Association between Job Stress, Psychosocial Well-being and Presenteeism, Absenteeism: Focusing on Railroad Workers / 대한산업의학회지

OBJECTIVES: The purpose of this study was to determine the current status of presenteeism and absenteeism among railroad workers as well as to investigate whether or not job stress level and psychosocial well-being status are associated with presenteeism and absenteeism. METHODS: As the cross-sectional design, a self-reported questionnaire using the Korean Occupational Stress Scale(KOSS), Psychosocial Well-being Index(PWI), and Work Productivity and Impairment-General Health(WPAI-GH) was administered to railroad workers. Univariate and multivariate logistic regressions were used to analyze the association between job stress, psychosocial well-being status and presenteeism, absenteeism in 1,099 subjects. RESULTS: Among the study subjects, 52.0% and 22.0% experiened presenteeism and absenteeism, respectively. Job stress level in railroad workers was higher than that in general workers. Multivariate logistic regression with presenteeism as the dependent variable showed an elevated odds ratio of 3.56(95% CI 1.48-8.54) in the highest job stress group, and an odds ratio of 3.20(95% CI 1.94-5.26) in the high-risk psychosocial stress group. There was no significant association between job stress level and absenteeism, whereas weak association between psychosocial stress and absenteeism was found. CONCLUSIONS: Since railroad workers have a high level of job stress and elevated experience of presenteeism, a management strategy is required to control presenteeism and absenteeism in order to promote railroad workers' health and safety.

Acquired Dyschromatopsia among Workers Exposed to Acetone and Isopropyl Alcohol (IPA) / 대한산업의학회지

OBJECTIVES: The purpose of this study was to examine the correlation between exposure to acetone and isopropyl alcohol (IPA) and the acquisition dyschromatopsia. METHODS: A study was performed on exposure group of 116 people exposed to and a group of 36 people not exposed to organic solvents were selected and examined. Their smoking and alcohol habits, symptoms, and exposure history were surveyed through questionnaires and interviews. Then dyschromatopsia was evaluated with the Lanthony D-15 d test in a room with standardized intensity of illumination. RESULTS: The statistical prevalence of dyschromatopsia was significantly higher in the exposed group (30.2%) compared to that found in the control group (19.4%). Out of the 116 subjects in the exposed group, 30 people had acquired dyschromatopsia (25.86%). The variables affecting the color confusion index, such as age, exposure, and the duration of exposure, were statistically significant variables. CONCLUSIONS: He prevalence of dyschromatopsia was found to be not significantly higher in the group with exposure to organic solvents compared to that found in the control group. In addition, a statistically significant correlation was found between exposure to organic solvents and the color confusion index.

The Effect of a Stretching Exercise on Myofascial Pain Syndrome Patients in Small and Medium Sized Industries / 대한산업의학회지

OBJECTIVES: This study was conducted to identify the effect of a stretching exercise on myofascial pain syndrome patients that work in small and medium-sized industry. METHODS: Questionnaires surveys including general characteristics, work-related characteristics, and musculoskeletal symptoms on neck and shoulder area was administered to 393 subjects who worked in small and medium sized industries. Symptomatic workers were examined to identify whether they had myofascial pain syndrome (MPS). Of the 393 subjects, 108 MPS patients performed 6 weeks stretching exercise program. Intensity of pain was estimated with visual analogue scales (VAS). All patients were interviewed to estimate their compliance to stretching exercise program. RESULTS: Of the 393 workers, 119 workers were diagnosed with MPS of the neck and shoulder. Post-exercise VAS was significantly reduced compared to pre-exercise VAS (p<0.05). High compliance patients to stretching exercise were more effective to exercise therapy (OR 2.89, 95% CI 1.19~7.04), and overtime workers were less effective to exercise therapy (OR 0.41, 95% CI 0.17~0.95). CONCLUSION: The Stretching exercise program was identified to be effective in MPS patients in small and medium-sized industries. It is recommended that workers with MPS in small and medium-sized industries practice a well-designed stretching exercise program, and avoid overtime work.

The Relationship between Occupational Stress and Burnout among Occupational Therapists / 대한산업의학회지

OBJECTIVE: A growing body of research has documented that occupational stress is associated with workers' adverse health outcomes such as mental distress, depression and burnout. This study was performed to identify the relationship between occupational stress and burnout among occupational therapists in Korea. METHODS: A total of 226 occupational therapists registered in the Korean Association of Occupational Therapist participated in the study. A self-administered questionnaire was used to assess demographics, subjective health status, work-related factors, occupational stress and burnout. Burnout was measured by Maslach Burnout Inventory (MBI). Occupational stressors were assessed using 26-items of the Korean Occupational Stress Scale (KOSS-26(R)). This scale consists of items targeting at physical environment, job demand, insufficient job control, interpersonal conflict, job insecurity, lack of reward, organizational system and occupational climate. Simple and multiple regression analyses were performed to investigate the relationship between 8 occupational stressors and burnout, separately. SAS 9.1 version was used for the analyses, and a P<0.05 was considered significant. RESULTS: The results show that all occupational stressors were associated with burnout after adjustment for control variables. Occupational stressors accounted for from 14.39% (p<0.001, organizational system) to 33.21% (p<0.001, occupational climate) of the variance in burnout. CONCLUSION: These results suggest that occupational stress might play a significant role in increasing the risk of burnout among occupational therapists.

The Clinical Utility of Blood Cultures by Pneumonia Severity Index for Patients with Community-Acquired Pneumonia in the Emergency Department

PURPOSE: Community-Acquired Pneumonia (CAP) is a common cause of mortality and serious morbidity. Regardless of the condition of the patients, almost all are hospitalized. And it seems to be a standard procedure to obtain blood cultures before the administration of antibiotics in suspected pneumonic patients. Recent studies show that the blood cultures don't affect the treatment of the patients with CAP. Accordingly, this study was designed to examine the usefulness of the blood cultures routinely performed and to evaluate the stratification of the patients with CAP by Pneumonia Severity Index (PSI) in the Emergency Department (ED). METHODS: Research subjects were patients over 16 years old who had been diagnosed with CAP in a general hospital between January and December 2008 and were admitted by way of the ED. We evaluated their records retrospectively. RESULTS: A total of 261 patients were diagnosed with CAP. According to the PSI, 155 (59%) of the 261 were classified as being in the low risk group and 106 (41%) in the high risk group. Blood cultures were positive in 13 of 261 (5%). Three of 13 patients belonged to the low risk group, and 10 to the high risk group. Antibiotics were changed in 43 of 261 patients. Nineteen of those belonged to the low risk group and 24 to the high risk group. Of the 13 bacteremic patients, blood cultures results altered therapy for 4 patients. CONCLUSION: Most often, blood cultures performed in the ED do not alter the therapy of patients with CAP. But we do recommend blood cultures for the high risk group.

Factors Related to Occupational Injuries and Health Problems for Some Female Workers in Non-standard Employment / 대한산업의학회지

OBJECTIVES: The purpose of this study was to examine certain factors associated with occupational injuries and health problems for some female workers in non-standard employment. METHODS: We enrolled 754 female workers that were selected from 1,040 people who had agreed to be surveyed as part of a group or company in either the Seoul and the Kyonggi area. We performed univariate logistic regression on survey data and again performed multivariate logistic regression on those variables that were statistically significant. RESULTS: In this study, the overall incidence of occupational injury for all workers was 12.5%. The incidence rates by position were as follows: 12.9%(insurance saleswoman), 7.4%(telemarketer), 9.2%(visiting teacher), 22%(golf caddy). The most frequent complaint was lower back pain(12.8%) in insurance saleswomen, voice symptoms(37%) in telemarketers, knee and ankle symptoms(33.8%) in golf caddies, and voice symptoms(14.4%) in visiting teachers. The factors related to occupational injuries included job type, and age. The factors related to health problems were job type, psychosocial stress, accident risk, and social support. The percentage of the cases that occurred without fringe benefits including social welfare was 30.4%, and the percentage of "paid out of the person's own pocket" of ways to arrange costs of accidents was 32.5%. CONCLUSIONS: In this study, some female workers in non-standard employment had relatively high level of occupational injuries, accompanied by various health problems. In these occupational classes, the conditions for social insurance and social welfare were poor. It is necessary to expand the application of social insurances including industrial accident compensation insurance. Regardless of job category, psychosocial stress and social support were statistically significant for many symptoms. We believe that measurement of these factors is necessary. In the future, additional studies are required with the use of objective methods for additional job categories.

Perceived Stress, Life Style, Health Status Indicatiors in Medical Center Employees

No abstract available.

Analysis of the role of social support on job stress and psychosocial stress in automobile factory workers using Structural Equation Model / 대한산업의학회지

OBJECTIVES: Social support was previously regarded as acting only a stress modifier, but many recent studies have found a direct effect on stress. The purpose of this study is to evaluate the role of social support on job stress and psychosocial stress to determine whether it acts via direct effect or indirect effect. METHODS: This study was performed in May 2003. The study population consisted of 425 male workers in an automobile factory in Korea. Data were collected with structured self-administered questionnaires. We used JCQ(Job Contents Questionnaires) to measure job stress and social support, and PWI-SF(Psychosocial Well-being Index-Short Form) to measure stress outcome. We analysed the relationships using Structural Equation Modeling software AMOS4. RESULTS: It was found that social support acts both as a direct stressor and an indirect stressor via job stress. However the direct effect was double the indirect effect. CONCLUSIONS: The direct effect of social support on stress was the more major. Therefore social support is an independent stressor rather than a stress modifier in automobile factory workers.

Analysis of the effect of job stress on occupational low back pain among shipyard workers using survival analysis / 대한산업의학회지

OBJECTIVES: Occupational low back pain is a major cause of morbidity and the increases of medical and industrial costs. Efforts to control occupational low back pain have been largely unsuccessful, and further understanding of the risks including the psychological factors is needed. This retrospective study was designed to identify the effect of job stress on occupational low back pain among shipyard workers. METHODS: The study group consisted of 976 male workers who were working at a Korean shipyard. A structured self-reported questionnaire was used to assess the participants' physical work factors, job stress and general characteristics. Job stress was measured using Karasek's JCQ(Job Content Questionnaire). Occupational low back pain was identified according to the NIOSH symptom survey criteria. Physical work factors were assessed using the Quick Exposure Check. Since the work duration can affect the relationship of physical work factors and job stress to occupational low back pain, we analyzed this association by dividing workers into two groups by work duration: 1) all workers, and 2) less than 5 years. Cox's proportional hazard model was used to elucidate the relationship of job stress with occupational low back pain in these two groups. Data were analysed with SAS 8.1. RESULTS: In the all workers group, job demand, bending or twisting of the back, and carrying heavy materials were associated with an increased the risk of occupational low back pain. In the workers with less than 5 years work experience, people with high job demand were more likely to experience occupational low back pain than those with low job demand. CONCLUSIONS: These RESULTS suggest that job stress as well as physical work factors can raise the risk of occupational low back pain. Especially, in the workers with less than 5 years work duration, job stress played a more crucial effect on the occurrence of occupational low back pain than physical work factors did.

Effect of Toluene on Phenol and S-phenylmercapturic Acid Excretion as Urinary Metabolites of Benzene in Rats / 대한산업의학회지

OBJECTIVES: This study was conducted to provide accurate exposure evaluation of workers in a biologicallymonitored state who were simultaneously exposed to benzene and toluene. For the purpose of this study, an animal experiment was conducted. METHODS: The following concentrations of solvents were administered orally to Sprague-Dawley rats : benzene at 2.26 mg/kg body weight (equivalent concentration to the 2.5 ppm, Threshold Limit Value-ShortTerm Exposure Limit, in the USA) and 9.02 mg/kg body weight (equivalent concentration to the 10 ppm, Threshold Limit Value-TimeWeighted Average in Korea), simultaneously with toluene at 106.42 mg/kg body weight (equivalent concentration to the 100 ppm, Threshold Limit Value-TimeWeighted RESULTS: The following results were obtained from the analysis of reading taken at 3hour intervals of S-phenylmercapturic acid (SPMA) and phenol concentration in urine metabolites of benzene after oral administration for 30 hours. 1. The concentrations of phenol and SPMA in urine were markedly decreased in the initial phase of the mixed group (both benzene and toluene administered group) as compared with the benzeneonly administered group, and the concentrations were slightly elevated. 2. The total excreted amounts of phenol and SPMA in urine decreased in the mixed group compared with the benzene-only group, and these decreases were more remarkable at the benzene administration concentration of 9.02 mg/kg than at 2.26 mg/kg. 3. The urinary excretions of phenol and SPMA were delayed in the case of the mixed group, and the extent of the delay was dependent on the amount of benzene administrat CONCLUSIONS: Benzene metabolism was suppressed by toluene, and hence the excretion of phenol and SPMA as urinary metabolites of benzene was delayed. This result will have applications in the interpretation of results from future biological monitoring of workers exposed to mixed solvents. We should not underestimate the importance of carefully interpreting the results of biological monitoring data when workers are exposed to mixed solvents. We should not underestimate the importance of carefully interpreting the results of biological monitoring data when workers are exposed to mixed benzene and toluene.

A Study on the Relationship between Emotional Labor and Depressive Symptoms among Korean Industrial Service Employees / 대한산업의학회지

OBJECTIVES: This study was designed to identify the relationship between emotional labor and depressive symptoms among Korean industrial service employees. METHODS: The case group consisted of 331 employees who were performing emotional labor at department stores, hotels, and family restaurants in Seoul. The control group in this study consisted of 150 employees (90 officers in Seoul and 60 manufacturing workers in Incheon) who were not expected to perform emotional labor. A structured questionnaire was used to estimate each participants level of emotional labor, general characteristics, job content, job satisfaction, and any depressive symptoms. The measurements for emotional labor were performed only on the case group and not the control group. RESULTS: While the mean values of job satisfaction, job insecurity, and the level of depressive symptoms of the employees who were working in the area of emotional labor were higher than the others, the mean values of job demand, and job control in the same group were lower than those who were not performing emotional labor. Overall, it was found that performing emotional labor and having high levels of job insecurity were related to increased depressive symptoms, and conversely, job satisfaction played a role in reducing depressive symptoms. Similarly, in the sub-sample of the emotional labor group, high levels of job insecurity, and performing high degrees of emotional labor, and low job satisfaction were associated with depressive symptoms. CONCLUSIONS: These results suggest that performing emotional labor is related to an increase in depressive symptoms. In other words, involuntary emotional expression and low job satisfaction in the workplace may influence the level of depressive symptoms in workers. It is, therefore, imperative that further research be undertaken, which considers the importance of emotional labor, and its adverse effect on the mental health of service workers.

A Study on the Relationship between Emotional Labor and Depressive Symptoms among Korean Industrial Service Employees / 대한산업의학회지

OBJECTIVES: This study was designed to identify the relationship between emotional labor and depressive symptoms among Korean industrial service employees. METHODS: The case group consisted of 331 employees who were performing emotional labor at department stores, hotels, and family restaurants in Seoul. The control group in this study consisted of 150 employees (90 officers in Seoul and 60 manufacturing workers in Incheon) who were not expected to perform emotional labor. A structured questionnaire was used to estimate each participants level of emotional labor, general characteristics, job content, job satisfaction, and any depressive symptoms. The measurements for emotional labor were performed only on the case group and not the control group. RESULTS: While the mean values of job satisfaction, job insecurity, and the level of depressive symptoms of the employees who were working in the area of emotional labor were higher than the others, the mean values of job demand, and job control in the same group were lower than those who were not performing emotional labor. Overall, it was found that performing emotional labor and having high levels of job insecurity were related to increased depressive symptoms, and conversely, job satisfaction played a role in reducing depressive symptoms. Similarly, in the sub-sample of the emotional labor group, high levels of job insecurity, and performing high degrees of emotional labor, and low job satisfaction were associated with depressive symptoms. CONCLUSIONS: These results suggest that performing emotional labor is related to an increase in depressive symptoms. In other words, involuntary emotional expression and low job satisfaction in the workplace may influence the level of depressive symptoms in workers. It is, therefore, imperative that further research be undertaken, which considers the importance of emotional labor, and its adverse effect on the mental health of service workers.

Analysis of Factors Associated with the Workers' Health Status Using Periodic Health Examination Data by Size of Enterprises

This study was conducted to determine whether the size of an enterprise can make a difference to workers' health and to examine those factors, which influence workers' health. The subjects of this study included 26,324 workers employed in manufacturing industry who received medical examinations at the Industrial Health Center at Yonsei University in 1995, 1996 and 1997. Medical examination data were used as a measure of health. Each enterprise was classified by size into three categories: Small scale enterprises (SSE) that employ no more than 50 regular employees; middle scale enterprise (MSE) that employ from 50 to 300 regular employees; and large scale enterprise (LSE) that employ more than 300 regular employees. Health conditions, according to the size of the enterprise, were determined by comparing prevalence rates, and direct standardization methods were used based upon the Korean population, as a standard population, in order to adjust for differences in population structure. 1. The findings of the medical examinations showed that, the prevalence rate in SSEs was higher than in MSEs or LSEs, but that this relationship was reversed after standardizing for sex and age. 2. Logistic regression analysis showed that, although subjects of advanced age, prolonged work history, and male gender had higher risks of disease, the size of the enterprise had no significant effect upon these risks.

Worker's demands and Group Health Service Agency's Intention for Worksite Medical Care / 대한산업의학회지

OBJECTIVES: This study was performed to survey worker's demands for worksite medical care and agency's intention for offering worksite medical care in Group Health Service Agency. METHODS: One study subjects were employers, workers and office personnels in 167 factories. They were asked for medical care utilization behavior and worksite medical care demand. 121 employers(72.5%), 145 office personnels(86.8%) and 816 workers(60.5%) answered the questionnaire. The other subjects were doctors, nurses and administrators in 66 Group Health Service Agencies nationwide. They were asked for intention of offering worksite medical care in Group Health Service Agency through the mail survey. 31 doctors(47.0%), 38 nurses(57.6%) and 34 administrators answered the questionnaire. RESULTS: 87 percentage of doctors and 94 percentage of nurses had experiences of being requested to prescribe and laboratory examination. All nurses, 94 percentage of administrators and 76 percentage of doctors thought that it was necessary to give medical treatment at worksite. Also in worksite 85 percentage of employers, 86 percentage of office personnels and 81 percentage of workers answered that they accepted the worksite medical care when it would be given. CONCLUSIONS: Worksite medical care should be permitted because almost of all workers and employers requested worksite medical care, and doctors and nurses in Group Health Service Agency were willing to give worksite medical care and there was necessity to prevent occupational cerebrovascular disease.

Cost-Benefit Analysis of a Factory Dispensary / 대한산업의학회지

OBJECTIVES: We performed cost-benefit analysis to investigate the benefit of companies dispensary. METHODS: We measured the cost and benefit of running a factory dispensary. This study focused on a factory with well arranged professional health-care staff. The study was carried out during 1995-1997. All the past values of cost and benefit were converted into present value. We used net benefit and cost/benefit ratio as determinants. RESULTS: The net benefit of the object factory dispensary was -73,000,000 Won, and cost/benefit ratio was about 0.65. This result showed no profitability. CONCLUSION: There would be limitation of generalization because this study included only one factory dispensary. As we did not consider many indirect benefits. the benefit portion might be underestimated. We should also think about the possibility of profitability. If one dispensary takes charge of two or more factories. then it can produce sufficient profit. With all of those efforts we dream the days of healthy workers will come.

Social status and role of students entering Jejoongwon: focus on Kyum-Rae Lee / 의사학

This study considers the social class and social role of the entering students of Jejoongwon at that time in light of its very first medical graduate, Kyum-Rae Lee. Foremost, Kyum-Rae Lee was confirmed to have been from a middle-class family. However, unlike other chungin-class families, his family belonged to the minority. He seemed to have entered medical school to seek opportunity to move up in social class by taking advantage of special government provisions, which allowed him to learn English and Western medicine. Afterwards, he performed heroic services in the peasant-war, proceeded up to administration and participated in the modernization of Great Han Empire. With his knowledge of Western concepts, he became involved in numerous social activities, such as organizing the Enlightenment Society and leading the Enlightenment Movement. In much the same way, most early students were from low-class background with exceptional personal abilities and were able to pass aptitude examinations. Such achievements allowed them to apply for positions in the military and administrative management. Ten years later, medical education to train medical professionals was revived with changes in attitudes of people of Chosun Dynasty toward Western medicine and with creation of formal medical study.

The Effectiveness of Questionnaire Utilized for Screening Noise Induced Hearing Loss / 대한산업의학회지

OBJECTIVES: This study was performed to investigate the effectiveness of the questionnaire. METHODS: Workers'health examination records, work environment record, and questionnaires of selected industries as samples were analysed using logistic regression analysis and discrimination analysis Results'Cases of bearing impairment (Dl+C) as dependent variables, and age, work duration and level of environmental noise as independent variables were selected for multiple unconditional logistic regression analysis. Odds ratio was 4.04 in hearing difficulty, 2.78 in tlnnitus and 1.08 in age. In the second analysis Noise induced hearing loss is selected as dependent variable. The OR in hearing difficulty was 3.67(95 % C.1. : 1.61 8.61), and was 1.09(95 % C.1. : 1.05-1.14) in age. Conditionnal multlple logistic regression analysis was performed. In hearing impairment as dependent variable, the OR of age was 1.02(95 % C.1. : 1.00-1.04) and other variables were not significant. However, NIHL as dependent, the OR of hearing difficulty was 4.57(95 % C.1. : 1.43-14.67). According to multiple logistic regression adopting each items of questionnaire as dependent variable, the only item of hearing difficulty showed significant difference with hearing ability. The discrimination analysis was performed with the class variable of hearing impairment, and discrimination variables of age, work duration, and environment noise level. The sensitivity of 59 %, and specificity of 88 %, and average error count of 23 % were obtained. When the numbers of items answered in questionnaire were assumed as the parameter of judgement for noise induced hearing loss (NIHL), the highest sensitivity and specificity were 33.5% and 49.0% in cases of more than two items answered. CONCLUSIONS: The development of items that is simple and discriminative mainly consisted of chronic and specific diseases related items is needed. Computerization for newly developed items might be needed to establish effective surveillance system for NIHL in the future.

The variation of thiodiglycolic acid concentration in urine with vinyl chloride exposure levels in rats / 대한산업의학회지

OBJECTIVES: It is the objective of this research to identify the variation of thiodiglycolic acid (TdGA) in urine with vinyl chloride monomer (VCM) exposure levels through methylation. METHODS: After rats were exposed to vinyl chloride monomer of 4 levels, 0 mg/m3, 50 mg /m3, 150 mg/m3, 500 mg/m3, respectively, of which urine was sampled in each sampling time of 0 hour, 2 hours, 4 hours, 8 hours, 16 hours, 24 hours, 36 hours, 48 hours. After urine had been methylated with diazomethane in the preliminary experiment and the peak of 146 m/z had been verified, the main experiment was done. RESULTS: In the variation of TdGA with sampling times, concentration of TdGA increased rapidly in 4 hours and then decreased after 8 hours. When the variation of urinary .TdGA concentration in urine according to exposure level of VCM was verified through Kruskal-Wallis statistical method at each sampling time, the significant increment with the exposure levels at 2 hours, 4 hours, 8 hours after exposure was clarified. CONCLUSION: TdGA concentration in urine with increment of VCM exposure level increased, especially significantly at 2 hours, 4 hours, 8 hours of sampling time.

Short-term Effects of Air Pollution on Hospital Visits for Respiratory Diseases in Seoul / 대한산업의학회지

Several studies have reported the associations between airborne particles and/or ozone and respiratory diseases. This study examined whether such an association could be seen in Seoul, one of the greatest city in Korea. We compiled daily records of hospital visits in Seoul from November 1, 1995 to October 31, 1996. The daily averages of ozone and particle matter whose diameter is 10 micrometer or less(PM10) from all monitoring stations were computed. Daily respiratory hospital visits were regressed on temperature, humidity, day of weak indicators, seasonal variation indicators, and air pollution. Each pollutant was first examined individually and then two pollutant models were fitted. RESULTS : Both PM10 and Ozone were associated with increased risk of respiratory hospital visits. The relative risk of respiratory hospital visits for 50 microgram/m3 increase in PM10(lagged 2 days) was 1.11(95% confidence interval: 1.05-1.18). The PM10 associations was insensitive to alternative methods of control for weather, including exclusion of extreme temperature days and control for temperature on another day. The ozone results were more sensitive to the approach for weather control. The relative risk of respiratory hospital visits for 0.01 ppm increase in O3 was 1.08(95% confidence interval 1.00-1.17). The magnitude of the PM10 effect in Seoul, where SO2 was essential present, was similar to that reported in the Europe and United states. In conclusion, The consistency of investigations of the health effects of air pollution suggest that attention should be paid to the control of air pollution.

Occupational Diseases due to Physical Agents

No abstract available.