaluated using self-administered questionnaires that were taken once in a 12-month period from 2005 to 2006. Firefighters were classified into the Depression Group or Control Group based on follow-up BDI results with a cutoff level that was set to having "over mild depression." RESULTS: The depression Group was comprised of 17 (9.1%) workers, including 9 firefighters who met had sufficient BDI scores twice in the 2-year test period and newly sufficient BDI scores in the follow-up test. A significantly higher number of subjects in the Depression Group experienced injuries and accidents in the 2-year test period as compared to the Control Group (15.4% vs. 1.5%, p=0.04). Firefighters who experienced injuries and accidents in the 2-year test period had a 7.4 times higher risk of being in the Depression Group than those who had not. As compared to accidents, near-miss accidents revealed stronger risks related to being classified as in the Depression group (adjusted odds ratio [OR] = 4.58, 95% confidence interval [CI] = 1.15-18.18 vs. Adjusted OR = 4.22, 95% CI = 1.08-16.58). CONCLUSION: The above results suggest that we should establish an effective program to promote mental health for groups at high risk for self-rated depression, including persons who have experienced consecutive injuries and accidents as well as near-miss injuries.

Occupational infection in Korea.

Occupational infection is a human disease caused by work-associated exposure to microbial agents through human and environmental contact. According to the literature, occupational infection was the third leading cause of occupational disease (861 cases, 8.0%), and health care, agricultural, forestry, and fishery workers were risk groups in Korea. In addition, most high-risk groups have not been protected by workers' compensation, which could lead to underestimation of the exact spectrum and magnitude of the problem, and may also result in a lack of development and implementation of occupational infection management. Through a review of national guidelines and documentations on prevention and control of occupational infection, a management strategy would promote adherence to worker safety regulations if it is explicit with regard to the agent and mode of infection in each of the high-risk groups.