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Background@#Swallowing of foreign bodies (FBs) is the most common indication of therapeutic endoscopy in children. Endoscopic removal may be necessary depending on the type of FB, age of the child, and location of the FB. We attempted to analyze the characteristics of each device used for the endoscopic removal of FBs in children. @*Methods@#Medical records of the patient’s age, sex, weight, type, location, size, shape, type of device used for endoscopic removal, and endoscopic time were retrospectively collected. @*Results@#A total of 424 FB removal procedures were analyzed. The average age of the patients at the time of FB removal was 4.1 ± 3.7 years. Coins were the most common FBs (192, 45.3%). The most common locations of the FBs were the esophagus (45.7%) and the stomach (48.3%), respectively. For a total of 371 cases, forceps were used in 96 cases (25.9%) for esophageal FBs and in 25 cases for gastric FBs (6.7%), while nets were used in 250 cases (67.4%) for gastric FBs retrieval; the average durations of the procedures were 7.2 ± 7.4 minutes, 8.5 ± 7.2 minutes, and 5.7 ± 7.3 minutes, respectively (P = 0.003). The procedure time was significantly shorter, in the group of patients with low body weights, when nets were used than when forceps were used to remove gastric FBs (P = 0.001). @*Conclusion@#The endoscopic procedure duration, in low-weight children, was shorter when retrieval nets were used than that with forceps.
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Background@#It has been 10 years since the outbreak of lung disease caused by humidifier disinfectants in Korea, but the health effects have not yet been summarized. Therefore, this study aims to systematically examine the health effects of humidifier disinfectants that have been discovered so far. @*Methods@#All literature with humidifier disinfectants and their representative components as the main words were collected based on the web, including PubMed, Research Information Sharing Service, and government publication reports. A total of 902 studies were searched, of which 196 were selected. They were divided into four groups: published human studies (group 1), published animal and cytotoxicology studies (group 2), technical reports (group 3), and gray literature (group 4). @*Results@#Out of the 196 studies, 97 (49.5%) were published in peer-reviewed journals as original research. Group 1 consisted of 49 articles (50.5%), while group 2 consisted of 48 articles (49.5%). Overall, respiratory diseases such as humidifier disinfectant associated lung injury, interstitial lung disease, and asthma have a clear correlation, but other effects such as liver, heart, thymus, thyroid, fetal growth, metabolic abnormalities, and eyes are observed in toxicological experimental studies, but have not yet been identified in epidemiologic studies. @*Conclusion@#The current level of evidence does not completely rule out the effects of humidifier disinfectants on extrapulmonary disease. Based on the toxicological evidence so far, it is required to monitor the population of humidifier disinfectant exposure continuously to see if similar damage occurs.
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Background@#Pneumonia, which is the third leading cause of death in South Korea, is continuously increasing with the aging society. The Health Insurance Review and Assessment of South Korea conducted a quality assessment (QA) for improving the outcome of community-acquired pneumonia (CAP). @*Methods@#We conducted a nationwide cross-sectional study of hospitalized CAP in South Korea. First to third QA data were gathered into a single database. The national health insurance database was merged with the QA database for analyzing the medical claims data. Comorbidities, pneumonia severity, and pneumonia care appropriateness were calculated using Charlson comorbidity index (CCI), CURB-65, and core assessment of CAP scores (CAP scores), respectively. @*Results@#Overall, 54,307 patients were enrolled. The CAP scores significantly improved on QA program implementation (P < 0.001). All the variables demonstrated an association with in-hospital mortality, hospital length of stay (LOS), and 30-day mortality in the univariate analyses. Following the adjustments, higher CCI and CURB-65 scores were associated with higher in-hospital mortality, longer hospital LOS, and higher 30-day mortality. Male sex was associated with higher in-hospital/30-day mortality and shorter hospital LOS. Higher CAP scores were associated with shorter hospital LOS (P < 0.001). Upon QA program implementation, in-hospital mortality (P < 0.001), hospital LOS (P < 0.001), and 30-day mortality (P < 0.001) improved. @*Conclusion@#Continuing QA program is effective in improving the clinical outcomes of hospitalized CAP.
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Background@#In 2017, Korea implemented nationwide latent tuberculosis infection (LTBI) project targeting healthcare workers (HCWs). We aimed to assess its performance using the cascade of care model. @*Methods@#We included 45,503 employees of medical institutions with positive interferongamma release assay result who participated between March 2017 and December 2018. We described percentages of LTBI participants completing each step in the cascade of care.Poisson regression model was conducted to assess individual characteristics and factors associated with not-visiting clinics for further care, not-initiating LTBI treatment, and notcompleting treatment. @*Results@#Proportions of visiting clinics and initiating and completing treatment in HCWs were 54.9%, 38.5%, and 32.0%, respectively. Despite of less likelihood of visiting clinics and initiating LTBI treatment, older age ≥ 65 years were more likely to complete treatment (adjusted relative risk [aRR], 0.80; 95% confidence interval [CI], 0.64–0.99), compared to young age < 35 years. Compared to nurses, doctors were less likely to visit clinic; however, were more likely to initiate treatment (aRR, 0.88; 95% CI, 0.81–0.96). Those who visited public health centers were associated with not-initiating treatment (aRR, 1.34; 95% CI, 1.29–1.40). When treated at private hospitals, 9-month isoniazid monotherapy was less likely to complete treatment, compared to 3-month isoniazid and rifampicin combination therapy (aRR, 1.33; 95% CI, 1.16–1.53). @*Conclusion@#Among employees of medical institutions with LTBI, only one third completed treatment. Age, occupation, treatment center, and initial regimen were significantly related to LTBI treatment performance indicators. Rifampicin-based short treatment regimens were effective under standard of care.
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Background/Aims@#The aim of the study was to investigate the current nationwide burden of nosocomial exposure to tuberculosis (TB) using national health insurance claims data. @*Methods@#All patients who had claims for drug susceptibility testing for TB from 2012 to 2016, which indicated culture-proven TB, were included. The first day of the infectious period was defined as 3 months before a doctor’s suspicion of TB in patients with respiratory symptoms and 1 month before in patients without symptoms. The last day of the infectious period was defined as one day before the prescription of anti-TB medications. Patients hospitalized during infectious periods were investigated and their hospitalization days were calculated. Records of medical procedures which increased the risk of nosocomial transmission by generating aerosols were also investigated. @*Results@#A total of 7,186 cases with 94,636 person-days of hospitalization with unrecognized active TB were found. Patients above 60 years of age accounted for 63.99% of the total number and 69.70% of the total duration of hospitalization. TB patients in the older age group showed a trend toward higher risks for hospitalization with unrecognized active TB. Patients in their 80s showed the highest risk (12.65%). Bronchoscopy (28.86%), nebulizer therapy (28.48%), and endotracheal intubation (13.02%) were common procedures performed in these patients during hospitalization. @*Conclusions@#The burden of nosocomial exposure to TB in South Korea is still substantial. Hospitalization with unrecognized active TB, especially among the elderly TB patients could be a serious public health issue in South Korea.
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In 2017, the Korean government launched an unprecedentedly large-scaled latent tuberculosis infection (LTBI) screening project which covered more than a million individuals in congregate settings. A total of 1,047,689 participants of source population (n = 2,336,157) underwent LTBI testing from 2017 to 2018. The overall LTBI test uptake rate during this project was 44.8%. Workers in daycare centers (83.5%) and kindergartens (78.9%) showed high participation rate. A total of 1,012,206 individuals with valid results of interferongamma release assay (IGRA) were selected to constitute the IGRA cohort. Most of the enrolled participants in the IGRA cohort were in their working age. Approximately, threequarters of total enrolled population were female. Investigating the LTBI prevalence, stages of LTBI care cascade, natural history of LTBI, efficacy of LTBI treatment and cost-effectiveness of LTBI screening are feasible within this IGRA cohort.
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Background/Aims@#The aim of the study was to investigate the current nationwide burden of nosocomial exposure to tuberculosis (TB) using national health insurance claims data. @*Methods@#All patients who had claims for drug susceptibility testing for TB from 2012 to 2016, which indicated culture-proven TB, were included. The first day of the infectious period was defined as 3 months before a doctor’s suspicion of TB in patients with respiratory symptoms and 1 month before in patients without symptoms. The last day of the infectious period was defined as one day before the prescription of anti-TB medications. Patients hospitalized during infectious periods were investigated and their hospitalization days were calculated. Records of medical procedures which increased the risk of nosocomial transmission by generating aerosols were also investigated. @*Results@#A total of 7,186 cases with 94,636 person-days of hospitalization with unrecognized active TB were found. Patients above 60 years of age accounted for 63.99% of the total number and 69.70% of the total duration of hospitalization. TB patients in the older age group showed a trend toward higher risks for hospitalization with unrecognized active TB. Patients in their 80s showed the highest risk (12.65%). Bronchoscopy (28.86%), nebulizer therapy (28.48%), and endotracheal intubation (13.02%) were common procedures performed in these patients during hospitalization. @*Conclusions@#The burden of nosocomial exposure to TB in South Korea is still substantial. Hospitalization with unrecognized active TB, especially among the elderly TB patients could be a serious public health issue in South Korea.
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In 2017, the Korean government launched an unprecedentedly large-scaled latent tuberculosis infection (LTBI) screening project which covered more than a million individuals in congregate settings. A total of 1,047,689 participants of source population (n = 2,336,157) underwent LTBI testing from 2017 to 2018. The overall LTBI test uptake rate during this project was 44.8%. Workers in daycare centers (83.5%) and kindergartens (78.9%) showed high participation rate. A total of 1,012,206 individuals with valid results of interferongamma release assay (IGRA) were selected to constitute the IGRA cohort. Most of the enrolled participants in the IGRA cohort were in their working age. Approximately, threequarters of total enrolled population were female. Investigating the LTBI prevalence, stages of LTBI care cascade, natural history of LTBI, efficacy of LTBI treatment and cost-effectiveness of LTBI screening are feasible within this IGRA cohort.
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Background/Aims@#Workers who are exposed to dust in the workplace tend to show a higher incidence of gastric cancer. Nevertheless, scientific evidence to support an association between dust exposure and the risk of gastric cancer is inadequate. This study aimed to investigate whether or not occupational dust exposure influences the risk of gastric cancer. @*Methods@#We collected the electronic data from the Pneumoconiosis Health Examination (PHE) program, provided by the Ministry of Employment and Labor and the Korea Workers’ Compensation and Welfare Service from 2002 to 2017. The PHE database was linked to the National Health Insurances databases. The age-standardized incidence ratio (SIR) and 95% confidence intervals (CIs) of the risk of gastric cancers were evaluated in workers with occupational dust exposure, and the results were compared to those in the general population. @*Results@#From 2004 to 2015, 1,543 cases of gastric cancer were observed in the male participants, as compared with 1,174 of expected cases, which yielded an SIR of 1.314 (95% CI, 1.249 to 1.380). Under dust exposure, the risk of gastric cancer was increased 23.9% in the male participants (95% CI, 19.9 to 27.5), and the degree of impairment of lung function was inversely related to the risk of gastric cancer. @*Conclusions@#Workers with occupational dust exposure were at higher risk of developing gastric cancer than the general population. Thus, future efforts for the prevention of gastric cancer are necessary for dust exposed workers.
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Background/Aims@#We performed a large-scale, retrospective, nationwide, cohort study to investigate the risk factors for lung cancer among never-smoking Korean females. @*Methods@#The study data were collected from a general health examination and questionnaire survey of eligible populations conducted between January 1, 2003 and December 31, 2004; the data were acquired from the tailored big data distribution service of the National Health Insurance Service. After a 1-year clearance period, 5,860,922 of 6,318,878 never-smoking female participants with no previous history of lung cancer were investigated. After a median follow-up of 11.4 years, 43,473 (0.74%) participants were defined as “newly diagnosed lung cancer”. @*Results@#After adjusting for all variables at baseline, the variables older age, lower body mass index (BMI), less exercise, frequent alcohol drinking, meat-based diet, rural residence, and previous history of cancer were associated with a higher incidence of lung cancer. Low BMI (< 18.5 kg/m2: hazard ratio [HR], 1.33; 95% confidence interval [CI], 1.27 to 1.40) was a significant independent risk factor; as BMI decreased, HR increased. Negative associations between BMI and lung-cancer development were also observed after controlling for age (p for trend < 0.001). Drinking alcohol one to two times a week (HR, 1.25; 95% CI, 1.21 to 1.28) and eating a meat-based diet (HR, 1.08; 95% CI, 1.01 to 1.15) were associated with lung-cancer incidence. @*Conclusions@#Modifiable baseline characteristics, such as BMI, exercise, alcohol consumption, and diet, are risk factors for lung-cancer development among never- smoking females. Thus, lifestyle modifications may help prevent lung cancer.
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Background@#It is well known that the prevalence of obesity in Korea is increasing over time, however it is not known how the trends among occupational groups and sex differ in such increasing trends. This study was designed to provide recent trends of obesity among workers in Korea and to identify whether there were differences among occupational groups. @*Methods@#We used data from the Korean National Health and Nutrition Examination Survey, Phases I to VI (1998–2015), to analyze trends in the prevalence of obesity in adult Korean workers. Obesity was defined as a body mass index of 25 kg/m2 or higher. Occupations were classified into 3 groups: (a) nonmanual workers, (b) service/sales workers, and (c) manual workers. @*Results@#During the period of the Korean National Health and Nutrition Examination Survey Phases I to VI, the prevalence of obesity in male workers increased in all occupations (31.1% to 39.5% in manual workers, 32.3% to 38.2% in service/sales workers, and 25.3% to 39.7% in manual workers). However, female workers did not show any particular tendency toward obesity, except for a significant decrease in the prevalence rate in service/sales workers (30.8% to 23.9%, p for trend = 0.0048). @*Conclusion@#The trends of obesity prevalence by sex and occupation were different. For male manual workers, the prevalence rate increased steadily during the data period, while it decreased steadily in female sales/service workers.
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BACKGROUND: Since the night time work was introduced as a ‘harmful factor’ for the worker's special health examination (WSHE) in 2014, the validation of the questionnaire used for screening gastrointestinal (GI) disorder has not been conducted. The purpose of this study is to verify the validity of the questionnaire using the data of specific health screening cluster. METHODS: We used WSHE screening data for 3 years, from 2014 to 2016, in health screening cluster. The subjects who had received upper GI endoscopy in opportunistic screening and WSHE simultaneously regardless of the results of the questionnaire were selected. We tested the validity of the questionnaire using upper GI endoscopy as a gold standard. RESULTS: This study was conducted on 5,057 examinees in 2014, 8,352 examinees in 2015, and 10,587 examinees in 2016. The validity of the questionnaire for each year was as follows: sensitivity 12.3% (95% confidence interval [CI], 11.1–13.4), specificity 88.6% (95% CI, 87.2–90.1), accuracy 41.1% (95% CI, 39.8–42.5) in 2014, sensitivity 5.9% (95% CI, 5.2–6.5), specificity 93.6% (95% CI, 92.7–94.4), accuracy 38.6% (95% CI, 37.6–39.6) in 2015, sensitivity 6.0% (95% CI, 5.4–6.5), a specificity of 9.42% (95% CI, 93.4–95.0), accuracy of 34.2% (95% CI, 33.3–35.1) in 2016. In generally, questionnaire showed sensitivity of 10%, specificity of 90%, and accuracy of 40%. CONCLUSIONS: Despite the purpose of WSHEs aiming to identify target disease early, the sensitivity of the questionnaire for GI disease was too low as 10%. The reasons for this are the problem of the question itself, and the problem of ambiguous target disease. In the future, the questionnaire should be improved to meet the purpose of the WSHE, and further correction of the target disease should be made.
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Endoscopia , Programas de Rastreamento , Sensibilidade e EspecificidadeRESUMO
BACKGROUND: To investigate the risk of injury for indirect employment in Korea, we compared work environment, workplace exposure, and injury risk according to the type of employment contract between Korea and European Union (EU) countries. METHODS: We analyzed data of blue-collar workers from the fourth Korean Working Conditions Survey (2014) and the sixth European Working Conditions Survey (2015) and compared workplace risk factors and preventive factors for occupational injuries. Multiple logistic regression analysis was conducted to identify the relationship between occupational injury and the type of employment contract after adjusting for age and sex. RESULTS: For descriptive characteristics, a relatively older age, lower income, lower proportion of full-time work, greater proportion in small-sized companies, and fewer unionizations were noted in indirect employment in Korea than in direct employment. Workplace exposure was significantly higher in indirect employment in both Korea and Europe. Among safety-related factors, indirect employment in both Korea and Europe lacked the support of company education, coworkers, and supervisors. Indirectly employed blue-collar workers had a significantly higher risk of occupational injury than those directly employed in Korea (odds ratio [OR]: 1.876), whereas there was no significant difference between directly and indirectly employed workers in EU countries (OR: 1.038). CONCLUSIONS: Indirectly employed blue-collar workers have an increased risk of occupational injury in Korea.
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Educação , Emprego , Europa (Continente) , União Europeia , Coreia (Geográfico) , Modelos Logísticos , Traumatismos Ocupacionais , Fatores de RiscoRESUMO
The main role of industrial accident compensation insurance is to protect injured workers and their families by providing various benefits. If a certain disease occurs due to work, the worker must prove the causal relationship between the work and the disease, although it is not easy for injured workers to do so. The epidemiological approach to causality is based on a comparison of the incidence rate in exposed and non-exposed groups. Recently, some arguments have been made regarding the application of epidemiological causality in litigation related to tobacco and some environmental-related diseases. The 3 main points of dispute are as follows: 1) the distinction between specific and non-specific diseases and causal inference, 2) the relative risk and the attributable fraction of the causative factor for the related disease, and 3) the application of population-level epidemiological study results to individual causation. Until now, the main approach to the causality of occupational diseases has been proximate causal relationships because of the practical difficulties in applying epidemiological causality to all events. As coverage under the Industrial Accident Compensation Insurance Act expands, the application of epidemiological causality must be considered, as well as the expansion of applicable occupational diseases. Moreover, doing that could provide enough evidence for managers and workers to take steps to prevent occupational disease. The safety net provided by industrial accident compensation insurance for protecting injured workers needs to be implemented on the basis of scientific evidence.
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Humanos , Acidentes de Trabalho , Compensação e Reparação , Dissidências e Disputas , Estudos Epidemiológicos , Epidemiologia , Incidência , Seguro , Jurisprudência , Doenças Profissionais , NicotianaRESUMO
Comprehensive consideration is necessary for setting guidelines to evaluate evidence of occupational cancer in painters due to work-related exposure to carcinogens in paint (a phenomenon termed herein as “work-relatedness”). The aim of the present research is to perform a comprehensive review and to suggest criteria for the provision of compensation for occupational neoplasm among painters in Korea. In order to perform a comprehensive review, this study assessed and evaluated scientific reports of carcinogenicities from the International Agency for Research on Cancer (IARC) and the Industrial Injuries Advisory Council (IIAC), as well as reviewed the existing literature about occupational exposure among painters in Korea and the epidemiologic investigations of claimed cases of cancer among painters in Korea. The IARC declares that occupational exposures in commercial painting are classified as Group 1 carcinogens for lung cancer and bladder cancer among painters. The epidemiologic studies show consistent causal relationships between occupational exposure in painters and cancers such as lung cancer [meta relative risk: 1.34 (95% confidence intervals (CIs): 1.23-1.41)] and bladder cancer [meta relative risk: 1.24 (95% CIs: 1.16-1.33)]. In reviewing occupational cancer risks for commercial painters, the Industrial Injuries Advisory Council (IIAC) confirms occupational cancer risks for lung and bladder cancer among commercial painters. According to the IIAC, however, the elevated cancer risks reported in existing literature are not doubled in either lung or bladder cancer in commercial painters relative to the risks of these cancers in the general population. Based on our review of existing Korean articles on the topic, painters are exposed to potential carcinogens including polycyclic aromatic hydrocarbons (PAHs), benzene, hexavalent chrome, crystalized silica, asbestos, and other agents, and relative levels are estimated within commercial painting processes. However, the cancer risks of occupational exposure to Group 1 carcinogens for lung and bladder cancer in painters per se are not fully assessed in existing Korean articles. Total work duration, potential carcinogens in paint, mixed exposure to paints across various industries such as construction and shipbuilding, exposure periods, latent periods, and other factors should be considered on an individual basis in investigating the work-relatedness of certain types of cancer in commercial painters.
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Amianto , Benzeno , Carcinógenos , Compensação e Reparação , Estudos Epidemiológicos , Agências Internacionais , Coreia (Geográfico) , Pulmão , Neoplasias Pulmonares , Exposição Ocupacional , Ocupações , Pintura , Pinturas , Hidrocarbonetos Policíclicos Aromáticos , Dióxido de Silício , Neoplasias da Bexiga UrináriaRESUMO
BACKGROUND: Compared to 10 years ago, the ambient particulate matter 10 (PM10) and carbon monoxide (CO) levels in South Korea have decreased. However, compared to many other OECD countries, these levels are still too high. Concentration of air pollutants such as PM10 is especially higher during winter than during summer. The first step to rationally solving the air pollution problem in Korea is to identify the key air pollution sources during each season. This ecological study was performed to assess the association between the number of days the accepted PM10 and CO thresholds were exceeded and the concentration of potential emission sources in winter season 2015. METHODS: An emission inventory of the PM10 and CO emissions in the 232 administrative South Korean districts in January, 2015, and February, 2015 and December, 2015, and the population density, number of car registrations, number of car accidents, industrial power usage, and presence of a fossil-fuel power plant in each district was established on the basis of official web-page data from the government. For all emission source variables except power plants, the administrative districts were grouped into quartiles. Districts were also divided according to whether a power plant was present or not. Negative binomial regression was performed to assess the associations between the PM10 and CO air pollution (defined as ≥100 g/m3 and ≥ 9 ppm, respectively) and the concentration of each emission source. RESULTS: Compared to the districts with the lowest population density, the districts with the third highest population density associated most strongly with air pollution. This was also observed for industrial power usage. Car accident number and car registration numbers showed a linear relationship with air pollution. Districts with power plants were significantly more likely to have air pollution than districts that lacked a plant. CONCLUSIONS: Greater car numbers, industrial activity, and population density, and the presence of fossil-fuel plants associated with air pollution in the 2015 winter in South Korea. These data highlight the contaminant sources that could be targeted by interventions that aim to reduce air pollution, decrease the incidence of exposure, and limit the impact of pollution on human health. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s40557-018-0273-5) contains supplementary material, which is available to authorized users.
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Humanos , Acidentes de Trabalho , Poluentes Atmosféricos , Poluição do Ar , Monóxido de Carbono , Incidência , Coreia (Geográfico) , Organização para a Cooperação e Desenvolvimento Econômico , Material Particulado , Plantas , Densidade Demográfica , Centrais Elétricas , Estações do AnoRESUMO
BACKGROUND: The present study aimed to update the prediction equations for spirometry and their lower limits of normal (LLN) by using the lambda, mu, sigma (LMS) method and to compare the outcomes with the values of previous spirometric reference equations. METHODS: Spirometric data of 10,249 healthy non-smokers (8,776 females) were extracted from the fourth and fifth versions of the Korea National Health and Nutrition Examination Survey (KNHANES IV, 2007–2009; V, 2010–2012). Reference equations were derived using the LMS method which allows modeling skewness (lambda [L]), mean (mu [M]), and coefficient of variation (sigma [S]). The outcome equations were compared with previous reference values. RESULTS: Prediction equations were presented in the following form: predicted value = e {a + b × ln(height) + c × ln(age) + M − spline}. The new predicted values for spirometry and their LLN derived using the LMS method were shown to more accurately reflect transitions in pulmonary function in young adults than previous prediction equations derived using conventional regression analysis in 2013. There were partial discrepancies between the new reference values and the reference values from the Global Lung Function Initiative in 2012. CONCLUSION: The results should be interpreted with caution for young adults and elderly males, particularly in terms of the LLN for forced expiratory volume in one second/forced vital capacity in elderly males. Serial spirometry follow-up, together with correlations with other clinical findings, should be emphasized in evaluating the pulmonary function of individuals. Future studies are needed to improve the accuracy of reference data and to develop continuous reference values for spirometry across all ages.
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Adulto , Idoso , Humanos , Masculino , Adulto Jovem , Seguimentos , Volume Expiratório Forçado , Coreia (Geográfico) , Pulmão , Métodos , Inquéritos Nutricionais , Valores de Referência , Espirometria , Capacidade VitalRESUMO
The main role of industrial accident compensation insurance is to protect injured workers and their families by providing various benefits. If a certain disease occurs due to work, the worker must prove the causal relationship between the work and the disease, although it is not easy for injured workers to do so. The epidemiological approach to causality is based on a comparison of the incidence rate in exposed and non-exposed groups. Recently, some arguments have been made regarding the application of epidemiological causality in litigation related to tobacco and some environmental-related diseases. The 3 main points of dispute are as follows: 1) the distinction between specific and non-specific diseases and causal inference, 2) the relative risk and the attributable fraction of the causative factor for the related disease, and 3) the application of population-level epidemiological study results to individual causation. Until now, the main approach to the causality of occupational diseases has been proximate causal relationships because of the practical difficulties in applying epidemiological causality to all events. As coverage under the Industrial Accident Compensation Insurance Act expands, the application of epidemiological causality must be considered, as well as the expansion of applicable occupational diseases. Moreover, doing that could provide enough evidence for managers and workers to take steps to prevent occupational disease. The safety net provided by industrial accident compensation insurance for protecting injured workers needs to be implemented on the basis of scientific evidence.
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BACKGROUND@#The purpose of this report is to introduce the occupational cancer surveillance system, implemented in June 2018, and to share the results of our cooperative program.@*METHODS@#The cooperative program begins when the patient is diagnosed with acute myeloid leukemia (AML). Newly diagnosed AML patients are admitted to the internal medicine hematology department, then attending hematology physician requests a consultation from the occupational and environmental medicine (OEM) department. The OEM doctor next visits the hospitalized patient and interviews them to take their occupational history, and preliminarily evaluates the likelihood that the condition is associated with occupation. If the patient wants to apply for compensation through the Korea Workers' Compensation & Welfare Service, the patient was informed to visits the outpatient clinic of the OEM department and requests a ‘work-relatedness evaluation report’ for use in applying for compensation.@*RESULTS@#Among the 103 patients, who received an OEM departmental work history evaluation, 18 patients were considered to have a work-related incidence and 12 patients were registered in the Industrial Accident Compensation Insurance system.@*CONCLUSIONS@#The present report provides data on a sustainable model for identifying occupational disease in a general hospital setting, while also informing patients about their occupational rights.
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BACKGROUND: This study investigated the relationship between job type and the risk for spontaneous abortion to assess the reproductive toxicity of female workers in the semiconductor industry. METHODS: A questionnaire survey was administered to current female workers of two semiconductor manufacturing plants in Korea. We included female workers who became pregnant at least 6 months after the start of their employment with the company. The pregnancy outcomes of 2,242 female workers who experienced 4,037 pregnancies were investigated. Personnel records were used to assign the subjects to one of three groups: fabrication process workers, packaging process workers, and clerical workers. To adjust for within-person correlations between pregnancies, a generalized estimating equation was used. The logistic regression analysis was limited to the first pregnancy after joining the company to satisfy the assumption of independence among pregnancies. Moreover, we stratified the analysis by time period (pregnancy in the years prior to 2008 vs. after 2009) to reflect differences in occupational exposure based on semiconductor production periods. RESULTS: The risk for spontaneous abortion in female semiconductor workers was not significantly higher for fabrication and packaging process workers than for clerical workers. However, when we stratified by time period, the odds ratio for spontaneous abortion was significantly higher for packaging process workers who became pregnant prior to 2008 when compared with clerical workers (odds ratio: 2.21; 95% confidence interval: 1.01–4.81). CONCLUSIONS: When examining the pregnancies of female semiconductor workers that occurred prior to 2008, packaging process workers showed a significantly higher risk for spontaneous abortions than did clerical workers. The two semiconductor production periods in our study (prior to 2008 vs. after 2009) had different automated processes, chemical exposure levels, and working environments. Thus, the conditions prior to 2008 may have increased the risk for spontaneous abortions in packaging process workers in the semiconductor industry. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s40557-017-0204-x) contains supplementary material, which is available to authorized users.