Fixed night workers and failed smoking cessation.

BACKGROUND: The objective of this study was to examine the relationship between employee work schedule and failure in smoking cessation. METHODS: Logistic regression was used to estimate the association between work schedule and failed smoking cessation rate among 4927 male workers who had attempted smoking cessation. The data was obtained from the annual Korean National Health and Nutrition Examination Survey from 2007 to 2015 (excluding data from 2013). An adjusted model, including demographic and occupational variables, was constructed after stratifying the data into two subgroups by age (the 19- to 40-year-old group and the 41- to 60-year-old group). RESULTS: The percentage of smoking-cessation failure varied according to work schedule and age. The failure rate in the 19- to 40-year-old group was generally higher for all work schedule categories than in the 41- to 60-year-old group. In particular, the highest percentage (90.9%) of smoking-cessation failure was in the fixed overnight work group. After adjusting for demographic characteristics and work organization variables, the odds ratio for failed smoking cessation across all ages was 3.30 (95%CI 2.23-4.86) among the fixed overnight workers compared to the daytime workers. Both of the age-stratified subgroups maintained this relationship, with a notably higher OR in the 19- to 40-year-old group (OR 3.74, 95% CI 1.80-7.77). CONCLUSIONS: Fixed overnight work is likely to negatively affect smoking cessation compared to other work schedules. Tailored anti-smoking intervention programs are required based on work schedule.

The Impact of Depression on Ill-Health Retirement and Its Moderating Factors: Analysis From the Korean Longitudinal Study of Aging (2006 to 2014).

OBJECTIVE: To investigate the effect of depressive symptoms on ill-health retirement (IHR). METHODS: Data were collected from the Korean Longitudinal Study of Ageing which conducted biennially from 2006 to 2014. IHR were defined as those who retired due to their health problems. The short-form Center for Epidemiological Studies-Depression scale served as outcome measure for definition of depressive symptoms. Hazard ratios of IHR were estimated by Cox regression. RESULTS: We observed that depressive symptoms significantly increased risk of IHR during 8-year follow-up period. Compared with those without depressive symptoms, depressed worker had 1.27-fold elevated risk for IHR. Subgroup analysis showed that the association between depressive symptoms and IHR is greater in the elders, women, and lower income group than the others. CONCLUSION: Depressive symptoms independently predicted IHR. Moreover, age, sex, and socioeconomic status modified these effects.

Overview of occupational cancer in painters in Korea.

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.

Service and sales workers, are they vulnerable to smoking cessation?

The aim of the present study was to evaluate the association between failed smoking cessation and occupation by age stratification among Korean males and provide quantitative evidence of factors associated with failed smoking cessation. The study comprised 3,127 male workers who had attempted smoking cessation during their life time. Data were obtained from the Korea National Health and Nutrition Examination Survey from 2010 to 2012. Participants were stratified by age into two subgroups comprising a younger group (19-40 yr) and an older group (41-60 yr). Multiple logistic regression analyses were used to estimate odds ratios (ORs) for failed smoking cessation. In the younger group, failed smoking cessation was related to the occupational fields "service and sales" and "manual work" compared to "office work" (OR: 2.10, 95% confidence interval (CI): 1.34-3.29; and OR: 1.47, 95% CI: 1.02-2.12, respectively). In the older group, the ORs of failed smoking cessation occupational categories "service and sales" and "manual work" [ref: office workers] were 0.58 (0.40-0.85) and 0.90 (0.66-1.24), respectively. Failed smoking cessation is associated with occupational categories and age stratification. Policy makers need to create tailored anti-smoking policy considering the occupation and the age of the subjects.

Risk factors associated with mortality from pneumonia among patients with pneumoconiosis.

BACKGROUND: The aim of this study was to evaluate factors associated with increased risk of mortality from pneumonia among patients with pneumoconiosis. METHODS: Medical records of 103 pneumoconiosis patients hospitalized for pneumonia were investigated. Seven patients who had lung cancer or other malignancy and 13 patients with insufficient medical record were excluded. Two female patients were excluded due to small number to analyze. The subjects were divided into two groups by clinical outcome of pneumonia, the deceased group and the survival group. The two groups were compared in terms of age, smoking history, episode of recent pneumonia, concomitancy of interstitial fibrosis or fungal ball infection, extent of small opacities, grade of large opacities and results of spirometry. Multiple logistic regression was applied to determine the association between these variables and mortality from pneumonia. RESULTS: The deceased group showed more frequent history of recent pneumonia (p = 0.006), higher prevalence of interstitial fibrosis (p = 0.007) and longer hospitalization period (p = 0.044). The proportion of subjects who had decreased FVC, less than 70 % of predicted value, was higher in the deceased group (p < 0.001). In multiple logistic regression, after adjusting age, smoking history, recent pneumonia, fungal ball, large opacity, profusion and FVC (or FEV1) less than 70 % of predicted value, history of recent pneumonia, concomitancy of interstitial fibrosis, type of pneumoconiosis and fungal ball presented statistically significant association with mortality from pneumonia. CONCLUSIONS: The concomitancy of fungal ball or interstitial fibrosis, history of recent pneumonia within last 90 days, type of pneumoconiosis, FVC less than 70 % of predicted value, FEV1 less than 70 % of predicted value presented statistically significant association with mortality from pneumonia. More attention should be given to patients who have such factors when treating pneumonia with pneumoconiosis.

The education and practice program for medical students with quantitative and qualitative fit test for respiratory protective equipment.

Tuberculosis infection is prevalent in Korea and health care workers are vulnerable to tuberculosis infection in the hospital. The aims of this study were to develop and validate an education program that teaches senior medical students how to wear and choose the proper size and type of respiratory protective equipment (RPE), which may help reduce the risk of contracting Mycobacterium tuberculosis (MTB) from patients. Overall, 50 senior medical students participated in this education program. Methods of choosing the proper type of RPE, performing a fit check of the RPE, and choosing a suitable mask size were taught by certified instructors using the real-time quantitative fit test (QNFT). The validity of education program was evaluated with qualitative fit test (QLFT) before and after the education as pass or fail. The education program was effective, as shown by the significantly pass rate (increased 30 to 74%) in the QLFT after the education program (p<0.05). Among study participants, changing mask size from medium to small significantly increased the pass rate (p<0.001). Incorporation of this program into the medical school curriculum may help reduce risk of MTB infection in medical students working in the hospital.

Work-related COPD after years of occupational exposure.

BACKGROUND: Cigarette smoking is known as the most important risk factor of chronic obstructive pulmonary disease (COPD). However, occupational exposure to other substances can result in COPD. CASE REPORT: A 76-year-old man with occupational exposures to mixtures of silica dust, gas, and fumes for 10 years and with a 25 pack-year smoking history was diagnosed with COPD. His computed tomogram scan revealed some hyperinflation with emphysematous change in both upper lobes. In the pulmonary function tests, his post-bronchodilator forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and FEV1/FVC% were 2.20 L (67% of the predicted value), 1.12 L (52% of the predicted value), and 51%, respectively, indicating moderate COPD. This case of COPD was confirmed as a work-related disease by the Occupational Lung Disease Research Institute in Korea Workers' Compensation & Welfare Service. CONCLUSION: Exposure to various substances such as silica dust, gas, and fumes from furnace and boiler installation was likely the cause of COPD in this patient. Thus, occupational exposure should be considered an important risk factor of COPD.

The association between bronchial anthracofibrosis and pneumoconiosis: A retrospective cross-sectional study.

OBJECTIVES: Bronchial anthracofibrosis (BAF) is associated with occupational hazardous dust exposure. The aim of the present study was to determine the prevalence of BAF and BAC without fibrosis in patients with pneumoconiosis, and to evaluate the associations between BAC/BAF and occupational dust exposure and clinical manifestations among patients with pneumoconiosis. METHODS: A retrospective cross-sectional study (n=170) among individuals who were diagnosed with pneumoconiosis or suspicious pneumoconiosis and underwent bronchoscopy between January 2000 and February 2013 was performed. Multiple logistic regression analysis was performed to estimate associations. RESULTS: In total, 153 eligible subjects were included in the study because their records contained all the required information. Of these, 81 (53%) and 63 (41%) had BAC and BAF, respectively. Occupational coal dust exposure increased the risk of BAF and BAC (odds ratio [OR]=2.980, 95% confidence interval [CI]=1.184-8.128; OR=2.840, 95% CI=1.092-7.926, respectively). Profusion category 3 pneumoconiosis also increased the risk of BAC (OR=33.887, 95% CI=5.317-394.729). CONCLUSIONS: BAF and BAC are associated with occupational exposure to coal dust. Therefore, clinicians should consider occupational history when they investigate the association between BAC/BAF and risk factors such as tuberculosis, lung cancer, and biomass fuel exposure.

The prevalence and risk factors for hepatitis B surface ag positivity in pregnant women in eastern region of ghana.

BACKGROUND/AIMS: The aim of this study was to evaluate the prevalence and risk factors for hepatitis B surface antigen (HBsAg) positivity in pregnant Ghanaian women. METHODS: We surveyed 1,500 pregnant women in Eastern region of Ghana. Direct interviews were performed by trained nurses using standardized questionnaires. Pregnant women were screened for human immunodeficiency virus (HIV) and hepatitis B infections, hemoglobin levels and sickle cell anemia as part of the antenatal check-up. RESULTS: The overall HBsAg positive rate was 10.6%, which varied among districts (13.8% for Kwahu West, 12.4% for Upper Manya, and 2.2% for Yilo Krobo). HBsAg positivity was significantly higher in women with depression (odds ratio [OR], 3.74; 95% confidence interval [CI], 2.13 to 6.57) and HIV (OR, 2.03; 95% CI, 1.06 to 3.89). Age, education, and gravidity were not related to HBsAg positivity. Anti-hepatitis B immunoglobulin for newborns of HBsAg-positive mothers is not provided at birth in public health facilities in Ghana. However, hepatitis B vaccination is provided as part of a routine vaccination schedule starting at 6 weeks of age. CONCLUSIONS: To prevent mother-to-child transmission of hepatitis B, screening tests for HBsAg in pregnant women and hepatitis B vaccination of newborns immediately after birth need to be performed in this region.