Influencing Factors in Approving Cerebrovascular and Cardiovascular Disease as Work-Related Disease of Workers' in Manufacturing Sectors / 대한산업의학회지

OBJECTIVES: This study was performed to analyze the factors that have been meaningful in recognizing cerebrovascular and cardiovascular diseases in manufacturing sector workers as work-related diseases, since amendment of Industrial Accident Compensation Insurance Act on July 1st, 2008, and provide information to establish an objective standard. METHODS: We examined 359 claims of cerebrovascular and cardiovascular diseases which were presented as occupational diseases from January 1st, to December 31th, 2010, collecting Industrial Accident Compensation data from the six Provincial Committees for work-related disease decision. We analyzed the approval rate and odds ratio of the general characteristics, past medical history and work-related information, by using univariate logistic regression. In addition, we confirmed the factors that have effects on when approving work-related diseases by using multivariate logistic regression. RESULTS: Overall, 92 claims out of the 359 claims were recognized as worked-related diseases with an approval rate of 25.6%. Because of accidental situations such as altercation, cold environments, fire etc., only 12 cases were approved. In addition, due to short-term overwork such as outdoor work in cold environments, only 18 cases were approved. Sixty-two cases were approved for chronic overwork. On chronic overwork, the approval rate was not significantly different in univariate logistic regression in gender, age, claimed disease, survival or death, smoker or non-smoker, or associated disease. However, factory size and, average working time for last one week and average working time for last four weeks were significantly. In the multivariate logistic regression analyzed, adjusted for age and sex, we found that the factors in approving cerebrovascular and cardiovascular disease as work-related disease were average working time for the last four weeks and factory size. CONCLUSION: We concluded that there has been a great deal of subjective judgements when approving cerebrovascular and cardiovascular diseases to be occupational diseases. Therefore, objective criteria should be established, especially with regard to the approval of work-related cerebrovascular and cardiovascular diseases and working hours.

Influencing Factors in Approving Cerebrovascular and Cardiovascular Diseases as Occupational Disease in Seoul / 대한산업의학회지

OBJECTIVES: This study was performed to analyze the factors that affected the decision making process in approving workers' compensation claims for cerebrovascular and cardiovascular diseases cases that occurred just before refoming approval standards of Industrial Accident Compensation Insurance Act on 1 July 2008 and to provide fundamental information in preparing better standards. METHODS: We examined 283 claims cases involving cerebrovascular and cardiovascular diseases that occurred between 1 January, 2006 and 31 December, 2007 and collected data based on the worker's compensation records from 3 Seoul Regional Centers of the Workers' Compensation & Welfare Service. We analyzed the approval rates and odds ratios according to the general characteristics, injury information, past medical histories, and work related information using chi-square or univariate logistic regression. In addition, we identified the factors affecting the approval using multivariate logistic regression. RESULTS: Overall, 101 of the 283 cases were approved and approval rate was 35.7%. Approval rates differed significantly according to type of disease, survival, accident site, accident time, the presence of associated disease and overwork (p-value <0.05). In the multivariate logistic regression analysis with adjusted for age and sex, approval rate of death cases with associated disease was lower than cases without associated disease (OR 0.22, 95% CI 0.12~0.42). Approval rate of cases occurred in worksite was higher than others (OR 4.81, 95% CI 2.22~10.40). Cases of accepted overwork had a higher approval rate significantly than cases of not accepted (OR 28.53, 95% CI 9.74~83.52). CONCLUSION: Factors in approving cases of cerebrovascular and cardiovascular disease as cases involving occupational disease included conditions of overwork, high rate of accidents in the workplace and the presence of associated disease. It is necessary to investigate further behaviors of work and chronic work-related stress.

Occupational Stress in Relation to Cerebrovascular and Cardiovascular Disease: Longitudinal Analysis from the NSDSOS Project / 대한산업의학회지

OBJECTIVES: This prospective study was performed to investigate the association between occupational stress and the development of cerebrovascular and cardiovascular diseases. METHODS: A total of 8,429 employees were selected from a nationwide sample, proportional to both the Korean Standard Industrial Classification and the Korean Standard Occupational Classification. A structured self-reported questionnaire was used to access the demographic and socioeconomic characteristics, health behavior and work related characteristics. 43-items of the full version of Korean Occupational Stress Scale (KOSS) were used to access the participants occupational stress. New cases of hospitalization due to cerebrovascular and cardiovascular diseases were evaluated using medical utilization files received from the National Health Insurance Corporation for the period of March 2004 to December 2005. A logistic regression analysis was performed to investigate the association between occupational stress and cerebrovascular and cardiovascular diseases. RESULTS: 43 new cases of hospitalization due to cerebrovascular and cardiovascular diseases were found. According to the results of the logistic regression analysis, job stressors were related with circulatory diseases after adjustment for gender, age, number of workers, employment type, shift work, smoking, alcohol intake, and regular exercise. Of the 8 subscales, insufficient job control (Adj. RR 2.802; 95% CI 1.038-7.564) and occupational climate (Adj. RR 2.365; 95% CI 1.087~5.143) were significantly associated with cerebrovascular and cardiovascular diseases. However, no significant relationships were found between the 6 KOSS subscales and cerebrovascular and cardiovascular diseases. CONCLUSIONS: Despite the short-term follow-up of about two years, the KOSS subscales of insufficient job control and occupational climate were significantly associated with cerebrovascular and cardiovascular diseases.

Analysis of Sufficient Conditions in Approving Cere b rovascular and Cardiovascular Disease as Occupational Disease / 대한산업의학회지

OBJECTIVES: This study was performed to analyze the factors that affect the decision to approve workers compensation claims for cerebrovascular and cardiovascular diseases and to analyze the worker characteristics. METHODS: Three hundred, sixty-nine cases were collected based on the workers compensation records of three Seoul and Incheon Regional centers of the Labor Welfare Corporation between 1998 and 1999. They contained the general characteristics, injury information and past medical histories. The x2-test and logistic regression were performed to investigate the factors affecting the approvals. Seventy-two survivors were surveyed by telephone for job stress. Job stress was surveyed in three parts: job demands, decision latitude and personal free time. RESULTS: Of the cases, 167 obtained approval from the Corporation; the others did not. Regardless of approval, 62% of all subjects had more than one of the cerebral and cardiovascular risk factors. Especially, 53.9% of subjects had hypertension. According to the logistic regression, the fatal cases had a higher approval rate (OR=26.4, CI=9.13-76.22). The cases with working condition change (OR=6.5, CI=3.45-12.07), accidents on worksite (OR=4.9, CI=2.39-10.07), female (OR=4.0, CI=1.21-13.3), accidents at night duty (OR=2.9, CI=.156-5.39), cases occurring on duty (OR=.25, CI=1.34-4.72) and cases without past disease history (OR=1.8, CI=1.02-3.36) also had higher approval rates. Telephone survey found that the approval rate increased with decreasing freedom of personal time schedule. However, the logistic regression revealed that job stress didnt affect the approvals. CONCLUSION: To prevent cerebrovascular and cardiovascular diseases, the most important aspect is to control hypertension which is the most common risk factor among the victims. Moreover, job stress and over working should be considered in the just approval of the workers compensation claims.