The range of diseases covered by workers' compensation is constantly expanding. However, new regulations are required for the recognition of occupational diseases (ODs) because OD types evolve with changes in industrial structures and working conditions. OD criteria are usually based on medical relevance, but they vary depending on the social security system and laws of each country. In addition, the proposed range and extent of work-relatedness vary depending on the socio-economic conditions of each country. The Labor Standards Act (LSA) and the Industrial Accident Compensation Insurance Act (IACIA) of Korea employ lists based on their requirements without listing causes and diseases separately. Despite a considerable reshuffle in 2003, the basic framework has been maintained for 50 yr, and many cases do not fit into the international disease classification system. Since July 1, 2013, Korea has expanded the range of occupational accidents to include occupational cancers and has implemented revised LSA and IACIA enforcement decrees. There have been improvements to OD recognition standards with the inclusion of additional or modified criteria, a revised and improved classification scheme for risk factors and ODs, and so on.
Accidents, Occupational/*classification/*economics ; Humans ; Insurance, Accident/economics ; Insurance, Health/economics ; Neoplasms/chemically induced ; Occupational Diseases/*classification/*economics/mortality ; Occupational Exposure/adverse effects ; Occupational Health ; Republic of Korea ; Risk Factors ; Workers' Compensation/*economics/legislation & jurisprudence/standards

OBJECTIVES: To investigate the mental health status of security firm workers focusing on job stress, depressive symptoms, and overall psychosocial stress and to determine the relationship between depressive symptoms and the level of distress with changes in labor conditions and intensity. METHODS: Using a cross-sectional design, a formal survey including basic sociodemographic factors, job-related characteristics, job stress, psychosocial stress, depressive symptoms, and changes in labor conditions and intensity was conducted on workers employed in nine security firms. A total of 1,313 workers replied to the survey. We estimated the relationship between psychosocial stress and depressive symptoms with job stress, and changes in labor conditions and intensity by multivariate logisitic regression analysis. RESULTS: Severe and intermediate level of depressive symptoms occurred in 18.5% (209) of the workers, and the high risk psychosocial distress groups accounted for 44.2% or the workers. Based on multivariate analysis, the Borg scale (OR=2.43 95%, CI=1.72-3.45), relative labor intensity (OR=1.05, 95% CI=1.00-1.09), high job demand (OR=1.47, 95% CI=1.06-2.06) were significantly associated with depressive symptoms. For psychosocial stress, the Borg scale (OR=2.39, 95% CI=1.84-3.10), relative labor intensity (OR=1.06, 95% CI=1.02-1.09), low job control (OR=1.80, 95%CI=1.38-2.35), and high job instability (OR=1.53, 95%CI=1.02-2.29) were significantly associated with high risk groups. CONCLUSIONS: This study showed that a large proportion of security firm workers encountered depressive symptoms and psychosocial stress. Also, labor intensity and changes in labor condition (relative work intensity) were influential factors for depressive symptoms and psychosocial stress. Therefore, we conclude that not only an intervention for job stress should be offered, but also a policy toward the systemic problem of labor intensification should be considered.
Depression ; Mental Health ; Multivariate Analysis

The prevalence of nonalcoholic fatty liver disease (NAFLD) has increased with the incidence of obesity; however, the underlying mechanisms are unknown. In this study, high-resolution metabolomics (HRM) along with transcriptomics were applied on animal models to draw a mechanistic insight of NAFLD. Wild type (WT) and catalase knockout (CKO) mice were fed with normal fat diet (NFD) or high fat diet (HFD) to identify the changes in metabolic and transcriptomic profiles caused by catalase gene deletion in correspondence with HFD. Integrated omics analysis revealed that cholic acid and 3β, 7α-dihydroxy-5-cholestenoate along with cyp7b1 gene involved in primary bile acid biosynthesis were strongly affected by HFD. The analysis also showed that CKO significantly changed all-trans-5,6-epoxy-retinoic acid or all-trans-4-hydroxy-retinoic acid and all-trans-4-oxo-retinoic acid along with cyp3a41b gene in retinol metabolism, and α/γ-linolenic acid, eicosapentaenoic acid and thromboxane A2 along with ptgs1 and tbxas1 genes in linolenic acid metabolism. Our results suggest that dysregulated primary bile acid biosynthesis may contribute to liver steatohepatitis, while up-regulated retinol metabolism and linolenic acid metabolism may have contributed to oxidative stress and inflammatory phenomena in our NAFLD model created using CKO mice fed with HFD.

Background/Aims: The aim of this study was to investigate incidence, survival, and risk factors of cancer in end-stage renal disease (ESRD) patients with hemodialysis using information from the National Health Information Database (NHID). Methods: Using the NHID, we identified ESRD patients who started maintenance hemodialysis between 2003 and 2005 in Korea. Patients were followed from initiation of hemodialysis to renal transplantation, death, or December 31, 2016, whichever came first. We calculated the incidence, survival, and risk factors of cancer. Results: Of the total 14,382 ESRD patients, 1,124 (7.82%; men:women, 728:396) werediagnosed with cancer during follow-up. The mean duration from the start of hemodialysis to new cancer identification was 64.40 ± 41.81 months. Significant risk factors for the development of new cancer were old age, male sex, and liver disease. Conversely, patients with diabetes showed low risk for new cancer. The colorectum (17.31%) was the most common primary site of cancer in men, followed by the liver (15.8%), stomach (14.29%), lung (13.6%), and kidney (10.3%). In women, the colorectum (14.65%) was also the most common primary site of cancer, followed by the breast (12.88%), thyroid (12.63%), stomach (10.86%), and lung (8.08%). According to the primary site of cancer, breast cancer showed the longest median survival duration (130.93 months), followed by thyroid, kidney, colorectum, bladder,stomach, liver, and lung cancer. On multivariate analyses, overall survival was affected by age and diabetes. Conclusions The cancer incidence of chronic hemodialysis patients was relatively high. Thus, careful monitoring and a specific cancer screening program are needed for chronic hemodialysis patients.

Purpose: A suboptimal nutritional status is often observed among hospitalized patients across all medical/surgical specialties. The objective of the present study was to (1) analyze the prevalence of malnutrition in severe trauma patients and (2) evaluate the relationship between malnutrition and select clinical outcomes. Materials and Methods: This retrospective study was conducted between October 2015 and March 2017 at the Pusan National University Hospital Trauma Center. Of a total of 3,560 patients, 945 were enrolled in this study. Patients were checked for malnutrition using a nutrition assessment tool by the hospital nutrition support team. The parameters assessed included serum albumin, the ratio of actual body weight to ideal body weight (%), total lymphocyte count, appetite, and gastrointestinal problems. Clinical outcomes under consideration included 1) mortality, 2) length of hospitalization, and 3) length of stay in the intensive care unit (ICU). Results: The total prevalence of malnutrition in hospitalized trauma patients was 55.0% (n=520). Malnutrition risk was the independent prognostic factor of mortality in severe trauma patients (adjusted odds ratio [OR]=3.440;95% confidence interval [CI]=1.401~8.447, P=0.007). Risk factors of malnutrition were age over 65 years (adjusted OR=2.393; 95% CI=1.699~3.370, P<0.001), injury severity score (adjusted OR=1.034, 95% CI=1.012~1.056, P=0.002), length of hospitalization (adjusted OR=1.104; 95% CI=1.007~1.020, P<0.001), and length of stay in the ICU (adjusted OR=1.050; 95% CI=1.029~1.072, P<0.001). Conclusion Malnutrition is widespread in hospitalized patients with severe trauma and results in suboptimal clinical outcomes. Thus, patients at high risk of malnutrition should be monitored carefully during hospitalization.

The orbitofrontal cortex (OFC) plays a crucial role in mood disorders; however, its specific role in the emotional behaviors of mice remains unclear.This study investigates the bidirectional control of emotional behaviors using population calcium dynamics and optogenetic manipulation of OFC neurons. Fiber photometry of OFC neurons revealed that OFC excitatory neurons consistently responded to the onset and offset of aversive conditions, showing decreased activation in response to anxiogenic and stressful stimuli, including tail suspension, restraint stress, and exposure to the center of the open field. The selective activation of excitatory neurons in the OFC reduced the time spent in the center of the open field, whereas optogenetic activation of inhibitory neurons in the OFC induced the opposite behavioral changes. We also provided a brain-wide activation map for OFC excitatory and inhibitory neuron activation. Our findings demonstrate that excitatory and inhibitory neurons in the OFC play opposing roles in the regulation of emotional behaviors. These results provide new insights into the neural mechanisms underlying emotional control and suggest that targeting these specific neuronal populations may offer novel therapeutic strategies for emotional disorders.

The Korean Workers’ Compensation-National Health Insurance Service (KoWorC-NHIS) cohort was established to investigate the longitudinal health outcomes of Korean workers who have been compensated for occupational injuries or diseases. This cohort study, which utilized data spanning from 2004 to 2015, merged workers’ compensation insurance claim data with the National Health Insurance Database (NHID), encompassing 858,793 participants. The data included socio-demographic factors such as age, sex, income, address, insurance type, and disability grade. It also covered the types of occupational accidents, International Classification of Diseases, 10th revision codes for diseases or accidents, work tenure, industry, occupation code, and company size. Additional details such as the occupational hire date, date of claim, date of recognition, and affected body parts were recorded. The cohort predominantly consisted of male workers (80.0%), with the majority experiencing their first occupational accident in their 40s (27.6%) or 50s (25.3%). Notably, 93.1% of the cases were classified as occupational injuries. By integrating this data with that from the NHID, updates on health utilization, employment status, and income changes were made annually. The follow-up period for this study is set to conclude in 2045.

The Korean Workers’ Compensation-National Health Insurance Service (KoWorC-NHIS) cohort was established to investigate the longitudinal health outcomes of Korean workers who have been compensated for occupational injuries or diseases. This cohort study, which utilized data spanning from 2004 to 2015, merged workers’ compensation insurance claim data with the National Health Insurance Database (NHID), encompassing 858,793 participants. The data included socio-demographic factors such as age, sex, income, address, insurance type, and disability grade. It also covered the types of occupational accidents, International Classification of Diseases, 10th revision codes for diseases or accidents, work tenure, industry, occupation code, and company size. Additional details such as the occupational hire date, date of claim, date of recognition, and affected body parts were recorded. The cohort predominantly consisted of male workers (80.0%), with the majority experiencing their first occupational accident in their 40s (27.6%) or 50s (25.3%). Notably, 93.1% of the cases were classified as occupational injuries. By integrating this data with that from the NHID, updates on health utilization, employment status, and income changes were made annually. The follow-up period for this study is set to conclude in 2045.

The orbitofrontal cortex (OFC) plays a crucial role in mood disorders; however, its specific role in the emotional behaviors of mice remains unclear.This study investigates the bidirectional control of emotional behaviors using population calcium dynamics and optogenetic manipulation of OFC neurons. Fiber photometry of OFC neurons revealed that OFC excitatory neurons consistently responded to the onset and offset of aversive conditions, showing decreased activation in response to anxiogenic and stressful stimuli, including tail suspension, restraint stress, and exposure to the center of the open field. The selective activation of excitatory neurons in the OFC reduced the time spent in the center of the open field, whereas optogenetic activation of inhibitory neurons in the OFC induced the opposite behavioral changes. We also provided a brain-wide activation map for OFC excitatory and inhibitory neuron activation. Our findings demonstrate that excitatory and inhibitory neurons in the OFC play opposing roles in the regulation of emotional behaviors. These results provide new insights into the neural mechanisms underlying emotional control and suggest that targeting these specific neuronal populations may offer novel therapeutic strategies for emotional disorders.

The Korean Workers’ Compensation-National Health Insurance Service (KoWorC-NHIS) cohort was established to investigate the longitudinal health outcomes of Korean workers who have been compensated for occupational injuries or diseases. This cohort study, which utilized data spanning from 2004 to 2015, merged workers’ compensation insurance claim data with the National Health Insurance Database (NHID), encompassing 858,793 participants. The data included socio-demographic factors such as age, sex, income, address, insurance type, and disability grade. It also covered the types of occupational accidents, International Classification of Diseases, 10th revision codes for diseases or accidents, work tenure, industry, occupation code, and company size. Additional details such as the occupational hire date, date of claim, date of recognition, and affected body parts were recorded. The cohort predominantly consisted of male workers (80.0%), with the majority experiencing their first occupational accident in their 40s (27.6%) or 50s (25.3%). Notably, 93.1% of the cases were classified as occupational injuries. By integrating this data with that from the NHID, updates on health utilization, employment status, and income changes were made annually. The follow-up period for this study is set to conclude in 2045.