Statement by the Korean Society of Occupational and Environmental Medicine on the proposed reform of working hours in South Korea

The current 52-hour workweek in South Korea consists of 40 hours of regular work and 12 hours of overtime. Although the average working hours in South Korea is declining, it is still 199 hours longer than the Organisation for Economic Co-operation and Development average of 1,716 hours per year. In view to this, the South Korean government has now proposed to reform the workweek, mainly intending to increase the workweek to 69 hours when the workload is heavy. This reform, by increasing the labor intensity due to long working hours, goes against the global trend of reducing work hours for a safe and healthy working environment. Long working hours can lead to increased cerebrovascular and cardiovascular diseases, industrial accidents, mental health problems, and safety accidents due to lack of concentration. In conclusion, the Korean government's working hour reform plan can have a negative impact on workers' health, and therefore it should be thoroughly reviewed and modified.

The Asbestos Ban in Korea from a Grassroots Perspective: Why Did It Occur?

In 2009, asbestos was finally banned in Korea, about 70 years after the first opening of asbestos mines under Japanese control. After having presented the history of asbestos industry, together with its regulations and health effects over time, we constructed narrative analyses of how the asbestos issue under the prevailing risk system was managed by whom and for what purpose, to provide context for the change. We could identify five different phases: laissez-faire, politico-technical, economic–managerial, health-oriented cultural, and human rights-based post-cultural risk systems. The changes leading to the asbestos ban evolved over different phases, and each phase change was necessary to reach the final ban, in that, without resolving the previous issues by examining different categories of potential alternatives, either the final ban was not possible or, even if instituted, could not be sustained. An asbestos ban could be introduced when all the alternatives to these issues, including legitimate political windows, economic rationalizations, health risk protections, and human rights sensitivities, were available. We think the alternatives that we had were not in perfect shape, but in more or less loosely connected forms, and hence we had to know how to build solidarities between different stakeholders to compensate for the imperfections.

Carbon disulfide exposure estimate and prevalence of chronic diseases after carbon disulfide poisoning-related occupational diseases

Background

In Korea, Carbon disulfide (CS₂) toxicity was an important social problem from the late 1980s to the early 1990s but there have been few large-scale studies examining the prevalence of diseases after CS₂ exposure discontinuance. So we investigated past working exposure to CS₂ characteristics from surviving ex-workers of a rayon manufacturing plant including cumulative CS₂ exposure index. Furthermore, we studied the prevalence of their chronic diseases recently after many years.

Methods

We interviewed 633 ex-workers identified as CS₂ poisoning-related occupational diseases to determine demographic and occupational characteristics and reviewed their medical records. The work environment measurement data from 1992 was used as a reference. Based on the interviews and foreign measurement documents, weights were assigned to the reference concentrations followed by calculation of individual exposure index, the sum of the portion of each time period multiplied by the concentrations of CS₂ during that period.

Results

The cumulative exposure index was 128.2 ppm on average. Workers from the spinning, electrical equipment repair, and motor repair departments were exposed to high concentrations of ≥10 ppm. Workers from the maintenance of the ejector, manufacturing of CS_2, post-process, refining, maintenance and manufacturing of viscose departments were exposed to low concentrations below 10 ppm. The prevalence for hypertension, coronary artery disease, cerebrovascular disease, diabetes, arrhythmia, psychoneurotic disorder, disorders of the nervous system and sensory organ were 69.2%, 13.9%, 24.8%, 24.5%, 1.3%, 65.7%, 72.4% respectively.

Conclusions

We estimated the individual cumulative CS₂ exposure based on interviews and foreign measurement documents, and work environment measurement data. Comparing the work environment measurement data from 1992, these values were similar to them. After identified as CS₂ poisoning, there are subjects over 70 years of average age with disorders of the nervous system and sensory organs, hypertension, psychoneurotic disorder, cerebrovascular disease, diabetes, coronary artery disease, and arrhythmia. Because among ex-workers of the rayon manufacturing plant, only 633 survivors recognized as CS₂ poisoning were studied, the others not identified as CS₂ poisoning should also be investigated in the future.

Risk factors for lesions of the knee menisci among workers in South Korea's national parks

Background

This study was designed to investigate the prevalence of the menisci lesions in national park workers and work factors affecting this prevalence.

Methods

The study subjects were 698 workers who worked in 20 Korean national parks in 2014. An orthopedist visited each national park and performed physical examinations. Knee MRI was performed if the McMurray test or Apley test was positive and there was a complaint of pain in knee area. An orthopedist and a radiologist respectively read these images of the menisci using a grading system based on the MRI signals. To calculate the cumulative intensity of trekking of the workers, the mean trail distance, the difficulty of the trail, the tenure at each national parks, and the number of treks per month for each worker from the start of work until the present were investigated. Chi-square tests was performed to see if there were differences in the menisci lesions grade according to the variables. The variables used in the Chi-square test were evaluated using simple logistic regression analysis to get crude odds ratios, and adjusted odds ratios and 95 % confidence intervals were calculated using multivariate logistic regression analysis after establishing three different models according to the adjusted variables.

Results

According to the MRI signal grades of menisci, 29 % were grade 0, 11.3 % were grade 1, 46.0 % were grade 2, and 13.7 % were grade 3. The differences in the MRI signal grades of menisci according to age and the intensity of trekking as calculated by the three different methods were statistically significant. Multiple logistic regression analysis was performed for three models. In model 1, there was no statistically significant factor affecting the menisci lesions. In model 2, among the factors affecting the menisci lesions, the OR of a high cumulative intensity of trekking was 4.08 (95 % CI 1.00–16.61), and in model 3, the OR of a high cumulative intensity of trekking was 5.84 (95 % CI 1.09–31.26).

Conclusion

The factor that most affected the menisci lesions among the workers in Korean national park was a high cumulative intensity of trekking.

Estimated rate of agricultural injury: the Korean Farmers' Occupational Disease and Injury Survey

Objectives

This study estimated the rate of agricultural injury using a nationwide survey and identified factors associated with these injuries.

Methods

The first Korean Farmers’ Occupational Disease and Injury Survey (KFODIS) was conducted by the Rural Development Administration in 2009. Data from 9,630 adults were collected through a household survey about agricultural injuries suffered in 2008. We estimated the injury rates among those whose injury required an absence of more than 4 days. Logistic regression was performed to identify the relationship between the prevalence of agricultural injuries and the general characteristics of the study population.

Results

We estimated that 3.2% (±0.00) of Korean farmers suffered agricultural injuries that required an absence of more than 4 days. The injury rates among orchard farmers (5.4 ± 0.00) were higher those of all non-orchard farmers. The odds ratio (OR) for agricultural injuries was significantly lower in females (OR: 0.45, 95% CI = 0.45–0.45) compared to males. However, the odds of injury among farmers aged 50–59 (OR: 1.53, 95% CI = 1.46–1.60), 60–69 (OR: 1.45, 95% CI = 1.39–1.51), and ≥70 (OR: 1.94, 95% CI = 1.86–2.02) were significantly higher compared to those younger than 50. In addition, the total number of years farmed, average number of months per year of farming, and average hours per day of farming were significantly associated with agricultural injuries.

Conclusions

Agricultural injury rates in this study were higher than rates reported by the existing compensation insurance data. Males and older farmers were at a greater risk of agriculture injuries; therefore, the prevention and management of agricultural injuries in this population is required.

Effect of Metalworking Fluid Mist Exposure on Cross‐Shift Decrement in Peak Expiratory Flow

Exposure to metalworking fluids (MWF) mist and cross-shift decrements in peak expiratory flow (PEF) were evaluated and their relationship was analyzed using several statistical methods. The objective of this study was to assess workers, exposure to MWF mineral mist and to find the MWF mist level for predicting cross-shift decrements in PEF. A total of 158 workers handling water-soluble MWF had MWF mist exposures with an arithmetic mean (AM) of 0.4 mg/m(3) (range: LOD-13.5 mg/m(3)), and 9.2% of workers (219) showed a cross-shift decline greater than 10% in PEF. MWF mist exposure and cross-shift decrements in PEF that were matched (n=113) were linearly significantly associated (R(2)=0.036, p=0.045) although the correlation was quite weak (r=0.189). We found a slight increase in cross-shift decrements in PEF with increased exposure to MWF aerosol mass concentration. The MWF mist exposure level was categorized into two or three groups by the cutoffs of either the National Institute for Occupational Safety and Health's Recommended Exposure Level (NIOSH REL: 0.5 mg/m(3)) or the American Conference of Governmental Industrial Hygienists Notice of Intended Change (ACGIH NIC: 0.2 mg/m(3)). The cross-shift decrement in PEF observed from workers exposed to > or =0.2 mg/m(3) was slightly higher than that of the exposure level of < or =0.2 mg/m(3) at p=0.207 while significant differences among categorized exposure groups (2 categories, <0.5 and > or =0.5 mg/m(3), or 3 categories, <0.2, 0.2-0.5 and > or =0.5 mg/m(3)) were not detected. In order to find out whether there is a specific level that allows us to predict cross-shift decrements in PEF, several statistical models were constructed. Logistic regression showed that the MWF concentration, whether treated as a continuous variable or a categorical variable, was not significantly associated with cross-shift decrements dichotomized by a cutoff of either 10% or 15% in PEF. We couldn't find evidence of a significant PEF decrement increase with increasing exposure category. Thus, we concluded that PEF decrements measured in workers exposed to MWF mist concentrations greater than either 0.2 mg/m(3) or 0.5 mg/m(3) was not significantly different from those found in workers exposed to lower MWF mist concentrations. Further study is needed to establish the level of MWF mineral mist predicting non-malignant respiratory health effects.

Cancer chemopreventive mechanisms of tea against heterocyclic amine mutagens from cooked meat

Cooking meat and fish under normal conditions produces heterocyclic amine mutagens, several of which have been shown to induce colon tumors in experimental animals. In our search for natural dietary components that might protect against these mutagens, it was found that green tea and black tea inhibit the formation of heterocyclic amine-induced colonic aberrant crypt foci (ACF) in the rat. Since ACF are considered to be putative preneoplastic lesions, we examined the inhibitory mechanisms of tea against the heterocyclic amines. In the initial studies using the Salmonella mutagenicity assay, green tea and black tea inhibited according to the concentration of tea leaves during brewing and the time of brewing; a 2-3-min brew of 5% green tea (w/v) was sufficient for >90% antimutagenic activity. N-hydroxylated heterocyclic amines, which are direct-acting mutagens in Salmonella, were inhibited by complete tea beverage and by individual components of tea, such as epigallocatechin-3-gallate (EGCG). Inhibition did not involve enhanced mutagen degradation, and EGCG and other catechins complexed only weakly with the mutagens, suggesting electrophile scavenging as an alternative mechanism. Enzymes that contribute to the metabolic activation of heterocyclic amines, namely microsomal NADPH-cytochrome P450 reductase and N, O-acetyltransferase, were inhibited by tea in vitro. Studies in vivo established that tea also induces cytochromes P450 and Phase II enzymes in a manner consistent with the rapid metabolism and excretion of heterocyclic amines. Collectively, the results indicate that tea possesses anticarcinogenic activity in the colon, and this most likely involves multiple inhibitory mechanisms.

Inhibitory activity of green and black tea in a free radical-generating system using 2-amino-3-methylimidazo[4,5-f]quinoline as substrate

Green tea and black tea inhibit colon carcinogenesis in rats exposed to the cooked meat mutagen 2-amino-3-methylimidazo[4,5-f]quinoline (IQ). In the present investigation, green tea, black tea and (-)-epigallocatechin gallate (EGCG) were shown to block the production of oxygen free radicals derived from IQ in the presence of NADPH-cytochrome P450 reductase. In kinetic studies using IQ as the substrate and DMPO as a free radical spin trap, EGCG increased the K(m) of the reaction without altering Vmax, suggesting competitive enzyme inhibition (Ki = 9.96 microM). This was confirmed in spectrophotometric studies using cytochrome c as the substrate, in which EGCG acted as a competitive inhibitor of NADPH-cytochrome P450 reductase (Ki = 9.7 microM). These results suggest that the inhibitory activities of green tea and black tea in electron spin resonance assays using IQ as the substrate for the reductase are related to an indirect effect on the enzyme rather than via direct scavenging of the free radicals. The possible implications of these findings are discussed in the context of pathways involved in the activation and detoxification of IQ in the colon.