Epidemiology and Health

Data Profile

Data profile: the Korean Workers’ Compensation-National Health Insurance Service (KoWorC-NHIS) cohort: Jeehee Min, Eun Mi Kim, Jaiyong Kim, Jungwon Jang, Youngjin Choi, Inah Kim; Epidemiol Health. 2024;46:e2024071. Published online August 19, 2024; DOI: https://doi.org/10.4178/epih.e2024071

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Abstract Summary PDF: Abstract
The Korean Workers’ Compensation-National Health Insurance Service (KoWorC-NHIS) cohort was established to investigate the longitudinal health outcomes of Korean workers who have been compensated for occupational injuries or diseases. This cohort study, which utilized data spanning from 2004 to 2015, merged workers’ compensation insurance claim data with the National Health Insurance Database (NHID), encompassing 858,793 participants. The data included socio-demographic factors such as age, sex, income, address, insurance type, and disability grade. It also covered the types of occupational accidents, International Classification of Diseases, 10th revision codes for diseases or accidents, work tenure, industry, occupation code, and company size. Additional details such as the occupational hire date, date of claim, date of recognition, and affected body parts were recorded. The cohort predominantly consisted of male workers (80.0%), with the majority experiencing their first occupational accident in their 40s (27.6%) or 50s (25.3%). Notably, 93.1% of the cases were classified as occupational injuries. By integrating this data with that from the NHID, updates on health utilization, employment status, and income changes were made annually. The follow-up period for this study is set to conclude in 2045.; Summary

Korean summary
KoWorC-NHIS Cohort (산재보험-국민건강보험공단 코호트) 는 2004년부터 2015년까지 산업재해를 경험한 근로자들의 장기적인 건강 결과를 추적 조사하기 위해 구축된 코호트이다. 이 코호트에는 총 858,793명의 근로자가 등록되었으며, 대다수는 남성 (80%)이었고, 업무상 사고 (93.1%)를 경험한 것으로 나타났다. 이 코호트를 활용하여 산업재해 피해 근로자들의 장기적인 건강영향을 분석할 수 있으며, 취약 계층 근로자의 건강을 보호하기 위한 예방 정책 수립의 근거로 활용할 수 있다.

Key Message
The KoWorC-NHIS Cohort (Workers' Compensation Insurance-National Health Insurance Service Cohort) was established to track the long-term health outcomes of workers who experienced occupational injuries and illnesses from 2004 to 2015. The cohort includes a total of 858,793 workers, with the majority being male (80%) and having experienced occupational accidents (93.1%). This cohort can be used to analyze the long-term health effects on workers who have suffered occupational injuries, and can serve as evidence for establishing preventive policies to protect the health of vulnerable workers.

Original Article

Effect of trajectory of employment status on all-cause mortality in the late middle-aged and older population: results of the Korea Longitudinal Study of Aging (2006-2020): Jeong Min Yang, Jae Hyun Kim; Epidemiol Health. 2023;45:e2023056. Published online June 8, 2023; DOI: https://doi.org/10.4178/epih.e2023056

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
This study conducted a longitudinal analysis of the effect of trajectory of employment status (TES) on all-cause mortality in late middle-aged and older Koreans based on the Korean Longitudinal Study of Aging (KLoSA).
METHODS
After excluding missing values, data on 2,774 participants were analyzed using the chi-square test and the group-based trajectory model (GBTM) for data from the first to fifth KLoSA and the chi-square test, log-rank test, and Cox proportional hazard regression for data from the fifth to eighth KLoSA.
RESULTS
The GBTM analysis identified 5 TES groups: sustained white collar (WC; 18.1%), sustained standard blue collar (BC; 10.8%), sustained self-employed BC (41.1%), WC to job loss (9.9%), and BC to job loss (20.1%). Compared to the sustained WC group, the WC to job loss group had higher mortality at 3 years (hazard ratio [HR], 4.04, p=0.044), 5 years (HR, 3.21, p=0.005), and 8 years (HR, 3.18, p<0.001). The BC to job loss group had higher mortality at 5 years (HR, 2.57, p=0.016) and 8 years (HR, 2.20, p=0.012). Those aged 65 years and older and males in the WC to job loss and BC to job loss groups had an increased risk of death at 5 years and 8 years.
CONCLUSIONS
There was a close association between TES and all-cause mortality. This finding highlights the need for policies and institutional measures to reduce mortality within vulnerable groups with an increased risk of death due to a change in employment status.; Summary

Korean summary
본 연구는 제 1차~8차 한국고령화연구패널을 활용하여 중고령층의 근로활동 궤적과 사망 간의 연관성을 분석하였다. 근로활동 궤적을 파악하기 위하여 집단중심추세모형을 활용하였으며, 총 5가지의 근로활동 궤적을 도출하였다. 도출된 궤적을 바탕으로 카이제곱 검정과 콕스 비례위험모형을 통해 근로활동 궤적과 사망률 간의 연관성을 분석하였다. 연구 결과 화이트칼라에서 실업으로 변화하는 집단과 블루칼라에서 실업으로 변화하는 두 집단에서 사망 간의 유의한 결과를 발견하였으며, 특히, 65세 이상 집단과 남성 집단에서 강한 연관성이 존재하였다. 본 연구 결과를 바탕으로 근로활동 변화로 인해 사망 위험이 증가하는 취약 집단을 위한 정책적, 제도적 방안의 기초자료로서 활용되기를 기대한다.

Key Message
Compared with the sustained White Collar (WC) trajectory group, changed WC to job loss trajectory group and changed BC to job loss trajectory had higher mortality. The over 65 years group and the male group, a strong association between change in employment status and mortality was observed. This study emphasizes the need for policy and institutional measures to reduce mortality for vulnerable groups who are at increased risk of death due to changes in employment status.

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