Background Concerns about long term low-dose radiation exposure from living in the vicinity of Wolsong nuclear power plant (NPPs) have persisted for decades. Tritium, a mildly radioactive isotope of hydrogen released from NPPs, can contribute to internal radiation exposure through ingestion or inhalation. This study assessed internal tritium exposure and associated behavioral and environmental factors among residents living near the Wolsong NPP in Korea. Methods A cross-sectional survey was conducted from June to July 2022 among 1,421 residents within a 5-km radius of the Wolsong NPP. Tritium was measured by 960 participants, and biological samples and detailed questionnaires were collected to assess tritium exposure and associated factors. Results A geometric mean of 960 residents was 4.32 Bq/L (arithmetic mean: 10.16 Bq/L), with a detection rate of 77%. The detected group showed higher proportions of NPP entry (10.4% vs. 4.1%, p=0.004) and underground water use for cooking (14.5% vs. 11.4%, p=0.01), with marginal significance for local seafood consumption (p=0. 06). Also, entering NPP (OR=3.07, 95% CI=1.50-6.31) and using purified tap water for cooking (OR=2.13, 95% CI=1.34-3.40) were significantly associated with tritium detection. Additionally, in 3 group sensitivity analysis, only entering the NPP had significant results. A spatial gradient was also observed, with higher concentrations near the NPP and lower concentrations farther away (region A to H: 6.31 to 2.72 Bq/L). Conclusions These findings highlight the importance of continued biomonitoring and evidence-based public health management to better understand internal tritium exposure among populations residing near facilities.
Background Exposure to hydrofluoric acid (HF) can cause systemic poisoning due to transdermal fluoride penetration (TFP). Therefore, accidents involving HF demand immediate first-aid measures. We investigated different skin-decontamination sequences and their impact on TFP in an ex-vivo human skin model. Methods Viable human skin was exposed to 30% HF for 1 min in a static diffusion-cell model, and TFP was observed for 72 h. We compared the efficiency of different decontamination sequences, consisting of a first acute decontamination phase and a second subacute decontamination phase, using various acute and subacute decontamination agents at different skin temperatures (26°C and 32°C). Results Despite quick decontamination, significant fluoride penetration was observed within the first hours of exposure across all decontamination scenarios.Acute phase: The choice of decontamination agent had minimal effect on TFP, while reducing the skin temperature from ∼32°C to ∼26°C significantly decreased fluoride absorption.Subacute phase: Decontamination with a calcium gluconate gel, with or without HEPES, significantly reduced TFP by 25% and 28%, respectively (at 32°C), compared to no additional intervention. The combination of calcium gluconate–HEPES gel and reduced skin temperature achieved a significant 52% reduction in TFP at 72 h compared to no subacute decontamination at 32°C (when primary decontamination was kept identical). Conclusion The findings from our ex-vivo experiments indicate that removal of HF by any possible means is vital in the acute phase, and that subsequent gel decontamination during the subacute phase may offer an additional benefit by reducing systemic absorption from the intradermal fluoride depot.
Background Vietnam is undergoing rapid industrial transition, with the occupational health burden shifting from accidents to work-related diseases. To strengthen occupational safety and health, the government enacted the National Program on Occupational Safety and Health (Decision 659/QD-TTg). This study assessed mid-term implementation using the WHO Health System Building Blocks framework. Methods We conducted a mixed-methods mid-term evaluation. Phase 1 used administrative data from all 63 provinces and centrally governed cities, including a 2020 baseline and 2021–2025 implementation data. Indicators were grouped into four WHO-adapted domains: governance, financing, service delivery, and information systems. Quantitative data were analyzed using descriptive statistics, trend analysis, and achievement rates against program targets. Phase 2 involved field verification in six purposively selected provinces; qualitative feedback from provincial occupational health officials was analyzed thematically. Results Provincial policy commitment increased, with approved action plans rising from 46.2% of provinces in 2020 to 88.5% in 2025. Budget allocation also expanded, although disbursement remained inconsistent. Service delivery was uneven: environmental monitoring exceeded targets, with an achievement rate of 143.4%, whereas occupational disease screening reached only 46.6% of planned targets. Information systems showed limited digitization, with completion rates below 20%, potentially contributing to under-ascertainment of occupational diseases, particularly among workers in SMEs. Conclusion Decision 659 strengthened governance and resource mobilization but has not yet translated these inputs into effective occupational health surveillance and service coverage. For 2026–2030, priorities should include digitizing the OSH registry, strengthening occupational disease detection, and shifting from punitive inspection toward technical support for SMEs.
Background The global escalation of disasters presents mental health concerns. However, disaster research primarily focuses on direct traumatic exposure, with less attention devoted to understanding how disruptions of public services after disasters are associated with psychological distress among workers from different employment sectors. Methods We analyzed one wave of the U.S. Census Bureau Household Trends and Outlook Pulse Survey (HTOPS), a cross-sectional survey of 3,971 employed respondents conducted from February 21 to March 7, 2025, to assess how disaster-related disruptions to essential services are associated with mental distress across diverse employment sectors. Mental distress was measured using the Patient Health Questionnaire-4 (range: 0–12). Results Safety service disruption showed the strongest positive association with mental distress (β = 0.071, p < 0.001), followed by social service disruption (β = 0.046, p < 0.05). Direct disaster impacts (displacement and property damage) and other service-disruption domains, including food, water, and infrastructure services, were not statistically associated with mental distress (p > 0.10). Public-sector (β = 0.116, p < 0.01) and non-profit workers (β = 0.094, p < 0.05) reported significantly higher mental distress than private-sector employees, whereas self-employed workers did not differ substantially. Public-sector employees exhibited amplified vulnerability to safety disruptions (interaction β = 0.117, p < 0.001), with no significant sectoral moderation observed for social service disruption. Conclusion Safety and social service disruptions were positively associated with post-disaster psychological distress rather than direct disaster impacts, with public-sector workers showing heightened vulnerability. Disaster preparedness should prioritize rapid service restoration and integrate sector-specific mental health interventions into planning frameworks.
Background Occupational injury surveillance typically depends on cases recognized as work-related, whereas health insurance claims capture treated injuries without prior attribution to work. Whether associations between claims-based injury prevalence and establishment size or industry differ across diagnostic categories and presumed mechanisms is not well established. Methods In this nationwide cross-sectional study, we analyzed National Health Insurance Service claims linked to establishment data for 11,212,512 Korean wage workers. Cases required ≥3 claims for the same three-character ICD-10 category in 2021. For all eligible categories, standardized prevalence and adjusted odds ratios were estimated by establishment size and industry; a representative subset was grouped by presumed mechanism after estimation. Results For ≥1,000 versus 5–29 workers, mechanical-group categories had lower odds (adjusted ORs, 0.33–0.72), including wrist/hand crushing injury (0.33) and external-eye foreign body (0.36). Ergonomic-group categories had slightly higher odds (1.15–1.17), but the corresponding prevalence gradients were absent when cases required ≥1 inpatient day for the category. The biomechanical comparator was null (1.00), and wrist/hand burns had the highest odds in Hotels and Restaurants versus Manufacturing (2.08). Conclusion Analysis at the category level identified patterns that diagnostic blocks obscured. Although claims cannot establish work-relatedness, they may help prioritize occupational investigation in smaller establishments and selected sectors. The ergonomic associations require confirmation. Linking claims with occupational exposure, injury-circumstance, and compensation data could identify work-related injuries absent from compensation records, complement official statistics, and inform policies addressing healthcare-access differences across worker and workplace characteristics.
Background Safety audits are commonly used as assurance and learning mechanisms, yet little is known about what their documented corrective actions actually improve. If audit actions mainly produce local paperwork improvements, then audits may verify compliance without substantially testing the controls or organizational conditions that shape risk. Method This exploratory study assessed 448 corrective actions from 65 health and safety audit reports sourced from two large engineering and construction companies, encompassing internal audits alongside reports from 16 independent external auditing firms. Actions were coded against two complementary dimensions: the strength of the risk control implied by the hierarchy of controls, and the organizational level targeted using Rasmussen’s risk management framework. Results Corrective actions were concentrated in administrative controls and at project management, staff, and work levels. No actions were coded to company management, client, regulator, or government levels. Few actions required verification of field risk control effectiveness. Conclusion While these findings do not, by themselves, establish that audits fail as assurance mechanisms, they do suggest that documented corrective actions were concentrated at lower levels, privileging local paperwork and visible conditions over higher-order controls and upstream organizational influences.
Background Maintaining healthcare worker (HCW) work ability and continuing employment are critical issues. We examined the association of work ability with the previously unexamined work-environment factors of organizational support for safety (OSS) and surface-acting emotional labor (SaEL). Methods A self-administered survey covering work-environment features recruited employees of five U.S. public-sector healthcare facilities in 2018-2019 and 2021. Linear regression on the outcome of work ability, both cross-sectionally and longitudinally, focused on OSS and SaEL with additional independent variables. Results A total of 1,059 and 1,553 surveys were collected from predominantly female HCWs; 425 answered both questionnaires. Almost two thirds of the HCWs were either non-direct care or unlicensed HCWs. Work ability scores were lower in direct-care workers versus non-direct-care workers. In multivariable regression models, OSS was positively associated with work ability, and SaEL was negatively associated, cross-sectionally at baseline and follow-up. Job strain, back pain, and safety hazards were also negatively associated with work in both cross-sectional and longitudinal analyses, while social support and civility norms (combined) were positively associated. In the longitudinal analysis, only OSS positively predicted work ability, while SaEL had a borderline negative effect. Conclusion The finding that OSS predicts work ability is novel. Despite high turnover, there has been little examination of risk factors for low work ability among HCWs. The importance of this organizational predictor justifies organization-level interventions to improve workplace safety. Such actions could simultaneously address and mitigate the additional risk factors of SaEL, job strain, and back pain in order to improve work ability for all groups of HCWs.
Introduction Human immunodeficiency virus (HIV) and tuberculosis (TB) remain global health challenges. Health workers (HWs), particularly laboratory HWs who handle infectious samples, face increased occupational risks of infection. Laboratory HWs are essential for disease diagnosis and monitoring, yet their health is endangered by workplace exposures to HIV and TB, potentially leading to workforce depletion and compromised healthcare delivery. Despite existing guidelines and policies for access and implementation of effective occupational health services (OHS), including hazard identification, medical surveillance, and postexposure preventive treatment, these are often obstructed by resource limitations. Objective This review paper discusses the morbidity of HIV and TB among laboratory HWs, and explores the enablers and barriers to accessing HIV and TB OHS. Methods A literature search was conducted using the EBSCOhost databases. Relevant keywords identified studies related to HWs, specifically laboratory HWs. Eligible studies were organised using a flow diagram, resulting in 13 papers. Data concerning morbidity, enabling factors, barriers, and recommendations were extracted using a modified tool. Results Studies consistently demonstrate a high prevalence of latent TB Infection and active TB among laboratory HWs handling mycobacteria. Barriers to accessing OHS are more frequently reported than enablers, and HIV data specific to laboratory HWs were limited. Recommended interventions include enhanced surveillance, stronger OHS programmes, and integrating OHS and infection control. Conclusion Despite growing evidence, gaps remain in implementation, and further studies are needed to assess the real-world application of recommended measures.
Background Occupational solar ultraviolet radiation (UVR) exposure is a major risk factor for keratinocyte carcinomas in outdoor workers. Individual causal attribution for medico-legal purposes requires partitioning risk contributions between occupational exposure and individual susceptibility factors—a question distinct from population-level burden estimation. This study is primarily a quantitative/methodological application of FAIR to occupational UV-related skin cancer. Methods This methodological framework study applies the FAIR approach (Filtering evidence, Association quantification, Individual partitioning, Reasoned interpretation) to occupational solar UVR and skin cancer. Meta-analyses (1995–2025) were reviewed and adjusted for phototype, sex, and immune status. Individual attribution was estimated using game-theory–based decomposition (Shapley values) and stochastic Monte Carlo simulation to propagate uncertainty. Preventive scenarios incorporated sector-specific compliance and long-term economic modeling. Results Mean occupational causal shares were 35% for squamous cell carcinoma (SCC), 25% for basal cell carcinoma (BCC), 10% for melanoma, and 50% for actinic keratosis. The probability of exceeding the 20% medico-legal attribution threshold reached 85% for SCC and 75% for BCC. Prevention reduced expected cases by 10-15% and healthcare costs by 8-12%. Conclusions The FAIR framework provides a transparent, reproducible approach for integrating epidemiological evidence with individual attribution. These quantitative thresholds support the clinical and medico-legal recognition of work-related skin cancers.
Background The Republic of Korea introduced the Serious Accidents Punishment Act (SAPA) in 2021 to improve workplace safety by holding company leaders legally accountable for serious accidents but its impact on injury trends has not been well established. This study evaluated SAPA’s effect on age–sex-standardized injury incidence rates (ASRs) in the Republic of Korea’s manufacturing sector, examining differences by company size (≥50 vs. <50 employees), sex, and injury type (inpatient vs. outpatient). Methods Using National Health Insurance Service Cohort data (January 2011–April 2024), we employed interrupted time-series design to assess SAPA’s effects from January 2022. Injury data (International Statistical Classification of Diseases and Related Health Problems, 10th Edition: S00–T88) were standardized using the 2015 Republic of Korea Statistical Information Service population. Generalized least squares regression analysis with an autoregressive moving average structure was performed to analyze ASR trends across subgroups. Results Following SAPA implementation, nonsignificant decreases in both inpatient and outpatient ASR were observed among men in companies with 50 or more employees. Among women, inpatient ASR showed opposite patterns according to company size; however, after Benjamini–Hochberg adjustment for multiple comparisons, these effects did not retain significance in the full 2011–2024 dataset. A sensitivity analysis restricted to 2017–2024 suggested that the increase in <50-employee companies may represent a robust signal in the more recent period. Conclusion SAPA implementation was not associated with statistically significant changes in injury rates in most subgroups after multiple testing adjustment, consistent with the early post-implementation experience of analogous international legislation. Exploratory subgroup analyses suggested differential responses by sex and company size, necessitating longitudinal research to evaluate the law’s long-term preventive effects.
Background Delivery gig workers face elevated risks of occupational injury, yet little is known about how working time exposures contribute to injury risk and the pathways underlying this association. This study examined the associations between multiple dimensions of working time exposures and occupational injury and whether sleep quality represented an indirect pathway co-occurring with these associations. Methods Using cross-sectional survey data from 1,537 delivery gig workers in Shanghai, China, we examined the associations between three dimensions of working time exposures (daily working hours, weekly working days, and night-shift frequency) and occupational injury. Sleep quality was examined as a potential indirect pathway based on the Effort–Recovery Model. We estimated a series of regression models and used bootstrap methods to decompose direct and indirect associations while adjusting for sociodemographic and job-related covariates. Results Longer daily working hours and more frequent night shifts were directly associated with higher occupational injury counts. Weekly working days and night-shift frequency showed significant indirect associations with occupational injury through poorer sleep quality. Robustness checks using a binary injury indicator yielded consistent results. Conclusion Working time exposures are associated with occupational injury risk among delivery gig workers through both direct exposure–related associations and indirect pathways involving sleep quality. Interventions and policies targeting excessive working hours, night work, and sleep quality may help reduce injury risks in this vulnerable transport workforce.
Background Fit testing is essential to evaluate the effectiveness of respiratory protective equipment for ensuring occupational safety. The Republic of Korea currently lacks a standardized fit test panel that reflects domestic facial characteristics, although international guidelines emphasize its establishment. This study aimed to validate a Korean fit test panel developed according to international standards and to examine the consistency of fit test results between human participants and headforms with comparable facial dimensions. Methods The panel was developed using facial anthropometric data from 11,429 adults in the Size Republic of Korea database based on ISO 16976-2:2022(E). Fifty participants representing the panel categories underwent quantitative fit testing with various respirator models. Fit test pass rates of human participants and headforms were evaluated against the U.S. National Personal Protective Technology Laboratory ( 2015) criterion of 64–76% to determine the panel’s applicability. Results Participants with medium-to-large faces achieved significantly higher fit factors with large respirators (p < 0.05), whereas those with small faces exhibited lower fit for small-sized models. Significant differences were observed across respirator size categories (p < 0.05), with full-face types showing higher pass rates than half-face types. Human fit tests exceeded the National Personal Protective Technology Laboratory criterion (76–100%), supporting the panel’s international applicability. In contrast, headform-based testing produced lower fit factors, particularly for small respirators. Intraclass correlation coefficient analysis revealed poor agreement (<16%) between human and headform results. Conclusion The Korean fit test panel appears to represent population-specific facial dimensions and shows potential for respirator evaluation under the tested conditions. However, differences between participants and headform outcomes indicate the need for improved headform fidelity to enhance test reliability.
This study aimed to identify the psychosocial characteristics and occupational stressors unique to workplace suicides by comparing them with suicides occurring at residences and other locations. Based on variables extracted through a structured coding scheme, we analyzed 472 national workers' compensation claims for suicide in the Republic of Korea (2010–2019) using multinomial logistic regression analysis. Relative to both residences and other locations, 99 workplace suicides showed significantly higher odds of occupational stressors, such as increased working hours and lack of organizational support. Compared with residential suicides, workplace suicides were significantly associated with nonpermanent employment, the absence of prior psychiatric and clinical histories, the presence of a suicide note, organizational injustice or irrationality, and unpaid wages. Workplace suicides may reflect a response to organizational injustice and inequality, necessitating comprehensive organizational interventions and enhanced psychosocial support within the workplace environment.
Background Long commutes are recognized as an occupational health risk and road safety. In high-traffic countries, prolonged commuting may represent a potentially significant yet underexplored public health concern, particularly with respect to gender-specific vulnerability patterns. This study thus examines the association between weekly commute time, weekday sleep duration and driving fatigue via a gender-based analysis. Methods Drawing data relating to 3,387 employed adults from the 2023 Israel Social Survey. Long commuting was defined as ≥15 hours/week. 20.2 percent of the survey respondents were long commuters, 54.7 percent women and 45.3 percent men. Outcomes measured included insufficient sleep duration (<6.5 hours) and self-reported driving fatigue. Multivariable logistic regression models were stratified by gender and adjusted for demographic and work-related variables. Results Long commuting was linked to insufficient sleep duration (OR=1.56) and increased driving fatigue (OR=1.71) amongst women and with driving fatigue (OR=2.13) but not significantly with sleep duration amongst men. Health behaviours differed according to gender, women with long commutes engaging in more physical activity (46.2% vs. 40.3%) and exhibiting lower obesity rates (18.1% vs. 19.3%), men being less active, more obese, and smoking more frequently. Conclusions Extended weekly commuting appears to be an independent gender-specific occupational health risk factor, exerting effects on sleep, fatigue, and health behaviors. Women report more sleep disruption while men experience higher fatigue and adverse health behaviors. These findings highlight the need for gender-sensitive health interventions, flexible work policies, improved transportation infrastructure and recognition of commuting as an important modifiable determinant of worker health.
Background: Despite growing evidence on the effects of workplace gender discrimination (WGD) and gender composition on workers’ mental well-being, little is known about how these two factors interact to shape overall well-being. This study aims to investigate the joint effect of WGD and gender composition on the risk of poor well-being among Korean workers. Methods: We used data from the 6th (2020) and 7th (2023) waves of the Korean Working Conditions Survey (n= 62,642). We assessed both multiplicative and additive interactions between WGD (no vs. yes) and gender composition (gender balanced vs. gender imbalanced) in relation to mental well-being (good vs. poor). Interaction on the multiplicative scale was evaluated using the multiplicative measure along with p value, whereas interaction on the additive scale was assessed using the relative excess risk due to interaction, the attributable proportion, and the synergy index. Results: WGD was strongly associated with poor well-being, with a higher risk observed among workers in gender-imbalanced workplaces [odds ratio = 2.96, 95% confidence interval (CI): 2.38 to 3.69] than among those in gender-balanced workplaces (odds ratio = 1.38, 95% CI: 0.92 to 2.05). Evidence of both supramultiplicative (multiplicative measure = 2.09, 95% CI: 1.33 to 3.28, p value<0.01) and supra-additive effects (relative excess risk due to interaction = 1.56, attributable proportion = 0.53, S = 4.82) was found. These statistically significant effects remained among women, whereas no significance was observed among men. Conclusion: The interaction between WGD and gender-imbalanced workplace environments was associated with poorer worker well-being. These findings underscore the importance of addressing both discriminatory practices and structural gender composition to address worker well-being.
Background:Public officials face diverse job-related hazards, yet systematic approaches to identify risk factors are limited in the Republic of Korea. This study developed a risk assessment tool to evaluate occupational risk factors among public officials and describes its development process and practical use. Methods:We conducted text analysis of injury/illness narratives from 25,317 approved compensation claims (2019-2023) to extract and classify key risk factors. The tool was designed as a first-tier self-assessment in which respondents rate the frequency and intensity of exposure to each risk factor on a 4-point Likert scale. The product of the two scores yields a four-level risk rating. The tool was developed in Microsoft Excel and consists of six worksheets. Results:Text analysis of the claim narratives identified 24 risk factors (psychological 5, organizational 2, ergonomic 5, physical 7, chemical 3, and biological 2); collision/fall risk was the most common (54.7%). In the Excel-based tool, users rate frequency and intensity for each item, which automatically generates a four-level risk rating. Items rated as high/very high prompt entry of detailed work situations. The tool also allows the addition of extra risk factors and provides guidance on second-tier in-depth assessments for high-risk results. Conclusion:This tool may help public officials across diverse job types easily screen job-related risk factors. Further studies should evaluate its usability and applicability across public service occupations.
Background:The occurrence of multiple cases of hematopoietic cancers (HC) among subway train maintenance workers (MWs) at a municipally owned metro company prompted an investigation into their association with this maintenance work. Objectives:We aimed to evaluate the occurrence of HC among MWs relative to the general population and to examine the association between job characteristics, past benzene exposure, and HC risk. Methods:A cohort of 4,438 MWs was analyzed for the period 2005-2024. HC cases were identified through self-reporting and coworker reports obtained from a structured questionnaire survey. Diagnoses were confirmed via follow-up interviews. Respective benzene exposure was assessed using a job-exposure matrix (JEM) based on maintenance type and the historical use of thinners. Standardized incidence ratios were calculated to compare HC occurrence among MWs with that of the general population, and Cox proportional hazards ratio (HR) was employed to evaluate HC risk. Results:A total of eleven HC cases were identified, including leukemia (n = 4) and non-Hodgkin lymphoma (n = 7). The HC incidence risk among MWs was not significantly elevated compared with the general population. MWs classified with "definite" past benzene exposure probability had a significantly higher risk of HC than those with "possible" exposure (HR = 3.58, 95% confidence interval [CI] = 1.09-11.75). Although qualitative benzene exposure levels suggested a potential association with HCs (HR for "high" group = 3.09, 95% CI = 0.69-13.84 and HR for "moderate" = 2.22, 95% CI = 0.55-8.93 vs. "low"), the results were not statistically significant. Conclusion:Extended follow-up and additional case identification among MWs are required to clarify maintenance-specific associations with HC risk.
This study aimed to share the case caused by N,N-Dimethylacetamide (DMAC) exposure. We report a 30-year-old man who died from DMAC exposure-induced acute liver failure after working in the cutting and cleansing of hollow fibre membranes for 5 days. While he was exposed to low-level DMAC by inhalation as the measurement of periodic working environment monitoring, considering his working method, considerable DMAC exposure via dermal absorption was suspected. Therefore, short-term, short-latency DMAC exposure via dermal absorption can cause fatal acute liver failure owing to idiosyncratic reactions.
Background:High coal dust exposure threatens miners' occupational health and safety. While dust control is mainly implemented by enterprises, miners' active participation is crucial for effective collaborative prevention. This study develops a feature reduction, genetic algorithm, and backpropagation (RS-GA-BP) hybrid evaluation model integrating behavioral and psychosocial factors to quantitatively assess collaborative dust prevention performance in coal mines. Methods:Guided by the theory of collaborative dust prevention among coal miners, this study incorporated human factors into the evaluation framework of prevention effectiveness. Using the rough set method, five key influencing factors were identified from twelve candidate variables. A prediction model for collaborative dust prevention effectiveness (RS-GA-BP) was then developed and applied by optimizing the BP neural network with a genetic algorithm. Results:The results indicated that technical context, conformity tendency, group cohesion, group driving force, and group dissipative force were the principal factors influencing collaborative prevention outcomes. Based on 955 survey responses from front-line coal miners, the model was trained and validated. The results showed that the GA-BP model outperformed the traditional BP model in terms of root mean square error, mean absolute error, and mean absolute percentage error, achieving a prediction accuracy of 95.73%. Conclusion:The research results indicate that the RS-GA-BP model can effectively evaluate the dust prevention and control effectiveness among coal miners, thereby enriching the methodological framework for assessing dust prevention effectiveness in coal mines.
