Medical radiation workers occupy the largest group of radiation workers and is rapidly increasing worldwide. They expose to protracted low-dose radiation and include a large proportion of women. The purpose of this article is to provide an overview of occupational radiation exposure and health effects among medical radiation workers through literature review and from the findings of Korean medical radiation workers' studies. Occupational radiation exposure increases the risk of many chronic diseases including cancer, cataract, cardiovascular diseases, thyroid diseases, and others. Although Korean medical radiation workers had a more favorable mortality than in general population, male workers experienced higher mortality from all cancers, leukemia, cancers of the stomach and the colon, and diseases of circulatory system after adjusting for the lower overall mortality. The potential adverse health risks from occupational radiation exposure are not negligible in medical radiation workers if current working level remains. Therefore, effective prevention efforts are needed to reduce the risks of diseases from occupational radiation exposures.
Cardiovascular Diseases ; Cataract ; Chronic Disease ; Colon ; Female ; Humans ; Leukemia ; Male ; Mortality ; Occupational Exposure ; Radiation Exposure* ; Stomach ; Thyroid Diseases

BACKGROUND: The South Korean criteria for occupational diseases were amended in July 2013. These criteria included formaldehyde as a newly defined occupational carcinogen, based on cases of “leukemia or nasopharyngeal cancer caused by formaldehyde exposure”. This inclusion was based on the Internal Agency for Research on Cancer classification, which classified formaldehyde as definite human carcinogen for nasopharyngeal cancer in 2004 and leukemia in 2012. METHODS: We reviewed reports regarding the causal relationship between occupational exposure to formaldehyde in Korea and the development of these cancers, in order to determine whether these cases were work-related. RESULTS: Previous reports regarding excess mortality from nasopharyngeal cancer caused by formaldehyde exposure seemed to be influenced by excess mortality from a single plant. The recent meta-risk for nasopharyngeal cancer was significantly increased in case-control studies, but was null for cohort studies (excluding unexplained clusters of nasopharyngeal cancers). A recent analysis of the largest industrial cohort revealed elevated risks of both leukemia and Hodgkin lymphoma at the peak formaldehyde exposure, and both cancers exhibited significant dose-response relationships. A nested case-control study of embalmers revealed that mortality from myeloid leukemia increased significantly with increasing numbers of embalms and with increasing formaldehyde exposure. The recent meta-risks for all leukemia and myeloid leukemia increased significantly. In South Korea, a few cases were considered occupational cancers as a result of mixed exposures to various chemicals (e.g., benzene), although no cases were compensated for formaldehyde exposure. The peak formaldehyde exposure levels in Korea were 2.70–14.8 ppm in a small number of specialized studies, which considered anatomy students, endoscopy employees who handled biopsy specimens, and manufacturing workers who were exposed to high temperatures. CONCLUSION: Additional evidence is needed to confirm the relationship between formaldehyde exposure and nasopharyngeal cancer. All lymphohematopoietic malignancies, including leukemia, should be considered in cases with occupational formaldehyde exposure.
Biopsy ; Case-Control Studies ; Classification ; Cohort Studies ; Endoscopy ; Formaldehyde ; Hodgkin Disease ; Humans ; Korea ; Leukemia ; Leukemia, Myeloid ; Mortality ; Nasopharyngeal Neoplasms ; Occupational Diseases ; Occupational Exposure ; Plants ; Workers' Compensation

BACKGROUND: Environmentally induced, occupational diseases are increasing worldwide, especially in rural agricultural communities. Poverty-associated malnutrition, environmental hazards and pollution, and lack of access to clean water, safe sanitation, and modern healthcare facilities are often associated with these chronic illnesses. METHOD: The authors systematically reviewed occupational public health issues that have been related to the environment. General interpretations of results were included as per the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Pertinent publications from research databases were reviewed on (A) the risk–benefits, (B) the prevalence of risk factors for various diseases, (C) the benefits of not ignoring the risk factors (i.e., broader evidence), and (D) the risks, effects, and outcomes of different types of interventions. The authors used chronic kidney disease of multifactorial origin (CKDmfo) as an example to explore the theme. Emphasis was given to the regions with emerging economies and developing countries located in the vicinity of the equator. FINDINGS: Geographical, socio-economic and aetiological similarities exist for many chronic non-communicable diseases that are affecting tropical countries around the equator. The authors identified manufacturing, mining, and agriculture as the biggest polluters of the environment. In addition, deforestation and associated soil erosion, overuse of agrochemicals, and irresponsible factory discharge (e.g., chemicals and paint, from rubber and textile factories, etc.), all contribute to pollution. To decrease the escalating incidences of environmentally induced diseases, governments should work proactively to protect the environment, especially watersheds, and take steps to minimise harmful occupational exposures and strictly enforce environmental regulations. CONCLUSION: Creating public awareness of environmental issues and their relationship to public health is essential. This includes regular monitoring and periodic publication of the quality of water, air and soil; preventing deforestation and man-made soil erosion, increasing forest and ground cover, preventing occupational injuries, judicious and safe use of agrochemicals, sustainable agriculture and development programs, and implementing legislation to protect and conserve water heriage and the environment. These actions are essential both for a healthier environment and for the health of the people who live in that environment. Such measures would also decrease public health threats from such, including global-warming-related erratic environmental changes and the occurrence and the spread of non-communicable diseases, such as CKDmfo.
Agriculture ; Agrochemicals ; Chronic Disease ; Conservation of Natural Resources ; Delivery of Health Care ; Developing Countries ; Forests ; Incidence ; Kidney Diseases ; Malnutrition ; Methods ; Mining ; Mortality, Premature ; Occupational Diseases* ; Occupational Exposure ; Occupational Injuries ; Paint ; Prevalence ; Public Health ; Publications ; Renal Insufficiency, Chronic* ; Risk Factors ; Rubber ; Sanitation ; Social Control, Formal ; Soil ; Textiles ; Water

BACKGROUND: Several studies have investigated the relationship between specific occupations and suicide mortality, as suicide rates differ by profession. The aim of this study was to investigate suicide mortality ratios across broad occupational groups in Greece for both sexes in the period 2000-2009. METHODS: Data of suicide deaths were retrieved from the Hellenic Statistical Authority and comparative mortality ratios were calculated. Occupational classification was based on the International Classification of Occupations (ISCO-88) and the coding for Intentional self-harm (X60-X84) was based on the international classification of diseases (ICD-10). RESULTS: Male dominant occupations, mainly armed forces, skilled farmers and elementary workers, and female high-skilled occupations were seen as high risk groups for suicide in a period of 10 years. The age-productive group of 30-39 years in Greek male elementary workers and the 50-59 age-productive group of Greek professional women proved to have the most elevated number of suicide deaths. CONCLUSION: Further research is needed into the work-related stressors of occupations with high suicide mortality risk and focused suicide prevention strategies should be applied within vulnerable working age populations.
Arm ; Classification ; Clinical Coding ; Female ; Greece* ; Humans ; International Classification of Diseases ; Male ; Mortality* ; Occupational Groups* ; Occupational Health ; Occupations ; Risk Assessment ; Suicide*

Some types of workers such as farmers and soldiers are at a higher risk of work-related injury and illness than workers from other occupations. Despite this fact, they are not covered under the Industrial Safety Health (ISH) Act or the Industrial Accident Compensation Insurance (IACI) Act. The Safety Aid System for Farmers (SASF) is a voluntary insurance scheme, and it is the only public compensation plan for self-employed farmers. Fifty percent of SASF premiums are subsidized by the Korean government. Soldiers are compensated by the Veterans' Pension (VP) Act. The approval standard of and procedure for the VP Act are provided in the Decree of VP Act, and the Council for VP Benefits determines work-relatedness in the claimed cases. Meanwhile, SASF applies the insurance clause automatically without any expert advice or additional procedures. Furthermore, compared with IACI, these programs pay fewer benefits to workers. Thus, a stronger institutional strategy is needed to maintain a safe work environment, to protect workers' health in unavoidably hazardous environments, and to compensate for work-related injuries and diseases.
Accidents, Occupational/economics ; *Agriculture ; Female ; Humans ; Insurance, Accident/economics ; Insurance, Health/economics ; Male ; *Military Personnel ; Occupational Diseases/*economics/mortality ; Occupational Health/economics ; Occupational Injuries/classification/*economics/mortality ; Republic of Korea ; Risk ; Workers' Compensation/*economics/standards

The legal scope and criteria for occupational cancer in Korea was out of date. The aim of this study was to review the current criteria for occupational cancer and amend the existent criteria on the basis of recent scientific evidence. The scientific evidence and the legal list of occupational cancer were analyzed to identify the causes of occupational cancer on a global scale. The relationship between compensated occupational cancer cases and carcinogen exposure in Korea was examined. The factors associated with specific causes and target cancers were determined to produce additional criteria. Five-hundred and nineteen cases of 2,468 were awarded compensation for occupational cancer including lung, malignant mesothelioma, lymphohematopoietic, and liver cancers from January 2000 to October 2012. Between 1996 and 2005, benzene accounted for 84.4% of cases, and between 1999 and 2005, asbestos was associated with 62.3% of cases. Fourteen novel causative agents and 12 additional target cancers were identified and the final guidelines were amended to include 23 causative agents and 21 target cancers. This amendment of the criteria for occupational cancer represents the widest change in Korean history and is expected to improve the understanding of occupational cancer by providing an up-to-date and accurate reference guide.
Asbestos/toxicity ; Benzene/toxicity ; Carcinogens/toxicity ; Female ; Humans ; Insurance, Health/*economics ; Middle Aged ; Neoplasms/chemically induced/*economics ; Occupational Diseases/*economics/mortality ; Occupational Exposure/*adverse effects ; Republic of Korea ; Workers' Compensation/*economics/legislation & jurisprudence/standards

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

Foundry workers are potentially exposed to a number of carcinogens. This study was conducted to describe the cancer incidence associated with employment in small-sized Korean iron foundries and to compare those findings to the Korean population. Cancer morbidity in 208 Korean foundries was analyzed using the Standardized Incidence Ratio (SIR) and Standardized Rate Ratio (SRR). Overall cancer morbidity in foundry workers (SIR=1.11, 95% confidence interval [CI]=1.01-1.21) was significantly higher than that of Korean general population. Lung cancer (SIR=1.45, 95%CI=1.11-1.87) and lymphohematopoietcic cancer (SIR=1.58, 95%CI=1.00-2.37) in production workers were significantly high compared to Korean general population. Stomach cancer in fettling (SRR=2.10, 95%CI=1.10-4.01) and lung cancer in molding (SRR=3.06, 95%CI=1.22-7.64) and in fettling (SRR=2.63, 95%CI=1.01-6.84) were there significant elevations compared to office workers. In this study, statistically significant excess lung cancer was observed in production workers comparing to Korean general population and office workers. Also, cancer morbidity of overall cancer, lung cancer and stomach cancer was significantly increased with duration of employment at ten and more years comparing to Korean general population. These findings suggest in causal association between exposure to carcinogens during foundry work and cancer morbidity.
Adult ; Aged ; Carcinogens/toxicity ; Cohort Studies ; Female ; Humans ; Iron/toxicity ; Lung Neoplasms/epidemiology/mortality ; Male ; Middle Aged ; Morbidity ; Neoplasms/*epidemiology/mortality ; Occupational Diseases/*epidemiology ; Occupational Exposure ; Republic of Korea ; Stomach Neoplasms/epidemiology/mortality

OBJECTIVES: We conducted a meta-analysis to investigate the relationship between low external doses of ionizing radiation exposure and the risk of cancer mortality among nuclear power plant workers. METHODS: We searched MEDLINE using key words related to low dose and cancer risk. The selected articles were restricted to those written in English from 1990 to January 2009. We excluded those studies with no fit to the selection criteria and we included the cited references in published articles to minimize publication bias. Through this process, a total of 11 epidemiologic studies were finally included. RESULTS: We found significant decreased deaths from all cancers (SMR = 0.75, 95% CI = 0.62 - 0.90), all cancers excluding leukemia, solid cancer, mouth and pharynx, esophagus, stomach, rectum, liver and gallbladder, pancreas, lung, prostate, lymphopoietic and hematopoitic cancer. The findings of this meta-analysis were similar with those of the 15 Country Collaborative Study conducted by the International Agency for Research on Cancer. A publication bias was found only for liver and gallbladder cancer (p = 0.015). Heterogeneity was observed for all cancers, all cancers excluding leukemia, solid cancer, esophagus, colon and lung cancer. CONCLUSIONS: Our findings of low mortality for stomach, rectum, liver and gallbladder cancers may explained by the health worker effect. Yet further studies are needed to clarify the low SMR of cancers, for which there is no useful screening tool, in nuclear power plant workers.
Humans ; Neoplasms, Radiation-Induced/*mortality ; *Nuclear Power Plants ; Occupational Diseases/*mortality ; Occupational Exposure/adverse effects ; Radiation Monitoring

OBJECTIVETo investigate whether asbestosis is a risk factor for mortality of lung cancer.

METHODSA fixed cohort study was established in an asbestos plant in Chongqing, China, and followed up for 30 years from the beginning of 1972. Basic personal information on life state, cause of death, and diagnosis of asbestosis was collected. Multiple logistic regressions were applied to analyze risk factors.

RESULTSDuring the 30-year follow-up, 584 male workers constituting a total of 14,664 person-years were monitored and data were analyzed. Among them, 203 (34.8%) died and the mortality rate was 13.8 per 1000 person-years, cancer accounting for 37.4%. Excess risks were observed for lung cancer (OR = 3.72) and nonmalignant respiratory diseases (OR = 2.73) among workers with asbestosis. High-exposure level was another risk factor for lung cancer (OR = 3.20). Workers with category II of asbestosis demonstrated a higher OR of both lung cancer and nonmalignant respiratory diseases than those with category I of asbestosis.

CONCLUSIONHigh asbestos exposure level and asbestosis were the risk factors for death of lung cancer and nonmalignant respiratory diseases. Asbestosis is an independent risk factor for lung cancer among Chinese workers exposed to chrysotile, the risk increases with the increasing profusion of opacities of lung.

Adult ; Air Pollutants, Occupational ; toxicity ; Asbestos, Serpentine ; toxicity ; Asbestosis ; complications ; mortality ; Chemical Industry ; China ; epidemiology ; Humans ; Lung Neoplasms ; chemically induced ; mortality ; Male ; Occupational Diseases ; chemically induced ; mortality ; Occupational Exposure ; adverse effects ; Odds Ratio ; Risk Factors