- Factors Affecting the Use of Medical Services by Workers with Respiratory Diseases.
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Yeon Soon Ahn, Jae Seok Song, Seong Kyu Kang, Ho Keun Chung
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Korean J Prev Med. 2002;35(1):49-56.
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To identify the relationship between the use of medical services by workers with three types of respiratory diseases (total respiratory diseases, acute upper respiratory infections and chronic lower respiratory diseases) and exposure to hazardous agents after controlling for other factors affecting medical services use, such as characteristics of the enterprises (scale, industry type) and employee demographics (sex, age). METHODS: The study population comprised 28,882 workers who had undergone general or special medical examinations at the industrial health center at least once between Jan 1995 and Dec 1997 and had possessed medical insurance during the period. We combined medical examination data with medical insurance data in order to analyze the relationship between exposure to hazardous agents and respiratory diseases. RESULTS: Among the 28,882 study subjects, 17,454 employees (60.4%) used medical services more than once during 3-year study period, owing to more than one kind of respiratory diseases. In logistic regression analysis, sex, age and the size of the enterprises proved to be significant variables on the use of medical services for all three types of respiratory disease: The use of medical services increased with employee age. Women used more medical services than men and the employees in the large-scale enterprises used more services than employees in small-scale enterprises. However, exposure to dust or organic solvents did not affect medical service use due to total respiratory diseases or acute upper respiratory infections. Only in the case of chronic lower respiratory diseases did workers exposed to dusts (OR=1.12, 95% CI=1.01 -1.24) or organic solvents (OR=1.19, 95% CI=1.05-1.35) use more medical services than those not exposed. CONCLUSIONS: Workers exposed to dusts or organic solvents are particularly apt to suffer from chronic lower respiratory diseases and use medical services more often than those not exposed. That is, chronic exposure to hazardous agents such as dusts and organic solvents is believed to be harmful and to cause respiratory symptoms and diseases.
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- Understanding the Occurrence of Lung Cancer in Foundry Workers through Health Insurance Data .
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Yeon Soon Ahn, Jae Seok Song, Seong Kyu Kang, Ho Keun Chung
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Korean J Prev Med. 2000;33(3):299-305.
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- CONCLUSIONS: To investigate the difference in the occurrence of lung cancer between foundry workers and non-foundry workers by comparing the number of workers diagnosed with lung cancer through health insurance data. METHODS: The study population was comprised of 28,884 workers who had undergone at least one general or special medical examination between January 1995 and December 1997 at the occupational health center. All of the subjects had health insurance during this period. We combined the medical examination data with the health insurance data to compare the number of foundry workers diagnosed with lung cancer and the number of non-foundry workers diagnosed with lung cancer. RESULTS: Seven workers were diagnosed with lung cancer among the 1,591 foundry workers, compared to twelve workers among the 27,293 non-foundry workers (odds ratio: 10.04, 95% confidence interval: 3.95-25.55). The seven foundry workers diagnosed with lung cancer were all exposed to dust, and six out these seven workers were engaged in finishing or shake-out processes. CONCLUSIONS: Although the information for this study was obtained from health insurance data, which has limitations such as accuracy and completeness, the number of foundry workers diagnosed with lung cancer was significantly higher than that of non-foundry workers. Therefore, a well-designed cohort study should be followed to confirm the higher lung cancer rates in foundry workers.
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- Health Care Utilization of Workers with Skin Disease in Inchon.
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Yeon Soon Ahn, Jae Seok Song, Jong Uk Won, Jaehoon Roh
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Korean J Prev Med. 1999;32(2):206-214.
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This study was carried out to identify relation of health care utilization due to skin disease(ICD-10, L00-L99) and characteristics(sex, age, exposure status, type of industry, size of enterprise) of workers. METHODS: We made new database composed of 30,536 workers' health examination results in one specific health examination institute in Inchon and data of medical insurance utilization due to skin disease in 4 medical insurance associations for enterprise from January, 1995 to December, 1997. And we analyzed determinants of health care utilization due to skin disease of workers. RESULTS: Among 30,536 study subjects, 8,837(28.9%) workers and 4,181(13.7%) workers utilized medical insurance due to total skin disease(ICD-10, L00-L99) and contact dermatitis(ICD-10, L23-L25), respectively. Female workers(p<.001), workers exposed to organic solvents(p<.05), workers in manufacturing industries(p<.05, p<.01, respectively) and in large scale enterprises(p<.001) utilized more medical insurance due to total skin disease and contact dermatitis than male workers, workers not exposed to organic solvents, workers in non-manufacturing industries and small scale enterprises. With multiple logistic regression analysis, significant explanatory variables affecting workers' medical utilization due to total skin disease and dermatitis and eczema(ICD-10, L20-L30) in total workers were sex, age, specific chemicals and size of enterprises. And age, type of industries, organic solvents, specific chemicals and size of enterprises were significant explanatory variables related to medical insurance utilization due to dermatitis and eczema and contact dermatitis in male workers. CONCLUSION: From the above results, we found that workers exposed to organic solvents utilized more medical insurance due to skin disease than workers not exposed to. And, comparing to workers in large scale enterprises, workers in small scale enterprises may have unmet medical care utilization due to skin disease. Therefore we have to establish counterplan to manage occupational skin disease of high risk group(organic solvent exposure group) and to satisfy unmet medical care utilization of workers in small scale enterprises.
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- Characteristics of Occupational Skin Disease Reported by Surveillance System.
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Yeon Soon Ahn, Hyoung Ok Kim, Jun Young Lee, Ho Keun Jung
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Korean J Prev Med. 1999;32(2):130-140.
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This study was carried out to estimate the magnitude of skin disease related to occupation and to find out the characteristics of it. METHODS: We collected and analyzed the cases of occupational skin disease reported by surveillance system composed of doctors and nurses in 150 enterprises with dispensary or attached hospital and physicians in 92 specific health examination institutes and 150 dermatologists from May to November, 1998. RESULTS: Among members of surveillance system, 66 enterprises and 47 specific health examination institutes and 55 dermatologists reported 571 cases of occupational skin disease in 512 workers. Excepting 81 cases reported by dermatologists, We analyzed 490 cases reported by enterprises and specific health examination institutes. Among 490 cases, contact dermatitis was most common(368 cases, 75.1%) and the second was hyper or hypopigmentation(36 cases, 7.3%). When we analyzed the characteristics of workers with occupational contact dermatitis, male workers were 281(79.2%) and female were 74(20.8%). 165 workers(64.5%) had chronic skin disease with repeated cure and relapse. 245 workers(72.5%) answered positively that their coworkers had similar skin disease. 27 workers(8.7%) experienced absence due to contact dermatitis related to occupation. To analyze the type of industries of workers with occupational contact dermatitis, automobile and trailer manufacturing industry was most common(105 cases, 29.6%) and the second was manufacturing industry for image, sound and communication equipment(55 cases, 15.5%). Organic solvent(183 cases, 46.7%) was the most common treating material of workers with contact dermatitis and the second was various kinds of chemicals(59cases, 15.1%). CONCLUSIONS: This is the first study using nationwide surveillance system to collect data of occupational skin disease. We found that many workers had skin disease related to occupation and characteristics of occupational skin disease were chronic and clustering. Therefore, we had to establish counterplan to manage occupational skin disease and to operate surveillance system to identify trends of occupational skin disease, continuously.
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- Basic Study on the Hearing-threshold Levels of Workers with Noise-induced Hearing Loss in Korea.
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Yeon Soon Ahn, Young Han Moon, Sang Yeal Lee, Kyung Nam Lee
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Korean J Prev Med. 1999;32(1):17-29.
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This study was carried out to analyze the hearing-threshold levels and relating factors of 1,048 workers with noise-induced hearing loss(D1). METHODS: We analyzed the hearing-threshold levels and relating factors of 1,048 workers with noise-induced hearing loss(D1) examined by the summary reports of specific health examination results of industries and personal reports of specific health examination results reported by 58 specific health examination institutes and 8 secondary pneumoconiosis examination institutes in 1996. RESULTS: Among 1,048 workers at 510 workplaces, male workers were 1,009 (96.3%) and female workers were 39 (3.7%). The mean ages of workers initially exposed to noise and at present were 28.7 and 47.2, respectively. The duration of total exposure was 16.5 years. Average hearing-threshold levels analyzed by three-divided classification of the study subjects were 43.7dB(Lt) and 42.6dB(Rt). Those analyzed by six-divided classification were 50.5dB(Lt) and 48.6dB(Rt). Among workers with noise-induced shearing loss(D1), 16.3% was unilateral hearing loss and 84.6% was classified to compensation case. 8.8%(Rt) and 10.2%(Lt) of them were suspected to be conductive hearing loss by differences of air-bone hearing-threshold levels. Hearing-threshold levels of workers in manufacturing industry were significantly increased during the short exposure compared with the levels in mining industry. Among manufacturing industries, hearing-threshold levels of workers in trailer and other transportation equipment manufacturing industry were significantly increased. Age and duration of total noise exposure were not significantly related to the average hearing-threshold levels analyzed by three-divided classification. Hearing-threshold levels of female workers were significantly increased during the short exposure compared with those of male workers. Hearing-threshold levels of workers at the high risk group, ages of 20s, 30s and total exposure duration of less than 10 years, were not significantly increased compared with those of the other groups. However, they were exposed at young ages. The 3 leading industries of workers at high risk group were trailer and other transportation equipment manufacturing, automobile manufacturing and assemble-metal manufacturing industries. CONCLUSIONS: This study was the first nationwide analysis of the hearing-threshold levels and relating factors of workers with noise-induced hearing loss(D1). We found the differences of the real number by the statistics of the department of labour and the expected number of worker's compensations for occupationally-induced hearing loss estimated by this study. According to the results of this study, we should carefully examine the methods to narrow this difference.
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- Factors Relating to Quitting in the Small Industries in Incheon.
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Yeon Soon Ahn, Jaehoon Roh, Kyoo Sang Kim
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Korean J Prev Med. 1995;28(4):795-807.
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- This study was carried out from 1993 to 1994 in the small industries in Incheon. The objectives of this study was in order to estimate the quitting rate, to identify its relating factors and to propose effective quitting management policy in the small industries. The results were as follows; 1. The quitting rate of 266 study workers was 42.1%(l12 workers). 2. Age, working duration, position, marital status were significant difference between the quitting group and the non-quitting group. 10 the quitting group, mean age was young, working duration was short, general employees and unmarried workers were many compared with the non-quitting group. 3. In the industry characteristics, total assets, total sales, sales per person, establishment duration and occupational health and safety status were significant difference between the quitting group and the non-quitting group. In the quitting group, total assets, total sales and sales per person were little, establishment duration of company was short and occupational health and safety status were poor compared with the non-quitting group. 4. In the quitting group, worker's response to employer's disposal about health and safety was more passive and the relation to employer with employee was significantly poor compared with the non-quitting group. 5. Multiple logistic regression analysis of quitting against family income per person, working duration, relation to employer with employee, occupational health and safety status in industry, worker`s response to employer's disposal about health and safety and sales per person was done. Working duration, occupational health and safety status, worker`s response to empolyer's disposal about health and safety were significant eiplainatory variables for quitting. Above results showed that the quitting rate was high and it was significant difference between the quitting group and non -quitting group according to characteristics of workers and of industries. Especially, it suggested that working duration, occupational health and safety status and worker's response to employers disposal about health and safety were significant quitting factor. Therefore, it should be reflected in the quitting management and the policy of steady employment.
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- An Analysis of Health Examination Outcome in the Special Health Examination Institute.
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Yeon Soon Ahn, Sang Hyuk Jung, Dong Chun Shin, Jong Uk Won, Jae Hoon Roh
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Korean J Prev Med. 1995;28(3):663-677.
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- Special health examination institute has done periodic health examination for workers who have worked in the hazardous workplace. However, assessment on outcome in special health examination institute about detection ability of occupational disease has not been. In this circumstances, we studied on the differences of health examination outcome among special health examination institutes and identified related factors which affected outcome of special health examination in the special health examination institutes. The summary of the results were as follows. 1. 50 special health examination institutes were examined in this study. Among them, university institutes were 13 cases(26.0%), hospitals were 20 cases(40.0%), a corporation aggregates were 9 cases(18.0%) and an auxiliary organs of company were 8 cases(16.0%). There were 29(58.0%) institutes with a preventive medicine specialist, but 21 institutes(42.0%) were not. 2. Total workers examined in 50 institutes were 606,948 and workers diagnosed as occupational disease(D1) were 3,156. The rate of occupational disease was 6 workers per 1,000 examined workers. Workers needed for close observation(C) were 95,809 and the rate of workers needed for close observation was 141 per 1,000 examined workers. 3. The rate of occupational disease of university institutes was highest(11.3 per l,000 examined workers) and followed by hospitals(6.0 per 1,000 examined workers), a corporation aggregates(4.2 per 1,000 examined workers), and an auxiliary organs of company(l.2 per 1,000 examined workers.). The difference of the rate of occupational disease between university institutes and an auxiliary organs of company was statistically moderate significant(p<.1).The rate of occupational disease in special health examination institutes with establishment duration was more than 10 years was statistically higher than institutes with establishment duration was less than 10 years(p<0.l). 4. The results of multiple regression, R2 was 0.3394(adjusted R2 was 0.2109), F-value was 2, fi41ft(p<0.5), and statistically significant variables were establishment duration(p<0.1), number of examined workers per one doctor(p<.l), and auxiliary organs of company(p<0.l), which dependent variable was the rate of occupational disease and independent variables were number of examined workers per one doctor, classification of institute, the rate of working environment exceeding TLV, duration of institute establishment, presence of a preventive medicine specialist.
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- The effects of age adjustment on the diagnosis of noise induced hearing loss.
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Jong Uk Won, Yeon Soon Ahn, Jae Hoon Roh
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Korean J Prev Med. 1995;28(3):651-662.
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- In Korea there is no specific method of age adjustment in noise induced hearing loss(NIHL). we attempted the age adjustment to understand the effects of age on the diagnosis of NIHL. We used the International Standard Organization 1999 as an age adjustment method. We used the 1,617 otologically normal person's hearing data from a health examination center, and 206 workers diagnosed as NIHL. we concluded as follows; 1. The ISO 7029 function used for age specific hearing loss is not suited to Korean people. 2. The mean of age specific hearing loss is 11.0 6.2dB, and the older of age, the more decrease on hearing loss, especially in 4000Hz. 3. The difference of NIHL between before age adjustment and after age adjustment in the 3rd decade is 5.4dB, in the 4th decade is 6.7dB, in the 5th decade is 8.5dB, in the 6th decade is 10.4dB, and in the 7th decade is 12.9dB. The older, the more is the difference. 4. After age adjustment, the number of workers diagnosed as NIHL decreases to 60% of unadjusted.
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