Modern Korean society is experiencing fundamental transformations in industrial structures and working environments driven by complex factors, including demographic shifts, the Fourth Industrial Revolution, the coronavirus disease 2019 pandemic, and digital transformation. The evolving dynamics between the manufacturing and service industries, the emergence of technology-driven sectors, and the proliferation of new occupational categories are reshaping traditional employment models. This has directed the labor market toward nonstandard employment forms, including temporary, contract-based, and platform labor. Consequently, issues such as employment instability and reduced accessibility to workplace health programs, including occupational safety training, health examinations, and workplace health management, have become increasingly prominent. Although occupational and environmental medicine has subsequently gained significance, the current occupational health and safety framework inadequately addresses the nuances of emerging labor forms. Legal gaps persist, leaving vulnerable groups such as nonregular workers, platform laborers, and older workers insufficiently protected under existing systems. Furthermore, systemic issues are evident in the inadequate follow-up care during occupational health examinations, lacking continued adherence to hazard-centric approaches, and insufficient attention to chronic diseases and mental health challenges. This study proposes strategies that occupational and environmental medicine can address these issues. First, legal and institutional reforms must encompass new labor forms, accompanied by modernized safety and health guidelines. Second, state-of-the-art technologies should be leveraged to enhance predictive disease management and personalized healthcare for workers. Third, a preventive approach integrating chronic disease management, mental healthcare, and psychosocial risk factors must be established. Fourth, fostering interdisciplinary research collaboration across medicine, engineering, and psychology is essential for developing practical solutions to emerging challenges. In conclusion, occupational and environmental medicine in Korea must adapt to effectively address the evolving labor landscape. Through systematic innovation, integrated health-management approaches, technological advancements, and interdisciplinary cooperation, the health and safety of all workers in the rapidly changing world can be ensured.

Modern Korean society is experiencing fundamental transformations in industrial structures and working environments driven by complex factors, including demographic shifts, the Fourth Industrial Revolution, the coronavirus disease 2019 pandemic, and digital transformation. The evolving dynamics between the manufacturing and service industries, the emergence of technology-driven sectors, and the proliferation of new occupational categories are reshaping traditional employment models. This has directed the labor market toward nonstandard employment forms, including temporary, contract-based, and platform labor. Consequently, issues such as employment instability and reduced accessibility to workplace health programs, including occupational safety training, health examinations, and workplace health management, have become increasingly prominent. Although occupational and environmental medicine has subsequently gained significance, the current occupational health and safety framework inadequately addresses the nuances of emerging labor forms. Legal gaps persist, leaving vulnerable groups such as nonregular workers, platform laborers, and older workers insufficiently protected under existing systems. Furthermore, systemic issues are evident in the inadequate follow-up care during occupational health examinations, lacking continued adherence to hazard-centric approaches, and insufficient attention to chronic diseases and mental health challenges. This study proposes strategies that occupational and environmental medicine can address these issues. First, legal and institutional reforms must encompass new labor forms, accompanied by modernized safety and health guidelines. Second, state-of-the-art technologies should be leveraged to enhance predictive disease management and personalized healthcare for workers. Third, a preventive approach integrating chronic disease management, mental healthcare, and psychosocial risk factors must be established. Fourth, fostering interdisciplinary research collaboration across medicine, engineering, and psychology is essential for developing practical solutions to emerging challenges. In conclusion, occupational and environmental medicine in Korea must adapt to effectively address the evolving labor landscape. Through systematic innovation, integrated health-management approaches, technological advancements, and interdisciplinary cooperation, the health and safety of all workers in the rapidly changing world can be ensured.

Modern Korean society is experiencing fundamental transformations in industrial structures and working environments driven by complex factors, including demographic shifts, the Fourth Industrial Revolution, the coronavirus disease 2019 pandemic, and digital transformation. The evolving dynamics between the manufacturing and service industries, the emergence of technology-driven sectors, and the proliferation of new occupational categories are reshaping traditional employment models. This has directed the labor market toward nonstandard employment forms, including temporary, contract-based, and platform labor. Consequently, issues such as employment instability and reduced accessibility to workplace health programs, including occupational safety training, health examinations, and workplace health management, have become increasingly prominent. Although occupational and environmental medicine has subsequently gained significance, the current occupational health and safety framework inadequately addresses the nuances of emerging labor forms. Legal gaps persist, leaving vulnerable groups such as nonregular workers, platform laborers, and older workers insufficiently protected under existing systems. Furthermore, systemic issues are evident in the inadequate follow-up care during occupational health examinations, lacking continued adherence to hazard-centric approaches, and insufficient attention to chronic diseases and mental health challenges. This study proposes strategies that occupational and environmental medicine can address these issues. First, legal and institutional reforms must encompass new labor forms, accompanied by modernized safety and health guidelines. Second, state-of-the-art technologies should be leveraged to enhance predictive disease management and personalized healthcare for workers. Third, a preventive approach integrating chronic disease management, mental healthcare, and psychosocial risk factors must be established. Fourth, fostering interdisciplinary research collaboration across medicine, engineering, and psychology is essential for developing practical solutions to emerging challenges. In conclusion, occupational and environmental medicine in Korea must adapt to effectively address the evolving labor landscape. Through systematic innovation, integrated health-management approaches, technological advancements, and interdisciplinary cooperation, the health and safety of all workers in the rapidly changing world can be ensured.

Background and Objectives: This study aimed to analyze the outcomes of Fontan surgery in the Republic of Korea, as there were only a few studies from Asian countries. Methods: The medical records of 1,732 patients who underwent Fontan surgery in 10 cardiac centers were reviewed. Results: Among them, 1,040 (58.8%) were men. The mean age at Fontan surgery was 4.3±4.2 years, and 395 (22.8%) patients presented with heterotaxy syndrome. According to the types of Fontan surgery, 157 patients underwent atriopulmonary (AP) type; 303, lateral tunnel (LT) type; and 1,266, extracardiac conduit (ECC) type. The overall survival rates were 91.7%, 87.1%, and 74.4% at 10, 20, and 30 years, respectively. The risk factors of early mortality were male, heterotaxy syndrome, AP-type Fontan surgery, high mean pulmonary artery pressure (mPAP) in pre-Fontan cardiac catheterization, and early Fontan surgery year. The risk factors of late mortality were heterotaxy syndrome, genetic disorder, significant atrioventricular valve regurgitation (AVVR) before Fontan surgery, high mPAP in pre-Fontan cardiac catheterization, and no fenestration. Conclusions In Asian population with a high incidence of heterotaxy syndrome, the heterotaxy syndrome was identified as the poor prognostic factors for Fontan surgery. The preoperative low mPAP and less AVVR are associated with better early and long-term outcomes of Fontan surgery.

Background and Objectives: This study aimed to analyze the outcomes of Fontan surgery in the Republic of Korea, as there were only a few studies from Asian countries. Methods: The medical records of 1,732 patients who underwent Fontan surgery in 10 cardiac centers were reviewed. Results: Among them, 1,040 (58.8%) were men. The mean age at Fontan surgery was 4.3±4.2 years, and 395 (22.8%) patients presented with heterotaxy syndrome. According to the types of Fontan surgery, 157 patients underwent atriopulmonary (AP) type; 303, lateral tunnel (LT) type; and 1,266, extracardiac conduit (ECC) type. The overall survival rates were 91.7%, 87.1%, and 74.4% at 10, 20, and 30 years, respectively. The risk factors of early mortality were male, heterotaxy syndrome, AP-type Fontan surgery, high mean pulmonary artery pressure (mPAP) in pre-Fontan cardiac catheterization, and early Fontan surgery year. The risk factors of late mortality were heterotaxy syndrome, genetic disorder, significant atrioventricular valve regurgitation (AVVR) before Fontan surgery, high mPAP in pre-Fontan cardiac catheterization, and no fenestration. Conclusions In Asian population with a high incidence of heterotaxy syndrome, the heterotaxy syndrome was identified as the poor prognostic factors for Fontan surgery. The preoperative low mPAP and less AVVR are associated with better early and long-term outcomes of Fontan surgery.

Background and Objectives: This study aimed to analyze the outcomes of Fontan surgery in the Republic of Korea, as there were only a few studies from Asian countries. Methods: The medical records of 1,732 patients who underwent Fontan surgery in 10 cardiac centers were reviewed. Results: Among them, 1,040 (58.8%) were men. The mean age at Fontan surgery was 4.3±4.2 years, and 395 (22.8%) patients presented with heterotaxy syndrome. According to the types of Fontan surgery, 157 patients underwent atriopulmonary (AP) type; 303, lateral tunnel (LT) type; and 1,266, extracardiac conduit (ECC) type. The overall survival rates were 91.7%, 87.1%, and 74.4% at 10, 20, and 30 years, respectively. The risk factors of early mortality were male, heterotaxy syndrome, AP-type Fontan surgery, high mean pulmonary artery pressure (mPAP) in pre-Fontan cardiac catheterization, and early Fontan surgery year. The risk factors of late mortality were heterotaxy syndrome, genetic disorder, significant atrioventricular valve regurgitation (AVVR) before Fontan surgery, high mPAP in pre-Fontan cardiac catheterization, and no fenestration. Conclusions In Asian population with a high incidence of heterotaxy syndrome, the heterotaxy syndrome was identified as the poor prognostic factors for Fontan surgery. The preoperative low mPAP and less AVVR are associated with better early and long-term outcomes of Fontan surgery.