The Relationship between Job Stress and Musculoskeletal Symptoms in Migrant Workers / 대한산업의학회지

OBJECTIVE: To investigate the musculoskeletal symptoms of migrant workers. We focused on the relationship between job stress and musculoskeletal symptoms. METHOD: A questionnaire was administered to 502 migrant workers who visited NGO migrant worker centers located in Gyung-gi province. A structured, self-reported questionnaire was administered to participants in order to capture the following information: sociodemographics, health factors including past medical history, work related characteristics, job stress, and musculoskeletal symptoms. The job stress questionnaires were used according to KOSS-26 and musculoskeletal symptoms were measured using KOSHA Code H-30-2003. We used multiple logistic regression analysis to assess the relationship between risk factors which included job stress, and musculoskeletal symptoms. RESULTS: The prevalence rate of musculoskeletal symptoms in survey subjects was 35.1%. Other than job stress factors, past medical history was the only factor that had a statistical relationship to musculoskeletal symptoms (P<0.01). In the domains of job stress, physical environment (OR 1.62, 95% CI: 1.03~2.54), job demand (OR 2.43, 95% CI: 1.46~4.03), job insecurity (OR 1.59, 95% CI: 1.03~2.47), occupational climate (OR 2.30, 95% CI: 1.27~4.19) were most likely experience musculoskeletal symptoms. CONCLUSION: The job stress factor appeared to correlate more with musculoskeletal symptoms than with sociodemographics or other factors. Hence, in order to prevent migrant worker's musculoskeletal symptoms, we believe that intervention in job stress (physical environment, job demand, job insecurity, occupational climate) is necessary.

The Relationship between Job Stress and Depressive Symptoms in Migrant Workers in Kyung-gi Province in Korea / 대한산업의학회지

OBJECTIVES: To investigate the mental health status of migrant workers. We focused on the relationship between depressive symptoms and job stress. METHEOD: A questionnaire was administered to 488 migrant workers who visited NGO migrant worker centers located in Kyung-gi province. A structured, self-reported questionnaire was used to assess each responder's sociodemographics, work related characteristics, health behaviors, past medical history, job stress and depression symptoms. The job stress questionnaire was used according to KOSS-26 and depression symptoms were measured using CES-D, which was translated into Korean. We used multiple logistic regression analysis to assess the relationship between risk factors included job stress and depression symptoms. RESULTS: The prevalence of depression symptoms in survey subjects was 25.2%, but the prevalence of non-Chinese nationalities and illegal workers were 32.1% and 32.8%, respectively. Adjusting for confounding factors, job stress (OR 2.55, 95% CI=1.30-4.99) had a statistical meaningful relationship with depression symptoms. Among job stress domains, physical environment (OR 2.97, 95% CI=1.59-5.53), job demand (OR 2.33, 95% CI=1.26-4.32) and occupational climate(OR 3.10, CI=1.49-6.48) were most likely to experience depression symptoms. CONCLUSIONS: The prevalence of depressive symptoms among the study subjects was similar to the prevalence among the general population in Korea, but higher than that among the Korean workers. In particular, the prevalence among non-Chinese and illegal workers was higher. However, the job stress factor appeared to have a more direct correlation with depressive symptoms than the sociodemographic factors of nationality or residential status. Hence, in order to prevent depressive symptoms of the migrant workers, we believe that intervention on job stress is necessary.

The Status and Characteristics of Industrial Accidents for Migrant Workers in Korea Compared with Native Workers / 대한산업의학회지

OBJECTIVES: To analyze the status and characteristics of the industrial accidents of migrant workers with comparison to those of native workers. METHODS: The industrial accident rate of migrant workers was estimated by the annual number of industrial accidents divided by the total number of annual labor population multiplied by the annual admission rate of industrial accident insurance. The characteristics of industrial accidents for total migrant workers were assessed and compared with those of total native workers (from 2004 to 2006). In addition, we compared the industrial accidental characteristics of the 7,210 native workers and the 458 migrant workers employed in the Incheon area who received compensation from the industrial accident insurance in 2006. RESULTS: In 2004, 2005 and 2006, the total annual industrial accident rates of the migrant workers were 0.93%, 0.90%, and 1.06%, the injury accident rates were 0.90%, 0.86%, and 1.00%, the number of injury deaths per 10,000 persons were 2.29, 2.22, and 2.39, and the disease rates were 0.011%, 0.014%, and 0.027%, respectively. As for the cause of injury, rolled/jammed and cutting-type injuries were more prevalent in the migrant workers. With the standardization of job category, industry size and work tenure, the rolled/jammed-type injury was still significantly more prevalent in the migrant workers. CONCLUSIONS: Even considering the exclusion of the possible missing numbers of the submission of industrial accident cases, and the numbers of workplaces not registered for industrial accident insurance, the publicized statistics confirm the higher industrial accident rate of migrant workers compared to ative workers. Especially, the injury death rate was 2.2 times higher for migrant workers than for native workers in 2006. In addition, the remarkably lower occupational disease rate of the migrant workers compared to that of the native workers, suggested that numerous cases of disease were not reported. Finally, the lack of communication and former education that usually lead to the most prevalent injury type, i.e., the rolled/jammed type, supported our conclusion that the migrant workers were in need of more education regarding workplace safety.

The Health Status Including Biologic Exposure Indices of Migrant Workers: Based on 2005 Special Health Examination Data / 대한산업의학회지

OBJECTIVES: To investigate the general health status and severity of exposure to hazardous agents - with a focus on heavy metals - of migrant workers utilizing the 2005 Special Health Examination data. METHODS: With data from the 2005 Special Health Examination, we examined the biologic exposure indices and several major clinical exam items of 25,086 migrant workers in the whole country in comparison with those of 19,616 native Korean workers in Kyunggi-do province. Of these we chose homogeneous samples from the same 3 health service centers in Kyunggi-do. (native workers:19,616, migrant workers:1,886) to be more precise. RESULTS: The results from the samples of the 3 centers were as follows. Blood lead (natives: 6.09 microgram/dl migrants: 8.37 microgram/L) and cadmium (natives: 0.29 microgram/dl, migrants: 0.36 microgram/L) were higher in the migrant workers than in the native Korean workers, whereas the biologic exposure indices of organic solvents were higher in the native workers. As for major clinical exam items, the liver battery was worse in the natives with incidence of abnormal AST/ALT level (natives: 8.1/6.8% migrants: 5.7/5.4%, p-value<0.01 for AST). Anemia was more prevalent in the migrant workers (natives: 9.0% migrants: 11.0%, p-value<0.05). CONCLUSIONS: Migrant workers in Korea are more frequently or more severely exposed to a hazardous working environment containing heavy metals. However, we were not able to explain the results for the exposure indices or organic solvents, and such an explanation will require further study in the future.

A Case of Hypersensitivity Pneumonitis in a Worker Exposed to Metal Working Fluid / 대한산업의학회지

INTRODUCTION: There have been no reports of hypersensitivity pneumonitis caused by metal working fluids in Korea, despite their existence in other countries. Here, we report the first such case, along with an assessment of work-relatedness through exposure assessment. CASE REPORT: A 64-year old male patient visited the hospital with dyspnea after metal pipe cutting for about a year. He was diagnosed with hypersensitivity pneumonitis from the evidence of specific exposure history, clinical symptoms, and radiologic findings. The air exposure levels of the oil mist, endotoxin, total bacteria and fungus in the work environment was TWA(8-hr) 0.531 mg/m3, 6.33 EU/m3, 100 CFU/m3 and 75 CFU/m3, respectively. The concentrations of the endotoxin, total bacteria and fungus within the metal working fluid was 1.5x10(4) EU/mL, 4.6x10(5) CFU/mL and 1.8x10(5) CFU/mL, respectively. DISCUSSION: Although the patient did not receive a specific precipitating antibody test, the microbial concentration within the metal working fluid was higher than normal and similar to previous case reports, The oil mist level in the air exceeded the NIOSH REL and ACGIH NIC, and were similar or higher than previous cases. By excluding other causes of hypersensitivity pneumonitis, we concluded that the disease developed from exposure to microbial antigens in the metal working fluid.

A Case of Hypersensitivity Pneumonitis in a Worker Exposed to Metal Working Fluid / 대한산업의학회지

INTRODUCTION: There have been no reports of hypersensitivity pneumonitis caused by metal working fluids in Korea, despite their existence in other countries. Here, we report the first such case, along with an assessment of work-relatedness through exposure assessment. CASE REPORT: A 64-year old male patient visited the hospital with dyspnea after metal pipe cutting for about a year. He was diagnosed with hypersensitivity pneumonitis from the evidence of specific exposure history, clinical symptoms, and radiologic findings. The air exposure levels of the oil mist, endotoxin, total bacteria and fungus in the work environment was TWA(8-hr) 0.531 mg/m3, 6.33 EU/m3, 100 CFU/m3 and 75 CFU/m3, respectively. The concentrations of the endotoxin, total bacteria and fungus within the metal working fluid was 1.5x10(4) EU/mL, 4.6x10(5) CFU/mL and 1.8x10(5) CFU/mL, respectively. DISCUSSION: Although the patient did not receive a specific precipitating antibody test, the microbial concentration within the metal working fluid was higher than normal and similar to previous case reports, The oil mist level in the air exceeded the NIOSH REL and ACGIH NIC, and were similar or higher than previous cases. By excluding other causes of hypersensitivity pneumonitis, we concluded that the disease developed from exposure to microbial antigens in the metal working fluid.

Exposure Level of Trichloroethylene in Stevens-Johnson Syndrome Due to Occupational Exposure: 3 Case Reports and a Review of Other Cases / 대한산업의학회지

BACKGROUND: Trichloroethylene (TCE) has been reported to be related to severe generalized exfoliative dermatitis frequently accompanied by toxic hepatitis. The measurements of environmental exposure were limited in the previous case reports and the reported exposure values were also diverse. We reviewed three cases of Stevens-Johnson syndrome associated with TCE. The work environment was measured by the Korea Occupational Safety and Health Agency (KOSHA) after the cases occurred. From the study results, we intended to clarify the relationship between TCE exposure level and Stevens- Johnson syndrome. CASE REPORT: Case 1. A 24-year-old Filipino female worker developed a skin rash 35 days after starting to use TCE for degreasing. The skin rash developed into a bullous eruption and the liver function findings were abnormal. She was diagnosed with Stevens-Johnson syndrome and toxic hepatitis. She died of hepatic failure 39 days after the onset of the first symptom. She had no previous history of taking medicine or viral infection. The work environment measured 22.0 to 32.3 ppm (personal exposure level) with TWA. Case 2. A 47-year-old Korean male worker developed a skin rash, 20 days after starting to use TCE for degreasing. The skin rash developed into a bullous eruption and the liver function findings were abnormal. He was diagnosed with Stevens-Johnson syndrome, toxic hepatitis and sepsis. He died of hepatic failure and sepsis 42 days after the onset of the first symptom. He had no previous history of taking medicine or viral infection. The work environment measured 30.1 ppm (personal exposure level) and 116.5~229.7 ppm (area exposure level close to the degreasing machine) with TWA. Case 3. A 22-yearold Vietnamese female worker developed a skin rash 30 days after starting to use TCE for degreasing. The skin rash developed into a bullous eruption and the liver function findings were abnormal. She was diagnosed with Stevens-Johnson syndrome and toxic hepatitis. Her symptoms improved and she was discharged 37 days after the onset of the first symptom. She had no previous history of taking medicine or viral infection. The work environment measured 107.2 ppm (personal exposure level) with TWA. DISCUSSION: These three case reports and the previously reported cases indicated that the majority of people susceptible to TCE develops Stevens-Johnson syndrome after high-level TCE exposure (above the TWA occupational exposure limit of 50 ppm). Therefore, work environmental survey and improvements to the TCE degreasing process are essential to prevent high exposure. Furthermore, considering the consistency of the latency period in symptoms and the possibility of sensitization in low-level exposure, we recommend that the first specific health examination also should be conducted 1 month after workers have commenced working.