Mediating Effect of Work–Family Conflict on the Relationship Between Long Commuting Time and Workers' Anxiety and Insomnia

Background@#Our study aimed to investigate the mediating role of work–family conflict (WFC) on the relationship between long commutes and workers' anxiety and insomnia. @*Methods@#Our study measured the two dimensions of WFC, time-related, and strain-related, which were considered multiple mediators. The mediating effect of WFC on anxiety and insomnia was investigated by decomposing the total effect into a direct effect (long commuting time → anxiety or insomnia) and an indirect effect (long commuting time → WFC → anxiety or insomnia). The combined indirect effect (joint indirect effect) of strain-related WFC and time-related WFC was estimated. The effects were presented as odds ratios and 95% confidence intervals (CIs). @*Results@#The direct effect of 120 min or longer of commuting time was 1.39 (95% CI: 1.17–1.65) times increase in the odds of anxiety and 1.64 (95% CI: 1.41–1.90) times increase in the odds of insomnia than those whose commuting time was less than 60 min. In the case of indirect effects, those whose commuting time was 120 min or longer had 1.13 times higher odds of anxiety (95% CI: 1.07–1.18) and 1.12 times higher odds of insomnia (95% CI: 1.07–1.17) via WFC. The joint indirect effects accounted for 26.4% and 18.5% of the total effect on anxiety and insomnia, respectively. The longer the commuting time, the stronger both direct and indirect effects. @*Conclusions@#Our findings highlight the mediating effect of WFC on the relationship between long commuting times and workers' anxiety and insomnia.

Self-Esteem Trajectories After Occupational Injuries and Diseases and Their Relation to Changes in Subjective Health: Result From the Panel Study of Workers’ Compensation Insurance (PSWCI)

Background@#Occupational injuries and diseases are life events that significantly impact an individuals’ identity. In this study, we examined the trajectories of self-esteem among victims of occupational injury and disease and their relation to health. @*Methods@#The Panel Study of Workers’ Compensation Insurance conducted annual followups on workers who had experienced occupational injury or disease. A total of 2,000 participants, who had completed medical care, were followed from 2013 to 2017. Growth mixture modeling was utilized to identify latent classes in the self-esteem trajectory.Additionally, logistic regressions were conducted to explore the association between trajectory membership, baseline predictors, and outcomes. @*Results@#Three distinct trajectory classes were identified. Total 65.8% of the samples (n = 1,316) followed an increasing self-esteem trajectory, while 31.1% (n = 623) exhibited a constant trajectory, and 3.1% (n = 61) showed a decreasing trajectory. Individuals with an increasing trajectory were more likely to have a higher educational attainment (odds ratio [OR], 1.86; 95% confidence interval [CI], 1.20–2.88), an absence of a moderate-to-severe disability rating (OR, 0.49; 95% CI, 0.25–0.96), no difficulty in daily living activities (OR, 0.81; 95% CI, 0.75–0.88), and were economically active (re-employed: OR, 2.46; 95% CI, 1.52–3.98; returned to original work: OR, 4.46; 9% CI, 2.65–7.50). Those with a decreasing self-esteem trajectory exhibited an increased risk of poor subjective health (OR, 1.89; 95% CI, 0.85–4.85 in 2013 to OR, 3.17; 95% CI, 1.04–13.81 in 2017), whereas individuals with an increasing trajectory showed a decreased risk (OR, 0.54; 95% CI, 0.43–0.68 in 2013 to OR, 0.44; 95% CI, 0.33–0.57 in 2017). @*Conclusion@#Our findings emphasize the diversity of psychological responses to occupational injury or disease. Policymakers should implement interventions to enhance the self-esteem of victims.

Evaluation of Temporal Trends of Lead Exposure in Korean Workers Using Workplace Monitoring Data

Background@#Lead, which is widely used in various industrial settings, is a major health hazard for manufacturing workers. Therefore, control of lead exposure has been implemented in an effort to prevent lead-related health problems. In this study, our aim was to evaluate temporal trends in occupational lead exposure in Korean lead workers using data from monitoring of workplace exposure. @*Methods@#A nationwide work environment monitoring database, data from a work environment monitoring institution, and data extracted from a review paper were utilized. Different versions of standard industrial classification codes were aligned with the 10th Korean Standard Industrial Classification, which is generally consistent with the 4th revision of the International Standard Industrial Classification. The multiple data sources were combined and temporal trends over the period from 1994–2021 were estimated. In addition, separate estimation of temporal trends in the storage battery manufacturing industry over the period from 1987–2021 was also performed. @*Results@#A total of 444,296 personal airborne lead measurements were used for the estimation process. The temporal trends in occupational exposure to lead declined by −6% annually over the study period. In particular, levels of lead exposure in the storage battery manufacturing industry showed a steeper decline of −12% annually. @*Conclusions@#Findings of our study showed that occupational exposure to lead declined over the period from 1994 to 2021 in Korea. However, adverse effects of exposure to lead on health should be regarded with caution. The results will be useful in conduct of epidemiological studies examining lead-related effects on health.

The role of customer service manual on workplace emotional burden in nationwide cross sectional study

BACKGROUND: We aim to discuss the overall effect of customer service manual (CSM) on service industry workers using Korean Working Condition Survey. METHODS: Out of 50,007 total survey participants, 11,946 customer service workers were included in the current study (5613 men, 6333 women). Answers to survey questions were used to define the use of CSM, emotional burden, emotional dissonance, engaging angry customers and other covariates. Emotional burden included either depressive event or stress level. Odds ratio (OR) with 95% confidence interval (95% CI) of experiencing emotional burden was calculated by logistic regression model. Interaction effect between CSM and engaging angry customer on emotional burden was also estimated. RESULTS: Out of 11,946 subjects, total of 3279 (27.4%) have experienced emotional burden. OR (95% CI) of experiencing emotional burden was 1.40 (1.19–1.64) in men and 1.25 (1.09–1.44) in women. There was gender difference in interaction effect between the use of CSM and engaging angry customers. In men, OR (95% CI) was 3.16 (1.38–7.23) with additive effect when always engaging angry customers with CSM compared to rarely engaging without CSM, while in women OR (95% CI) was 8.85 (3.96–19.75) with synergistic effect. Moreover, the risk of depressive event increased only in women with OR (95% CI) 2.22 (1.42–3.48). CONCLUSIONS: Our current study highlighted association between emotional burden and CSM in both men and women service workers. Furthermore, women were affected more severely by CSM. The results from current study suggest that CSM should be changed appropriately to benefit workers.

Association between job-related stress and experience of presenteeism among Korean workers stratified on the presence of depression

BACKGROUND: Presenteeism refers to the phenomenon of working while sick. Its development can be attributed to not only somatic symptoms but also underlying social agreements and workplace atmosphere. In this study, we analyzed presenteeism among workers from various industries, focusing on job-related stress with stratification on the presence of depression. METHODS: We conducted the study with data from questionnaires filled in by different enterprises enrolled in the Federation of Korean Trade Unions. Workers' depressive symptoms were investigated using the Patient Health Questionnaire-2, while questions on job-related stress and presenteeism were derived from the short form of the Korean Occupational Stress Scale and the official Korean version of the Work-Productivity and Activity Impairment Questionnaire-General Health, respectively. Multilevel logistic analysis was conducted to determine the statistical differences derived from the differences between companies. RESULTS: In total, 930 participants (753 men and 177 women) from 59 enterprises participated in the research. We conducted multilevel logistic regression to determine the association between the variables and presenteeism, with stratification by the presence of depression. Higher job demands and higher interpersonal conflict showed significantly elevated odds ratios (ORs) in univariate models and in the multivariate multilevel model. In the final model of total population, fully adjusted by general and work-related characteristics, higher job demands (OR: 3.29, 95% confidence interval [CI]: 2.08–5.21) and interpersonal conflict (OR: 1.87, 95% CI: 1.29–2.71) had significantly higher ORs—a tendency that remained in participants without depression. CONCLUSIONS: This study reflected the factors associated with presenteeism among workers from various enterprises. The findings revealed that job-related stress was closely related to presenteeism in both the total population and in the population without depression. Thus, it emphasized interventions for managing job stress among workers to reduce presenteeism in general workers' population.

Impacts of Return-to-Work Type and Period on Job Retention in Workers with Occupational Injuries and Diseases

BACKGROUND: Despite the necessity of job retention in achieving return-to-work (RTW) goals, many workers leave their jobs after returning to work. The objective of this study was to examine the impacts of RTW type and period on job retention in Korean workers with occupational injuries and diseases. METHODS: Data were derived from the Panel Study of Worker's Compensation Insurance, including data from 2,000 systemically sampled workers who had finished recuperation in 2012; three waves of survey data were included in the analyses. Workers who returned to work (n = 1,610) were included in the analysis of the relationship between RTW type and job retention, and 664 workers who returned to their original workplaces were included in the analysis of the relationship between RTW period and job retention. The participants completed a questionnaire, and administrative data were provided by workers' compensation insurance. RESULTS: A Cox proportional-hazards regression analysis showed an increased hazard ratio (HR) for non-retention of 2.66 (95% confidence interval, 2.11–3.35) in reemployed workers compared to that in workers returning to their original workplaces. Among workers returning to their original workplaces, HRs for non-retention were increased in workers with a RTW period of 13–24 months (3.03 [1.52–6.04]) and > 24 months (5.33 [2.14–13.25]) compared to workers with a RTW period of ≤ 3 months. CONCLUSION: RTW type and period were significantly related to job retention, suggesting that policies for promoting job retention rate should be implemented.

Radiation-related occupational cancer and its recognition criteria in South Korea

Ionizing radiation is a well-known carcinogen, and is listed as one carcinogenic agent of occupational cancer. Given the increase in the number of workers exposed to radiation, as well as the increase in concern regarding occupational cancer, the number of radiation-related occupational cancer claims is expected to increase. Unlike exposure assessment of other carcinogenic agents in the workplace, such as asbestos and benzene, radiation exposure is usually assessed on an individual basis with personal dosimeters, which makes it feasible to assess whether a worker's cancer occurrence is associated with their individual exposure. However, given the absence of a threshold dose for cancer initiation, it remains difficult to identify radiation exposure as the root cause of occupational cancer. Moreover, the association between cancer and radiation exposure in the workplace has not been clearly established due to a lack of scientific evidence. Therefore, criteria for the recognition of radiation-related occupational cancer should be carefully reviewed and updated with new scientific evidence and social consensus. The current criteria in Korea are valid in terms of eligible radiogenic cancer sites, adequate latent period, assessment of radiation exposure, and probability of causation. However, reducing uncertainty with respect to the determination of causation between exposure and cancer and developing more specific criteria that considers mixed exposure to radiation and other carcinogenic agents remains an important open question.

Differences in the performance of health officers at the workplace according to their qualifications

BACKGROUND: Health officers are an integral part of the occupational health service, and there have been studies to identify and improve the role of health officers in the workplace in order to improve the level of health care in the workplace. This study aimed to determine the contribution of health officers to the role of a health officer as prescribed by law and the percentage of health management work performed during work according to their qualifications. METHODS: Questionnaires were distributed to a total of 4584 workplaces where health officers were hired, and a total of 806 copies (17.58%) were returned. Of these, 336 questionnaires were finally analyzed, after excluding questionnaires missing the main variables. Using the data, the difference of role contributions and the percentage of health care work performed during the whole day according to the qualification of the health officer was analyzed. RESULTS: Nurses were highly rated in the field of medical care, and industrial hygienists and air environmental engineers were highly rated in terms of chemicals and risk factor management. The percentage of health care work performed during the whole day differed according to the size of the workplace and industrial classification, but it was generally the lowest among air environmental engineers. CONCLUSIONS: Health officers play a very different role in the workplace depending on their qualification, and they need support for areas of other qualification. In order to effectively manage the health of the staff at a workplace, it is necessary to consider the development of a support system for small- and medium-sized enterprises and adjust the conditions of employment of the health officer according to the law.

The Association between Involuntary Smoking Exposure with Urine Cotinine Level and Blood Cadmium Level in General Non-Smoking Populations

Unintentional environmental exposure to toxicants is associated with an aggravated health status of the general population. Involuntary smoking (IS) exposure is one of the main routes to involuntary toxicants exposure. However, few studies have attempted to understand the environmental cadmium exposure by IS exposure in the general, non-smoking population. The purpose of the current study was to examine the relationship between blood cadmium level and IS level according to gender and age. We used the Korea National Health and Nutrition Examination Survey (KNHANES) IV–VI data that included heavy metal and urine cotinine sampling with IS exposure history. The final analysis comprised 3,493 adults (1,231 males and 2,262 females) and 395 adolescents (210 males and 185 females). Linear regression was performed to estimate the association between self-reported IS exposure with urine cotinine level and blood cadmium level in non-smokers with gender and age group stratification. In final regression model, the effect values (B) (standard errors [SE]) between blood cadmium and urine cotinine level in men was 0.0004 (0.0001) and 0.0006 (0.0002) in adults and adolescents, the B (SE) in women was 0.0006 (0.0002) and 0.0016 (0.0006) in adults and adolescents. Our study revealed, for the first time, a significant association between blood cadmium and IS exposure in non-smokers. Greater efforts are needed to improve environmental justices of the general population from IS, considering the severe harmful effects of involuntary exposure to even a low level of cadmium.

Hospital Qualities Related to Return to Work from Occupational Injury after Controlling for Injury Severity as Well as Occupational Characteristics

We examined associations between hospital quality in the workers' compensation system and injured patients' return to work after controlling for injury severity, occupational factors, and demographic factors. Return to work data of injured workers were constructed from 2 datasets: 23,392 patients injured in 2009-2011 from the Korea Workers' Compensation & Welfare Service and return to work data from Korea Employment Information Services. After de-identifying the data, quality scores were matched for each hospital that cared for injured patients. Injury severity was measured by Abbreviated Injury Scales. Relative risk and 95% confidence interval were calculated using log binomial regression models. After adjusting for age, sex, injury severity, occupation, factory size, city, and hospital type, the relative risk (95% confidence interval) for the total score was 1.04 (1.02-1.06), 1.06 (1.04-1.09), and 1.07 (1.05-1.10) in the 2nd, 3rd, and 4th quartiles, respectively, compared to the 1st quartile. The RR (95% CI) in the 2nd, 3rd, and 4th quartiles was 1.05 (1.02-1.07), 1.05 (1.02-1.08), and 1.06 (1.04-1.09) for the process score; and 1.02 (1.01-1.04), 1.05 (1.03-1.07), and 1.06 (1.04-1.09) for the outcome score compared to the 1st quartile score, respectively. In conclusion, our study design with blinded merge methods shows that total, process, and outcome qualities are related to the return to work of injured workers after controlling for other factors.

The Perceived Socioeconomic Status Is an Important Factor of Health Recovery for Victims of Occupational Accidents in Korea

We aimed to examine whether there is a correlation between the health recovery of industrial accident victims and their perceived socioeconomic status. Data were obtained from the first Panel Study of Worker's Compensation Insurance, which included 2,000 participants. We performed multivariate regression analysis and determined the odds ratios for participants with a subjectively lower socioeconomic status and for those with a subjectively lower middle socioeconomic status using 95% confidence intervals. An additional multivariate regression analysis yielded the odds ratios for participants with a subjectively lower socioeconomic status and those with a subjectively upper middle socioeconomic class using 95% confidence intervals. Of all participants, 299 reported a full recovery, whereas 1,701 did not. We examined the odds ratio (95% confidence intervals) for participants' health recovery according to their subjective socioeconomic status while controlling for sex, age, education, tobacco use, alcohol use, subjective state of health prior to the accident, chronic disease, employment duration, recovery period, accident type, disability status, disability rating, and economic participation. The odds of recovery in participants with a subjectively lower middle socioeconomic status were 1.707 times greater (1.264-2.305) than that of those with a subjectively lower socioeconomic status. Similarly, the odds of recovery in participants with a subjectively upper middle socioeconomic status were 3.124 times greater (1.795-5.438) than that of those with a subjectively lower socioeconomic status. Our findings indicate that participants' perceived socioeconomic disparities extend to disparities in their health status. The reinforcement of welfare measures is greatly needed to temper these disparities.

The Perceived Socioeconomic Status Is an Important Factor of Health Recovery for Victims of Occupational Accidents in Korea

We aimed to examine whether there is a correlation between the health recovery of industrial accident victims and their perceived socioeconomic status. Data were obtained from the first Panel Study of Worker's Compensation Insurance, which included 2,000 participants. We performed multivariate regression analysis and determined the odds ratios for participants with a subjectively lower socioeconomic status and for those with a subjectively lower middle socioeconomic status using 95% confidence intervals. An additional multivariate regression analysis yielded the odds ratios for participants with a subjectively lower socioeconomic status and those with a subjectively upper middle socioeconomic class using 95% confidence intervals. Of all participants, 299 reported a full recovery, whereas 1,701 did not. We examined the odds ratio (95% confidence intervals) for participants' health recovery according to their subjective socioeconomic status while controlling for sex, age, education, tobacco use, alcohol use, subjective state of health prior to the accident, chronic disease, employment duration, recovery period, accident type, disability status, disability rating, and economic participation. The odds of recovery in participants with a subjectively lower middle socioeconomic status were 1.707 times greater (1.264-2.305) than that of those with a subjectively lower socioeconomic status. Similarly, the odds of recovery in participants with a subjectively upper middle socioeconomic status were 3.124 times greater (1.795-5.438) than that of those with a subjectively lower socioeconomic status. Our findings indicate that participants' perceived socioeconomic disparities extend to disparities in their health status. The reinforcement of welfare measures is greatly needed to temper these disparities.

Workplace Violence Experienced by Substitute (Daeri) Drivers and Its Relationship to Depression in Korea

Workplace violence is related to various health effects including mental illness such as anxiety or depression. In this study, the relationship between the experience of workplace violence and depression in substitute drivers in Korea, namely, daeri drivers, was investigated. To assess workplace violence, questions regarding types and frequency of the experience of violence over the past year were asked to the daeri drivers. In order to assess the risk of depression, the Center for Epidemiological Studies Depression Scale was used. Odds ratios with 95% confidence intervals of depression were estimated using multiple logistic regression analysis. All of the daeri drivers had experienced instance of verbal violence while driving and 66 of the drivers (34.1%) had been in such a situation more than once in the past quarter of a year. Sixty-eight daeri drivers (42.2%) had experienced certain type of physical violence over the past year. Compared to daeri drivers who had experienced workplace verbal violence less than 4 times and who had not experienced workplace physical violence over the past year, higher odds ratio was observed in daeri drivers who had experienced workplace verbal violence or physical violence, more than 4 times and more than one time respectively, after adjustment. Experience of verbal or physical type of workplace violence over the past year increased the risk of depression in the daeri drivers. Because violence against drivers can compromise the safety of the driver, the customer, and all the passengers, it is imperative that the safety and health of daeri drivers be highlighted.

Case report of renal cell carcinoma in automobile manufacturing factory worker due to trichloroethylene exposure in Korea

BACKGROUND: The aim of this paper was report first case of renal cell carcinoma developed in a worker who worked in an automobile manufacture line which handles trichloroethylene in Korea. CASE PRESENTATION: To clarify the relationship between the onset of renal cell carcinoma in 52-years old male worker and the exposure to trichloroethylene, document studies and work environment measurement were done. Past work environment exposure data were reviewed and medical history and surgery records of the worker were also reviewed. The patient had no personal risk factor related to renal cell carcinoma except for his smoking habit of quarter a pack per day for twenty years, and since trichloroethylene was not part of measurement criteria, past work environment risk assessment data could not verify the exposure. The exposure level is deduced by analyzing material exposure level of work environments which has similar processes in data from revised research of chemical exposure standard and work environment validity assessment. Evaluation Committee of Epidemiologic Survey decided that there are relevant relationship between the exposure and the disease, though we do not have exact data during that period, most experts agree that in every factories they used trichloroethylene without any direction. CONCLUSIONS: From the relevant medical history and the results of the usage of trichloroethylene in the relevant industries, and initial discovery of renal cell carcinoma at health inspection sonogram in 2001, it can be concluded that suggests significant causal relationship between the exposure to trichloroethylene and renal cell carcinoma onset, thus reporting it to be the first domestic case declared to be occupational disease.

Factors related to the physician and the employer influencing successful return to work in Korea: results from the first panel study of workers' compensation insurance (PSWCI)

OBJECTIVES: This study aims to investigate associated factors including the physician and the employer of successful return to work (RTW) in occupationally injured workers. METHODS: This study is based on the first panel study of workers' compensation insurance (PSWCI), published in June 2014. The PSWCI is a sample survey of occupationally injured workers who completed medical care in 2012 (89,921 people). A total of 2000 subjects were sampled based on sex, age, nine metropolitan-based regions, disability ratings, duration of rehabilitation, and whether vocational rehabilitation service was used. We divided the study population into two groups: return to work (RTW) group (job retention, reemployment, unpaid family worker, and self-employment), and non-RTW group (joblessness and economical inactivity). The odds ratios (ORs) and 95 % confidence intervals (CI) related to differences in basic characteristics, part of physician and employer-related factors between those who succeeded to RTW and those who did not were measured using multivariable logistic regression model. RESULTS: The success of RTW is 70.6 % (n = 1412) among participants. The ORs (95 % CI) of the participants belonging to RTW who received periodic recovery assessment from the medical care institution and the physician are 1.51 (1.07-2.13). The ORs (95 % CI) are 1.68 (1.05-2.69) for the RTW group who received work ability assessment and referral for vocational return. When the employer maintains the relationship with the occupationally injured worker, the worker has 1.39 times higher odds (95 % CI: 1.41-2.26) of the RTW group compared to the non-RTW group. CONCLUSIONS: The physician and the employer have a significant impact on the RTW.

Compensation for Work-Related Cerebrocardiovascular Diseases

The purpose of this study was to discuss the history of, and concerns regarding, the newly amended criteria of occupational cerebrovascular or cardiovascular diseases (CCVDs). Since the early 1990s, CCVDs have been the second most common occupational disease, despite fluctuations in their criteria. The first issue was the deletion of cerebral hemorrhage on duty as a recognized occupational disease in 2008. The second issue was the obscurity regarding definitions of an acute stressful event (within 24 hr before disease occurrence), short-term overwork (within 1 week), and chronic overwork (for 3 or more months). In this amendment, chronic overwork was defined as work exceeding 60 hr per week. If the average number of weekly working hours does not exceed 60 hr, night work, physical or psychological workload, or other risk factors should be considered for the recognition of occupational CCVDs. However, these newly amended criteria still have a few limitations, considering that there is research evidence for the occurrence of disease in those working fewer than 60 hr per week, and other risk factors, particularly night work, are underestimated in these criteria. Thus, we suggest that these concerns be actively considered during future amendment and approval processes.

The association between concealing emotions at work and medical utilization in Korea

OBJECTIVES: We aimed to investigate the association between concealing emotions at work and medical utilization. METHODS: Data from the 2007-2009 4th Korea National Health and Nutrition Examination Survey (KNHANES IV) was used, 7,094 participants (3,837 males, 3,257 females) aged between 20 and 54 who were economically active and completed all necessary questionnaire items were included. Odds ratios (ORs) and 95% confidence intervals (95% CI) for differences in hospitalization, outpatient visits, and pharmaceutical drug use between those who concealed their emotions and those who did not were investigated using logistic regression models with and without gender stratification. RESULTS: Among those who concealed their emotions (n = 2,763), 47.4% were females, and 50.1% had chronic disease. In addition, 9.7% of the concealing emotions group had been hospitalized within the last year, 24.8% had been outpatients in the last two weeks, and 28.3% had used pharmaceutical drugs in the last two weeks. All ORs represent the odds of belonging to the concealing emotions group over the non-concealing emotions group. After adjustment for individual, occupational, socioeconomic and disease factors, the adjusted ORs (95% CI) in hospitalization are 1.29 (1.08 ~ 1.53) in the total population, 1.25 (0.98 ~ 1.60) in males and 1.30 (1.02 ~ 1.66) in females, in outpatient visits are 1.15 (1.02 ~ 1.29) in the total population, 1.05 (0.88 ~ 1.24) in males and 1.25 (1.06 ~ 1.47) in females and in pharmaceutical drug use are 1.12 (1.01 ~ 1.25) in the total population, 1.08 (0.92 ~ 1.27) in males and 1.14 (0.98 ~ 1.33) in females. CONCLUSIONS: Those who concealed their emotions at work were more likely to use medical services. Moreover, the health effects of concealing emotions at work might be more detrimental in women than in men.

Workers' experiences with compensated sick leave due to musculoskeletal disorder: a qualitative study

OBJECTIVES: The most common occupational disease that is compensated by Industrial Accident Compensation Insurance (IACI) in Korea is musculoskeletal disease (MSD). Although complaints about the workers' compensation system have been raised by injured workers with MSD, studies that examine workers' experiences with the Korean system are rare. This paper is a qualitative study designed to examine injured workers' experiences with the workers' compensation system in Korea. The aim of this study is to explore the drawbacks of the workers' compensation system and to suggest ways to improve this system. METHODS: All workers from an automobile parts factory in Anseong, GyeongGi province who were compensated for MSD by IACI from January 2003 to August 2013 were invited to participate. Among these 153 workers, 142 workers completed the study. Semi-structured open-ended interviews and questionnaires were administered by occupational physicians. The responses of 131 workers were analyzed after excluding 11 workers, 7 of whom provided incomplete answers and 4 of whom were compensated by accidental injury. Based on their age, disease, department of employment, and compensation time, 16 of these 131 workers were invited to participate in an individual in-depth interview. In-depth interviews were conducted by one of 3 occupational physicians until the interview contents were saturated. RESULTS: Injured workers with MSD reported that the workers' compensation system was intimidating. These workers suffered more emotional distress than physical illness due to the workers' compensation system. Injured workers reported that they were treated inadequately and remained isolated for most of the recuperation period. The compensation period was terminated without ample guidance or a plan for an appropriate rehabilitation process. CONCLUSIONS: Interventions to alleviate the negative experiences of injured workers, including quality control of the medical care institutions and provisions for mental and psychological care for injured workers, are needed to help injured workers return to work earlier and more healthy.

The Effect of Work Characteristics on Dermatologic Symptoms in Hairdressers

OBJECTIVES: Hairdressers in Korea perform various tasks and are exposed to health risk factors such as chemical substances or prolonged duration of wet work. The objective of this study is to provide descriptive statistics on the demographics and work characteristics of hairdressers in Korea and to identify work-related risk factors for dermatologic symptoms in hairdressers. METHODS: 1,054 hairdressers were selected and analyzed for this study. Independent variables were exposure to chemical substances, the training status of the hairdressers, and the main tasks required of them, and the dependent variable was the incidence of dermatologic symptoms. The relationships between work characteristics and dermatologic symptoms were evaluated by estimating odds ratios using multiple logistic regression analysis. RESULTS: Among the 1,054 study subjects, 212 hairdressers (20.1%) complained of dermatologic symptoms, and the symptoms were more prevalent in younger, unmarried or highly educated hairdressers. The main tasks that comprise the majority of the wet work were strictly determined by training status, since 96.5% of staff hairdressers identified washing as their main task, while only 1.5% and 2.0% of master and designer hairdressers, respectively, identified this as their main task. Multiple logistic regressions was performed to estimate odds ratios. While exposure to hairdressing chemicals showed no significant effect on the odds ratio for the incidence of dermatologic symptoms, higher odds ratios of dermatologic symptoms were shown in staff hairdressers (2.70, 95% CI: 1.32 - 5.51) and in hairdressers who perform washing as their main task (2.03, 95% CI: 1.22 - 3.37), after adjusting for general and work characteristics. CONCLUSIONS: This study showed that the training status and main tasks of hairdressers are closely related to each other and that the training status and main tasks of hairdressers are related to the incidence of dermatologic symptoms. This suggests that in the future, regulations on working conditions and health management guidelines for hairdressers should be established.

Return-to-Work According to Impairment Type Among Occupationally Injured Workers in Korea

This study examined the association between return-to-work and impairment type. Database of the Korea Workers' Compensation and Welfare Service was used to identify disabled persons; and return-to-work information was obtained from the Korea Employment Information Services database. The study participants were 79,328 persons who received Workers' compensation and who were confirmed as disabled during 2009-2011. Logistic regression was used to analyze the association between return-to-work and impairment type, adjusted by age, sex, impairment severity, pre-injury businesses size, and pre-injury occupational category. Compared to injuries of the upper limbs, the odds ratio of return-to-work was 0.63 (95% CI, 0.60-0.65) for injuries involving the lower limbs, 0.62 (95% CI, 0.59-0.66) for the spine, 0.75 (95% CI, 0.66-0.86) for the eyes, 0.98 (95% CI, 0.77-1.25) for the oral cavity, 0.44 (95% CI, 0.37-0.53) for the ears, 1.02 (95% CI, 0.83-1.25) for the figure, 0.75 (95% CI, 0.72-0.79) for pain, and 0.36 (95% CI, 0.32-0.41) for neuropsychiatric impairment. These findings indicate that impairment type influences return-to-work rates.