OBJECTIVES: The physical activity paradox suggests that occupational physical activity (OPA), unlike leisure-time physical activity (LTPA), may detrimentally impact health. We explored the relationships of OPA and LTPA with work ability (WA) and health-related productivity loss (HRPL). METHODS: This study included 5,501 workers in Korea who were recruited in 2021 through a web-based cross-sectional questionnaire. The questionnaire was utilized to quantify OPA and LTPA in metabolic equivalents, while WA and HRPL were also measured. Non-parametric regression, using a generalized additive model (GAM), was employed to visualize the relationships of LTPA and OPA with WA and HRPL. Mean differences in WA and HRPL, in relation to OPA and LTPA, were examined using linear regression models. These models were adjusted for covariates including sex, age, body mass index, education level, alcohol consumption, smoking history, insomnia, occupation, hours worked, and income. RESULTS: The GAM and linear regression analyses revealed that higher LTPA corresponded with higher WA and lower HRPL. In contrast, as OPA increased, WA decreased and HRPL increased. However, within the group with high OPA, HRPL was not significantly lower in the high-LTPA subgroup relative to the low-LTPA subgroup (mean difference=1.92%, p=0.343). This pattern was especially pronounced among workers aged 60 years and older, with an increase in HRPL observed with increasing LTPA among the respondents with high OPA. CONCLUSIONS High LTPA levels were associated with elevated WA and diminished HRPL. In contrast, higher levels of OPA were associated with lower WA and higher HRPL.

OBJECTIVES: Occupational stress management is particularly important for successful business operations, since occupational stress adversely affects workers’ health, eventually lowering their productivity. Therefore, this study aimed to investigate the correlation between occupational stress and health-related productivity loss (HRPL) among Korean workers. METHODS: In 2021, 1,078 workers participated in a web-based questionnaire survey. HRPL was measured using the Work Productivity and Activity Impairment Questionnaire, and occupational stress was measured using the Korean Occupational Stress Scale-Short Form. The occupational stress level was divided into tertiles (low, intermediate, and high), and the low occupational stress group was used as the reference group. Using a generalised linear model, differences in labour productivity loss according to the level of occupational stress were tested after adjusting for demographic characteristics such as age, gender, education level, household income, occupation, and underlying medical conditions. RESULTS: Non-parametric regression analysis of HRPL according to occupational stress showed a direct association between occupational stress and HRPL. A statistically significant difference was observed in HRPL between participants with intermediate and high occupational stress and those with low occupational stress. CONCLUSIONS Our results support the hypothesis that high occupational stress is associated with decreased labour productivity.

OBJECTIVES: We conducted this study to investigate the relationship between the blood concentration of cadmium and cognitive function in elderly Koreans. METHODS: This research is a part of the Korean Elderly Environmental Panel Study (KEEPS). A total of 403 subjects were enrolled and analyzed from August 2008 through August 2010. Demographic information and medical histories were obtained using a questionnaire. Blood concentration of cadmium and Mini-Mental State Examination (MMSE) with Functional Activities Questionnaire (FAQ) were evaluated for each subject. RESULTS: The mean age of subjects was 70.67 (SD 5.18, n=403) and 72% were female. The mean blood cadmium level was 1.22 microg/dl (SD 0.56), mean MMSE score was 25.12 out of 30 and mean FAQ score was 2.03 out of 30. Using linear regression analysis to estimate the relationship between blood cadmium concentration and MMSE and FAQ, we observed a significant association between log transformed values of blood cadmium levels and MMSE (p<0.002) or FAQ (p=0.005) scores. After adjusting for age, sex, level of education, alcohol consumption and smoking habits, the relationship between blood cadmium concentration and MMSE and FAQ scores ramained statistically significant (p=0.033 and 0.029, respectively). CONCLUSIONS: These results suggest that blood cadmium concentration is strongly associated with cognitive function and functional activity in the elderly.
Aged ; Alcohol Drinking ; Cadmium ; Female ; Humans ; Linear Models ; Questionnaires ; Smoke ; Smoking

STUDY DESIGN: A retrospective study. SUMMARY OF THE LITERATURE REVIEW: The reports comparing short- and long-segment instrumentation are insufficient. OBJECTIVES: To determine the postoperative results and to analyze relative factors affecting results between short- and long-segment instrumentation in thoracolumbar fractures. MATERIALS AND METHODS: From March 2006 to March 2012, 97 patients with thoracolumbar fracture were treated with posterior instrumentation. They were divided into 2 groups, the short- (Group I) and long-segment groups (Group II). To analyze factors affecting results, several factors including age, anterior column height (ACH), and the kyphotic angle were reviewed. For radiologic evaluation, postoperative and follow-up radiographs were evaluated by measuring the kyphotic angle and ACH. Additionally, the presence of complications was reviewed. RESULTS: Groups I and II consisted of 45, 52 cases and had mean ages of 50.3, 55.8 years, respectively. In Group I, the ACH increased from 44.2% to 75.3% postoperatively, and remained 72.8% at follow-up. The kyphotic angle decreased from 19.4degrees to 10.6degrees postoperatively, and remained at 12.8degrees at follow-up. In Group II, the ACH recovered from 41.6% to 76.4% postoperatively, and was 74.8% at follow-up. The kyphotic angle decreased from 21.6degrees to 12.6degrees postoperatively, and was 13.9degrees at follow-up. The canal compromise, age, and comminution were not directly related with results. However, the mean age of the 7 cases showing complications was 72 years, and the 7 cases had severe comminuted fractures. CONCLUSIONS: The short- and long-segment instrumentations of thoracolumbar fractures are not significantly different with respect to the results attained. However, in order to decrease complications, we should pay attention to age and fracture comminution.
Follow-Up Studies ; Fractures, Comminuted ; Humans ; Retrospective Studies

Background: It is well known that the prevalence of obesity in Korea is increasing over time, however it is not known how the trends among occupational groups and sex differ in such increasing trends. This study was designed to provide recent trends of obesity among workers in Korea and to identify whether there were differences among occupational groups. Methods: We used data from the Korean National Health and Nutrition Examination Survey, Phases I to VI (1998–2015), to analyze trends in the prevalence of obesity in adult Korean workers. Obesity was defined as a body mass index of 25 kg/m2 or higher. Occupations were classified into 3 groups: (a) nonmanual workers, (b) service/sales workers, and (c) manual workers. Results: During the period of the Korean National Health and Nutrition Examination Survey Phases I to VI, the prevalence of obesity in male workers increased in all occupations (31.1% to 39.5% in manual workers, 32.3% to 38.2% in service/sales workers, and 25.3% to 39.7% in manual workers). However, female workers did not show any particular tendency toward obesity, except for a significant decrease in the prevalence rate in service/sales workers (30.8% to 23.9%, p for trend = 0.0048). Conclusion The trends of obesity prevalence by sex and occupation were different. For male manual workers, the prevalence rate increased steadily during the data period, while it decreased steadily in female sales/service workers.

BACKGROUND: Various combinations of treatment modalities have been reported in stage III non-small cell lung cancer (NSCLC), however, the standard treatment modality has not established yet. Recently, the efficacy of concurrent chemotherapy and radiation therapy has been reported in locally advanced lung cancer. We evaluate the response rate, toxicity, arid survival of concurrent chemotherapy with etoposide and cisplatin(EP) arid radiation therapy for unresectable stage III NSCLC. METHODS: Between October 1995 and December 1996, 32 patients with histologically proven unresectable stage III NSCLC without, malignant pleural effusion were entered into this study. Twenty-nine patients were eligible for the response, survival, and toxicity analysis. Induction was two cycles of chemotherapy with etoposide arid cisplatin plus concurrent chest RT to 4500cGy. Resection was attempted if the clinical response offered surgical resectability. Boost radiation therapy upto 5940cGy and one cycle of EP were performed if the disease were stable or responsive but still unresectable. RESULTS: Of 29 eligible patients, 22(75.9%) showed partial response(PR). The progression free interval was 6.3months(range 1.1 to 19.5months). Surgical resection was performed in one patient The median survival was l2.1months and one-year survival rate was 50.6%. The major toxicity was leukopenia(> or = grade 3,46%) Thrombocytopenia over grade 3 was found in 1%. Radiation pneumonitis occurred in 13 patients(46%). CONCLUSION: Concurrent chemotherapy(EP) pins radiotherapy was effective and tolerable in the treatment of unresectable stage III NSCLC.
Carcinoma, Non-Small-Cell Lung* ; Cisplatin* ; Drug Therapy* ; Etoposide* ; Humans ; Lung Neoplasms ; Pleural Effusion, Malignant ; Radiation Pneumonitis ; Radiotherapy ; Survival Rate ; Thorax ; Thrombocytopenia

OBJECTIVES: The purpose of the present study was to investigate the effects of volatile organic compounds, and formaldehyde on heart rate variability among elderly people who are vulnerable to ambient pollution. METHODS: From May to August of 2009, 57 subjects older than 60 years were recruited in this study. Indoor air pollutants (volatile organic compounds and formaldehyde) were measured by a personal passive sampler. Heart rate variability (HRV) was measured in the sitting position for five minutes and assessed by time-domain and frequency-domain. RESULTS: Multiple linear regression analysis showed significantly less low-frequency (LF) and high-frequency (HF) associated with elevated benzene levels. Exposure to toluene was associated with decreases in the Standard deviation of the NN intervals (SDNN) and LF. SDNN and LF were negatively associated with the increment of ethylbenzene levels. CONCLUSIONS: An adverse effect on cardiovascular function caused by volatile organic compounds was observed among the elderly people of Seoul even though indoor air pollutant levels were lower than the yearly average guideline for indoor air quality in Korea.
Aged ; Air Pollutants ; Air Pollution, Indoor ; Benzene ; Benzene Derivatives ; Formaldehyde ; Heart ; Heart Rate ; Humans ; Korea ; Linear Models ; Toluene ; Volatile Organic Compounds

PURPOSE: This study evaluated the incidence of imatinib-associated skin rash, the interventional outcomes of severe rash, and impact of severe rash on the outcomes of imatinib treatment in gastrointestinal stromal tumor (GIST) patients. MATERIALS AND METHODS: A total of 620 patients were administered adjuvant or palliative imatinib for GIST at Asan Medical Center between January 2000 and July 2012. This analysis focused on a group of 42 patients who developed a severe rash requiring major interventions, defined as dose interruption or reduction of imatinib or systemic steroid use. RESULTS: Of the 620 patients treated with imatinib, 148 patients (23.9%) developed an imatinib-associated skin rash; 42 patients (6.8%) developed a severe rash requiring major intervention. Of these, 28 patients (66.8%) successfully continued imatinib with interventions. Serial blood eosinophil levels during imatinib treatment were associated with skin rash and severity. A significant association was observed between successful intervention and blood eosinophil level at the time of intervention initiation. In metastatic settings, patients with severe rash requiring major interventions tended to show poorer progression-free survival than patients who did not require major intervention and patients with no rash, although this finding was not statistically significant (p=0.326). CONCLUSION: By aggressive treatment of severe rash through modification of imatinib dose or use of systemic steroid, the majority of patients can continue on imatinib. In particular, imatinib dose intensity can be maintained with use of systemic steroid. Measuring the blood eosinophil levels may be helpful in guiding the management plan for skin rash regarding the intensity and duration of interventions.
Chungcheongnam-do ; Disease-Free Survival ; Eosinophils ; Exanthema* ; Gastrointestinal Stromal Tumors* ; Humans ; Incidence ; Skin* ; Treatment Outcome

PURPOSE: This study examined therelationship between the clinical outcome and risk factors of intertrochanteric femoral fractures in patients over 65 years old. MATERIALS AND METHODS: From January 2000 to March 2012, three hundred and twenty one patients older than 65 years, who underwent surgeryfor intertrochanteric femoral fractures, were evaluated. The following parameters wereanalyzed: the patient risk factors, such as age, sex, smoking, drinking history, cardiovascular disease, cerebrovascular disease and delayed days to surgery; admission day of the week; anesthetic method; operation time by perioperative care related to clinical outcome including postoperative mortality; and complications. RESULTS: An analysis of the risk factors revealedfemale patients to have a 13% higher mortality (P=0.043). Aduration of surgerylonger than 3 hours was associated with a 29.1% and 20.8% higher mortality and complication rate, respectively (P<0.001, P=0.027). Asurgical delay of four days or more after admission wasassociated with a 20.1% and 18.8% higher mortality risk and complication rate, respectively (P<0.001, P<0.001). Smoking, drinking history, underlying disease, anesthetic method, and operation time had no significant effect on the outcome. CONCLUSION: In addition to recognizing the importance of patient-related risk factors, modifying the operative factors, such as reducing surgical delays and method of anesthesia, can reduce the mortality and postoperative complications of intertrochanteric femoral fractures.
Anesthesia ; Cardiovascular Diseases ; Drinking ; Femoral Fractures ; Hip Fractures ; Humans ; Perioperative Care ; Postoperative Complications ; Risk Factors ; Smoke ; Smoking

OBJECTIVES: Vitamin D deficiency is increasing worldwide. However, few studies have attempted to examine the vitamin D status of wage workers and the correlation between vitamin D deficiency and working conditions. Hence, we aimed to evaluate the prevalence of vitamin D deficiency and the association between occupational conditions and vitamin D deficiency among Korean wage workers. METHODS: Wage workers aged 20-65 years from the 5th Korea National Health and Nutrition Examination Survey (KNHANES 2010-2012; n = 5409) were included in our analysis. We measured the prevalence of vitamin D deficiency and identified the correlations with the working conditions of these subjects. RESULTS: The prevalence of vitamin D deficiency in male and female subjects was 69.5% and 83.1%, respectively. Among the male subjects, a significant correlation between vitamin D deficiency and working conditions was observed among shift workers, office workers, and permanent workers. No significant correlation with any type of working conditions was observed among female subjects. CONCLUSION: The prevalence of vitamin D deficiency among Korean wage workers was very high and was found to correlate significantly with working conditions, likely because of insufficient exposure to sunlight associated with certain types of work. Wage workers require more frequent outdoor activity and nutrition management to maintain sufficient vitamin D level.
Female ; Humans ; Korea* ; Male ; Nutrition Surveys* ; Prevalence ; Salaries and Fringe Benefits* ; Sunlight ; Vitamin D Deficiency ; Vitamin D* ; Vitamins*