Factors associated with suicide ideation among subway drivers in Korea

Junsu Byun,Hyoung-Ryoul Kim,Hye-Eun Lee,Se-Eun Kim,Jongin Lee 대한직업환경의학회 2016 대한직업환경의학회지 Vol.28 No.-

Background: There were several suicide events of subway drivers in Korea. The aim of this study is to explore work-related factors associated with suicide ideation among subway drivers. Methods: We analyzed data from 980 male subway drivers. A section of the Korean version of the Composite International Diagnostic Interview (K-CIDI 2.1) was administered by trained interviewers to judge whether a driver has suicide ideation and to diagnose psychiatric disorders. A questionnaire was also administered to collect data on sociodemographic characteristics, work environments, occupational stress, person under train (PUT) experience, and work-related problems. Occupational stress was examined by using the Korean Occupational Stress Scale (KOSS). Logistic regression was applied to evaluate the association between work-related factors and suicide ideation among subway drivers. Results: Regarding work-related problems, conflict with passengers and sudden stops due to the emergency bell were significantly associated with suicide ideation. MDD, PTSD, and panic disorder were strongly associated with suicide ideation. In the analysis of occupational stress, insufficient job control (OR 2.34) and lack of reward (OR 2.52) were associated with suicide ideation even after being adjusted for psychiatric disorders and other work-related factors. Conclusions: Insufficient job control and lack of reward were associated with suicide ideation among subway drivers. Strategies for drivers to have autonomy while working and to achieve effort-reward balance should be implemented. Furthermore, drivers who have experienced negative work-related problems should be managed appropriately.

지역간 상대위험도 변동을 고려한 미세먼지 기인 질병부담 및 사회경제적 비용 추정 연구

변가람(Garam Byun),최용수(Yongsoo Choi),길준수(Junsu Gil),차준일(Junil Cha),이미혜(Meehye Lee),이종태(Jong-Tae Lee) 한국환경보건학회 2021 한국환경보건학회지 Vol.47 No.5

Background: Particulate matter (PM) is one of the leading causes of premature death worldwide. Previous studies in South Korea have applied a relative risk calculated from Western populations when estimating the disease burden attributable to PM. However, the relative risk of PM on health outcomes may not be the same across different countries or regions. Objectives: This study aimed to estimate the premature deaths and socioeconomic costs attributable to longterm exposure to PM in South Korea. We considered not only the difference in PM concentration between regions, but also the difference in relative risk. Methods: National monitoring data of PM concentrations was obtained, and missing values were imputed using the AERMOD model and linear regression model. As a surrogate for relative risk, hazard ratios (HRs) of PM for cardiovascular and respiratory mortality were estimated using the National Health Insurance Service- National Sample Cohort. The nation was divided into five areas (metropolitan, central, southern, southeastern, and Gangwon-do Province regions). The number of PM attributable deaths in 2018 was calculated at the district level. The socioeconomic cost was derived by multiplying the number of deaths and the statistical value of life. Results: The average PM₁₀ concentration for 2014~2018 was 45.2 μg/㎥. The association between long-term exposure to PM10 and mortality was heterogeneous between areas. When applying area-specific HRs, 23,811 premature deaths from cardiovascular and respiratory disease in 2018 were attributable to PM₁₀ (reference level 20 μg/㎥). The corresponding socioeconomic cost was about 31 trillion won. These estimated values were higher than that when applying nationwide HRs. Conclusions: This study is the first research to estimate the premature mortality caused by long-term exposure to PM using relative risks derived from the national population. This study will help precisely identify the national and regional health burden attributed to PM and establish the priorities of air quality policy.

Case Report : Allopurinol-induced DRESS syndrome mimicking biliary obstruction

( Hyung Gyu Choi ),( Junsu Byun ),( Chae Ho Moon ),( Jong Ho Yoon ),( Ki Young Yang ),( Su Cheol Park ),( Chul Ju Han ) 대한간학회 2014 Clinical and Molecular Hepatology(대한간학회지) Vol.20 No.1

An 84-year-old man was admitted to our hospital with fever, jaundice, and itching. He had been diagnosed previously with chronic renal failure and diabetes, and had been taking allopurinol medication for 2 months. A physical examination revealed that he had a fever (38.8ºC), jaundice, and a generalized maculopapular rash. Azotemia, eosinophilia, atypical lymphocytosis, elevation of liver enzymes, and hyperbilirubinemia were detected by blood analysis. Magnetic resonance cholangiography revealed multiple cysts similar to choledochal cysts in the liver along the biliary tree. Obstructive jaundice was suspected clinically, and so an endoscopic ultrasound examination was performed, which ruled out a diagnosis of obstructive jaundice. The patient was diagnosed with DRESS (Drug Rash with Eosinophilia and Systemic Symptoms) syndrome due to allopurinol. Allopurinol treatment was stopped and steroid treatment was started. The patient died from cardiac arrest on day 15 following admission. (Clin Mol Hepatol 2014;20:71-75)

육군 장병의 비타민 C 섭취와 상기도 감염 예방과의 관계

석웅 ( Seog Woong ),김태경 ( Kim Taekyung ),변준수 ( Byun Junsu ),임형렬 ( Lim Hyungryul ) 국군의무사령부 2018 대한군진의학학술지 Vol.49 No.1

Objectives : This study was conducted to investigate whether vitamin c intake can prevent common colds in the Republic of Korea Army soldiers. Methods : To determine if vitamin c intake can prevent common colds, we selected soldiers who enlisted the Korea Army Training Center for 30 days from February 12, to March 13, 2018. In the randomized, placebo-controlled, and double-blind trial, study participants were divided into groups(vitamin c vs. placebo). Also, whether or not the participants had a common cold was detected by searching the military medical records. Based on the synthesized data, multiple logistic regression analysis was performed to identify association between intake of vitamin c and diagnosis of common colds. Results : A total of 1,444 participants were included in the our study. Of the participants, 695 participants took vitamin c(6,000 mg/day) and 749 participants took placebo(0 mg/day). Also, 895 never smokers, 450 smokers(temporary non-smokers) and 99 former smokers were included in the study. The group took vitamin c had a 0.80-fold lower risk of getting a common cold than the placebo-treated group. In addition, the relationship between intake of vitamin c and common cold diagnosis was analyzed after categorizing the participants as smoking status(non-smoker vs. smoker). Conclusions : Through this study, we confirmed that vitamin c ingestion is effective in preventing common colds. Our results may serve as a basis for introducing military health-care policies that can provide vitamin c with military personnel in basic military training.

Risk factors associated with mortality from pneumonia among patients with pneumoconiosis

Bum Seak Jo,Jongin Lee,YounMo Cho,Junsu Byun,Hyoung Ryoul Kim,Jung Wan Koo,Jun Pyo Myong 대한직업환경의학회 2016 대한직업환경의학회지 Vol.28 No.-

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.

Sleepiness while driving and shiftwork patterns among Korean bus drivers

Seyoung Lee,Hyoung-Ryoul Kim,Junsu Byun,Taewon Jang 대한직업환경의학회 2017 대한직업환경의학회지 Vol.29 No.-

Background: Sleepiness while driving has been regarded as a major cause of death due to traffic accidents. We compared the degree of sleepiness across five different working time periods (first, morning, post-lunch, afternoon, and last) among Korean bus drivers with different shift types (Daily two shift/Alternating day shift). Method: We interviewed 332 bus drivers with two shift types (Daily two shift, 128; Alternating day shift, 204). The questionnaire included demographic information (age, alcohol consumption and history of disease), a sleep disorder diagnosed by a doctor, job duration, the number of workdays in the past month, average working hours per workday and week, sleepiness while driving (Karolinska Sleepiness Scale), and sleeping time for both workdays and off-days. We conducted log-binomial regression analyses and produced prevalence ratios (PRs) of severe sleepiness (KSS ≥ 7) while driving with 95% confidence intervals (95% CI) to identify the difference in sleepiness for five working times between both groups. Results: For the first and morning periods, there were no statistically significant differences in the KSS scores between the two groups. However, from lunch to last driving, drivers with Alternating day shift had a much larger proportion of severe sleepiness than those on Daily two shift. Thirteen (10.2%), 2 (1.6%) and 7 (5.5%) Daily two shift workers reported severe sleepiness in the post-lunch, afternoon and last periods. In contrast, 81 (39.7%), 63 (30.9%) and 64 (31.4%) of Alternating day shift drivers experienced severe sleepiness during the post-lunch, afternoon and last driving periods (p < 0.0001). According to the log-binomial regression analyses, Alternating day shift was associated with severe sleepiness from lunch to last driving. After adjusting for job duration, alcohol consumption and sleeping time on workdays, the PRs were 3.97 (95% CI: 2.29–6.90) post-lunch, 18.26 (95% CI: 4.51–73.89) in the afternoon and 5.71 (95% CI: 2.51–12.99) for the last driving period. Conclusion: We found that Alternating day shift bus drivers suffered from more sleepiness while driving from lunch to last driving than Daily two shift bus drivers. This difference may be because Alternating day shift drivers had more irregular work schedules and longer working hours per day and week.

Workers’ experiences with compensated sick leave due to musculoskeletal disorder: a qualitative study

Min Choi,Hyoung-Ryoul Kim,Jinwoo Lee,Hye-Eun Lee,Junsu Byun,Jong Uk Won 대한직업환경의학회 2014 대한직업환경의학회지 Vol.26 No.-

Objectives: The most common occupational disease that is compensated by Industrial Accident Compensation Insurance (IACI) in Korea is musculoskeletal disease (MSD). Although complaints about the workers’ compensation system have been raised by injured workers with MSD, studies that examine workers’ experiences with the Korean system are rare. This paper is a qualitative study designed to examine injured workers’ experiences with the workers’ compensation system in Korea. The aim of this study is to explore the drawbacks of the workers’ compensation system and to suggest ways to improve this system. Methods: All workers from an automobile parts factory in Anseong, GyeongGi province who were compensated for MSD by IACI from January 2003 to August 2013 were invited to participate. Among these 153 workers, 142 workers completed the study. Semi-structured open-ended interviews and questionnaires were administered by occupational physicians. The responses of 131 workers were analyzed after excluding 11 workers, 7 of whom provided incomplete answers and 4 of whom were compensated by accidental injury. Based on their age, disease, department of employment, and compensation time, 16 of these 131 workers were invited to participate in an individual in-depth interview. In-depth interviews were conducted by one of 3 occupational physicians until the interview contents were saturated. Results: Injured workers with MSD reported that the workers’ compensation system was intimidating. These workers suffered more emotional distress than physical illness due to the workers’ compensation system. Injured workers reported that they were treated inadequately and remained isolated for most of the recuperation period. The compensation period was terminated without ample guidance or a plan for an appropriate rehabilitation process. Conclusions: Interventions to alleviate the negative experiences of injured workers, including quality control of the medical care institutions and provisions for mental and psychological care for injured workers, are needed to help injured workers return to work earlier and more healthy.

The association between psychiatric disorders and work-related problems among subway drivers in Korea

Se-eun Kim,Hyoung-Ryoul Kim,Jong-Ik Park,Hae Woo Lee,Jongin Lee,Junsu Byun,Hyeon Woo Yim 대한직업환경의학회 2014 대한직업환경의학회지 Vol.26 No.-

Objectives: This study aimed to find the prevalence and occupational risk factors for major psychiatric disorders among subway drivers in South Korea. Methods: Of all 998 current subway drivers, 995 participated in this study. The Korean version of the Composite International Diagnostic Interview (K-CIDI 2.1) was administered by trained interviewers to diagnose psychiatric disorders in all participants. The questions on socio-demographic characteristics and working conditions included some questions related to a person under train (PUT) experience and work-related problems. One-year prevalence and lifetime prevalence of major depressive disorder (MDD), post-traumatic stress disorder (PTSD), and panic disorder were diagnosed through the interview. The standardized prevalence ratios (SPRs) of these three disorders were calculated in the sample of subway drivers using the 2011 Korean National Epidemiologic Survey data as a basis. Multiple logistic regressions were performed to determine the association between work-related factors and the prevalence of the psychiatric disorders. Results: The standardized prevalence ratios (SPRs) for a 1-year prevalence of MDD and PTSD among subway drivers were 1.1 (95% CI 0.7-1.7) and 5.6 (95% CI 3.1-8.8), respectively. Conflict with passengers was significantly associated with an increased risk for both MDD and PTSD in 1-year and in lifetime prevalence. Experiencing a sudden stop due to an emergency bell increased the risk of the lifetime prevalence of MDD (OR 2.61, 95% CI 1.14-6.97) and PTSD (OR 7.53, 95% CI 1.77-32.02). The risk of PTSD significantly increased among drivers who once experienced a near accident in terms of both the 1-year prevalence (OR 8.81, 95% CI 1.96-39.3) and the lifetime prevalence (OR 6.36, 95% CI 2.40-16.90). Conclusions: PTSD and panic disorder were more prevalent among subway drivers than in the general population. We found that having a conflict with passengers, a near accident, and a breakdown while driving can be risk factors for psychiatric disorders among subway drivers. Therefore, a prompt and sensitive approach should be introduced for these high risk groups within the subway company.

Ongoing outbreak of human adenovirus-associated acute respiratory illness in the Republic of Korea military, 2013 to 2018

( Jae-hoon Ko ),( Hyeong-taek Woo ),( Hong Sang Oh ),( Song Mi Moon ),( Joon Young Choi ),( Jeong Uk Lim ),( Donghoon Kim ),( Junsu Byun ),( Soon-hwan Kwon ),( Daeyoun Kang ),( Jung Yeon Heo ),( Kyong 대한내과학회 2021 The Korean Journal of Internal Medicine Vol.36 No.1

Background/Aims: Human adenovirus type 55 (HAdV-55), an emerging epidemic strain, has caused several large outbreaks in the Korean military since 2014, and HAdV-associated acute respiratory illness (HAdV-ARI) has been continuously reported thereafter. Methods: To evaluate the epidemiologic characteristics of HAdV-ARI in the Korean military, we analyzed respiratory virus polymerase chain reaction (RV-PCR) results, pneumonia surveillance results, and severe HAdV cases from all 14 Korean military hospitals from January 2013 to May 2018 and compared these data with nationwide RV surveillance data for the civilian population. Results: A total of 14,630 RV-PCRs was performed at military hospitals. HAdV (45.4%) was the most frequently detected RV, followed by human rhinovirus (12.3%) and influenza virus (6.3%). The percentage of the military positive for HAdV was significantly greater than the percentage of civilians positive for HAdV throughout the study period, with a large outbreak occurring during the winter to spring of 2014 to 2015. The outbreak continued until the end of the study, and non-seasonal detections increased over time. The reported number of pneumonia patients also increased during the outbreak. Case fatality rate was 0.075% overall but 15.6% in patients with respiratory failure. The proportion of severe patients did not change significantly during the study period. Conclusions: A large HAdV outbreak is currently ongoing in the Korean military, with a trend away from seasonality, and HAdV-55 is likely the predominant strain. Persistent efforts to control the outbreak, HAdV type-specific surveillance, and vaccine development are required.