• Journal of Environmental Health Sciences
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• v.37 no.5
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• pp.342-347
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• 2011

Healthy worker effect (HWE) refers to the consistent tendency for actively employed individuals to have a more favorable mortality experience than the population at large. Although HWE has been well known since the 1970s, only a few studies in occupational epidemiology have attempted to fully define and evaluate HWE. HWE can be separated into effects on the initial hiring into the workforce (healthy worker hire effect) and those on continuing employment (healthy worker survival effect). In this review, we summarize the methods for minimizingor adjusting for the healthy worker effect available in occupational epidemiology. It is noteworthy that healthy worker survival effect appears complicated, considering that employment status plays simultaneous roles as a counfounding variable and intermediate variable, whereas healthy worker hire effect may be adjusted by incorporating health status at baseline into the statistical model. In addition, two retrospective cohort studies for workers in the semiconductor industry and Vietnam veterans in Korea, respectively, were introduced, and their results were explained in terms of healthy worker effect.

• Proceedings of the Korean Statistical Society Conference
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• 2002.11a
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• pp.197-201
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• 2002

The healthy worker effect is an important issue in occupational epidemiology. We proposed a new statistical method to test the relationship between exposure and time to death in the presence of the healthy worker effect. In this study, we considered the healthy worker hire effect to operate as a confounder and the healthy worker survival effect to operate as a confounder and an intermediate variable. The basic idea of the proposed method reflects the length bias-sampling caused by changing one's employment status. Simulation studies were also carried out to compare the proposed method with the Cox proportional hazards models. According to our simulation studies, both the proposed test and the test based on the Cox model having the change of the employment status as a time-dependent covariate seem to be satisfactory at an upper 5% significance level. The Cox models, however, are inadequate with the change, if any, of the employment status as time-independent covariate. The proposed test is superior in power to the test based on the Cox model including the time-dependent employment status.

• 월간산업보건
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• s.67
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• pp.30-35
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• 1993

지난 호에 게재하였던 Formaldehyde와 nasal cancer의 관련성에 관한 글에서 볼수 있었던 바와 같이 SMR과 PMR은 산업보건역학연구에서 가장 흔히 접하게 되는 지수들이다. SMR을 설명하다 보면 heal worker effect를 설명하지 않을수 없게 된다. 이 글에서는 SMR, PMR, 그리고 healthy worker effect에 대한 설명을 하고자 하였다

• Journal of Environmental Health Sciences
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• v.40 no.5
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• pp.385-396
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• 2014

Objectives: By conducting a meta-analysis of cohort studies reporting standardized mortality ratios (SMRs) for workers exposed to trichloroethylene, we attempted to adjust for healthy hired effect by applying the same methods as described in a recent report from the Agricultural Health Study. Methods: Among all cohort studies that evaluated the association between all cancer, non-Hodgkin's lymphoma (NHL), kidney cancer, liver cancer and occupational exposure to trichloroethylene, a total of 10 studies reporting SMR values were selected. A random-effects model was used to estimate the summary SMRs or rSMRs and 95% confidence intervals. Relative SMR ($rSMR=SMR_x/SMR_{not\;x}$) was calculated comparing observed and expected counts for all cancer, NHL, kidney cancer, and liver cancer with an independent referent set of values consisting of the observed and expected counts for other causes. Results: The SMR values for all causes ranged from 0.68 to 1.03, suggesting moderate to weak healthy worker effect for the selected studies. When the healthy worker hire effect was taken into account, the summarized risk became statistically significant; the summary SMR of all cancer was 0.95 (0.91-1.00) and the summary rSMR of all cancer was 1.10 (1.04-1.15). The summary SMR of NHL was 1.04 (0.93-1.14) and the summary rSMR of NHL was 1.23 (1.04-1.46). The summary SMR of kidney cancer was 1.08 (0.88-1.33) and the summary rSMR of kidney cancer was 1.23 (1.02-1.49). The summary SMR of liver cancer was 0.88 (0.78-0.99), and the summary rSMR of liver cancer was 0.95 (0.84-1.07). Conclusion: The rSMR method is useful to determine summary risk adjusted for healthy worker effect through meta-analysis.

• Safety and Health at Work
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• v.10 no.4
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• pp.428-436
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• 2019

Background: Metalworking fluids (MWFs) are mixtures with inhalation exposures as mists, dusts, and vapors, and dermal exposure in the dispersed and bulk liquid phase. A quantitative risk assessment was performed for exposure to MWF and respiratory disease. Methods: Risks associated with MWF were derived from published studies and NIOSH Health Hazard Evaluations, and lifetime risks were calculated. The outcomes analyzed included adult onset asthma, hypersensitivity pneumonitis, pulmonary function impairment, and reported symptoms. Incidence rates were compiled or estimated, and annual proportional loss of respiratory capacity was derived from cross-sectional assessments. Results: A strong healthy worker survivor effect was present. New-onset asthma and hypersensitivity pneumonitis, at 0.1 mg/㎥ MWF under continuous outbreak conditions, had a lifetime risk of 45%; if the associated microbiological conditions occur with only 5% prevalence, then the lifetime risk would be about 3%. At 0.1 mg/㎥, the estimate of excess lifetime risk of attributable pulmonary impairment was 0.25%, which may have been underestimated by a factor of 5 or more by a strong healthy worker survivor effect. The symptom prevalence associated with respiratory impairment at 0.1 mg/㎥ MWF was estimated to be 5% (published studies) and 21% (Health Hazard Evaluations). Conclusion: Significant risks of impairment and chronic disease occurred at 0.1 mg/㎥ for MWFs in use mostly before 2000. Evolving MWFs contain new ingredients with uncharacterized long-term hazards.

• 대한예방의학회:학술대회논문집
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• 2002.10a
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• pp.190-191
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• 2002

• Journal of Family Resource Management and Policy Review
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• v.19 no.4
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• pp.163-181
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• 2015

This study focused on the Healthy Family Support Center and Multicultural Family Support Center, which supervise the main field of family resource management with institutional household factors. Our research objective was to present datas demonstrating an improvement in the organizational effectiveness of the Multicultural Family Support Center. The burn out average of employees working for the non-profit organization was 2.45, emotional burnout was 2.87, achievement was 2.43, and dehumanization was 2.06. The effectiveness average of the nonprofit organization was 3.56, profitability was 3.65, job satisfaction was 3.58, and organizational commitment was 3.45. The generic characters that caused burnout were age, information, and professionalism in research. The generic characters and burnout that affected the organizational effectiveness included a lack of accomplishment, and emotional exhaustion, and depersonalization, lack of information and professionalism, lack of external resources in that order. The purpose of this research was to determine the effects of burnout in order to prevent job changes and to provide basic data for the improvement of organizational effectiveness.

• Safety and Health at Work
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• v.11 no.1
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• pp.118-124
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• 2020

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.

• Journal of Family Relations
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• v.20 no.4
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• pp.157-172
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• 2016

Object: This study investigated the effect of self-esteem on depression through family relations satisfaction and tested whether working types would moderate such associations. Method: The subjects were 2,145 elderly who are healthy enough to work and were selected for the ninth Korean Welfare Panel Study. The resulting data were analysed by using the statistical program SPSS 2.1 with reference to steps for testing mediation by Baron and Kenny, moderated mediation by Heyes. Results: Self-esteem has both direct and indirect significant effects, revealing that family relations satisfaction fully mediates the effects of coping strategies of family conflict on depression. From the working types, self-employed/employer and unpaid family worker, moderate the indirect effect of self-esteem on depression through family relations satisfaction. Conclusions: In practical intervention of elderly depression reduction, efforts to increase family relations satisfaction is effective when it is difficult to us address satisfaction. Moreover, we have to provide intervention for elderly with work in context of relationship of individual and familial factor.

• Journal of the Korean Society for Aviation and Aeronautics
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• v.19 no.4
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• pp.99-104
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• 2011

Pilots are exposed to carcinogenic substances like radiation, ozone, exhaust gas from jet engine, and electromagnetic wave, their environment can be very hazardous. I designed this study to know if there is any difference between pilots and general people in cancer incidence. I analyzed cancer cases between 1999 and 2008, and investigated their age, site, aircraft types, and sex. I compared pilot's cancer incidence with general people during same periods. Statistical analysis was performed with standardized incidence ratio (SIR). 10 cases were high performance pilots, 5 cases were low performance pilots. The average age when the diagnosis had been made was $39{\pm}7.8$. Pilot's incidence ratio was lower than people's, the most common cancer was kidney, and there was no lung cancer. Cancer is influenced by gene and environment, each country has different patterns. The low incidence ratio in Korean pilots might be due to "healthy worker effect". I think we should perform further investigation on kidney cancer.