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Standards for recognition and approval rate of occupational cerebro-cardiovascular diseases in Korea
Ui-Jin Kim1,2, Won-Jun Choi1,2,3, Seong-Kyu Kang1,2,3
1Department of Medicine, Graduate School of Gachon University, Incheon, Korea.
Insights
Amendments to regulations in Korea have improved the approval rate for occupational cardiovascular and cerebrovascular diseases (CCVDs) linked to overwork. Further strategies are needed to reduce CCVD incidence.
Area of Science:
- Occupational Health
- Public Health
- Cardiology
Background:
- High working hours in Korea contribute to occupational cardiovascular and cerebrovascular diseases (CCVDs).
- Overwork-related CCVDs impose a significant social burden in Korea.
- This study examines regulatory changes impacting occupational CCVD approval rates.
Purpose of the Study:
- To investigate the impact of regulatory amendments on the approval rates of occupational CCVDs in Korea.
- To analyze trends in CCVD mortality in relation to employment status and regulatory changes.
Main Methods:
- Analysis of Korean Acts and public notices regarding occupational CCVD recognition standards.
- Utilized Ministry of Employment and Labor yearbooks for regulatory data.
- Estimated CCVD mortality using national death statistics, employment data, and population registries.
- Applied the Kaplan-Meier method to estimate cumulative CCVD mortality.
Main Results:
- Occupational disease recognition expanded to include major CCVDs like myocardial infarction and aortic dissection.
- Introduction of 'chronic overwork' concept in 2013.
- Approval rates for occupational CCVDs fluctuated, decreasing to 12.9% in 2011 and rising to 41.3% in 2018 after regulatory improvements.
- Overall CCVD mortality showed a decreasing trend from 2000-2017 for both employed and unemployed populations.
Conclusions:
- Cardiovascular and cerebrovascular diseases are recognized as occupational illnesses in Korea.
- Regulatory changes, including the establishment of the Occupational Disease Adjudication Committee and working hour reductions, have influenced approval rates.
- Strategic interventions are necessary to further decrease the incidence of occupational CCVDs.
Background:
Although working hours have decreased in Korea, they are still high compared to that of other countries. In Korea, cardiovascular and cerebrovascular diseases (CCVDs) related to overwork in Korea continually occur, and the social burden from overwork is estimated to be high. This study investigated the amendment of regulations affecting the approval rate of occupational CCVDs.
Methods:
The change in approval rate of occupational CCVDs and related regulations were investigated using the Act and public notice on the standards for recognition of occupational CCVDs and the yearbooks of the Ministry of Employment and Labor. The CCVD mortality was estimated using data on the number of deaths according to the cause of death, the number of employed people, and resident registration population aged 15-64 years. The cumulative mortality of CCVDs was estimated using the Kaplan-Meier method.
Results:
Since the establishment of the standards for recognition in Korea in 1982, the scope of occupational diseases has been expanded to include intracerebral hemorrhage, subarachnoid hemorrhage, cerebral infarction, myocardial infarction, and aortic dissection. In 2013, the concept of working hours was introduced in chronic overwork. The approval rate of occupational CCVDs was 44.7% in 2006, which decreased to 12.9% in 2011. After the improvement of related regulations, the approval rate increased to 41.3% in 2018. From 2000 to 2017, the CCVD mortality of both the unemployed and employed tended to decrease, and their cumulative CCVD mortalities were 549.3 and 319.7 per 100,000 people, respectively.
Conclusions:
CCVDs are recognized as occupational diseases in Korea. The amendments to the standards for recognition, the introduction of the Occupational Disease Adjudication Committee, the principle of presumption, and the reduction of working hours have changed the approval rate of occupational CCVDs. A strategic approach is needed to further reduce the incidence of CCVDs.
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