The Prevalence of Work Related Sickness Absences According to the Second Korean Working Condition Survey / 대한산업의학회지

OBJECTIVES: Worker's health is an important index used to evaluate working conditions and to prioritize prevention policies. However, this index has never before been calculated in Korea. The purpose of this study was to calculate the prevalence of health problems caused by work related sickness absences using the second Korean Working Condition Survey (KWCS) conducted in 2010. METHODS: The second KWCS was conducted from June to October 2010 as a household survey for employed workers. The work related sickness absence rate was estimated using gender, age, business size, occupational status, level of education, and level of income. A logistic regression was performed in order to evaluate the relationship of the work related sickness absence with general characteristics and work-related conditions. RESULTS: The rate of work related sickness absence was 1.8(+/-0.2)% for all workers, with 6.0(+/-0.3)% of it being in agriculture, forestry, and fishing, and 2.2(+/-0.5)% in manufacturing. Musculoskeletal disorders (MSD) were the most common work related disorder [1.01(+/-0.12)%], followed by psychiatric disorders [0.18(+/-0.05)%], and respiratory disorders [0.14(+/-0.04)%]. The highest odds ratio (OR) for the work related sickness absence rate was in self-employed workers with employees (OR=2.23, 95%CI=1.05~4.74). CONCLUSIONS: The work related sickness absence rate for all workers, both self-employed and employed, including agriculture, forestry and fishing workers, and wholesale and retail trade workers was 1.8(+/-0.2)%. Because the KWCS was based on a self-reported questionnaire survey, this figure might be overestimated. In addition, it might omit chronic occupational disease and death cases.

Cognition and Practice on Medical Information Protection of Iudustrial Health Care Manager of Small and Medium Sized Enterprises / 대한산업의학회지

OBJECTIVES: This research aimed to know the actual condition and problems of medical information protection at a workplace with the target of industrial health care managers of small and medium-sized enterprises. METHODS: A self-administered questionnaire was given to industrial health-care managers of 216 enterprises from March 15 to May 17, 2010. The questionnaire was produced by referring to the Act on Personal Information Protection of Public Institutions, etc. This research evaluated agreement of cognition and practice according to 10 items of medical information protection using kappa and cross-analysis of significant factors between cognition and practice of medical information protection and general characteristics. RESULTS: Cognition about medical information protection appeared to be 85.4-97.1% and its practice appeared to be 44.1-95.3%, so practice was lower than cognition. In addition, the agreement of cognition and practice appeared significantly low (kappa 0.082-0.387). The practice of medical information protection tended to be lower when the managers were older and held a higher job title. Health examination results were being delivered only to workers except for an employer (94.2%), but there were many industrial health-care managers who felt discomfort about their work in group occupational health-care systems (58.1%). CONCLUSIONS: The practice of protecting medical information by industrial health-care managers was clearly lower than the cognition. Therefore, introduction of educational programs about personal information protection and provision of an independent place for group occupational health care service is urgent. In addition, in order to use the health examination results conveniently in group occupational health services, an institutional complement is necessary.

A Case of Gastric Rupture after Cardiopulmonary Resuscitation by a Bystander

The presence of a bystander who can implement cardiopulmonary resuscitation would appear to increase chances of survival. However, there have been many reported complications associated with bystander CPR. Gastric rupture is a rare complication following cardiopulmonary resuscitation. An incidence of 0.1% has been reported in the literature. The majority of reported cases have been associated with inappropriate airway management or esophageal intubation. Gastric rupture can occur during chest compressions when the stomach is overinflated due to difficult airway management or esophageal intubation. Here we present the case of a patient with sudden cardiac arrest who experienced gastric rupture and pneumoperitoneum after bystander cardiopulmonary resuscitation.

Characteristics of Work-related Musculoskeletal Disorders in Korea and Their Work-relatedness Evaluation

Work-related musculoskeletal disorders (WMSDs) can be compensated through the Industrial Accident Compensation Insurance Act. We looked at the characteristics of WMSDs in worker's compensation records and the epidemiological investigation reports from the Occupational Safety and Health Research Institute (OSHRI). Based on the records of compensation, the number of cases for WMSDs decreased from 4,532 in 2003 to 1,954 in 2007. However the proportion of WMSDs among the total approved occupational diseases increased from 49.6% in 2003 to 76.5% in 2007, and the total cost of WMSDs increased from 105.3 billion won in 2004 to 163.3 billion won in 2007. The approval rate of WMSDs by the OSHRI accounted for 65.6%. Ergonomic and clinical characteristics were associated with the approval rate; however, the degenerative changes had a minimal affect. This result was in discordance between OSHRI and the Korea Workers' Compensation & Welfare Service. We presumed that there were perceptional gaps in work-relatedness interpretation that resulted from the inequality of information in ergonomic analyses. We propose to introduce ergonomic analysis to unapproved WMSDs cases and discuss those results among experts that will be helpful to form a consensus among diverse groups.

A Case of Moderate Paraquat Intoxication with Pulse Therapy in the Subacute Stage of Pulmonary Fibrosis

In South Korea, attempted suicide by paraquat (PQ) intoxication is fairly common, and is lethal by pulmonary fibrosis and hypoxemia. However, the treatment of PQ poisoning is primarily supportive management. To increase the survival rate associated with PQ intoxication, many treatments have been developed. Here, we treated a case of PQ intoxication with steroid pulse therapy. A 23-year-old man was admitted to the hospital because of PQ intoxication. He drank two mouthfuls of Gramoxon (24% commercial paraquat). His vital signs were stable, but he had a throat infection, and navy blue urine in the sodium dithionite test. Standard treatment, including gastric lavage with activated charcoal was performed, and emergent hemoperfusion with a charcoal filter was initiated 11 h after PQ ingestion. Pharmacotherapy was initiated 18 h after PQ ingestion with the administration of 5 mg dexamethasone. On day 10, chest PA showed pulmonary fibrosis. Therefore, we initiated steroid pulse therapy, with 1 g methylprednisolone in 100 mL of D5W administered over 1 h repeated daily for 3 days, and 1g cyclophosphamide in 100 mL of D5W administered over 1 h daily for 2 days. On day 15, dexamethasone therapy was initiated. On day 30, pulmonary fibrosis was improved. Thus, if pulmonary fibrosis becomes exacerbated after dexamethasone therapy during the subacute stage, pulse therapy with methylprednisolone and cyclophosphamide could be helpful.

Severity-Based Analysis of Prehospital Transportation Time Using the Geographic Information System (GIS)

PURPOSE: Response time is an important factor in determining the quality of prehospital Emergency Medical Services (EMS). Our objective was to analyze the Daegu Korean Fire Department's ambulances' response time by use of the Geographic Information System (GIS) and to suggest general factors for quality improvement of EMS. METHODS: We retrospectively reviewed computerized ambulance calls of the Daegu Korean Fire Department. During the period from July 2006 to June 2007, computerized ambulance calls could be pinpointed geographically by the GIS. Patients were divided into injury and disease groups. And each group was subdivided into emergency and non-emergency groups at triage. We reviewed the EMS response time, response velocity, distance from 119 safe center to scene, and distance from scene to hospital. RESULTS: Of 46,606 patients, 27,825 patients could be pinpointed geographically by the GIS. The mean response time was 5.5+/-18.9 minutes. Among injury patients, there were no significant differences between emergency and non-emergency groups in mean response time and mean response velocity. In disease patients, however, emergency group response time was shorter than for the non-emergency group, and response velocity was faster for the emergency group. Distance from 119 safe center to scene and from scene to hospital was greater among all total patients for the emergency group than for the non-emergency group. CONCLUSION: Using GIS, we evaluated response velocity as a measure of the quality of prehospital EMS. We found that in injury patients, prehospital triage and transportation were not properly managed. We suggests that EMS could be more effective if GIS is used as a tool for the improvement of EMS quality.