Association Between Flexible Work Arrangement and Sleep Problems Among Paid Workers: Using 6th Korean Working Conditions Survey.

Background: As social distancing persists and interest in work-life balance grows, more companies are adopting flexible work policies. While there have been studies on sleep disorders associated with different types of work, such as shift work, research exploring the relationship between flexible work schedules and sleep disorders is still limited, particularly among Korean workers. Methods: We performed a secondary analysis of the 6th Korean Working Conditions Survey, focusing on 31,243 paid workers out of a total of 50,538 participants. We defined flexible workers as those who set their own working hours. Sleep disorders were divided into three categories: 'difficulty falling asleep,' 'frequent waking during sleep,' and 'waking up feeling exhausted and fatigued.' Using scores derived from three specific symptoms, the Minimal Insomnia Symptoms Scale (MISS) was calculated to assess the prevalence of insomnia. We used chi-square tests to analyze demographic and job-related differences. A multivariate logistic regression analysis was employed to identify any relationship between flexible work schedules and sleep disorders. Results: Significant differences were found between flexible and non-flexible workers regarding age, income level, education level, and job type. Flexible workers reported sleep-related symptoms significantly more often. The odds ratio for insomnia was 1.40 (95% CI 1.21-1.61). For males, the odds ratio was 1.68 (1.36-2.08). Conclusion: This study establishes a correlation between flexible work schedules and sleep disorders among Korean salaried workers. Potential causes could include changes in circadian rhythm, increased work demands, and extended working hours. To precisely determine causality and associated diseases, further research is required.

Beyond working hours: the association between long working hours, the use of work-related communication devices outside regular working hours, and anxiety symptoms.

OBJECTIVES: The present study aimed to identify and compare the associations between long working hours and use of work-related communication devices outside regular working hours and anxiety symptoms, thereby providing insight into redefining working hours. METHODS: Based on the cross-sectional data from the sixth Korean Working Conditions Survey (KWCS), specifically the responses from 46 055 workers, the use of work-related communication devices outside of regular working hours, long working hours, and anxiety symptoms were assessed. To investigate the associations between using work-related communication devices outside regular working hours or long working hours with anxiety symptoms, odds ratios (ORs) and 95% CIs were calculated using multiple logistic regression models. RESULTS: Among 46 055 participants, 25 659 (55.7%) used work-related communication devices outside working hours, 8145 (17.7%) worked long hours, and 2664 (5.8%) experienced anxiety symptoms. Compared with the reference group, those who used work-related communication devices outside regular working hours without working long hours, had higher OR of anxiety symptoms (OR: 2.18; 95% CI, 1.97-2.41) than those who worked long hours without using work-related communication devices during off-hours (OR: 1.32; 95% CI, 1.09-1.59). Furthermore, the group that both worked long hours and used work-related communication devices outside working hours exhibited the highest OR of anxiety symptoms (OR: 2.57; 95% CI, 2.24-2.97). CONCLUSIONS: Using work-related communication devices outside regular working hours is associated with a higher risk of anxiety symptoms compared with long working hours. This result suggests that using work-related devices outside regular working hours, in addition to regular work time, should be considered when redefining working hours.

The relationship between exposure to environmental noise and risk of atopic dermatitis, asthma, and allergic rhinitis.

BACKGROUND: Noise is defined as unwanted sound. It may induce negative emotions and mental health problems and may even lead to increased suicide risk. However, the impact of noise exposure on environmental diseases and disease severity is not well understood. This study aimed to elucidate the association between night-time noise exposure and the prevalence of environmental diseases in South Korea. METHODS: We conducted an analysis of the Environmental Disease Database provide by the National Health Insurance Service (NHIS) from 2013 to 2017. After spatially interpolating the noise data provided by the National Noise Information System (NNIS), night-time noise values in the district level were obtained by calculating the mean noise values at the administrative district level. The linear regression analyses were performed to test the association between the age-standardized prevalence ratio (SPR) and the night-time noise exposure in the district level. RESULTS: In areas with high night-time noise exposure (≥55 dB), the SPR for atopic dermatitis and allergic rhinitis were 1.0515 (95 % confidence interval [CI]:1.0508-1.0521) and 1.0202 (95 % CI:1.0201-1.0204), respectively, which were higher than those in the general population. The SPR for environmental diseases, including atopic dermatitis, asthma, and allergic rhinitis, was 1.0104 (95 % CI:1.0103-1.0105). Additionally, a significant linear association was observed between the level of nocturnal noise exposure and the total hospitalization period for atopic dermatitis (ß = 399.3, p < 0.01). CONCLUSION: We provide evidence of a significant association between night-time environmental noise and environmental diseases, particularly atopic dermatitis and allergic rhinitis. Furthermore, we observed a significant linear association between night-time noise exposure and the severity of atopic dermatitis.

Association between lone work and self-rated health status: using the 5th Korean Working Conditions Survey.

Background: Lone workers are generally defined as individuals who work alone without supervision, including self-employed people. While lone workers are considered a vulnerable group in some countries, there is a lack of research on their health status in domestic studies. Globally, the number of lone workers has been increasing, and this trend has been further accelerated since the coronavirus disease 2019 (COVID-19) pandemic with the rise of remote work. Methods: The study analyzed data from 44,281 participants, excluding unpaid family workers, soldiers, and those with missing data. Lone workers were defined as individuals who reported having no colleagues with the same job at their current workplace. Self-rated health status was categorized as "good" or "poor." Results: This study found a statistically significant higher number of lone workers among women compare to men. The largest occupational category for lone workers was service and sales workers, followed by agriculture and fisheries workers. A majority of non-lone workers reported working 40 hours or less per week, while the majority of lone workers reported working 53 hours or more per week. In addition, lone workers had significantly poorer health status evaluations compared to non-lone workers (odds ratio: 1.297; 95% confidence interval: 1.165-1.444). Conclusions: Further research is needed to investigate the causal relationship between lone work and health, using data collected after the COVID-19 pandemic.

Cancer risk in Vietnam war veterans from the Korean Vietnam war veterans' health study cohort.

Introduction: During the Vietnam War, several unknown chemicals, such as Agent Orange, were used in Vietnam by the military. Therefore, there have been continuous health concerns among the Vietnamese population and veterans exposed to these hazardous chemicals. This study aimed to investigate the risk of all cancers and also organ-specific cancers among Korean veterans of the Vietnam War. Methods: This study used a national representative cohort that included all Korean Vietnam War veterans as the interest group, with 1:4 age-sex-region-matched general Korean citizens as the reference group, from 2002 to 2018. Age-standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) were calculated for all cancers and for 31 organ-specific cancer categories based on the medical facility visit data. Results: An increased SIR of 1.07 (95% CI, 1.06-1.08) was observed for all cancers among the veterans. There was a significantly increased risk of cancer among 22/31 organspecific cancers, with 18 cancer categories showing a significantly higher risk than all cancers. The highest risk was observed for "malignant neoplasms of other parts of the central nervous system" (SIR, 1.71; 95% CI, 1.51-1.92). Discussion: This study evaluated the risk of cancer among Korean Vietnam War veterans. Further studies are warranted to investigate various health determinants in the veterans as well as the Vietnamese population.

Standards for recognition and approval rate of occupational cerebro-cardiovascular diseases in Korea.

Background: Although working hours have decreased in Korea, they are still high compared to that of other countries. In Korea, cardiovascular and cerebrovascular diseases (CCVDs) related to overwork in Korea continually occur, and the social burden from overwork is estimated to be high. This study investigated the amendment of regulations affecting the approval rate of occupational CCVDs. Methods: The change in approval rate of occupational CCVDs and related regulations were investigated using the Act and public notice on the standards for recognition of occupational CCVDs and the yearbooks of the Ministry of Employment and Labor. The CCVD mortality was estimated using data on the number of deaths according to the cause of death, the number of employed people, and resident registration population aged 15-64 years. The cumulative mortality of CCVDs was estimated using the Kaplan-Meier method. Results: Since the establishment of the standards for recognition in Korea in 1982, the scope of occupational diseases has been expanded to include intracerebral hemorrhage, subarachnoid hemorrhage, cerebral infarction, myocardial infarction, and aortic dissection. In 2013, the concept of working hours was introduced in chronic overwork. The approval rate of occupational CCVDs was 44.7% in 2006, which decreased to 12.9% in 2011. After the improvement of related regulations, the approval rate increased to 41.3% in 2018. From 2000 to 2017, the CCVD mortality of both the unemployed and employed tended to decrease, and their cumulative CCVD mortalities were 549.3 and 319.7 per 100,000 people, respectively. Conclusions: CCVDs are recognized as occupational diseases in Korea. The amendments to the standards for recognition, the introduction of the Occupational Disease Adjudication Committee, the principle of presumption, and the reduction of working hours have changed the approval rate of occupational CCVDs. A strategic approach is needed to further reduce the incidence of CCVDs.

Must countries shoulder the burden of mesothelioma to ban asbestos? A global assessment.

INTRODUCTION: Mesothelioma is a key asbestos-related disease (ARD) but can be difficult to diagnose. Countries presumably ban asbestos to reduce future ARD burdens, but it is unknown if countries ban asbestos as a consequence of ARD burdens. We assessed if and to what extent mesothelioma burden has an impact on a country banning asbestos and obtaining targets for preventative strategies. METHODS: We analysed the status of asbestos ban and mesothelioma burden during 1990-2019 in 198 countries. We assessed mesothelioma burden by age-adjusted mortality rates (MRs) estimated by the Global Burden of Disease Study (GBD) and mesothelioma identification by the WHO mortality database. For GBD-estimated mesothelioma MR, the pre-ban period in the asbestos-banned countries was compared with the 1990-2019 period in the not-banned countries. For mesothelioma identification, the 1990-2019 period was applied to both banned and not-banned countries. RESULTS: The association of mesothelioma MR with ban status increased as the ban year approached. Logistic regression analyses showed that the odds of a country banning asbestos increased 14.1-fold (95% CI 5.3 to 37.9) for mesothelioma identification combined with a 26% (12% to 42%) increase per unit increase of mesothelioma MR (one death per million per year) during the period 1-5 year before ban (model p<0.0001). CONCLUSION: Mesothelioma burden had an impact on, and together with its identification, explained the banning of asbestos in many countries. Asbestos-banned countries likely learnt lessons from their historical policies of using asbestos because mesothelioma burden and identification follow historical asbestos use. Prevention targets for ARD elimination should combine asbestos ban with mesothelioma identification.

The effect of occupational exposure to welding fumes on trachea, bronchus and lung cancer: A systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury.

BACKGROUND: The World Health Organization (WHO) and the International Labour Organization (ILO) are the producers of the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury (WHO/ILO Joint Estimates). Welding fumes have been classified as carcinogenic to humans (Group 1) by the WHO International Agency for Research on Cancer (IARC) in IARC Monograph 118; this assessment found sufficient evidence from studies in humans that welding fumes are a cause of lung cancer. In this article, we present a systematic review and meta-analysis of parameters for estimating the number of deaths and disability-adjusted life years from trachea, bronchus, and lung cancer attributable to occupational exposure to welding fumes, to inform the development of WHO/ILO Joint Estimates on this burden of disease (if considered feasible). OBJECTIVES: We aimed to systematically review and meta-analyse estimates of the effect of any (or high) occupational exposure to welding fumes, compared with no (or low) occupational exposure to welding fumes, on trachea, bronchus, and lung cancer (three outcomes: prevalence, incidence, and mortality). DATA SOURCES: We developed and published a protocol, applying the Navigation Guide as an organizing systematic review framework where feasible. We searched electronic databases for potentially relevant records from published and unpublished studies, including Medline, EMBASE, Web of Science, CENTRAL and CISDOC. We also searched grey literature databases, Internet search engines, and organizational websites; hand-searched reference lists of previous systematic reviews; and consulted additional experts. STUDY ELIGIBILITY AND CRITERIA: We included working-age (≥15 years) workers in the formal and informal economy in any Member State of WHO and/or ILO but excluded children (<15 years) and unpaid domestic workers. We included randomized controlled trials, cohort studies, case-control studies, and other non-randomized intervention studies with an estimate of the effect of any (or high) occupational exposure to welding fumes, compared with occupational exposure to no (or low) welding fumes, on trachea, bronchus, and lung cancer (prevalence, incidence, and mortality). STUDY APPRAISAL AND SYNTHESIS METHODS: At least two review authors independently screened titles and abstracts against the eligibility criteria at a first review stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. If studies reported odds ratios, these were converted to risk ratios (RRs). We combined all RRs using random-effects meta-analysis. Two or more review authors assessed the risk of bias, quality of evidence, and strength of evidence, using the Navigation Guide tools and approaches adapted to this project. Subgroup (e.g., by WHO region and sex) and sensitivity analyses (e.g., studies judged to be of "high"/"probably high" risk of bias compared with "low"/"probably low" risk of bias) were conducted. RESULTS: Forty-one records from 40 studies (29 case control studies and 11 cohort studies) met the inclusion criteria, comprising over 1,265,512 participants (≥22,761 females) in 21 countries in three WHO regions (Region of the Americas, European Region, and Western Pacific Region). The exposure and outcome were generally assessed by job title or self-report, and medical or administrative records, respectively. Across included studies, risk of bias was overall generally probably low/low, with risk judged high or probably high for several studies in the domains for misclassification bias and confounding. Our search identified no evidence on the outcome of having trachea, bronchus, and lung cancer (prevalence). Compared with no (or low) occupational exposure to welding fumes, any (or high) occupational exposure to welding fumes increased the risk of acquiring trachea, bronchus, and lung cancer (incidence) by an estimated 48 % (RR 1.48, 95 % confidence interval [CI] 1.29-1.70, 23 studies, 57,931 participants, I2 24 %; moderate quality of evidence). Compared with no (or low) occupational exposure to welding fumes, any (or high) occupational exposure to welding fumes increased the risk dying from trachea, bronchus, and lung cancer (mortality) by an estimated 27 % (RR 1.27, 95 % CI 1.04-1.56, 3 studies, 8,686 participants, I2 0 %; low quality of evidence). Our subgroup analyses found no evidence for difference by WHO region and sex. Sensitivity analyses supported the main analyses. CONCLUSIONS: Overall, for incidence and mortality of trachea, bronchus, and lung cancer, we judged the existing body of evidence for human data as "sufficient evidence of harmfulness" and "limited evidence of harmfulness", respectively. Occupational exposure to welding fumes increased the risk of acquiring and dying from trachea, bronchus, and lung cancer. Producing estimates for the burden of trachea, bronchus, and lung cancer attributable to any (or high) occupational exposure to welding fumes appears evidence-based, and the pooled effect estimates presented in this systematic review could be used as input data for the WHO/ILO Joint Estimates. PROTOCOL IDENTIFIER: https://doi.org/10.1016/j.envint.2020.106089.

Cohort Profile: Gachon Regional Occupational Cohort Study (GROCS).

Background/Aims: The Gachon Regional Occupational Cohort Study (GROCS) is a large-scale longitudinal study of occupational safety and health data (covering Work Environment Monitoring, Workers' Health Surveillance, and Occupational Health Service) conducted by the Gachon University Gil Medical Center (GUGMC) in Incheon, Republic of Korea. We conducted GROCS to identify the health effects of workers' occupational risks, behavior, socioeconomic status, and life style. Methods: The GROCS includes data from Work Environment Monitoring, Workers' Health Surveillance, and Occupational Health Service. The baseline year for all data collection was 2018. Work Environment Monitoring was conducted in 240 companies located in Incheon. General Health Examination and Special Health Examination were performed on 32,725 and 9,504 workers, respectively. Occupational Health Services were provided to 16,883 workers in 171 companies. These data have been collected and operated at an external data management institution and were provided as a retrospective cohort after removing personal identification information. Results: In 2018, the total number of companies was 2,854, among which which 488 special Health Examination, 171 Work Environment Monitoring, and 240 Occupational Health Service. The proportion of companies undergoing Special Health Examination was 17.1%, the proportion of companies undergoing Work Environment Monitoring was 8.4%, and the proportion of Companies undergoing Occupational Health Service was 6.0%. Conclusion: GROCS expects researchers to utilize its useful and reliable resource for occupational health and surveillance with for academic or political purposes to lead to improved workers' health and working environment.

Premenstrual syndrome incidence rate and risk factors among the working population in the Republic of Korea: a prospective cohort study.

BACKGROUND: Premenstrual syndrome (PMS) is the most common disease of the genitourinary tract in women. Although a sizeable proportion of women have symptoms or diagnosed PMS, its etiology remains unclear. The purpose of this cohort is to offer incidence and relevant risk factors of PMS among reproductive-aged Korean female workers. METHODS: Cohort data used were from the National Health Insurance Service-Female Employees (from 2007 to 2015) conducted by the NHIS. A total of 121,024 female workers were analyzed to estimate the incidence and hazard ratio of PMS. PMS data was based on information obtained from medical facility visits during an eight-year follow-up. RESULTS: The incidence of PMS was 7.0% during follow-up periods. In industrial classification, human health and social work activities have the highest incidence (9.0%) of PMS. Cumulative incidence of PMS has continuously increased by approximately 1% annually for eight years. Adjusted hazard ratio with 95% confidence interval was significantly higher in the 15-19 years old age group (2.81, 95%CI 2.35-3.36), manual worker (1.06, 95%CI 1.01-1.12), with anemia (1.13, 95%CI 1.06-1.20), and underweight (1.21, 95%CI 1.10-1.25) compared to those in the reference group. CONCLUSION: This study describes the PMS status with trend and risk factors using follow-up design among women under a middle-aged working population. Further study is warranted for better understanding on the risk factors of PMS for reproductive-aged female workers.

Analysis of self-reported mental health problems among the self-employed compared with paid workers in the Republic of Korea.

Background: As self-employed workers are vulnerable to health problems, this study aimed to analyze mental health problems and sleep disturbances among self-employed workers compared with paid workers in Korea. Methods: A total of 34,750 workers (23,938 paid workers and 10,812 self-employed workers) were analyzed from the fifth Korean Working Condition Survey, which included 50,205 households collected by stratified sampling in 2017. To compare mental health problems and sleep disturbance among self-employed workers and paid workers, multivariate logistic regression analyses were performed. Results: The odds ratio in self-employed workers compared with paid workers was 1.25 (95% confidence interval [CI]: 1.09-1.42) for anxiety, 1.11 (95% CI: 1.04-1.17) for overall fatigue, 1.11 (95% CI: 1.04-1.20) for difficulty falling asleep, 1.10 (95% CI: 1.02-1.18) for difficulty maintaining sleep and 1.24 (95% CI: 1.16-1.32) for extreme fatigue after waking up. Conclusions: Self-employed workers in Korea have a higher risk of self-reported mental health problems and sleep disturbances than paid workers. Further studies with a longitudinal design and structured evaluation are required to investigate the causal relationship between health problems and self-employment.

Cohort Profile: The Korean Vietnam War Veterans' Health Study Cohort (KOVECO).

During the Vietnam War, many troops and citizen were exposed to large amounts of Agent Orange (AO), and the hazardous effects of AO are continuously being researched and reported. The Korean Vietnam War Veterans' Health Study Cohort (KOVECO) is a retrospective cohort to demonstrate the health status of the Korean Vietnam War veterans and their second-generation offsprings. The KOVECO is a collaboration of data from the Ministry of Patriots and Veterans Affairs and the National Health Insurance Sharing Service from 2002 to 2018. The study participants were all Korean Vietnam War veterans and their second-generation offsprings, and the references were the general population in which gender and region were matched with the participants. As of 2002, 191,272 Vietnam War veterans (1,000,320 comparisons) and 1,963,402 s-generations (1,173,061 references) were included in the cohort. The KOVECO consists of personal information, medical facility visit information, and general health examination information. The KOVECO could act as a health surveillance system, which would be able to detect long-term health effects caused by exposure to AO and provide a direction for policy making through academic research.

Heat exposure and workers' health: a systematic review.

OBJECTIVES: Several studies on the health effects of heat exposure on workers have been reported; however, only few studies have summarized the overall and systematic health effects of heat exposure on workers. This study aims to review the scientific reports on the health status of workers exposed to high temperatures in the workplace. METHODS: We reviewed literature from databases such as PubMed and Google Scholar, using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines to identify studies that address health effects of heat exposure among workers. RESULTS: In total, 459 articles were identified, and finally, 47 articles were selected. Various health effects of heat exposure on workers have been reported, such as heat-related diseases, deaths, accidents or injuries, effects on the urinary system, reproductive system, and on the psychological system. CONCLUSIONS: Our review suggests that many workers are vulnerable to heat exposure, and this has a health effect on workers.

Association between occupational or environmental noise exposure and renal function among middle-aged and older Korean adults: a cross-sectional study.

Exposure to occupational and environmental noise is closely linked to various auditory system diseases. Few studies have focused on the effect of noise exposure on the extra auditory system, especially the urinary system. We analyzed 17,154 participants aged 40-79 years from the Korea National Health and Nutrition Examination Survey between 2013 and 2018. A self-reported questionnaire was used to assess occupational or environmental noise exposure. Logistic regression was used to determine the differences in the prevalence of chronic kidney disease (CKD) based on noise exposure characteristics. For participants with noise exposure, linear regression was performed to determine relationship of the noise exposure period and estimated glomerular filtration rate (eGFR). In the noise exposure group, a higher CKD prevalence was associated with females who experienced long-term occupational noise (≥ 240 months) (adjusted OR 2.72, 95% CI 1.11-6.66). An increase of one month of occupational noise exposure was associated with a 0.0106 mL/min/1.73 m2 decrease in eGFR in females aged < 60 years. Overall, noise exposure may be a risk factor for reduced renal function, especially long-term occupational noise exposure. More precise studies should determine (1) the relationship between noise and renal function and (2) the underlying mechanisms.

An 8-week randomized, double-blind, placebo-controlled study to evaluate the efficacy and safety of red Platycodon grandiflorus root extract on enhancement of immune function.

BACKGROUND: The immune-enhancing effects of red Platycodon grandiflorus root extract (RPGE) has been reported in vitro and in vivo, but there are few studies on humans. Therefore, this study aimed to investigate the efficacy and safety of RPGE in enhancing immune function in healthy subjects. SUBJECTS AND METHODS: An 8-week randomized, double-blind, parallel, placebo-controlled clinical trial was conducted at the Gachon University Gil Medical Center, Incheon, South Korea. A total of 100 adults aged 20-75 years with white blood cell counts of 3000-10,000 cell/µL were randomly divided into two groups (RPGE group, 50 and placebo group, 50) using a computer-generated random list with a 1:1 allocation ratio. The subjects consumed RPGE (2 times/day, 2 tablets/time, 375 mg RPGE powder/tablet) or placebo for 8 weeks. All test foods for the human study were coded and administered under double-blind conditions. The primary outcome was a change in the NK cell activity after 8 weeks of treatment compared to the baseline. RESULTS: Among 100 subjects enrolled for the study, 87 completed the study. NK cell activity (p = 0.005) and IFN-γ level (p = 0.003) of the RPGE group (n = 41) were higher than those of the placebo group (n = 46). The findings of the safety assessment revealed absence of clinically significant changes in any test and serious adverse events throughout the study. CONCLUSION: In conclusion, these results demonstrate the efficacy and safety of RPGE, suggesting it to be a beneficial agent for enhancing immune function in humans. TRIAL REGISTRATION: CRIS Registration Number KCT0005945, https://cris.nih.go.kr.

Tuberculosis infection status and risk factors among health workers: an updated systematic review.

Tuberculosis (TB) infection is a common occupational risk for health workers (HWs) and poses a threat to the patients under their care and to other HWs. Hence, the development of a prevention strategy is crucial. We conducted a study to understand the status and risk factors of TB infection among HWs. The existing literature was searched for all published reports from 1 August 2010 to 31 December 2018, related to TB among HWs according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The inclusion criteria were: (1) study participants working in a health care facility; (2) TB cases diagnosed by medical professionals; (3) original research articles; and (4) English reports in a peer-reviewed journal. We finally included 61 studies from 642 articles searched initially. The TB infection rate in HWs was higher than that of the general population. Based on 39 studies, the prevalence of TB in HWs (tuberculin skin test positive) was 29.94%. In contrast, the global burden of latent TB infection was 23.0% (95% uncertainty interval: 20.4%-26.4%) in 2014. The risk factors of TB among HWs were aging, long duration of employment, nursing professionals, lack of Bacillus Calmette-Guerin vaccination, and low body mass index. HWs have an increased risk for TB infection, which can cause secondary infections in patients or other HWs. An effective prevention strategy must be developed to enable early diagnosis and prompt treatment.

Sunlight exposure and eye disorders in an economically active population: data from the KNHANES 2008-2012.

BACKGROUND: Sunlight exposure is a major risk factor for eye disorders. Most outdoor workers cannot avoid sunlight exposure. This study aimed to analyze the relationship between outdoor sunlight exposure and eye disorders in an economically active population. METHODS: This study analyzed the 2008-2012 Korea National Health and Nutritional Examination Survey data. Sunlight exposure was categorized as < 5 hours and > 5 hours. We also analyzed the dose-dependent relationship between exposure to sunlight and eye disorders (cataracts, pterygium, and age-related macular degeneration [AMD]) using data from 2010 to 2012 by subdividing the exposure groups into < 2 hours, 2-5 hours, and ≥ 5 hours. Eye disorders were diagnosed by an ophthalmologist. The study participants were stratified by sex, and the results were analyzed using the χ2 test and multiple logistic regression analysis. RESULTS: In the female group, the odds ratio of pterygium in the high-level sunlight exposure group was 1.47 (95% confidence interval [CI]: 1.15-1.89). Regarding AMD, the odds ratios were 1.42 (95% CI: 1.16-1.73), 1.33 (95% CI: 1.03-1.73), and 1.58 (95% CI: 1.15-2.16) in the total, male, and female groups, respectively. Analysis of the dose-response relationship revealed that the odds ratios of pterygium in the high-level sunlight exposure subgroups of the total and female groups were 1.62 (95% CI: 1.25-2.08) and 2.00 (95% CI: 1.39-2.88), respectively. CONCLUSIONS: This study demonstrated a relationship between sunlight exposure and eye disorders in an economically active population. Women were found to be especially vulnerable to pterygium. However, additional prospective studies to clarify the pathophysiology of pterygium are needed.

A Novel Robot-Assisted Kinematic Measure for Children with Attention-Deficit/Hyperactivity Disorder: A Preliminary Study.

OBJECTIVE: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. In contrast to neurocognitive measurements of inattention and impulsivity, there has been limited research regarding the objective measurement of hyperactivity in youths with ADHD. The purpose of the present study was to investigate the clinical effectiveness of a newly developed Robot-assisted Kinematic Measure for ADHD (RAKMA) in children with ADHD. METHODS: In total, 35 children with ADHD aged 5 to 12 years and 50 healthy controls (HCs) were recruited, and the parents completed the Child Behavior Checklist and the Korean ADHD Diagnostic Scale. RAKMA performance was represented by RAKMA stimulus-response and hyperactivity variables. We compared the RAKMA performance of those with ADHD and with that of HCs and also investigated the correlation between the RAKMA variables and ADHD clinical scale scores. RESULTS: Significant differences between the ADHD and HC groups were observed regarding most RAKMA variables, including correct reactions, commission errors, omission errors, reaction times, migration distance, and migration speed scores. Significant correlations were detected between various ADHD clinical scale scores and RAKMA variables. CONCLUSION: The RAKMA was a clinically useful tool for objectively measuring hyperactivity symptoms in children with ADHD. Further studies with larger samples are warranted.

Association between breakfast skipping and metabolic outcomes by sex, age, and work status stratification.

BACKGROUND: The association between breakfast skipping and abnormal metabolic outcomes remains controversial. A comprehensive study with various stratified data is required. OBJECTIVE: The aim of this study was to investigate the relationship between abnormal metabolic outcomes and breakfast skipping by sex, age, and work status stratification. METHODS: We used data from the Korea National Health and Nutrition Examination Surveys from 2013 to 2018. A total of 21,193 (9022 men and 12,171 women) participants were included in the final analysis. The risk of metabolic outcomes linked to breakfast skipping was estimated using the negative binomial regression analysis by sex, work status, and age stratification. RESULTS: A total of 11,952 (56.4%) participants consumed breakfast regularly. The prevalence of abnormal metabolic outcomes was higher among those with irregular breakfast consumption habits. Among young male workers, negative binomial regression analysis showed that irregular breakfast eaters had a higher risk of abnormal metabolic outcomes, after adjusting for covariates (odds ratio, 1.15; 95% confidence interval, 1.03-1.27). CONCLUSIONS: The risk of abnormal metabolic outcomes was significant in young men in the working population. Further studies are required to understand the association of specific working conditions (working hours or shift work) with breakfast intake status and the risk of metabolic diseases.