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      Prevalence and Risk Factors of Occupational Skin Disease in Korean Workers from the 2014 Korean Working Conditions Survey

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          Abstract

          Purpose

          Occupational skin disease (OSD) is a commonly known occupational disease. However, epidemiological data about this condition in Korea are limited. We aimed to estimate the prevalence and risk factors of OSD using nationally representative data.

          Materials and Methods

          We used data from the large-scale, cross-sectional, nationwide 4th Korean Working Conditions Survey conducted in 2014. OSD was defined as skin diseases caused or aggravated by working environments as indicated in a self-reported questionnaire. Factors affecting the occurrences of OSD were investigated using logistic regression analysis.

          Results

          The prevalence rates of OSD were 1.35% in all workers and 62.2% in workers with skin diseases. The workers with OSD were older, had lower educational levels, and had longer working times per week than those without OSD ( p<0.001). Furthermore, OSDs occurred more frequently in self-employed workers ( p=0.002), those with small-sized businesses ( p=0.008), those with longer working durations ( p<0.001), and manual and service workers ( p<0.001). Although the workers with OSD had greater exposure to various hazardous factors, logistic multivariate analysis showed that high temperatures and skin contact with chemical products were significantly correlated (odds ratios: 2.096 and 2.326, respectively). High prevalence rates of OSD were observed in membership organizations/repair/other personal services (3.2%), agriculture/forestry/fishing (2.7%), manufacturing (2.0%), and construction (1.6%) industries. Additionally, depression/anxiety problems were significantly more prevalent in workers with OSD than in those without ( p<0.001).

          Conclusion

          This is the first study to present large-scale epidemiological data on OSD prevalence in Korean workers. Our results highlight modifiable factors contributing to the development of OSDs.

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          Most cited references29

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          Psychiatric and psychological co-morbidity in patients with dermatologic disorders: epidemiology and management.

          Psychiatric and psychological factors play an important role in at least 30% of dermatologic disorders. In many cases the impact of the skin disorder upon the quality of life is a stronger predictor of psychiatric morbidity than the clinical severity of the disorder as per physician ratings. Furthermore, in certain disorders such as acne and psoriasis, the psychiatric co-morbidity, which can be associated with psychiatric emergencies such as suicide, is an important measure of the overall disability experienced by the patient. The severity of depression and increased suicide risk are not always directly correlated with the clinical severity of the dermatologic disorder. Consideration of psychiatric and psychosocial factors is important both for the management, and for some aspects of secondary and tertiary prevention of a wide range of dermatologic disorders. It is useful to use a biopsychosocial model which takes into account the psychological (e.g. psychiatric comorbidity such as major depression and the impact of the skin disorder on the psychological aspects of quality of life) and social (e.g. impact upon social and occupational functioning) factors, in addition to the primary dermatologic factors, in the management of the patient. Some dermatology patients are likely to benefit from psychotherapeutic interventions and psychotropic agents for the management of the psychosocial comorbidity, in addition to the standard dermatologic therapies for their skin disorder.
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            The Validity and Reliability of the Second Korean Working Conditions Survey

            Background The aim of this study was to evaluate the quality of the Second Korean Working Conditions Survey (KWCS), focusing on its validity and reliability. Methods The external validity was evaluated by the assessment of sampling procedures and the response rate, in order to investigate the representativeness of the sample. The content validity was evaluated by the assessment of the development of the questionnaire, and the consistency of questions for the selected construct. The test-retest method was used to evaluate the reliability by means of a phone call survey of 30% of the respondents, who were randomly selected. The respondents' satisfaction regarding the survey procedures and interview time were analyzed to evaluate the quality of survey data. Results The external validity was assured by an acceptable sampling procedure, rigid multi-stage stratified cluster random sampling. The content validity was also guaranteed by a reasonable procedure for the development of the questionnaire with a pretest. The internal consistency of the questions for work autonomy was maintained, with 0.738 of Cronbach's alpha. The response rate of 36% was lower than that of the European Working Conditions Survey (EWCS), with a contact rate of 66%, compared to 76% for the EWCS. The matching rates of the five retested questions were more than 98% reliable. Conclusion The quality of the second KWCS was assured by the high external and content validity and reliability. The rigid sampling procedure and development of the questionnaire contributed to quality assurance. The high level of reliability may be guaranteed by the sophisticated field survey procedures and the development of a technical manual for interviewers. The technical strategies for a high response rate should be developed for future surveys.
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              Differences between the sexes with regard to work-related skin disease.

              Work-related skin disease is common and usually presents as hand eczema. From the Occupational Injury Information System in Sweden, as well as from registers of industrial injuries in other countries, it is evident that females report skin disease more often than males. Epidemiological studies of hand eczema also show that women are more often affected than men, in particular young women. The most common type of hand eczema is irritant contact dermatitis, which is often caused by wet work. Many female-dominated occupations involve extensive wet work, e.g., hairdressing, catering, cleaning and health-care work. These occupations are also high-risk occupations for hand eczema. Experimental studies of skin irritation have not confirmed differences between the sexes; thus, the higher prevalence of irritant contact dermatitis among females is most likely due to exposure, occupational and non-occupational. Nickel allergy is the most common contact allergy, which is most frequent in young females, and in 30-40% results over time in hand eczema. Hand eczema has an impact on quality of life and females seem to report a higher degree of discomfort than males. To achieve the optimal effect of preventive efforts regarding occupational skin disease, the focus for prevention should aim at reducing wet exposure.
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                Author and article information

                Journal
                Yonsei Med J
                Yonsei Med. J
                YMJ
                Yonsei Medical Journal
                Yonsei University College of Medicine
                0513-5796
                1976-2437
                01 January 2020
                23 December 2019
                : 61
                : 1
                : 64-72
                Affiliations
                [1 ]Occupational Safety and Health Research Institute , Korea Occupational Safety and Health Agency, Ulsan, Korea.
                [2 ]Department of Medical Humanities and Social Medicine, Kosin University College of Medicine, Busan, Korea.
                [3 ]Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
                Author notes
                Corresponding author: Gil-Soon Choi, MD, PhD, Department of Internal Medicine, Kosin University College of Medicine, 262 Gamcheon-ro, Seo-gu, Busan 49267, Korea. Tel: 82-51-990-6152, Fax: 82-51-990-3145, soonichoi@ 123456gmail.com

                *Jong-Sun Park and Eun-Kee Park contributed equally to this work.

                Author information
                https://orcid.org/0000-0001-8613-2386
                https://orcid.org/0000-0002-9240-1113
                https://orcid.org/0000-0003-0692-1639
                https://orcid.org/0000-0003-3466-3294
                Article
                10.3349/ymj.2020.61.1.64
                6938776
                31887801
                27a9b1dc-19df-4881-bf28-131176ecb839
                © Copyright: Yonsei University College of Medicine 2020

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 17 June 2019
                : 30 October 2019
                : 04 November 2019
                Categories
                Original Article
                Allergy

                Medicine
                occupational skin disease,occupational dermatitis,epidemiology
                Medicine
                occupational skin disease, occupational dermatitis, epidemiology

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