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      Work-related Cerebro-Cardiovascular Diseases in Korea

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          Abstract

          Cerebro-cardiovascular disease (CVD) is one of compensable occupational diseases in Korea as in Japan or Taiwan. However, most countries accept only cardiovascular diseases (ischemic heart diseases) as compensable occupational diseases if any, but not cerebrovascular diseases. Korea has a prescribed list of compensable occupational diseases. CVD was not included in the list until 1993. In the early 1990s, a case of cerebral infarction was accepted as occupational disease by the Supreme Court. The decision was based on the concept that workers' compensation system is one of the social security systems. In 1994, the government has established a diagnostic criterion of CVD. The crude rate of compensated cerebrovascular disease decreased by 60.0% from 18.5 in 2003 to 7.4 in 2008 per 100,000 workers, and that of compensated coronary heart disease decreased by 60.5% from 3.8 in 2003 to 1.5 in 2008 per 100,000 workers. The compensated cases of CVD dramatically increased and reached its peak in 2003. Since many preventive activities were performed by the government and employers, the compensated cases have slowly decreased since 2003 and sharply decreased after 2008 when the diagnostic criterion was amended. The strategic approach is needed essentially because CVDs are common, serious and preventable diseases which lead to economic burden.

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          Most cited references39

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          Workhours in relation to work stress, recovery and health.

          This paper aims at describing the associations between workhours and psychosocial work characteristics and reviews the health effects of workhours and the related pathways. The role of insufficient sleep as a possible common pathway from workhours and work stress to cardiovascular illness is discussed. Finally, the key possibilities for improving recovery and health through changes in workhours are identified. Night work and shift work are related to a wide range of health effects, the evidence for the risk of cardiovascular morbidity being the strongest. Insufficient or poor sleep, related to insufficient recovery, can be a common pathway from long workhours, shift work, and work stress to cardiovascular illness. The most promising worktime-related means for decreasing the psychosocial workload and negative health effects of workhours would be (i) to regulate overtime and excessive workhours, (ii) increase individual worktime control, and (iii) increase recovery from the introduction of sleep-promoting principles into shift rotation.
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            Prospective study of shift work and risk of coronary heart disease in women.

            The purpose of this study was to examine prospectively the relation of shift work to risk of coronary heart disease (CHD) in a cohort of women. An ongoing prospective cohort of US female nurses, in whom we assessed (in 1988) the total number of years during which they worked rotating night shifts (at least three nights per month in addition to day and evening shifts), included 79,109 women, 42 to 67 years old in 1988, who were free of diagnosed CHD and stroke. Incident CHD was defined as nonfatal myocardial infarction and fatal CHD. During 4 years of follow-up (1988 to 1992), 292 cases of incident CHD (248 nonfatal myocardial infarction and 44 fatal CHD) occurred. The age-adjusted relative risk of CHD was 1.38 (95% CI, 1.08 to 1.76) in women who reported ever doing shift work compared with those who had never done so. The excess risk persisted after adjustment for cigarette smoking and a variety of other cardiovascular risk factors. Compared with women who had never done shift work, the multivariate adjusted relative risks of CHD were 1.21 (95% CI, 0.92 to 1.59) among women reporting less than 6 years and 1.51 (95% CI, 1.12 to 2.03) among those reporting 6 or more years of rotating night shifts. These data are compatible with the possibility that 6 or more years of shift work may increase the risk of CHD in women.
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              Rotating night shift work and the risk of ischemic stroke.

              Rotating night shift work disrupts circadian rhythms and is associated with coronary heart disease. The relation between rotating night shift work and ischemic stroke is unclear. The Nurses' Health Study, an ongoing cohort study of registered female nurses, assessed in 1988 the total number of years the nurses had worked rotating night shifts. The majority (69%) of stroke outcomes from 1988 to 2004 were confirmed by physician chart review. The authors used Cox proportional hazards models to assess the relation between years of rotating night shift work and ischemic stroke, adjusting for multiple vascular risk factors. Of 80,108 subjects available for analysis, 60% reported at least 1 year of rotating night shift work. There were 1,660 ischemic strokes. Rotating night shift work was associated with a 4% increased risk of ischemic stroke for every 5 years (hazard ratio = 1.04, 95% confidence interval: 1.01, 1.07; P(trend) = 0.01). This increase in risk was similar when limited to the 1,152 confirmed ischemic strokes (hazard ratio = 1.03, 95% confidence interval: 0.99, 1.07; P(trend) = 0.10) and may be confined to women with a history of 15 or more years of rotating shift work. Women appear to have a modestly increased risk of stroke after extended periods of rotating night shift work.
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                Author and article information

                Journal
                J Korean Med Sci
                JKMS
                Journal of Korean Medical Science
                The Korean Academy of Medical Sciences
                1011-8934
                1598-6357
                December 2010
                15 December 2010
                : 25
                : Suppl
                : S105-S111
                Affiliations
                Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, Incheon, Korea.
                Author notes
                Address for Correspondence: Dae-Seong Kim, M.D. Center for Occupational Disease Research, Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, 478 Munemi-ro, Bupyeong-gu, Incheon 430-711, Korea. Tel: +82.32-510-0842, Fax: +82.32-518-0862, daisui@ 123456naver.com
                Article
                10.3346/jkms.2010.25.S.S105
                3023355
                21258582
                67b1c05c-f6c9-4e6d-84aa-5b31ea82fdf0
                © 2010 The Korean Academy of Medical Sciences.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 12 October 2010
                : 19 November 2010
                Categories
                Review
                Occupation & Environmental Medicine

                Medicine
                cardiovascular diseases,compensation,korea,cerebrovascular diseases,work-related,psychosocial factors

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