Decrease in Weekly Working Hours of Korean Workers From 2010 to 2020According to Employment Status and Industrial Sector

Background@#The present study examined changes in the working hours of Korean workers from 2010 to 2020 according to employment status and industrial sector. @*Methods@#This was a secondary analysis of data from the third (2010), fourth (2014), fifth (2017) and sixth (2020) Korean Working Conditions Surveys, which were conducted by the Korea Occupational Safety and Health Agency. @*Results@#During the past 10 years, workers classified as employees, self-employed, or employers experienced clear declines in average weekly working hours and in the percentages of individuals who worked more than 48 hours per week. During 2020, the largest proportion of employees (52.8%) had 40-hour work weeks, whereas the largest proportions of selfemployed individuals (26.8%) and employers (25.1%) had very long work weeks (≥ 60 h/ week). Also during 2020, individuals who were self-employed or employers in the sectors of ‘Accommodation and food service’ had the longest weekly work hours, whereas employees in the sector of ‘Transportation’ had the longest weekly work hours. All three groups (employees, self-employed, and employers) in all 21 industrial sectors experienced declines in average weekly working hours from 2017 to 2020. @*Conclusion@#From 2010 to 2020, employees, self-employed individuals, and employers experienced clear declines in average weekly working hours, and in the percentages of individuals with long weekly working hours. However, there were also differences in the weekly working hours of those who had different employment status and who worked in different industrial sectors. The implementation of the 40-hour work-week and the 52-hour maximum work-week in Korea reduced excessive work hours by individuals who had different employment status and who worked in different industrial sectors, and probably improved worker quality-of-life. We recommend extension of these regulations to workplaces with fewer than 5 employees.

Factors that Affect Depression and Anxiety in Service and Sales Workers Who Interact With Angry Clients

Methods@#This was a secondary analysis of data from the fifth Korean Working Conditions Survey conducted in 2017. A structural equation model was used for mediation and moderation analysis. @*Results@#Service and sales workers who had more interactions with angry clients had increased risk for depression and anxiety. Experiencing clients' adverse behaviors (acute episodes) mediated the relationship between interacting with angry clients (a chronic situation) on depression and anxiety. Job satisfaction and managers' support moderated the relationship between interacting with angry clients and mental health problems. @*Conclusion@#We suggest that employers of service and sales workers should recruit staff based on their aptitude for such work, thus ensuring job satisfaction, and train them to deal with angry clients in such a way that they experience less emotional burden. Employers should also make bylaws requiring managers to directly take care of adverse social behavior by clients. Furthermore, a sociocultural campaign to prevent adverse social behavior by clients is also needed.

Association of Participation in Health Check-ups with Risk Factors for Cardiovascular Diseases

Background@#We compared the risk factors for cardiovascular diseases (CVDs) among Koreans who did and did not participate in national periodic health check-ups, after adjustment for demographic factors, socioeconomic status, and lifestyle factors. @*Methods@#This cross-sectional study used data from the Korea National Health and Nutrition Examination Survey (KNHANES) from 2007 to 2018. Study subjects were classified as participants or non-participants in health check-ups, based on attendance at national periodic health check-ups during the previous two years. @*Results@#Comparison of participants and non-participants in health check-ups indicated statistically significant differences in age, gender, region, education level, monthly income, employment status, obesity, smoking, alcohol consumption, exercise, and marital status. After adjustment for demographic, socioeconomic factors, and health-related behaviors, woman non-participants were more likely to have metabolic syndrome, pre-hypertension, hypertension, prediabetes, and diabetes, and man non-participants were more likely to have pre-diabetes and diabetes. @*Conclusion@#Subjects who participated in periodic health check-ups had fewer CVD-related risk factors than non-participants. Thus, health care providers should encourage nonparticipants to attend periodic health check-ups so that appropriate interventions can be implemented and decrease the risk for CVDs in these individuals.

Factors that Affect Depression and Anxiety in Service and Sales Workers Who Interact With Angry Clients

Methods@#This was a secondary analysis of data from the fifth Korean Working Conditions Survey conducted in 2017. A structural equation model was used for mediation and moderation analysis. @*Results@#Service and sales workers who had more interactions with angry clients had increased risk for depression and anxiety. Experiencing clients' adverse behaviors (acute episodes) mediated the relationship between interacting with angry clients (a chronic situation) on depression and anxiety. Job satisfaction and managers' support moderated the relationship between interacting with angry clients and mental health problems. @*Conclusion@#We suggest that employers of service and sales workers should recruit staff based on their aptitude for such work, thus ensuring job satisfaction, and train them to deal with angry clients in such a way that they experience less emotional burden. Employers should also make bylaws requiring managers to directly take care of adverse social behavior by clients. Furthermore, a sociocultural campaign to prevent adverse social behavior by clients is also needed.

Comparison of Long Term Follow-up Chest CT Imaging in Adult and Pediatric Patients with Humidifier Disinfectant-related Lung Injury

Background@#To compare the chest computed tomography (CT) images of children and adults in families with clusters of humidifier disinfectant-related lung injury (HDLI) after cessation of exposure to humidifier disinfectant (HD). @*Methods@#We reviewed medical records of 19 families with 43 patients (21 adults, 22 children) among families, which had at least one adult and one child with HDLI. Each family was exposed to the same HD exposure environment. @*Results@#In adults, centrilobular nodules were predominant (95.2%) in chronic HDLI findings after cessation of exposure to HD, however, in children, normal pattern was most prevalent on chest CT (45.5%), followed by centrilobular nodule (36.4%), bizarre lung cysts (36.4%), and reticulation (13.6%). @*Conclusion@#Unlike the known chronic HDLI finding of adults, centrilobular nodules were only present in 36.4% of children. The frequency of bizarre lung cysts were significantly greater in children than that in adults after cessation of similar exposure to HD. Thus, bizarre lung cysts may be useful as another novel finding of chronic HDLI in children who have no history of pulmonary infection or other perinatal disorder such as hyaline membrane disease or other interstitial lung disease.

Factors Related to Subjective Wellbeing in Workers Who Interact with Angry Clients

Background@#Among workers who interact with angry clients, there is limited information about the characteristics of workers who are most vulnerable to mental health problems. Thus, we determined the association of multiple demographic, socioeconomic, and modifiable work-related psychosocial factors with the subjective well-being of workers who interact with angry clients. @*Methods@#This was a secondary analysis of data from the fifth Korean Working Conditions Survey, conducted in 2017. The study focused on workers who interacted with angry clients during 25% or more of their work time. Multiple logistic regression was used to determine odds ratios (ORs) and 95% confidence intervals for the association of multiple factors with self-reported subjective well-being after adjustment for demographic, socioeconomic, and modifiable psychosocial factors. @*Results@#Overall, 9.6% of men and 7.4% of women who interacted with angry clients reported poor subjective well-being. Poor well-being was significantly more likely to be reported by men who worked 40 hours or more per week (aOR, 3.97–5.37) and by men who were daily workers (aOR, 2.21). Poor subjective well-being had a significantly positive association with exposure to adverse social behaviors by clients (men: aOR, 1.54, women: aOR, 1.58), and significantly negative associations with unskilled manual work (women only: aOR, 0.30), job satisfaction (men: aOR, 0.70, women: aOR, 0.52), and good social climate (men: aOR, 0.70, women: aOR, 0.44). @*Conclusion@#Workers who interact with angry clients were widely distributed over nonmanual labor and manual labor, but not limited to service and sales job. We identified modifiable factors that affect the subjective well-being of workers who interact with angry clients. We suggest that employers provide protection to prevent adverse social behaviors by clients, and also make an effort to establish a good social climate at the workplace.

From Workers to the Working-Age Population: A New Paradigm for the Occupational Health Service

No abstract available.

Relationship of Occupational Category With Risk of Physical and Mental Health Problems

OBJECTIVES: We evaluated the physical and mental health problems of waged workers in Korea who had different classes of occupation.METHODS: We used data from the Korean National Health and Nutrition Examination Survey (2007–2017) to examine 22,788 workers who were waged employees and categorized these workers into 5 occupational classes.RESULTS: “Unskilled manual workers” were more likely to be older, less educated, have lower monthly income, and work fewer hours per week. Among men and relative to “managers and professionals” (reference group), “skilled manual workers” were more likely to have physician-diagnosed osteoarthritis, “clerks” were less likely to report suicidal ideation, and “unskilled manual workers” were more likely to report suicidal ideation. Among women and relative to “managers and professionals” (reference group), “service and sales workers” and “unskilled manual workers” were more likely to report physician-diagnosed osteoarthritis, depressive feelings, and suicidal ideation. However, hypertension, hyperlipidemia, diabetes, and cardiovascular diseases did not differ among the occupational classes for men and women.CONCLUSION: We identified differences between men and women and among those in different occupational classes regarding employment status, physical health, and mental health. “Unskilled manual workers” of both genders were more likely to be older, less educated, have less monthly income, work fewer hours per week, and have suicidal ideation. Female “service and sales workers” were more likely to have osteoarthritis, depressive feelings, and suicidal ideation.

Environmental and Body Concentrations of Heavy Metals at Sites Near and Distant from Industrial Complexes in Ulsan, Korea

BACKGROUND: Industrial pollution may affect the heavy metal body burden of people living near industrial complexes. We determined the average concentrations of atmospheric heavy metals in areas close to and distant from industrial complexes in Korea, and the body concentrations of these heavy metals in residents living near and distant from these facilities. METHODS: The atmospheric data of heavy metals (lead and cadmium) were from the Regional Air Monitoring Network in Ulsan. We recruited 1,148 participants, 872 who lived near an industrial complex (“exposed” group) and 276 who lived distant from industrial complexes (“non-exposed” group), and measured their concentrations of blood lead, urinary cadmium, and urinary total mercury. RESULTS: The results showed that atmospheric and human concentrations of heavy metals were higher in areas near industrial complexes. In addition, residents living near industrial complexes had higher individual and combined concentrations (cadmium + lead + mercury) of heavy metals. CONCLUSION: We conclude that residents living near industrial complexes are exposed to high concentrations of heavy metals, and should be carefully monitored.

Cognitive Function and Neuropsychological Comorbidities in Children with Newly Diagnosed Idiopathic Epilepsy

BACKGROUND: In this study, we aimed to identify cognitive function and neuropsychological comorbidities in children with newly diagnosed idiopathic epilepsy. METHODS: We retrospectively reviewed the records of 97 antiepileptic drug-naïve children (9.7 ± 2.9 years; 54 males and 43 females) with newly diagnosed idiopathic epilepsy, all of whom underwent a neuropsychological battery. The battery consisted of the Korean Wechsler Intelligence Scale, Attention Deficit Hyperactivity Disorder (ADHD) Rating Scale, ADHD Diagnostic System, Children's Depression Inventory, and State-Trait Anxiety Inventory for Children. We investigated association between scores of the neuropsychological battery and epilepsy classification, lateralization of interictal epileptiform discharges (IEDs) on electroencephalography (EEG), and variables related to seizures. RESULTS: Thirteen patients (14.3%) had ADHD symptoms. Three patients (4.1%) had depressive symptoms, and 9 (12.3%) had anxiety symptoms. Patients with idiopathic generalized epilepsy (IGE) had significantly lower full-scale intelligence and performance intelligence quotient scores than patients with idiopathic localization-related epilepsy (ILRE) (89.0 ± 17.6 vs. 96.3 ± 14.8; P = 0.030 and 88.9 ± 16.3 vs. 97.0 ± 16.4; P = 0.016, respectively). Patients with ILRE having unilateral IEDs had significantly higher full-scale intelligence quotient scores than patients with ILRE having bilateral IEDs and patients with IGE (99.9 ± 12.2 vs. 93.7 ± 16.1 vs. 89.0 ± 17.6; P = 0.039, respectively). CONCLUSION: Our results suggest that idiopathic epilepsy may be accompanied by various neuropsychological comorbidities even at initial diagnosis. Patients with IGE and ILRE having bilateral IEDs on EEG appear more likely to be at high risk of decreased cognitive function.

Review of carcinogenicity of hexavalent chrome and proposal of revising approval standards for an occupational cancers in Korea

BACKGROUND: The objective of this study is to suggest revised recognition standards for occupational disease due to chromium (VI) by reflecting recent domestic and international research works and considering domestic exposure status with respect to target organs, exposure period, and cumulative exposure dose in relation to the chromium (VI)-induced occupational disease compensation. METHODS: In this study, the reports published by major international institutions such as World Health Organization (WHO) International Agency for Research on Cancer (IARC) (2012), Occupational Safety and Health Administration (OSHA) (2006), National Institute for Occupational Safety and Health (NIOSH) (2013), American Conference of Governmental Industrial Hygienists (ACGIH) (2004), National Toxicology Program (NTP) (2014), and Agency for Toxic Substances and Disease Registry (ASTDR) (2012) were reviewed and the recent research works searched by PubMed were summarized. RESULTS: Considering the recent research works and the domestic situation, only lung cancer is conserved in the legislative bill in relation to chromium (VI), and the exposure period is not included in the bill. Nasal and paranasal sinus cancer was excluded from the list of cancers that are compensated as the chromium (VI)- induced occupational disease, while lung cancer remains in the list. In the view of legislative unity, considering the fact that only the cancers having sufficient evidence are included in the conventional list of cancers compensated as occupational disease, nasal and paranasal sinus cancer having limited evidence were excluded from the list. The exposure period was also removed from the legislative bill due to the insufficient evidence. Recent advices in connection with cumulative exposure dose were proposed, and other considerable points were provided with respect to individual occupational relevance. CONCLUSIONS: It is suggested that the current recognition standard which is “Lung cancer or nasal and paranasal sinus cancer caused by exposure to chromium (VI) or compounds thereof (exposure for two years or longer), or nickel compounds” should be changed to “Lung cancer caused by exposure to chromium (VI) or compounds thereof, and lung cancer or nasal and paranasal sinus cancer caused by exposure to nickel compounds”.

Correction to: Guidelines for recognition of occupational cancers in Korea: the results of scientific review by Korean Society of Occupational and Environmental Medicine (2013–2016)

The authors flagged that the spelling of author YangHo Kim was incorrect. It is published on the original manuscript as Yang Ho Kim, but should be spelt YangHo Kim.

Health effects of environmental pollution in population living near industrial complex areas in Korea

Several epidemiological studies have reported an association between environmental pollution and various health conditions in individuals residing in industrial complexes. To evaluate the effects of pollution from industrial complex on human health, we performed a pooled analysis of environmental epidemiologic monitoring data for residents living near national industrial complexes in Korea. The respiratory and allergic symptoms and the prevalence of acute and chronic diseases, including cancer, were used as the outcome variables for health effects. Multiple logistic regression analysis was used to analyze the relationship between exposure to pollution from industrial complexes and health conditions. After adjusting for age, sex, smoking status, occupational exposure, level of education, and body mass index, the residents near the industrial complexes were found to have more respiratory symptoms, such as cough (odds ratio [OR], 1.18; 95% confidence interval [CI], 1.06 to 1.31) and sputum production (OR, 1.13; 95% CI, 1.03 to 1.24), and symptoms of atopic dermatitis (OR, 1.10; 95% CI, 1.01 to 1.20). Among residents of the industrial complexes, the prevalence of acute eye disorders was approximately 40% higher (OR, 1.39; 95% CI, 1.04 to 1.84) and the prevalence of lung and uterine cancer was 3.45 times and 1.88 times higher, respectively, than those among residents of the control area. This study showed that residents living in the vicinity of industrial complexes have a high risk of acute and chronic diseases including respiratory and allergic conditions. These results can be used as basic objective data for developing health management measures for individuals residing near industrial complexes.

Association of Blood Pressure with Blood Lead and Cadmium Levels in Korean Adolescents: Analysis of Data from the 2010–2016 Korean National Health and Nutrition Examination Survey

BACKGROUND: We evaluated the association of blood pressure (BP) with blood levels of cadmium, lead, and cadmium and lead together (cadmium + lead) in a representative sample of adolescents from Korea. METHODS: We used 2010–2016 data from the Korean National Health and Nutrition Examination Survey. This cross-sectional study enrolled adolescents aged at 10–18 years-old who completed a health examination survey and had blood measurements of lead and cadmium. The association of adjusted mean differences in diastolic and systolic BP with doubling of blood lead and cadmium were estimated by regression of BP against log2-transformed blood metals and their quartiles after covariate adjustment. Adjusted odds ratio for prehypertension were calculated for log2-transformed blood levels of lead and cadmium and their quartiles. RESULTS: Our analysis of adolescents in Korea indicated that blood levels of lead and cadmium were not significantly associated with increased BP or risk of prehypertension. However, the cadmium + lead level was associated with prehypertension. Previous studies showed that blood levels of lead and cadmium were associated with increased BP and risk of hypertension in adult populations. We found no such association in Korean adolescents. CONCLUSION: We found that the cadmium + lead level was associated with prehypertension. The differences between adults and adolescents are because adolescents generally have lower levels of these blood metals or because adolescents only rarely have hypertension.

Work Sectors with High Risk for Work-Related Musculoskeletal Disorders in Korean Men and Women

BACKGROUND: To identify work sectors with high risk for work-related musculoskeletal disorders (MSDs) in Korean men and women. METHODS: We analyzed nationwide data to identify ergonomic risk factors in Korean employees. In particular, we analyzed data on exposure to five ergonomic risk factors (painful/tiring postures, lifting/moving heavy materials, standing/walking, repetitive hand/arm movements, and hand/arm vibration) according to employment sector, sex, and age, using the 2014 Fourth Korean Working Conditions Survey. We also used workers' compensation data on work-related MSDs in 2010, which is available by sex. RESULTS: The different work sectors had different gender distributions. “Manufacturing” (27.7%) and “construction” (11.3%) were dominated by males, whereas “human health and social work activities” (12.4%), “hotel and restaurants” (11.7%), and “education” (10.4%) were dominated by females. However, “wholesale and retail trade” and “public administration and defense” employed large numbers of males and females. Furthermore, the work sectors with a greater proportion of work-related MSDs and with multiple ergonomic risk factors were different for men and women. For men, “construction” and “manufacturing” had the highest risk for work-related MSDs; for women, “hotel and restaurants” had the highest risk for work-related MSDs. CONCLUSION: Ergonomic interventions for workers should consider gender and should focus on work sectors with high risk for MSDs, with multiple ergonomic risk factors, and with the largest number of workers.

Health effects of environmental pollution in population living near industrial complex areas in Korea

Several epidemiological studies have reported an association between environmental pollution and various health conditions in individuals residing in industrial complexes. To evaluate the effects of pollution from industrial complex on human health, we performed a pooled analysis of environmental epidemiologic monitoring data for residents living near national industrial complexes in Korea. The respiratory and allergic symptoms and the prevalence of acute and chronic diseases, including cancer, were used as the outcome variables for health effects. Multiple logistic regression analysis was used to analyze the relationship between exposure to pollution from industrial complexes and health conditions. After adjusting for age, sex, smoking status, occupational exposure, level of education, and body mass index, the residents near the industrial complexes were found to have more respiratory symptoms, such as cough (odds ratio [OR], 1.18; 95% confidence interval [CI], 1.06 to 1.31) and sputum production (OR, 1.13; 95% CI, 1.03 to 1.24), and symptoms of atopic dermatitis (OR, 1.10; 95% CI, 1.01 to 1.20). Among residents of the industrial complexes, the prevalence of acute eye disorders was approximately 40% higher (OR, 1.39; 95% CI, 1.04 to 1.84) and the prevalence of lung and uterine cancer was 3.45 times and 1.88 times higher, respectively, than those among residents of the control area. This study showed that residents living in the vicinity of industrial complexes have a high risk of acute and chronic diseases including respiratory and allergic conditions. These results can be used as basic objective data for developing health management measures for individuals residing near industrial complexes.

Modeling the effects of pollutant emissions from large industrial complexes on benzene, toluene, and xylene concentrations in urban areas

This study utilized the Community Multiscale Air Quality model to simulate the spatial distribution of benzene, toluene, and xylene (BTX) concentrations from large national industrial complexes (IC) located in the Ulsan metropolitan region (UMR). Through controlling pollutant emissions from major IC, this study performed a quantitative analysis of the influence of pollutant emissions on BTX concentrations in surrounding urban areas. The results showed that approximately 40% of the annual average BTX concentrations in nearby urban grids were directly influenced by pollutant emissions from the IC. Seasonal modeling results indicated that average BTX concentrations were high around petrochemical complexes, with higher concentrations in the surrounding urban areas during the summer (July). All three of the BTX pollutants showed similar seasonal differences. Daily contributions differed significantly throughout the modeling period, with some values reaching a maximum of 80% during July. Overall, when urban areas were located downwind of the IC, contributions rose. Moreover, this study compared the differences in BTX contributions at each measurement point within the IC and urban areas, which showed that the influence of the IC emissions decreased significantly with distance. The spatial distribution and direct influence of the IC on BTX concentrations in the UMR identified through this study could be used to provide input data in environmental epidemiological studies.

Factors affecting heat-related diseases in outdoor workers exposed to extreme heat

BACKGROUND: The objectives of the present study are to: (i) evaluate the effect of environmental and metabolic heat on heat-related illnesses in outdoor workers; and (ii) evaluate the effect of personal factors, including heat acclimation, on the risk of heat-related illnesses in outdoor workers. METHODS: We identified 47 cases of illnesses from exposure to environmental heat in outdoor workers in Korea from 2010 to 2014, based on review of workers' compensation data. We also obtained the information on location, time, and work environment of each heat-related illness. RESULTS: Our major results are that 29 cases (61.7%) occurred during a heat wave. Forty five cases (95.7%) occurred when the maximum estimated WBGT (WBGTmax) was equal to or greater than the case specific threshold value which was determined by acclimatization and metabolic rate. Twenty two cases (46.8%) were not acclimated to the heat. Thirty-seven cases (78.7%) occurred after tropical night (temperature above 25 °C), during which many people may find it hard to sleep. CONCLUSION: Personal risk factors such as heat acclimation as well as environmental factors and high metabolic rate during work are the major determinants of heat-related illnesses.

The association between cadmium and lead exposure and blood pressure among workers of a smelting industry: a cross-sectional study

BACKGROUND: Lead and cadmium are harmful heavy metals that are used for a variety of occupational purposes. Considering their potentially hazardous effects on health, studies on the association between exposure to these two heavy metals and health disorders have been actively conducted. This study aimed to determine the association between blood lead and cadmium levels and blood pressure in workers exposed to lead and cadmium in a smelter. METHODS: Nine hundred and sixty-three male workers who worked in a smelter, and underwent medical examinations at the Ulsan University Hospital between January 1 and December 31, 2014, were selected as participants. Among them, 310 subjects whose data on height, weight, blood pressure, fasting blood glucose, lipid profile, and blood lead and cadmium levels were available and who answered the questionnaire were selected as the final participants. We investigated the drinking habit, smoking status, exercise adequacy, and family history of hypertension of these workers using formal questionnaires. A statistical analysis was conducted using Student's t-test, analysis of variance, and linear or logistic regression. RESULTS: The association between blood lead and cadmium levels and blood pressure was analyzed through statistical adjustment of the risk factors of hypertension. Results showed an association between blood cadmium level and blood pressure elevation. However, blood lead level was found to be not correlated with blood pressure elevation. CONCLUSIONS: This study shows the association between blood cadmium level and systolic blood pressure (SBP) and diastolic blood pressure (DBP) elevation. TRIAL REGISTRATION: IRB No. 2017–03-037. Retrospectively Registered 30 March 2017.

Hazards and health problems in occupations dominated by aged workers in South Korea

BACKGROUND: South Korea's population is aging more rapidly than any other country. Aging of the productive population will lead to shortage of labor and the decreasing quality of the labor force in South Korea. South Korea needs health care strategies to support the establishment of work environments that are appropriate for elderly workers who have reduced physical capacity. This paper aims to identify occupations that are dominated by aged workers and assess the exposure to hazards and work-related health problems of aged workers in these occupations. METHODS: We identified the 20 occupations in South Korea that employ the most aged workers (at least 55 years-old), among all 149 occupations that are defined as minor categories (identified by three digits) by the Korean Standard Classification of Occupations (KSCO). Exposure to hazards and work-related health problems of individuals in these occupations were evaluated by analyzing the results of the fourth Working Conditions Survey of 2014. RESULTS: Among the 20 occupations that employ the most aged workers, ‘Elementary Occupations', which the KSCO classifies as major category (9), had the largest proportion of aged workers. After this, there were five occupations of skilled manual workers and six occupations of skilled non-manual workers. Aged workers in elementary and skilled manual occupations reported frequent exposure to job-specific hazards, such as noise, vibrations, high and low temperatures, solvents, and chemicals. Relative to other workers, aged workers in the occupations reported more frequent exposure to ergonomic hazards, such as tiring or painful positions, carrying or moving heavy loads, and repetitive movements, and also reported more work-related musculoskeletal disorders and general fatigue. Injury due to accident was common in machinery-handling occupations. CONCLUSION: Job-specific hazards should be reduced to prevent occupation-related disorders in elementary and skilled manual occupations that are dominated by aged workers.