This study examined the association between return-to-work and impairment type. Database of the Korea Workers' Compensation and Welfare Service was used to identify disabled persons; and return-to-work information was obtained from the Korea Employment Information Services database. The study participants were 79,328 persons who received Workers' compensation and who were confirmed as disabled during 2009-2011. Logistic regression was used to analyze the association between return-to-work and impairment type, adjusted by age, sex, impairment severity, pre-injury businesses size, and pre-injury occupational category. Compared to injuries of the upper limbs, the odds ratio of return-to-work was 0.63 (95% CI, 0.60-0.65) for injuries involving the lower limbs, 0.62 (95% CI, 0.59-0.66) for the spine, 0.75 (95% CI, 0.66-0.86) for the eyes, 0.98 (95% CI, 0.77-1.25) for the oral cavity, 0.44 (95% CI, 0.37-0.53) for the ears, 1.02 (95% CI, 0.83-1.25) for the figure, 0.75 (95% CI, 0.72-0.79) for pain, and 0.36 (95% CI, 0.32-0.41) for neuropsychiatric impairment. These findings indicate that impairment type influences return-to-work rates.
Adult ; Disability Evaluation ; Disabled Persons/*rehabilitation ; Employment ; Female ; Humans ; Male ; Middle Aged ; Occupational Injuries/*rehabilitation ; Occupations ; Rehabilitation, Vocational ; Republic of Korea ; Return to Work/*statistics & numerical data ; Workers' Compensation/statistics & numerical data

PURPOSE: Multiple chemical sensitivity (MCS) is a clinical syndrome representing multi-organ and psychological symptoms caused by chronic exposure to various chemicals in low concentrations. We evaluated the prevalence and related factors of MCS targeting Korean adults using the Quick Environmental Exposure and Sensitivity Inventory (QEESI(c)). METHODS: A total of 446 participants were recruited from Severance Hospital. Participants underwent a questionnaire interview including questions on sociodemographic factors, occupational and environmental factors, allergic diseases, and the QEESI(c). Among them, 379 participants completed the questionnaire and the QEESI(c). According to the QEESI(c) interpretation results, participants were divided into very suggestive (VS) group and less suggestive (LS) group. RESULTS: The estimated prevalence of MCS was higher in allergic patients than non-allergic participants (19.7% and 11.3%, respectively, P=0.04). In the multivariate logistic regression analysis, ages of 30-39 (OR, 2.94; 95% CI, 1.25-6.95) and those of 40-49 (OR, 2.51; 95% CI, 1.02-6.21) were significantly related to MCS compared to those aged less than 30 years. Female sex (OR, 2.16; 95% CI, 1.11-4.18), experience of dwelling in a new house (OR, 2.05; 95% CI, 1.04-4.03), and atopic dermatitis (OR, 1.95; 95% CI, 1.04-3.69) were also significantly related to MCS. However, only age of 30-39 in the allergic group was significant in the stratified analysis. CONCLUSIONS: The estimated prevalence of MCS was higher among allergic patients than non-allergic participants. People with experience of dwelling in a new house and atopic dermatitis were more at risk of being intolerant to chemicals. Further studies to provide the nationally representative prevalence data and clarify risk factors and mechanisms of MCS are required.
Adult* ; Dermatitis, Atopic ; Environmental Exposure ; Female ; Humans ; Logistic Models ; Multiple Chemical Sensitivity* ; Prevalence ; Risk Factors

BACKGROUND: Iron and steel foundry workers are exposed to various toxic and carcinogenic substances including crystalline silica, polycyclic aromatic hydrocarbons, and arsenic. Studies have been conducted on lung cancer in iron and steel founding workers and the concentration of crystalline silica in foundries; however, the concentration of crystalline silica and cases of lung cancer in a single foundry has never been reported in Korea. Therefore, the authors report two cases of lung cancer and concentration of crystalline silica by the X-ray diffraction method. CASE PRESENTATION: A 55-year-old blasting and grinding worker who worked in a foundry for 33 years was diagnosed with lung cancer. Another 64-year-old forklift driver who worked in foundries for 39 years was also diagnosed with lung cancer. Shot blast operatives were exposed to the highest level of respirable quartz (0.412 mg/m3), and a forklift driver was exposed to 0.223 mg/m3. CONCLUSIONS: The lung cancer of the two workers is very likely due to occupationally related exposure given their occupational history, the level of exposure to crystalline silica, and epidemiologic evidence. Further studies on the concentration of crystalline silica in foundries and techniques to reduce the crystalline silica concentration are required.
Arsenic ; Crystallins ; Humans ; Iron ; Korea ; Lung Neoplasms* ; Lung* ; Middle Aged ; Occupational Exposure ; Occupations ; Polycyclic Hydrocarbons, Aromatic ; Quartz ; Silicon Dioxide ; Steel ; X-Ray Diffraction

BACKGROUND: Despite the necessity of job retention in achieving return-to-work (RTW) goals, many workers leave their jobs after returning to work. The objective of this study was to examine the impacts of RTW type and period on job retention in Korean workers with occupational injuries and diseases. METHODS: Data were derived from the Panel Study of Worker's Compensation Insurance, including data from 2,000 systemically sampled workers who had finished recuperation in 2012; three waves of survey data were included in the analyses. Workers who returned to work (n = 1,610) were included in the analysis of the relationship between RTW type and job retention, and 664 workers who returned to their original workplaces were included in the analysis of the relationship between RTW period and job retention. The participants completed a questionnaire, and administrative data were provided by workers' compensation insurance. RESULTS: A Cox proportional-hazards regression analysis showed an increased hazard ratio (HR) for non-retention of 2.66 (95% confidence interval, 2.11–3.35) in reemployed workers compared to that in workers returning to their original workplaces. Among workers returning to their original workplaces, HRs for non-retention were increased in workers with a RTW period of 13–24 months (3.03 [1.52–6.04]) and > 24 months (5.33 [2.14–13.25]) compared to workers with a RTW period of ≤ 3 months. CONCLUSION: RTW type and period were significantly related to job retention, suggesting that policies for promoting job retention rate should be implemented.
Insurance ; Occupational Diseases ; Occupational Health ; Occupational Injuries ; Return to Work ; Workers' Compensation

Background: Change in working time arrangement (WTA) can be harmful to workers' sleep and health. This study aimed to investigate the association between change in working time arrangement and sleep disturbance. Methods: This study used data from the Fifth Korean Working Condition Survey and included 33,203 paid workers. We performed a stratified analysis by sex. After dividing the participants into 6 groups based on whether or not they experienced WTA changes, and their weekly working hours (≤40, 41–52, ≥53 hours), we calculated odds ratio (OR) using the weekly working hours ≤40 hours and with no WTA change as the reference group. Results: Of the 33,203 paid workers, participants who experienced change in working time arrangement had higher prevalence of all three types of sleep disturbance symptoms (difficulty in falling asleep, waking up repeatedly during sleep, and waking up with a feeling of exhaustion and fatigue) in both sexes. Compared to the reference group at 95% confidence interval (CI), the group with change in WTA showed elevated OR values of 1.91 (95% CI:1.73–2.11), 1.93 (95% CI: 1.74–2.14), 2.47 (95% CI: 2.26–2.71) for male workers; and 1.93 (95% CI: 1.73–2.16), 2.02 (95% CI: 1.80–2.27), 2.24 (95% CI: 2.01–2.50) for female workers, for difficulty in falling asleep, waking up repeatedly during the sleep, waking up with a feeling of exhaustion, and fatigue, respectively. Conclusions Workers who experience change in work time arrangement show a high risk of sleep disturbance in both sexes.

Background: Change in working time arrangement (WTA) can be harmful to workers' sleep and health. This study aimed to investigate the association between change in working time arrangement and sleep disturbance. Methods: This study used data from the Fifth Korean Working Condition Survey and included 33,203 paid workers. We performed a stratified analysis by sex. After dividing the participants into 6 groups based on whether or not they experienced WTA changes, and their weekly working hours (≤40, 41–52, ≥53 hours), we calculated odds ratio (OR) using the weekly working hours ≤40 hours and with no WTA change as the reference group. Results: Of the 33,203 paid workers, participants who experienced change in working time arrangement had higher prevalence of all three types of sleep disturbance symptoms (difficulty in falling asleep, waking up repeatedly during sleep, and waking up with a feeling of exhaustion and fatigue) in both sexes. Compared to the reference group at 95% confidence interval (CI), the group with change in WTA showed elevated OR values of 1.91 (95% CI:1.73–2.11), 1.93 (95% CI: 1.74–2.14), 2.47 (95% CI: 2.26–2.71) for male workers; and 1.93 (95% CI: 1.73–2.16), 2.02 (95% CI: 1.80–2.27), 2.24 (95% CI: 2.01–2.50) for female workers, for difficulty in falling asleep, waking up repeatedly during the sleep, waking up with a feeling of exhaustion, and fatigue, respectively. Conclusions Workers who experience change in work time arrangement show a high risk of sleep disturbance in both sexes.

Background: Long commuting times have a negative impact on mental health. However, few studies have explored the relationship between commuting time and well-being based on urbanization by region. Our study examines this relationship as well as the effect of regional differences on Korean workers. Methods: We used data from the sixth Korean Working Conditions Survey. Commuting time and occupational factors were assessed using a questionnaire, and subjective well-being was assessed using the World Health Organization-5 Well-Being Index. Regions were divided into the cities and the provinces based on Korea’s administrative divisions. Logistic regression analysis was performed to investigate the association between commuting time and wellbeing. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) for well-being were estimated, using participants commuting time of < 20 minutes as a reference group. Results: The total number of workers was 29,458 (13,855 men, 15,603 women). We found higher aORs for low well-being among workers with long commuting times (aOR, 1.23; 95% CI, 1.11–1.36 and aOR, 1.28; 95% CI, 1.16–1.42 for 60–79 and ≥ 80 minutes, respectively). When stratified by sex and region, higher aORs for low well-being were found only in the workers who lived in cities. Conclusion Long commuting time was negatively associated with well-being in Korean wage workers living in the cities. Policies for reducing commuting time should be discussed to address the mental health of workers, especially those living in metropolitan cities.

BACKGROUND: Prospective studies on occupational stress and depression among Korean workers are scarce. This study aimed to investigate the causal relationship between changes in occupational stress and the presence of depression. METHODS: This study analyzed data from a survey conducted with workers in a large Korean company (2015–2016). Occupational stress was measured using the Korean Occupational Stress Scale, and depression was screened using the WHO-5 Well-being Index. The levels of occupational stress were grouped in quartiles based on subjects’ occupational stress scores in 2015, and changes in occupational stress were measured using the score changes between the 2015 and 2016 surveys. Subjects were divided into four groups according to the presence or absence of depression in 2015 and 2016: a non-depressed group whose mental health did not change, a non-depressed group whose mental health deteriorated, a depressed group that continued to be depressed, and a depressed group whose symptoms of depression were alleviated. Logistic regression analysis was used to calculate the odds ratios (ORs) and confidence intervals (CIs) of the subjects’ deterioration in mood or alleviation of depression by occupational stress levels and changes. RESULTS: The OR for developing depressive symptoms was 2.51 (95% CI 1.46–4.33) and 2.73 (95% CI 1.39–5.36) in the third and the fourth quartiles of occupational stress, respectively, compared to the first quartile. When the occupational stress score increased by 1 point, the OR for increasing depressive symptoms was 1.07 (95% CI 1.04–1.10). There was no significant difference in the alleviation of depressive symptoms between the groups by level of occupational stress. However, when the occupational stress score decreased by 1 point, the OR for alleviating depressive symptoms was 1.08 (95% CI 1.05–1.11). CONCLUSION: The results showed that increased occupational stress increased the presence of depressive symptoms, and that reduced occupational stress suppressed the development of depressive symptoms. More attention should be paid to stress management among workers.
Depression ; Logistic Models ; Longitudinal Studies ; Mental Health ; Odds Ratio ; Prospective Studies

BACKGROUND: Dependent self-employment is precarious employment, which can be vulnerable to mental health problems. This study aimed to investigate the association of dependent self-employment with depression, anxiety, and sleep disorder in South Korea. METHODS: This study used data from the Fourth Korean Working Conditions Survey and included 32,691 paid workers. Dependent self-employment and self-reported depression/anxiety, and sleep disorder were investigated using a questionnaire. Logistic regression analysis was performed to investigate the association between dependent self-employment and mental health problems. RESULTS: Of the 32,691 paid workers, 2,371 (7.3%) were dependent self-employed workers. The odds ratio (OR) of dependent self-employment for self-reported depression/anxiety was 1.78 (95% confidence interval [CI]: 1.29–2.45) and the OR of dependent self-employment for self-reported sleep disorder was 1.26 (95% CI: 1.01–1.59) compared to other paid workers. CONCLUSIONS: Dependent self-employment is related to an increased risk of self-reported depression/anxiety and sleep disorder in South Korea.
Anxiety ; Depression ; Employment ; Korea ; Logistic Models ; Mental Health ; Odds Ratio ; Sleep Wake Disorders

Background: Transfusion appropriateness is extremely important due to the growing concerns about the decrease in the supply of blood products and the increase in demand. Considerable time and effort are required to effectively collect and analyze large volumes of data. Therefore, we aimed to develop a transfusion appropriateness management program using the Tableau visual analytics platform, which allows intuitive visualization through various visualization options and interactive features and can quickly process large volumes of data. Methods: Using the transfusion prescription history and blood management and distribution history, we created a data mart comprising patient information, hospitalization history, inpatient/outpatient prescriptions, test results, records, and surgical information. Based on this we developed visualization analysis content for monitoring transfusion appropriateness.We automated the periodic aggregation of the data mart into an analysis database and connected it to Tableau. Results: We developed Transfusion Appropriateness Management (TAM), a program for managing transfusion appropriateness linked to Tableau, after analyzing transfusion-related data and metadata extracted from the Daejeon Eulji Medical Center's order communication system/electronic medical record (OCS/EMR) system. Detailed filters were applied to allow users to intuitively view the desired data according to their criteria. Data were visualized in various forms, such as bar graphs, heat maps, and box plots based on filtering criteria. Conclusion The development of the Transfusion Appropriateness Management program at the Daejeon Eulji Medical Center is expected to effectively reduce inappropriate transfusions in clinical settings and enhance patient safety within the hospital by swiftly and conveniently visualizing vast amounts of data.