Epidemiology and Health

Original Articles

Cancer incidence among male construction workers in Korea: a standardized incidence ratio analysis, 2009-2015: Soonsu Shin, Woo-Ri Lee, Jin-Ha Yoon, Wanhyung Lee; Epidemiol Health. 2023;45:e2023060. Published online June 19, 2023; DOI: https://doi.org/10.4178/epih.e2023060

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
Construction workers face an elevated risk for several types of cancer. Nevertheless, there is a lack of large-scale epidemiological studies examining the risk of all cancers in construction workers. This study aimed to investigate the risk of various cancers in male construction workers using the Korean National Health Insurance Service (NHIS) database.
METHODS
We used data from the NHIS database from 2009 to 2015. Construction workers were identified using the Korean Standard Industrial Classification code. We calculated the age-standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) for cancer occurrence in male construction workers compared to all male workers.
RESULTS
Compared to all male workers, the SIRs for esophageal cancer (SIR, 1.24; 95% CI, 1.07 to 1.42) and malignant neoplasms of the liver and intrahepatic bile ducts (SIR, 1.18; 95% CI, 1.13 to 1.24) were significantly higher in male construction workers. The SIRs for malignant neoplasms of the urinary tract (SIR, 1.19; 95% CI, 1.05 to 1.35) and non-Hodgkin lymphoma (SIR, 1.21; 95% CI, 1.02 to 1.43) were significantly elevated in building construction workers. The SIR for malignant neoplasms of the trachea, bronchus, and lung (SIR, 1.16; 95% CI, 1.03 to 1.29) was significantly higher in heavy and civil engineering workers.
CONCLUSIONS
Male construction workers have an increased risk for esophageal cancer, liver cancer, lung cancer, and non-Hodgkin’s cancer. Our results indicate that tailored strategies for cancer prevention should be developed for construction workers.; Summary

Korean summary
건설 노동자는 작업환경에서 수많은 유해 인자에 노출되지만, 건설 노동자에서 암의 연령 표준화 발생비를 조사한 역학 연구는 부족하다. 이번 연구에서 식도암과 간담도암의 연령 표준화 발생비는 전체 남성 근로자에 비해 남성 건설 근로자에게서 증가하였다. 이러한 결과는 건설 근로자에서 암 위험이 증가했음을 나타내며, 이 직업군에서 암 예방을 위한 추가 연구와 정책이 필요함을 의미한다.

Key Message
Despite the exposure of construction workers to numerous hazardous substances at workplace, epidemiological studies investigating the risk of all cancers in this occupational group are lacking. In this study, the age-standardized incidence ratio of esophageal cancer and hepatobiliary cancers increased in male construction workers compared to all male workers. Our results underscore the increased several cancer risks faced by male construction workers, necessitating the development of tailored strategies for cancer prevention in this occupational group.

Estimated trends in hospitalizations due to occupational injuries in Korea based on the Korean National Hospital Discharge In-depth Injury Survey (2006-2019): Seong-Uk Baek, Won-Tae Lee, Min-Seok Kim, Myeong-Hun Lim, Jin-Ha Yoon; Epidemiol Health. 2023;45:e2023042. Published online April 5, 2023; DOI: https://doi.org/10.4178/epih.e2023042

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
In recent years, occupational injuries have sparked a huge social and political debate. Thus, in this study, we focused on the characteristics and trends of occupational injuries requiring hospitalization in Korea.

METHODS

The Korea National Hospital Discharge In-depth Injury Survey was designed to estimate the annual number and characteristics of all injury-related hospitalizations in Korea. The annual number of hospitalizations due to occupational injuries and the age-standardized rates (ASRs) were estimated from 2006 to 2019. The annual percentage change (APC) and average annual percentage change (AAPC) of ASRs and their 95% confidence intervals (CIs) were calculated using joinpoint regression. All analyses were stratified by gender.

RESULTS

In men, the APC of the ASRs of all-cause occupational injuries was -3.1% (95% CI, -4.5 to -1.7) in 2006-2015. However, a non-significant upward trend was observed after 2015 (APC, 3.3%; 95% CI, -1.6 to 8.5). In women, the APC of all-cause occupational injuries was -8.6% (95% CI, -12.1 to -5.1) in 2006-2012. However, a non-significant upward trend was observed after 2012 (APC, 2.1%; 95% CI, -0.9 to 5.2). A recent upward trend in stabbing injuries was observed after 2012 (APC, 4.7%; 95% CI, -1.8 to 11.8) in women. A non-significant overall increasing trend was also observed for occupational injuries caused by exposure to extreme temperatures (AAPC, 3.7%; 95% CI, -1.1 to 8.7) in women.

CONCLUSIONS

A recent upward trend in all-cause injury hospitalizations and hospitalizations caused by stabbing injuries was observed. Therefore, active policy interventions are required to prevent occupational injuries.

Summary

Korean summary
본 연구는 퇴원환자 심층조사를 사용하여 2006년부터 2019년까지 우리나라에서 발생한 업무상 손상의 추세를 연령표준화발생률을 구함으로써 분석하였다. 남녀 모두에서 2010년대 초반 까지는 발생률이 유의하게 감소하는 추세를 보였지만, 2013-2015년 이후부터는 통계적으로 유의하지 않은 점진적 상승 추세가 관찰되었다. 이러한 연구 결과는 업무상 손상을 예방하기 위해 적극적인 정책적 개입이 필요하다는 것을 시사한다.

Key Message
This study analyzed the trends in work-related injury occurrences in South Korea from 2006 to 2019 based on a nationally representative, repeated cross-sectional dataset. Age-standardized rates were calculated and their annual trend was estimated using a JointPoint regression. While both males and females exhibited a significant decline in occupational injury rates until the early 2010s, a non-significant but gradual upward trend has been observed since 2013-2015. These findings underscore the need for active policy interventions to prevent work.

Citations

Citations to this article as recorded by

Factors Affecting Mortality and Distribution of Co-morbidities in Chronic Obstructive Pulmonary Disease
Sung-Soo Kim
Journal of Health Informatics and Statistics.2024; 49(1): 35. CrossRef

COVID-19: Perspective

Magnifying the importance of collecting race, ethnicity, industry, and occupation data during the COVID-19 pandemic: Sai Krishna Gudi, Sophia M. George, Komal Krishna Tiwari; Epidemiol Health. 2021;43:e2021095. Published online November 6, 2021; DOI: https://doi.org/10.4178/epih.e2021095

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Abstract Summary PDF

Abstract

The contagiousness of coronavirus disease-2019 (COVID-19) led to the imposition of historical lockdowns in various countries. No scientific mind could have made accurate projections of the tremendous impact that COVID-19 would have on nations, communities, and the global-wide economy. Meanwhile, millions of workers have lost their jobs, while healthcare workers are overwhelmed and are reaching a state of mental and physical exhaustion. With the uncontrollable spread, researchers have been working to identify factors associated with COVID-19. In this regard, race, ethnicity, industry, and occupation have been found to be predominant factors of interest. However, unfortunately, the unavailability of such information has been a difficult reality. Since race, ethnicity, and employment are essential social determinants of health and could serve as potential risk-factors for COVID-19, collecting such information may offer important context for prioritising vulnerable groups. Thus, this perspective aims to highlight the importance and need for collecting race, ethnicity, and occupation-related data to track and treat the racial/ethnic groups that have been most strongly affected by the COVID-19 pandemic. Collecting such data will provide valuable insights and help public health officials recognise workplace-related outbreaks and evaluate the odds of various ethnic groups and professions contracting COVID-19.

Summary

Key Message
As essential social determinants of health, collecting and recording the race/ethnicity, occupation and industry information will provide valuable insights and help public health officials identify workplace-related outbreaks and evaluate the odds of various ethnic groups and professions contracting COVID-19.

Citations

Citations to this article as recorded by

Evaluating COVID-19 Risk to Essential Workers by Occupational Group: A Case Study in Massachusetts
Beth M. Haley, Prasad Patil, Jonathan I. Levy, Keith R. Spangler, Koen F. Tieskens, Fei Carnes, Xiaojing Peng, R. Monina Klevens, T. Scott Troppy, M. Patricia Fabian, Kevin J. Lane, Jessica H. Leibler
Journal of Community Health.2024; 49(1): 91. CrossRef

Original Articles

Effect of tobacco outlet density on quit attempts in Korea: a multi-level analysis of the 2015 Korean Community Health Survey: Jaehyung Kong, Sung-il Cho; Epidemiol Health. 2021;43:e2021048. Published online August 3, 2021; DOI: https://doi.org/10.4178/epih.e2021048

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Abstract Summary PDF

Abstract

OBJECTIVES
This study aimed to examine whether the regional density of tobacco outlets in Korea was associated with the likelihood of attempting to quit among smokers

METHODS

This study was designed as a secondary data analysis of a cross-sectional study. Data from the 2015 Korean Community Health Survey and tobacco outlet registrations in 17 metropolitan cities and provinces with 254 communities in Korea were used for the analysis. In total, 41,013 current smokers (≥19 years of age) were included. Multi-level logistic regression analysis was conducted to investigate regional differences associated with smokers’ attempts to quit and to evaluate the effects of individual and regional characteristics on quit attempts.

RESULTS

Higher tobacco outlet density was associated with lower odds of attempting to quit. Smokers who resided in districts with the highest tobacco outlet density were 18% less likely to attempt quitting (odds ratio, 0.82; 95% confidence interval, 0.70 to 0.98) than smokers who resided in the regions with the lowest tobacco outlet density (intraclass correlation coefficient, 0.030).

CONCLUSIONS

This study showed that quit attempts were related to community-level factors, such as tobacco outlet density, as well as other individual factors. These findings support the implementation of national policies restricting the number of tobacco outlets within communities or zones and limiting tobacco marketing in tobacco outlets.

Summary

Korean summary
본 연구는 2015년 지역사회건강조사에 응답한 19세 이상 현재 흡연자 41,013명을 대상으로 금연 시도와 관련된 개인 수준의 요인과 지역 수준의 요인을 파악하기 위하여 다수준 분석을 실시하였다. 분석결과, 개인 수준의 요인뿐만 아니라 거주하는 지역의 담배소매점 밀집도가 흡연자의 금연 시도와 유의한 관계가 있는 것으로 확인되었다. 흡연조장환경 개선을 위한 담배 공급 감소 노력의 일환으로 지역사회 수준의 담배소매점 관리 정책이 필요하다.

Key Message
This study aimed to investigate whether the environment related to tobacco retailers impacts adult smokers’ attempts to quit smoking, for the first time in South Korea, using nationwide data on tobacco retailers and current smokers. Smokers who resided in districts with the highest tobacco outlet density were 18% less likely to attempt quitting (odds ratio, 0.82; 95% confidence interval, 0.70-0.98) than smokers who resided in the regions with the lowest tobacco outlet density. These findings support the implementation of national policies restricting the number of tobacco outlets within communities or zones and limiting tobacco marketing in tobacco outlets.

Citations

Citations to this article as recorded by

Association between area deprivation index and concerns to COVID-19: A multi-level analysis of individual and area factors
Doo Woong Lee, Jieun Jang, Jaeyong Shin
SSM - Population Health.2024; 25: 101580. CrossRef
Use of geographically weighted regression models to inform retail endgame strategies in South Korea: application to cigarette and ENDS prevalence
Heewon Kang, Eunsil Cheon, Jaeyoung Ha, Sung-il Cho
Tobacco Control.2023; : tc-2023-058117. CrossRef

Analysis of the severity of occupational injuries in the mining industry using a Bayesian network: Mostafa Mirzaei Aliabadi, Hamed Aghaei, Omid kalatpuor, Ali Reza Soltanian, Asghar Nikravesh; Epidemiol Health. 2019;41:e2019017. Published online May 11, 2019; DOI: https://doi.org/10.4178/epih.e2019017

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7 Crossref

Abstract PDF

Abstract

OBJECTIVES
Occupational injuries are known to be the main adverse outcome of occupational accidents. The purpose of the current study was to identify control strategies to reduce the severity of occupational injuries in the mining industry using Bayesian network (BN) analysis.

METHODS

The BN structure was created using a focus group technique. Data on 425 mining accidents was collected, and the required information was extracted. The expectation-maximization algorithm was used to estimate the conditional probability tables. Belief updating was used to determine which factors had the greatest effect on severity of accidents.

RESULTS

Based on sensitivity analyses of the BN, training, type of accident, and activity type of workers were the most important factors influencing the severity of accidents. Of individual factors, workers’ experience had the strongest influence on the severity of accidents.

CONCLUSIONS

Among the examined factors, safety training was the most important factor influencing the severity of accidents. Organizations may be able to reduce the severity of occupational injuries by holding safety training courses prepared based on the activity type of workers.

Summary

Citations

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A fuzzy Bayesian network DEMATEL model for predicting safety behavior
Mohsen Mahdinia, Iraj Mohammadfam, Ahmad Soltanzadeh, Mostafa Mirzaei Aliabadi, Hamed Aghaei
International Journal of Occupational Safety and Ergonomics.2023; 29(1): 36. CrossRef
Analysis of occupational accidents among nurses working in hospitals based on safety climate and safety performance: a Bayesian network analysis
Fakhradin Ghasemi, Hamed Aghaei, Taleb Askaripoor, Farhad Ghamari
International Journal of Occupational Safety and Ergonomics.2022; 28(1): 440. CrossRef
Retrospective assessment of the association between noise exposure and nonfatal and fatal injury rates among miners in the United States from 1983 to 2014
Abas Shkembi, Lauren M. Smith, Richard L. Neitzel
American Journal of Industrial Medicine.2022; 65(1): 30. CrossRef
Contributing effects of individual characteristics, behavioural and job-related factors on occurrence of mining-related injuries: A systematic review
Michael Mayom Ajith, Apurna Kumar Ghosh, Janis Jansz
Work.2022; 71(1): 87. CrossRef
Human Error Analysis for Hydraulic Engineering: Comprehensive System to Reveal Accident Evolution Process with Text Knowledge
Dan Tian, Hao Liu, Shu Chen, Mingchao Li, Chengzhao Liu
Journal of Construction Engineering and Management.2022;[Epub] CrossRef
Analysis of occupational accidents in Spain using shrinkage regression methods
Vicente Gallego, Ana Sánchez, Isabel Martón, Sebastián Martorell
Safety Science.2021; 133: 105000. CrossRef
Research trends in mining accidents study: A systematic literature review
Siti Noraishah Ismail, Azizan Ramli, Hanida Abdul Aziz
Safety Science.2021; 143: 105438. CrossRef

Functional disorders of the lung and symptoms of respiratory disease associated with occupational inhalation exposure to wood dust in Iran: Masoud Neghab, Zeinab Jabari, Fatemeh Kargar Shouroki; Epidemiol Health. 2018;40:e2018031. Published online July 4, 2018; DOI: https://doi.org/10.4178/epih.e2018031

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Abstract PDF

Abstract

OBJECTIVES
The possible adverse respiratory effects of airborne pollutants in sawmills have not been thoroughly investigated in Iran. Additionally, the extent to which workers are exposed to this organic dust and its associated bioaerosols has not been extensively quantified. Likewise, the predominant bacterial and fungal species associated with wood dust have not been characterized. The present study was undertaken to address these issues.

METHODS

One hundred male individuals exposed to wood dust and 100 unexposed male subjects were investigated. They completed a standardized respiratory symptom questionnaire and underwent spirometry testing. Additionally, airborne concentrations of respirable and inhalable dust particles, bacteria, and fungi were measured.

RESULTS

The mean concentrations of inhalable and respirable dust particles, bacteria, and fungi were found to be 2.44, 6.76 mg/m3 , 756.38, and 299.15 colony-forming units/m3 , respectively. The predominant Gram-negative bacteria in the sawmills included the Pseudomonadaceae, Klebsiella pneumoniae, and Rhinoscleromatis spp., and the predominant fungi consisted of the zygomycetes and Aspergillus spp. Respiratory symptoms were significantly more prevalent among exposed workers. Significant cross-shift decrements were noted in some pulmonary function parameters. Similarly, pre-shift spirometry results indicated that some pulmonary function parameters were significantly lower in the exposed group.

CONCLUSIONS

Exposure to wood dust and its bioaerosols was associated with significantly higher prevalence of respiratory symptoms and both acute (i.e., partially reversible) and chronic (i.e., irreversible) decrements in the functional capacity of the lung. Additionally, the characterized bioaerosols did not differ significantly from those isolated in other parts of the world.

Summary

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Jill A. Poole, Jose L. Zamora-Sifuentes, Leticia De las Vecillas, Santiago Quirce
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Angelina Wójcik-Fatla, Barbara Mackiewicz, Anna Sawczyn-Domańska, Jacek Sroka, Jan Siwiec, Mariola Paściak, Bogumiła Szponar, Krzysztof Pawlik, Jacek Dutkiewicz
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Marta Dias, Bianca Gomes, Renata Cervantes, Pedro Pena, Susana Viegas, Carla Viegas
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The impact of wood dust on pulmonary function and blood immunoglobulin E, erythrocyte sedimentation rate, and C‐ reactive protein: A cross‐sectional study among sawmill workers in Tangail, Bangladesh
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Review

Road dust and its effect on human health: a literature review: Raihan K. Khan, Mark A. Strand; Epidemiol Health. 2018;40:e2018013. Published online April 10, 2018; DOI: https://doi.org/10.4178/epih.e2018013

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Abstract

The purpose of this study was to determine the effects of road dust on human health. A PubMed search was used to extract references that included the words “road dust” and “health” or “fugitive dust” and “health” in the title or abstract. A total of 46 references were extracted and selected for review after the primary screening of 949 articles. The respiratory system was found to be the most affected system in the human body. Lead, platinum-group elements (platinum, rhodium, and bohrium), aluminum, zinc, vanadium, and polycyclic aromatic hydrocarbons were the components of road dust that were most frequently referenced in the articles reviewed. Road dust was found to have harmful effects on the human body, especially on the respiratory system. To determine the complex mechanism of action of various components of road dust on the human body and the results thereof, the authors recommend a further meta-analysis and extensive risk-assessment research into the health impacts of dust exposure.

Summary

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Original Articles

The Usefulness of the Secondary Database for Occupational Asthma Surveillance System in Korea.: Hyungjune Im, Sungwoo Choi, Jaiyong Kim, Sang Yun Lee, Kijung Yoon, Youngju Lee, Ho Jang Kwon, Daehee Kang, Soo Hun Cho; Korean J Epidemiol. 1999;21(2):266-275.

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Occupational asthma is defined as a disease that is characterized by airway narrowing and bronchial hyperresponsiveness caused by specific working environment. It is estimated that occupational asthma cases in Korea have been underreported. This study, using Korean Medical Insurance Data(KMID), examined the distribution of asthma patients' occupations and the frequency of high risk occupations for occupational asthma in Seoul, Korea to evaluate the usefulness of the KMID data as a database for active occupational asthma surveillance system. Six hundreds and forty two(30.7%) of 2093 patients who were finally chosen as a study population by using 1995-year KMID, were contacted by telephone. 296 persons(47.4%) of 642 patients replied that they were diagnosed as asthma. The occupations of 296 asthma patients were classified by Korean standardized industrial classfication (KSIC). The most common occupations included Wholesale and Retail trade(19.5%), Real estate, Renting and Business activities(14.9%), Construction(14.9%), Manufacturing(12.3%). Forty(13.5%) of 296 patients who could be classified by KSIC were working at high risk jobs for occupational asthma. KMID could be used as a useful data for occupational asthma surveillance system if the limitations of KMID, which is the accuracy of diagnosis, data accessibility, difficulty of following up study subjects, would be solved. The prevalence of occupational asthma could be estimated if the follow-up study diagnosing occupational asthma for asthma patients working in high risk jobs would be held.; Summary

Epidemiologic Characteristics of the Pneumoconiosis Patients in Manufacturing Industries.: Won Chul Lee, Hyeon Woo Yim, Kyung Jae Lee, Se Yong Lee, Kwang Ho Meng, Young Gyu Phee, Hyun Wook Kim, Jung Wan Koo, Young Lim, Im Goung Yun; Korean J Epidemiol. 1998;20(1):141-153.

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Abstract PDF: Abstract
Pneumoconiosis was the first reported occupational disease in Korea and was the most common one until 1990. In the past, most pneumoconiosis patients were found among underground workers in various mines. Recently this occupational disease has increasingly affected workers in manufacturing industries such as ship building, briquette, glass, foundry industries, and so on. In order to investigate the scale of pneumoconiosis in manufacturing industries, we evaluated the detailed medical examination records and insurance deliberation data from 1989 until 1994. Information about work history, medical history, and exposure dust type were collected for each member of the study population. All chest X-rays were interpreted and classified using the International Labor Organization(ILO) scale by three radiologist who have had extensive experience evaluation pneumoconiosis. For the calculation of the incidence rate of manufacturing pneumoconiosis, we analyzed the Specific Health Examination data and estimated the population at risk as a denominator of the incidence rate. We divided manufacturing industry into 9 subclasses by industrial classification and estimated the incidence rate of pneumoconiosis per 100,000 workers at risk respectively. The results were as follows, 1. 485 workers were newly diagnosed with pneumoconiosis during 6 years from 1989 to 1994. 482 workers had radiographs consistent with simple pneumoconiosis and three with progressive massive fibrosis. Among those with radiographs consistent with simple pneumoconiosis, 395 workers(81.4%) had category 1 profusion, 76 workers(15.7%) had category 2 profusion and 11 workers(2.3%) had category 3 profusion. 2. Almost all of them were male(97.9%) and their average age was 48.3 uears. Manufacturing pneumoconiosis patients were more common in their forties and fifties. 3. The average duration of dust exposure required for the occurrence of pneumoconiosis was 13.5 years. In the case of metal products manufacturing which is mostly related to welding, the average duration of dust exposure was 12.0 years. It was slightly shorter than other manufacturing industries. The average duration of dust exposure required for the occurrence of pneumoconiosis seemed to be shorter in welding operators, even though the welders lung has a weak tissue reaction and the condition is reversible. 4. According to the Industrial classification, 299 cases(61.6%) were found in workers of non-metal mineral products manufacturing, and 56 cases(11.5%) in basic metals industry. 5. The average annual incidence rate of pneumoconiosis in manufacturing industries from 1990 to 1994 was 56.6 per 100,000 workers at risk. On sub-classification, the average annual incidence rate of pneumoconiosis in non-metal mineral products manufacturing industry was the highest among them, showing 479 per 100,000 workers at risk. 6. Radiologic prevalence rate of tuberculosis in these cases was 6.6%. 7. X-ray category profusion in newly diagnosed manufacturing pneumoconiosis varied according to sub-classification. The proportion of category 1 profusion in metal products manufacturing is higher than that in non-metal mineral products manufacturing. 8. The type pattern of small round opacities varied according to sub-classification in manufacturing industry. In non-metal mineral products manufacturing, the small round opacity were observed 25.9% cases with p type, 72.1% with q type and 2.0% with r type respectively. But in metal products manufacturing, the small round opacity were observed 51.4% cases with p type and 48.6% with q type respectively. The cause might be that the exposed dust is different according to job. 9. The type pattern of small round opacities varied according to dust type. Metal dusts showed similar radiologic shape to the coal dusts, but welding fume showed more frequent p type(60.3%) and less frequent q type(377%). rock dust showed less frequent p types(18.3%) and more frequent q types(75.3%). Since the incidence rate of non-metal manufacturing workers showed higher rate than other manufacturing industry, Preventive measures and health care education should be carefully carried out in these workers.; Summary

Distribution of House Dust Mites in the Bedroom of Patients with Allergic Rhinitis in Pusan Area.: Soon Ock Choi, Baik Kee Cho, Jung Soon Moon; Korean J Epidemiol. 1997;19(2):190-199.

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This study was conducted to investigate distribution of the house dust mites in the bedroom of allergic rhinitis patients in Pusan. From July to December 1995, 51 dust samples were drawn from the bedroom of the patients by using electronic vaccum cleaner. House dust mites were isolated from 50mg dust by applying the modified wet sieving method. The results were as follows: 1 Out of a total 49 dust samples(96.1%) were isolated house mites. 2 Total 977 mites were collected and identified the most prevalent house mites was Pyroglypidae mite with 92.2%. Among them D.pteronyssinus was predominant species. 3 In 1gm of the house dust, 100-499 mites were found in 17 samples(33.3%), more then 500 mites in 12 samples (23.6%). 4 The density of Pyoglypidae mite was close associated with the month. 5 The density of house dust mite was not affected by the type of house, region and the relative humidity of the bed room; Summary

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