Background: As the impact of climate change intensifies, exposure to heat stress will grow, leading to a loss of work capacity for vulnerable occupations and affecting individual labor decisions. This study estimates the future work capacity under the Representative Concentration Pathways 8.5 scenario and discusses its regional impacts on the occupational structure in the Republic of Korea. Methods: The data utilized for this study constitute the local wet bulb globe temperature from the Korea Meteorological Administration and information from the Korean Working Condition Survey from the Occupational Safety and Health Research Institute of Korea. Using these data, we classify the occupations vulnerable to heat stress and estimate future changes in work capacity at the local scale, considering the occupational structure. We then identify the spatial cluster of diminishing work capacity using exploratory spatial data analysis. Results: Our findings indicate that 52 occupations are at risk of heat stress, including machine operators and elementary laborers working in the construction, welding, metal, and mining industries. Moreover, spatial clusters with diminished work capacity appear in southwest Korea. Conclusion: Although previous studies investigated the work capacity associated with heat stress in terms of climatic impact, this study quantifies the local impacts due to the global risk of climate change. The results suggest the need for mainstreaming an adaptation policy related to work capacity in regional development strategies.

Background: The elevated risk of occupational infection such as tuberculosis among health workers in many countries raises the question of whether the quality of occupational health and safety (OHS) and infection prevention and control (IPC) can be improved by auditing. The objectives of this study were to measure (1) audited compliance of primary health-care facilities in South Africa with national standards for OHS and IPC, (2) change in compliance at reaudit three years after baseline, and (3) the inter-rater reliability of the audit. Methods: The study analyzed audits of 60 primary health-care facilities in the Western Cape Province of South Africa. Baseline external audits in the time period 2011-2012 were compared with follow-up internal audits in 2014-2015. Audits at 25 facilities that had both internal and external audits conducted in 2014/2015 were used to measure reliability. Results: At baseline, 25% of 60 facilities were "noncompliant" (audit score<50%), 48% "conditionally compliant" (score >50 < 80%), and only 27% "compliant" (score >80%). Overall, there was no significant improvement in compliance three years after baseline. Percentage agreement on specific items between internal and external audits ranged from 28% to 92% and kappa from -0.8 to 0.41 (poor to moderate). Conclusion: Low baseline compliance with OHS-IPC measures and lack of improvement over three years reflect the difficulties of quality improvement in these domains. Low inter-rater reliability of the audit instrument undermines the audit process. Evidence-based investment of effort is required if repeat auditing is to contribute to occupational risk reduction for health workers.

Background: Childbirth represents a significant transition for women, with physical and psychological sequelae. Reentry to the workplace during the postpartum period is understudied, with implications for maternal well-being and job-related outcomes. This study's aim was to examine selected pregnancy, childbirth, and return-to-work correlates of overall self-rated health within the first month of work reentry after maternity leave. Methods: Between December 2016 and January 2017, we surveyed women employed at a large, public Midwestern university who had given birth in the past five years (N = 249) to examine self-rated overall health in the first month of work reentry. Using ordinal logistic regression, we examined whether physical or psychological health problems during pregnancy, childbirth complications, length of maternity leave, and depression and anxiety at work reentry were related to overall health. Results: Women who experienced depression (odds ratio [OR] = 0.096 [95% confidence interval {CI} = 0.019 to 0.483, p = 0.004]) and anxiety (OR = 0.164, [95% CI = 0.042 to 0.635, p = 0.009]) nearly every day reported worse health at work reentry than those with no symptoms. Controlling for demographics and mental health, women who experienced medical problems during pregnancy (OR = 0.540 [95% CI = 0.311 to .935, p = 0.028]) were more likely to report poor health, while taking a longer maternity leave (OR = 14.552 [95% CI = 4.934 to 42.918, p < 0.001]) was associated with reporting better health at work reentry. Conclusion: Women who experience medical complications during pregnancy, return to the workplace too soon after birth, and experience mental health symptoms are vulnerable physically as they return to work.

Background: Hong Kong's construction industry currently faces a manpower crisis. Blue-collar workers are a disadvantaged group and suffer higher levels of chronic diseases, for example, cancer, than the wider population. Cancer risk factors are likely to cluster together. We documented prevalence of cancer-associated lifestyle risk behaviors and their correlates among Hong Kong construction workers. Methods: Data were collected from workers at 37 railway-related construction worksites throughout Hong Kong during May 2014. Tobacco use, alcohol consumption, unbalanced nutrition intake, and physical inactivity were included in the analysis. Latent class analysis and multivariable logistic regression were performed to identify the patterns of risk behaviors related to cancer, as well as their impact factors among construction workers in Hong Kong. Results: Overall, 1,443 workers participated. Latent class analysis identified four different behavioral classes in the sample. Fully adjusted multiple logistic regression identified age, gender, years of Hong Kong residency, ethnicity, educational level, and living status differentiated behavioral classes. Conclusion: High levels of lifestyle-related cancer-risk behaviors were found in most of the Hong Kong construction workers studied. The present study contributes to understanding how cancer-related lifestyle risk behaviors cluster among construction workers and relative impact factors of risk behaviors. It is essential to tailor health behavior interventions focused on multiple risk behaviors among different groups for further enlarging the effects on cancer prevention.

Background: Exploratory study to investigate whether co-exposure to physical wrist stressors and chemicals is associated with carpal tunnel syndrome (CTS) in French male farmers and agricultural workers. Methods: Cross-sectional study of 711 men aged 30-65 years and working as either farmers or agricultural workers in 2009-2010 within a cohort covered by the French Agricultural Workers' and Farmers' Mutual Benefit Fund. CTS and exposure to physical wrist stressors and chemicals were assessed using a self-administered questionnaire. Associations between CTS and personal/medical factors, exposure to physical wrist stressors, exposure to chemicals, and co-exposure to physical wrist stressors and chemicals were studied using multivariate logistic regression models. Results: Forty-four men {5.6% [95% confidence interval (CI) 4.0-7.7]} reported that they had suffered from unilateral/bilateral CTS during the last 12 months. CTS was associated with age, current smoking [odds ratio (OR) = 2.1 (1.0-4.5)], and exposure to physical wrist stressors [OR = 2.6 (1.1-5.9)]. An association was found between CTS and co-exposure to physical wrist stressors and chemicals [OR = 3.3 (0.8-14.3), p = 0.044] in comparison with the no-exposure group. Conclusions: This exploratory study shows an association of CTS with exposure to biomechanical wrist stressors in male farmers and agricultural workers and suggests an association of CTS with co-exposure to physical wrist stressors and chemicals. Owing to the limitations of the study, this result must be confirmed by a prospective study with objective assessments of the outcome and exposure before drawing conclusions on the possible synergistic effects of mechanical stressors and chemicals on the impairment of the median nerve.

Background: We performed this study to investigate the inequalities in site-specific cancer incidences among workers across different occupations in Korea. Methods: Subjects included members of the national employment insurance. Incident cancers among 8,744,603 workers were followed from 1995 to 2007. Occupational groups were classified according to the Korean Standard Occupational Classification. Age-standardized incidence rate ratios were calculated. Results: We found that men in service/sales and blue-collar occupations had elevated rates of esophageal, liver, laryngeal, and lung cancer. Among women, service/sales workers had elevated incidences of cervical cancer. Male prostate cancer, female breast, corpus uteri, and ovarian cancers, as well as male and female colorectal, kidney, and thyroid cancer showed lower incidences among workers in lower socioeconomic occupations. Conclusions: Substantial differences in cancer incidences were found depending on occupation reflecting socioeconomic position, in the Korean working population. Cancer prevention policy should focus on addressing these socioeconomic inequalities.

Background: The relationship between risk factors and likelihood of occupational injury has been studied. However, what has been published has only provided a limited explanation of why some of the employees working in the same environment as other employees suffered a single-injury event, while other employees experienced multiple-injury events. This article reports on an investigation of whether artisanal and small-scale miners in Migori County of Kenya are susceptible to a single-injury or multiple-injury incidences, and if so, what underpinning parameters explain the differences between the single incident injured and the multiple incident injured group. Mine management commitment to safety in artisanal and small-scale mining (ASM) operations is also considered. Materials and methods: The research objectives were achieved by surveying 162 uninjured and 74 injured miners. A structured, closed-end questionnaire was administered to participants after the stratification of the study population and systematic selection of the representative samples. Results: The results showed that most injured miners suffer a single-injury incident rather than experiencing multiple-injury events, and laceration (28.40%) was the common injury suffered by the miners. The analysis showed that the risk factors for the single incident injured group were not similar to those in the multiple incident injured group. The research also found mine workers have low opinion about mine management/owners commitment to safety. Conclusion: The study concluded that mine management and miners need to be educated and sensitized on the dangers of this operation. Provision of safety gears and positive safety culture must be a top priority for management.

Background: This study aims to assess whether the TSI PortaCount (Model 8020) is a measuring instrument comparable with the flame photometer. This would provide an indication for the suitability of the PortaCount for determining the workplace protection factor for particulate filtering facepiece respirators. Methods: The PortaCount (with and without the N95-Companion^TM) was compared with a stationary flame photometer from Moores (Wallisdown) Ltd (Type 1100), which is a measuring instrument used in the procedure for determining the total inward leakage of the particulate filtering facepiece respirator in the European Standard. Penetration levels of sodium chloride aerosol through sample respirators of two brands (A and B) were determined by the two measuring systems under laboratory conditions. For each brand, thirty-six measurements were conducted. The samples were split into groups according to their protection level, conditioning before testing, and aerosol concentration. The relationship between the gauged data from two measuring systems was determined. In addition, the particle size distribution inside the respirator and outside the respirator was documented. Linear regression analysis was used to calculate the association between the PortaCount (with and without the N95-Companion^TM) and the flame photometer. Results: A linear relationship was found between the raw data scaled with the PortaCount (without N95-Companion^TM) and the data detected by the flame photometer (R² = 0.9704) under all test conditions. The distribution of particle size was found to be the same inside and outside the respirator in almost all cases. Conclusion: Based on the obtained data, the PortaCount may be applicable for the determination of workplace protection factor.

Background: Protection from yellow dust and particulate matter is ensured by the use of respirators among the Korean citizens and workers. However, the manikins used to test the performance of the same were manufactured considering western facial specifications owing to which they do not represent Korean facial characteristics. Methods: Analysis of the data from the 6th 3D anthropometric survey of Koreans (Size Korea; 2010-2013) of 4,583 people aged 7 to 69 years was performed to obtain their facial dimensions. We subsequently clustered 44 facial measurements using Design X software, followed by the creation of the cluster centroid. Results: Three 3D head forms were developed-small, medium, and large, and their images were stored in ".stl" format for 3D printing. The facial widths and lengths of the three head forms were 127.1 mm × 90.6 mm, 143.2 mm × 104.0 mm, and 149.1 mm × 120.2 mm, respectively. Conclusion: We developed manikin head forms according to the facial dimensions of the Korean population, which was essential in evaluating respiratory protective equipment. These head forms can be used to test the performance of respirators considering the facial dimensions of the Korean population.

Background: Residential and commercial cleaning is a part of our daily routine to maintain sanitation around the environment. Health care of professionals involved in such cleaning activities has become a major concern all over the world. The present study investigates the risk of musculoskeletal disorders in professional cleaners involved in floor mopping tasks. Methods: A cross-sectional study was performed on 132 mopping professionals using a modified Nordic questionnaire. The Pearson correlation test was implemented to study the association of perceived pain with work experience. The muscle strain and postural risk were evaluated by means of three-channel electromyography and real-time motion capture respectively of 15 professionals during floor mopping. Results: Regarding musculoskeletal injuries, risk was reported majorly in the right hand, lower back, left wrist, right shoulder, left biceps, and right wrist of the workers. Work experience had a low negative association with MSDs in the left wrist, right wrist, right elbow, lower back, and right lower arm (p < 0.01). Surface EMG showed occurrence of higher muscle activity in upper trapezius and biceps brachii (BB) muscles of the dominant hand and flexor carpi radialis and BB muscles of the nondominant hand positioned at the upper and lower portion of the mop rod, respectively. Conclusion: Ergonomic mediations should be executed to lessen the observed risk of musculoskeletal injuries in this professional group of workers.

Background: The current lack of the number of nurses and high nurse turnover rate leads to major problems for the health-care system in terms of cost, patient care ability, and quality of care. Theoretically, burnout may help link emotional labor with turnover intention. The purpose of this study was to investigate the mediating effect of burnout in the association between emotional labor and turnover intention in Korean clinical nurses. Methods: Using data collected from a sample of 606 nurses from six Korean hospitals, we conducted a multiple regression analysis to determine the relationships among clinical nurses' emotional labor, burnout, and turnover intention, looking at burnout as a mediator. Results: The results fully and partially support the mediating role of burnout in the relationship between the subfactors of emotional labor and turnover intention. In particular, burnout partially mediated the relationship between emotional disharmony and hurt, organizational surveillance and monitoring, and lack of a supportive and protective system in the organization. In addition, we found that burnout has a significant full mediation effect on the relationship between overload and conflicts in customer service and turnover intention. Although the mediating effect of burnout was significantly associated with the demands and regulation of emotions, no significant effects on turnover intention were found. Conclusion: To reduce nurses' turnover, we recommend developing strategies that target both burnout and emotional labor, given that burnout fully and partially mediated the effects of emotional labor on turnover intention, and emotional labor was directly associated with turnover intention.

Background: It is well known that the prevalence of obesity in Korea is increasing over time, however it is not known how the trends among occupational groups and sex differ in such increasing trends. This study was designed to provide recent trends of obesity among workers in Korea and to identify whether there were differences among occupational groups. Methods: We used data from the Korean National Health and Nutrition Examination Survey, Phases I to VI (19982015), to analyze trends in the prevalence of obesity in adult Korean workers. Obesity was defined as a body mass index of 25 kg/㎡ or higher. Occupations were classified into 3 groups: (a) nonmanual workers, (b) service/sales workers, and (c) manual workers. Results: During the period of the Korean National Health and Nutrition Examination Survey Phases I to VI, the prevalence of obesity in male workers increased in all occupations (31.1% to 39.5% in manual workers, 32.3% to 38.2% in service/sales workers, and 25.3% to 39.7% in manual workers). However, female workers did not show any particular tendency toward obesity, except for a significant decrease in the prevalence rate in service/sales workers (30.8% to 23.9%, p for trend = 0.0048). Conclusion: The trends of obesity prevalence by sex and occupation were different. For male manual workers, the prevalence rate increased steadily during the data period, while it decreased steadily in female sales/service workers.

Background: Presenteeism has emerged as an important health-related issue and has been studied in a variety of occupation groups. This study examines the relationship between emotional labor and presenteeism in nurses in Republic of Korea. Methods: As a cross-sectional study, our study was conducted on 328 female nurses participating in the fourth Korean Working Conditions Survey (2015). Nurses were identified by the Korean Industry Classification Code. Multivariable logistic regression analysis was performed to explore the association between emotional labor and presenteeism. Results: Female nurses who always or sometimes hide their emotions in the workplace were found to have a high risk for presenteeism compared with female nurses who rarely hide their emotions in the workplace {odds ratio [OR] = 2.40 [95% confidence interval (CI) 1.04-5.54]; OR = 4.12 [95% CI 1.72-9.84], respectively}. Furthermore, the risk of presenteeism was higher in nurses who sometimes engaged with complaining customers compared with nurses who rarely did so, but it lacked statistical significance. Conclusion: Presenteeism in nurses can cause various negative secondary effects; therefore, an alternative should be sought to mediate nurses' emotional labor to prevent presenteeism.

Background: Ammonia and hydrogen sulfide are harmful gases generated during aerobic/anaerobic bacterial decomposition of livestock manure. We evaluated ammonia and hydrogen sulfide concentrations generated from workplaces at livestock farms and determined environmental factors influencing the gas concentrations. Methods: Five commercial swine farms and five poultry farms were selected for monitoring. Real-time monitors were used to measure the ammonia and hydrogen sulfide concentrations and environmental conditions during the manure-handling processes. Monitoring was conducted in the manure storage facility and composting facility. Information on the farm conditions was also collected through interview and walk-through survey. Results: The ammonia concentrations were significantly higher at the swine composting facilities (9.5-43.2 ppm) than at other manure-handling facilities at the swine and poultry farms, and high concentrations of hydrogen sulfide were identified during the manure agitation and mixing process at the swine manure storage facilities (6.9-19.5 ppm). At the poultry manure-handling facilities, the ammonia concentration was higher during the manure-handling processes (2.6-57.9 ppm), and very low hydrogen sulfide concentrations (0-3.4 ppm) were detected. The air temperature and relative humidity, volume of the facility, duration of manure storage, and the number of animals influenced the gas concentrations. Conclusion: A high level of hazardous gases was generated during manure handling, and some levels increased up to risk levels that can threaten workers' health and safety. Some of the farm operational factors were also found to influence the gas levels. By controlling and improving these factors, it would be possible to protect workers' safety and health from occupational risks.

Background: The poultry industry in Pakistan has flourished since the 1960s; however, there are scarce data regarding the impact of occupational exposure on the pulmonary health of farm workers in terms of years working in the industry. The objective of the present study was to assess the effect of poultry environment on the health of occupationally exposed poultry farmers in countries of warm climatic regions, such as Pakistan. This study will also show the effect of exposure to poultry facilities on the health of poultry farmers in the context of low-income countries with a relatively inadequate occupational exposure risk management. Materials and methods: The lung function capacity of 79 poultry workers was measured using a spirometer. Along with spirometry, a structured questionnaire was also administrated to obtain information about age, height, weight, smokers/nonsmokers, years of working experience, and pulmonary health of farm workers. The workers who were directly involved in the care and handling of birds in these intensive facilities were considered and divided into four groups based on their years of working experience: Group I (3-10 months), Group II (1-5 years), Group III (6-10 years), and Group IV (more than 11 years). The forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and the FEV1/FVC ratio were considered to identify lung function abnormalities. Statistical analysis was carried out using independent sample t test, Chi-square test, Pearson's correlation, and linear regression. Results: Based on the performed spirometry, 68 (86 %) of workers were found normal and healthy, whereas 11 (14 %) had a mild obstruction. Of the 11 workers with mild obstruction, the highest number with respect to the total was in Group IV (more than 11 years of working experience) followed by Group III and Group II. Most of the workers were found healthy, which seems to be because of the healthy survivor effect. For the independent sample t test, a significant difference was noticed between healthy and nonhealthy farmers, whereas Chi-square test showed a significant association with height, drugs, and working experience. Linear regression that was stratified by respiratory symptoms showed for workers with symptoms, regression models for all spirometric parameters (FVC, FEV1, and FEV1/FVC) have better predictive power or R square value than those of workers without symptoms. Conclusion: These findings suggest that lung function capacity was directly related to years of working experience. With increasing number of working years, symptoms of various respiratory problems enhanced in the poultry workers. It should be noted that most of the poultry workers were healthy and young, the rationale being that there is a high turnover rate in this profession. The mobility in this job and our finding of 86% of the healthy workers in the present study also proposed healthy worker survivor effect.