Annals of Occupational and Environmental Medicine

The Korean Society of Occupational & Environmental Medicine (대한직업환경의학회)
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Comparison of Cardiovascular Disease Status Between Large Scale Industry Office and Self Employed Male Workers

대규모 사업장 사무직 남성 근로자들과 자영업 남성 근로자들의 심혈관질환 이환에 대한 비교

  • Jang, Keun-Ho (Department of Occupational and Environmental Medicine, Chonnam National University College of Medicine) ;
  • Park, Won-Ju (Department of Occupational and Environmental Medicine, Chonnam National University College of Medicine) ;
  • Kim, Myeong-Bo (Department of Occupational and Environmental Medicine, Chonnam National University College of Medicine) ;
  • Lee, Dae-Kwang (Department of Occupational and Environmental Medicine, Chonnam National University College of Medicine) ;
  • Chae, Hong-Jae (Department of Occupational and Environmental Medicine, Chonnam National University College of Medicine) ;
  • Moon, Jai-Dong (Department of Occupational and Environmental Medicine, Chonnam National University College of Medicine)
  • 장근호 (전남대학교 의과대학 산업의학교실) ;
  • 박원주 (전남대학교 의과대학 산업의학교실) ;
  • 김명보 (전남대학교 의과대학 산업의학교실) ;
  • 이대광 (전남대학교 의과대학 산업의학교실) ;
  • 채홍재 (전남대학교 의과대학 산업의학교실) ;
  • 문재동 (전남대학교 의과대학 산업의학교실)
  • Published : 2011.06.30
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Abstract

Objectives: The aim of this study is to compare the cardiovascular disease status between large scale industry office and self employed male workers who have gaps in their intensive health management. Methods: The cross sectional study was carried out with subjects composed of 244 shipyard office male workers and 381 self employed male workers, aged 30 to 55 years. They were given a health exam in a general hospital from January 2007 to June 2009. Information was based on data from self-administered questionnaires, physical examination and laboratory results on blood samples. The degree of coronary artery calcification and stenosis was evaluated by a 64 channel multi-detector computed tomography angiography. Results: The prevalence of hypertension(p<0.01) and diabetes mellitus(p=0.02) and waist circumference( p<0.01) was significantly lower in the shipyard office workers than in self employed workers. Proper drinking(p<0.01) was more commmon in shipyard office workers. The rates of coronary artery calcification and stenosis were estimated to be 18.4% and 11.5% respectively for shipyard office workers and were significantly lower than the 26.5% and 21.5% for self employed workers. After adjustment for age, the probability of coronary artery stenosis in shipyard office workers was lower than in self employed workers (OR=0.56, 95% CI=0.35~0.90). Conclusions: The study results verified the benefits of a health promotion and intervention program and the healthy worker effect for cardiovascular diseases. More specifically, it verified the benefits regarding coronary artery stenosis in large scale industry office workers. This result should encourage the establishment of health promotion programs and the study of occupational epidemiology.

목적: 본 연구는 일개 대규모 조선소 사무직 남성 근로자를 대상으로 자영업 근로자들과 심혈관질환 위험요인 비교 및 실제 유소견률 비교를 통하여, 보건관리를 받는 대규모 사업장의 근로자의 건강 상태를 비교분석하고자함이다. 방법: 연구대상자는 2007년 1월부터 2009년 6월까지 건강진단을 목적으로 일개 대학 병원 건강증진센터에 내원한 30~55세 사이의 성인 남성 중 과거력 상 뇌혈관질환 및 심혈관질환 기왕력 자를 제외한, 일개 조선소 사무직 근로자 약 244명과, 자영업에 종사하는 381명을 비교집단으로 단면조사 연구를 실시하였다. 건강진단 과정으로 신장, 체중, 허리둘레, 혈압을 측정하고, 문진을 통해 연령, 흡연력, 음주력, 고혈압 기왕력, 당뇨병 기왕력 등 에 대한 정보를 수집하며, 혈액검사를 통하여 공복혈당 및 중성지방과 총콜레스테롤, 고밀도 콜레스테롤, 저밀도 콜레스테롤을 측정하였다. 또한, 64 channel MDCT(Multidetector Computed Tomography)를 시행하여 관상동맥 칼슘점수 및 칼슘침착유무, 관상동맥협착유무를 평가 및 비교하였다. 결과: 연구대상자들의 일반적 특성 중 일개 조선소 사무직 근로자가 자영업 근로자 집단에 비해 허리둘레가 짧았고(p<0.01) 기왕력상 고혈압(p<0.01) 및 당뇨병(p=0.02)이 적었으며, 생활습관 중 음주 자가 유의하게 많았지만(p<0.01), 음주자 중 적정음주자 비율은 더 높았다(p<0.01). 관상동맥 석회화와 협착증에서 자영업 근로자 집단은 각각 26.5%, 21.5%의 유소견률을 보였고, 조선소 사무직 근로자 집단은 18.4%, 11.5%의 유소견률을 보여, 조선소 사무직 근로자 집단이 유의하게 낮게 측정되었다. 연령을 보정한 후에도 조선소 사무직 근로자 집단에서 자영업 근로자 집단에 비해 관상동맥 협착 소견률은 0.56배(95% CI 0.35~0.90)로 유의하게 낮았다. 결론: 이상의 결과에서 대규모 사업장인 조선소 사무직 근로자의 경우 대부분의 심혈관계 위험 요인에서 자영업 근로자보다 건강한 상태를 보였으며, 관상동맥 협착 유소견률 또한 0.56배로 낮은 유의한 결과를 보였다. 이는 집중적 보건관리의 중요성 및 근로자 건강의 역학연구에서 나타나는 건강 근로자 효과를 잘 보여 주었으며, 추후 다른 만성질환을 바탕으로 추가 연구가 필요하다.

Keywords

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