Annals of Occupational and Environmental Medicine

The Korean Society of Occupational & Environmental Medicine (대한직업환경의학회)
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Are Cerebrovascular and Cardiovascular Diseases among Employees Work-related?

근로자의 뇌, 심혈관질환의 업무관련성에 대한 고찰

Park, Jung-Sun
박정선

  • Published : 20051200
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Abstract

Cerebrovascular and cardiovascular diseases (CVDs) are a major cause of deaths among workers as well as in general population in Korea. The term 'Karoshi' in Japan represents work-related cerebrovascular and cardiovascular diseases (WR-CVD) due to excessive overwork. According to the Karaseks Demand-Control Model many prospective studies reported a significant association between working in jobs with high strain and increased likelihood of subsequent development of cardiovascular diseases. However, further understanding of the etiopathology of each different work-relatedness is needed to prevent WR-CVDs effectively. This review was planned to help the readers with knowledge on the etiopathology of the WR-CVDs. Based on the causal or triggering factors, work-relatedness in the literature can be classified into four types: 'accidental type (e.g. sudden cardiac deaths)', 'typical Karoshi type due to extreme overwork', 'maladaptation type due to dramatic change in job characteristics', and 'job stress type due to inherent characteristics'. Even though the outcome of each type is apparently similar, their causes and pathophysiologic mechanisms are quite different. In conclusion, the work-relatedness of CVDs among employees is very limited and usually works as a trigger rather than as the causal factors. A thorough understanding of the etiopathology of WR-CVDs can be very helpful in developing a prevention strategy.

근로자에게서 재직 중에 문제가 되는 뇌$\cdot$심혈관질환은 심근경색증, 돌연사와 같은 급성관상동맥증후군과 뇌경색 또는 뇌출혈과 같은 급성 뇌혈관질환이다. 최근까지의 관련 문헌 검토 결과 이러한 급성 뇌$\cdot$심혈관질환의 업무관련성에서 다른 직업병과는 달리 업무적 요인이 대개 직접적인 발병원인으로서 보다는 유발인자로 관여하는 것으로 보고되고 있다. 또한 문헌상 나타난 업무관련 뇌$\cdot$심혈관질환의 발병기전은 사고성, 급성 과로성, 한시적 스트레스성, 만성 스트레스성 등 대개 네 가지 유형으로 정리할 수 있었다. 따라서, 업무상 뇌$\cdot$심혈관질환의 발병 원인 및 기전을 단지 막연한 개념의 <업무상 과로>로 다룰 것이 아니라, 앞에서 정리한 몇 가지 발병 유형별로 특성화지어 구분하여 다룰 필요가 있다. 각각의 발병 유형은 각각 다른 특성의 스트레스가 발병에 관여하여 다른 유형의 발병기전을 만들어 내는 것이므로 결과는 비슷하게 또는 같게 보일지 몰라도 사실상 다른 유형으로 구별하여 다루는 것이 연구를 하거나 예방 전략을 수립하는데 크게 도움이 될 것이다.

Keywords

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