Hospital Qualities Related to Return to Work from Occupational Injury after Controlling for Injury Severity as Well as Occupational Characteristics

We examined associations between hospital quality in the workers' compensation system and injured patients' return to work after controlling for injury severity, occupational factors, and demographic factors. Return to work data of injured workers were constructed from 2 datasets: 23,392 patients injured in 2009-2011 from the Korea Workers' Compensation & Welfare Service and return to work data from Korea Employment Information Services. After de-identifying the data, quality scores were matched for each hospital that cared for injured patients. Injury severity was measured by Abbreviated Injury Scales. Relative risk and 95% confidence interval were calculated using log binomial regression models. After adjusting for age, sex, injury severity, occupation, factory size, city, and hospital type, the relative risk (95% confidence interval) for the total score was 1.04 (1.02-1.06), 1.06 (1.04-1.09), and 1.07 (1.05-1.10) in the 2nd, 3rd, and 4th quartiles, respectively, compared to the 1st quartile. The RR (95% CI) in the 2nd, 3rd, and 4th quartiles was 1.05 (1.02-1.07), 1.05 (1.02-1.08), and 1.06 (1.04-1.09) for the process score; and 1.02 (1.01-1.04), 1.05 (1.03-1.07), and 1.06 (1.04-1.09) for the outcome score compared to the 1st quartile score, respectively. In conclusion, our study design with blinded merge methods shows that total, process, and outcome qualities are related to the return to work of injured workers after controlling for other factors.

The Perceived Socioeconomic Status Is an Important Factor of Health Recovery for Victims of Occupational Accidents in Korea

We aimed to examine whether there is a correlation between the health recovery of industrial accident victims and their perceived socioeconomic status. Data were obtained from the first Panel Study of Worker's Compensation Insurance, which included 2,000 participants. We performed multivariate regression analysis and determined the odds ratios for participants with a subjectively lower socioeconomic status and for those with a subjectively lower middle socioeconomic status using 95% confidence intervals. An additional multivariate regression analysis yielded the odds ratios for participants with a subjectively lower socioeconomic status and those with a subjectively upper middle socioeconomic class using 95% confidence intervals. Of all participants, 299 reported a full recovery, whereas 1,701 did not. We examined the odds ratio (95% confidence intervals) for participants' health recovery according to their subjective socioeconomic status while controlling for sex, age, education, tobacco use, alcohol use, subjective state of health prior to the accident, chronic disease, employment duration, recovery period, accident type, disability status, disability rating, and economic participation. The odds of recovery in participants with a subjectively lower middle socioeconomic status were 1.707 times greater (1.264-2.305) than that of those with a subjectively lower socioeconomic status. Similarly, the odds of recovery in participants with a subjectively upper middle socioeconomic status were 3.124 times greater (1.795-5.438) than that of those with a subjectively lower socioeconomic status. Our findings indicate that participants' perceived socioeconomic disparities extend to disparities in their health status. The reinforcement of welfare measures is greatly needed to temper these disparities.

The Perceived Socioeconomic Status Is an Important Factor of Health Recovery for Victims of Occupational Accidents in Korea

We aimed to examine whether there is a correlation between the health recovery of industrial accident victims and their perceived socioeconomic status. Data were obtained from the first Panel Study of Worker's Compensation Insurance, which included 2,000 participants. We performed multivariate regression analysis and determined the odds ratios for participants with a subjectively lower socioeconomic status and for those with a subjectively lower middle socioeconomic status using 95% confidence intervals. An additional multivariate regression analysis yielded the odds ratios for participants with a subjectively lower socioeconomic status and those with a subjectively upper middle socioeconomic class using 95% confidence intervals. Of all participants, 299 reported a full recovery, whereas 1,701 did not. We examined the odds ratio (95% confidence intervals) for participants' health recovery according to their subjective socioeconomic status while controlling for sex, age, education, tobacco use, alcohol use, subjective state of health prior to the accident, chronic disease, employment duration, recovery period, accident type, disability status, disability rating, and economic participation. The odds of recovery in participants with a subjectively lower middle socioeconomic status were 1.707 times greater (1.264-2.305) than that of those with a subjectively lower socioeconomic status. Similarly, the odds of recovery in participants with a subjectively upper middle socioeconomic status were 3.124 times greater (1.795-5.438) than that of those with a subjectively lower socioeconomic status. Our findings indicate that participants' perceived socioeconomic disparities extend to disparities in their health status. The reinforcement of welfare measures is greatly needed to temper these disparities.

Case report of renal cell carcinoma in automobile manufacturing factory worker due to trichloroethylene exposure in Korea

BACKGROUND: The aim of this paper was report first case of renal cell carcinoma developed in a worker who worked in an automobile manufacture line which handles trichloroethylene in Korea. CASE PRESENTATION: To clarify the relationship between the onset of renal cell carcinoma in 52-years old male worker and the exposure to trichloroethylene, document studies and work environment measurement were done. Past work environment exposure data were reviewed and medical history and surgery records of the worker were also reviewed. The patient had no personal risk factor related to renal cell carcinoma except for his smoking habit of quarter a pack per day for twenty years, and since trichloroethylene was not part of measurement criteria, past work environment risk assessment data could not verify the exposure. The exposure level is deduced by analyzing material exposure level of work environments which has similar processes in data from revised research of chemical exposure standard and work environment validity assessment. Evaluation Committee of Epidemiologic Survey decided that there are relevant relationship between the exposure and the disease, though we do not have exact data during that period, most experts agree that in every factories they used trichloroethylene without any direction. CONCLUSIONS: From the relevant medical history and the results of the usage of trichloroethylene in the relevant industries, and initial discovery of renal cell carcinoma at health inspection sonogram in 2001, it can be concluded that suggests significant causal relationship between the exposure to trichloroethylene and renal cell carcinoma onset, thus reporting it to be the first domestic case declared to be occupational disease.

Factors related to the physician and the employer influencing successful return to work in Korea: results from the first panel study of workers' compensation insurance (PSWCI)

OBJECTIVES: This study aims to investigate associated factors including the physician and the employer of successful return to work (RTW) in occupationally injured workers. METHODS: This study is based on the first panel study of workers' compensation insurance (PSWCI), published in June 2014. The PSWCI is a sample survey of occupationally injured workers who completed medical care in 2012 (89,921 people). A total of 2000 subjects were sampled based on sex, age, nine metropolitan-based regions, disability ratings, duration of rehabilitation, and whether vocational rehabilitation service was used. We divided the study population into two groups: return to work (RTW) group (job retention, reemployment, unpaid family worker, and self-employment), and non-RTW group (joblessness and economical inactivity). The odds ratios (ORs) and 95 % confidence intervals (CI) related to differences in basic characteristics, part of physician and employer-related factors between those who succeeded to RTW and those who did not were measured using multivariable logistic regression model. RESULTS: The success of RTW is 70.6 % (n = 1412) among participants. The ORs (95 % CI) of the participants belonging to RTW who received periodic recovery assessment from the medical care institution and the physician are 1.51 (1.07-2.13). The ORs (95 % CI) are 1.68 (1.05-2.69) for the RTW group who received work ability assessment and referral for vocational return. When the employer maintains the relationship with the occupationally injured worker, the worker has 1.39 times higher odds (95 % CI: 1.41-2.26) of the RTW group compared to the non-RTW group. CONCLUSIONS: The physician and the employer have a significant impact on the RTW.

Workplace Violence Experienced by Substitute (Daeri) Drivers and Its Relationship to Depression in Korea

Workplace violence is related to various health effects including mental illness such as anxiety or depression. In this study, the relationship between the experience of workplace violence and depression in substitute drivers in Korea, namely, daeri drivers, was investigated. To assess workplace violence, questions regarding types and frequency of the experience of violence over the past year were asked to the daeri drivers. In order to assess the risk of depression, the Center for Epidemiological Studies Depression Scale was used. Odds ratios with 95% confidence intervals of depression were estimated using multiple logistic regression analysis. All of the daeri drivers had experienced instance of verbal violence while driving and 66 of the drivers (34.1%) had been in such a situation more than once in the past quarter of a year. Sixty-eight daeri drivers (42.2%) had experienced certain type of physical violence over the past year. Compared to daeri drivers who had experienced workplace verbal violence less than 4 times and who had not experienced workplace physical violence over the past year, higher odds ratio was observed in daeri drivers who had experienced workplace verbal violence or physical violence, more than 4 times and more than one time respectively, after adjustment. Experience of verbal or physical type of workplace violence over the past year increased the risk of depression in the daeri drivers. Because violence against drivers can compromise the safety of the driver, the customer, and all the passengers, it is imperative that the safety and health of daeri drivers be highlighted.

The association between concealing emotions at work and medical utilization in Korea

OBJECTIVES: We aimed to investigate the association between concealing emotions at work and medical utilization. METHODS: Data from the 2007-2009 4th Korea National Health and Nutrition Examination Survey (KNHANES IV) was used, 7,094 participants (3,837 males, 3,257 females) aged between 20 and 54 who were economically active and completed all necessary questionnaire items were included. Odds ratios (ORs) and 95% confidence intervals (95% CI) for differences in hospitalization, outpatient visits, and pharmaceutical drug use between those who concealed their emotions and those who did not were investigated using logistic regression models with and without gender stratification. RESULTS: Among those who concealed their emotions (n = 2,763), 47.4% were females, and 50.1% had chronic disease. In addition, 9.7% of the concealing emotions group had been hospitalized within the last year, 24.8% had been outpatients in the last two weeks, and 28.3% had used pharmaceutical drugs in the last two weeks. All ORs represent the odds of belonging to the concealing emotions group over the non-concealing emotions group. After adjustment for individual, occupational, socioeconomic and disease factors, the adjusted ORs (95% CI) in hospitalization are 1.29 (1.08 ~ 1.53) in the total population, 1.25 (0.98 ~ 1.60) in males and 1.30 (1.02 ~ 1.66) in females, in outpatient visits are 1.15 (1.02 ~ 1.29) in the total population, 1.05 (0.88 ~ 1.24) in males and 1.25 (1.06 ~ 1.47) in females and in pharmaceutical drug use are 1.12 (1.01 ~ 1.25) in the total population, 1.08 (0.92 ~ 1.27) in males and 1.14 (0.98 ~ 1.33) in females. CONCLUSIONS: Those who concealed their emotions at work were more likely to use medical services. Moreover, the health effects of concealing emotions at work might be more detrimental in women than in men.