Annals of Occupational and Environmental Medicine

The Korean Society of Occupational & Environmental Medicine (대한직업환경의학회)
권호 표지

A Workplace Cardiovascular Health Promotion Program and its Short-term Health Effects

뇌.심혈관질환 예방을 위한 사업장 지원 프로그램의 단기효과 분석

Kwak, Woo-Seok;Won, Jong-Uk;Rhie, Jeong-Bae;Lee, Myoung-Suk;Kang, Eun-Ju;Roh, Jae-Hoon
곽우석;원종욱;이정배;이명숙;강은주;노재훈

  • Published : 20090300
⟨ Previous Next ⟩

Abstract

Objectives: Cardiovascular disease is the leading cause of death and a major source of workers' compensation claims in Korea. Since 2000 the Korea Occupational Safety and Health Agency (KOSHA), working through local occupational health institutions, has supported cardiovascular disease prevention programs at a number of companies in Korea. The purpose of this study was to assess the short-term effects of this effort. Methods: A total of 11,077 workers at risk were enrolled in the workplace cardiovascular disease prevention program and 5,902 workers (53.3%) completed the 1-year course during 2007. The program consisted of a medical checkup and health counseling for the workers by occupational health nurses. The guidelines for this prevention program were adopted from KOSHA Code H-11-2004. To determine the program's effectiveness, the workers' risks for cardiovascular disease were assessed before and one year after completion of the program. Results: The intervention led to significant reductions in the mean systolic and diastolic blood pressures of 4.9 mmHg and 3.1 mmHg, respectively. Mean total cholesterol and BMI were also reduced significantly by 8.4 g/dl and 0.1 kg/m$^2$. The rate of smoking was decreased by 6.0% and the percentage of workers engaging in regular exercise was increased by 23.1%. Of the 3,530 workers with the low risk and above, the overall cardiovascular risk was improved in 1,734 (49.1%) of them. Conclusions: The cardiovascular disease prevention program supported by the Korea Occupational Safety and Health Agency reduces cardiovascular diseases risks among workers and may improve the health status of workers in Korea.

목적: 뇌 심혈관질환은 주요한 사망원인이며 우리나라 산업재해 보상에 있어 중요 부분을 차지하고 있다. 따라서 한국산업안전보건공단은 2000년도부터 지역 산업보건기관을 통해 많은 사업장에 뇌∙심혈관질환 예방 프로그램을 지원해왔다. 본 연구는 이 프로그램이 근로자의 뇌 심혈관질환 발병위험도 개선에 미치는 단기영향을 평가하고자 수행되었다. 방법: 2007년도 집중관리 프로그램 대상자 중 전후 발병위험도 평가가 가능했던 5,902명(53.3%)을 대상으로 혈압, 콜레스테롤, 비만도 및 발병위험도를 전후 비교하였다. 발병위험도 평가는 KOSHA CODE H-11-2004 지침을 사용하였다. 결과: 평균 수축기 및 이완기 혈압이 4.9 mmHg, 3.1 mmHg 감소하였으며 총콜레스테롤과 비만도(BMI)는 각각 8.4 g/dL, 0.1 kg/m$^2$ 감소하였다. 흡연율은 6.0% 감소하였으며 규칙적인 운동 시행률은 23.1% 증가하였다. 전체적인 발병위험도 개선율은 49.1%였다. 결론: 국가 지원의 뇌∙심혈관질환 예방 프로그램은 단기적으로 좋은 성과를 나타냈다. 향후 연구에서는 사업장 단위의 장기적인 영향과 비용-효과에 대한 분석이 이루어질 필요가 있다.

Keywords

References

  1. World Health Organization. Prevention of Cardiovascular Disease: Guidelines for Assessment and Management of Total Cardiovascular Risk. World Health Organization. Geneva. 2007
  2. Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med 2006;3(11):e442. (Electronic article) https://doi.org/10.1371/journal.pmed.0030442
  3. World Health Organization. Monitoring and Evaluation of Worksite Health Promotion Programs - Current State of Knowledge and Implications for Practice. World Health Organization. Geneva. 2008
  4. Korea National Statistical Office. Annual Report on the Cause of Death Statics 2007. Korea National Statical Office. Daejeon. 2008. (Korean)
  5. Ministry of Labor. Statistics of Industrial Accidents and Occupational Diseases in 2007. Ministry of Labor. Gwacheon. 2008. (Korean)
  6. Pearson TA, Blair SN, Daniels SR, Eckel RH, Fair JM, Fortmann SP, Franklin BA, Goldstein LB, Greenland P, Grundy SM, Hong Y, Miller NH, Lauer RM, Ockene IS, Sacco RL, Sallis JF Jr, Smith SC Jr, Stone NJ, Taubert KA. AHA guidelines for primary prevention of cardiovascular disease and stroke: 2002 update. Circulation 2002;106(3):388-91 https://doi.org/10.1161/01.CIR.0000020190.45892.75
  7. Ministry for Helath and Welfare, Korea Centers for Disease Control and Prevention. The Third Korea National Health and Nutrition Examination Survey (KNHANES III), 2005. Ministry for Helath and Welfare. Seoul. 2006. (Korean)
  8. Korea Centers for Disease Control and Prevention, Korea Institute for Health and Social Affairs. In-depth Analyses of the Third National Health and Nutrition Examination Survey: The Health Interview and Health Behavior Survey part. Korea Centers for Disease Control and Prevention. Seoul. 2007. (Korean)
  9. Centers for Disease Control and Prevention. Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit. Available: http://198.246.98.21/DHDSP/library/ toolkit/index.htm [cited 1 January 2009]
  10. Korea Occupational Safety and Health Agency. Cardiovascular Disease Prevention Assistance at Workplace (translated by Kwak WS). Available: http://www.kosha.or.kr/health/business08/step.jsp? menuId=1?menuId=2 [cited 1 January 2009]
  11. Matson-Koffman DM, Goetzel RZ, Anwuri VV, Shore KK, Orenstein D, LaPier T. Heart healthy and stroke free: successful business strategies to prevent cardiovascular disease. Am J Prev Med 2005;29(5S1):113-21
  12. Lee SY, Lee KS, Koo JW, Yim HW, Kim HR, Park CY, Choi SK. Effectiveness of tailored health promotion program for reducing cardiovascular risk factors in subway workers. Korean J Occup Environ Med 2006;18(1):15-24. (Korean)
  13. Korea Occupational Safety and Health Agency. KOSHA Code H-11-2004: Guidelines for Assessment and Management of Cardiovascular Risk at Workplace (translated by Kwak WS). Korea Occupational Safety and Health Agency. 2004. (Korean)
  14. Rose G. Sick individuals and sick populations. Int J Epidemiol 2001;30(3):427-32 https://doi.org/10.1093/ije/30.3.427
  15. Prior JO, van Melle G, Crisinel A, Burnand B, Cornuz J, Darioli R. Evaluation of a multicomponent worksite health promotion program for cardiovascular risk factors-correcting for the regression towards the mean effect. Prev Med 2005 ;40(3):259-67 https://doi.org/10.1016/j.ypmed.2004.05.032
  16. Chapman LS. Meta-evaluation of worksite health promotion economic return studies: 2005 update. Am J Health Promot 2005;19(6):1-11
  17. Lee KH, Lee KS, Hong HS, Song YE. The survey of worksite health promotion activities. Korean J Occup Health 2000;39(2):63-75. (Korean)
  18. Ministry for Helath and Welfare. Health Plan 2010. Ministry for Helath and Welfare. Seoul. 2005. (Korean)
  19. Linnan L, Bowling M, Childress J, Lindsay G, Blakey C, Pronk S, Wieker S, Royall P. Results of the 2004 national worksite health promotion survey. Am J Public Health 2008;98(8):1503-9 https://doi.org/10.2105/AJPH.2006.100313
  20. Mahon A, Kelleher CC, Helly G, Duffy E. Evaluation of a workplace cardiovascular health promotion programme in the Republic of Ireland. Health Promot Int 2002;17(4):297-308 https://doi.org/10.1093/heapro/17.4.297
  21. Centers for Disease Control and Prevention. Addressing the Nation's Leading Killers 2008. Available: http://www.cdc.gov/nccdphp/publications/AAG/pdf/dh dsp.pdf [cited 1 January 2009]
  22. Muto T, Yamauchi K. Evaluation of a multi-component workplace health promotion program conducted in Japan for improving employees' cardiovascular disease risk factors. Prev Med 2001;33(6):571-7 https://doi.org/10.1006/pmed.2001.0923
  23. O'Donnell MP. Health Promotion in the Workplace. 3rd ed. Delmar. New York. 2002. pp 1-22