Annals of Occupational and Environmental Medicine

The Korean Society of Occupational & Environmental Medicine (대한직업환경의학회)
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Factors for Approving Cerebrovascular Disorders and Cardiovascular Diseases as Work-related Diseases in Chronically Overworked Workers

만성과로 근무자의 업무상 뇌심혈관질환 승인여부에 영향을 미치는 요인

  • Ryu, Sang-Chul (Department of Occupational and Environmental Medicine, Hangang Sacred Hospital) ;
  • Kim, In-Suk (Department of Occupational and Environmental Medicine, Hangang Sacred Hospital) ;
  • Lee, Jong-Heon (Department of Occupational and Environmental Medicine, Hangang Sacred Hospital) ;
  • Won, Jong-Uk (Institute for Occupational Health, Yonsei University College of Medicine) ;
  • Jang, Tae-Won (Department of Occupational and Environmental Medicine, Hangang Sacred Hospital) ;
  • Kwon, Young-Jun (Department of Occupational and Environmental Medicine, Hangang Sacred Hospital)
  • 유상철 (한림대학교 한강성심병원 산업의학과) ;
  • 김인석 (한림대학교 한강성심병원 산업의학과) ;
  • 이종헌 (한림대학교 한강성심병원 산업의학과) ;
  • 원종욱 (연세대학교 의과대학 산업보건연구소) ;
  • 장태원 (한림대학교 한강성심병원 산업의학과) ;
  • 권영준 (한림대학교 한강성심병원 산업의학과)
  • Published : 2011.12.31
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Abstract

Objectives: This study was conducted to analyze the factors that affected the decision of claims for cerebrovascular disorders and cardiovascular diseases in chronically overworked workers, that submitted their claims after the reformation of approval standards in the Industrial Accident Compensation Insurance Act on 1 July 2008. Methods: Of 2909 cases, who claimed between January 1. and December 31. 2009, 1046 cases were selected based on their worker's compensation record and investigated following 6 provincial committees for work-related diseases. The approval rate and odds ratio were analyzed with respect to the general characteristics, past medical history and work-related information using a logistical regression and Student t-test. Results: Of the 1046 selected cases, the approval rate was 18.5%(194 cases). In the multivariate logistical regression analysis, the factors for approving cerebrovascular disorders and cardiovascular diseases as work-related diseases were found to be the average working time over the last 1 week, occupational category, gender, age, death or survival, the presence of an associated disease, claimed province, and smoking. Conclusion: Factors for approving claims of cerebrovascular disorders and cardiovascular diseases as work-related diseases were the average working time over last 1 week, gender, age, death or survival, claimed disease, presence of associated disease, claimed province, smoking.

목적: 2008년 7월 산업재해보상법 개정 후 뇌심혈관계 질환으로 업무상 질병 요양 신청자 중 만성 과로 사례들을 분석하여 업무상 재해 승인여부에 영향을 미쳤던 요인들을 파악하고 보다 합리적인 인정기준을 마련하는데 기여하고자 하였다. 방법: 전국 6개 지역 업무상질병 판정위원회(서울, 경인, 부산, 대전, 대구, 광주)에서 2009년도에 뇌심혈관 질환으로 산재요양 신청 사례 중 만성 과로 여부를 보기위해 본 연구에서 설정한 기준을 만족하는 1046건을 연구대상으로 하였다. 재해자 관련 기본특성과 발병경위 및 상병관련 사항, 동반질환, 업무관련 사항 등을 조사하였고 단변량 로지스틱 회귀분석 및 t-test를 이용 각 요인별 승인율의 차이 및 오즈비를 구하였다. 다변량 로지스틱 회귀분석을 이용하여 업무상 질병 승인에 기여하는 요인들에 대해서 최종 확인하였다. 결과: 연구대상 1046명 중 승인받은 경우는 194명(승인율 18.5%)이었으며, 단변량 로지스틱분석에서는 발병전 1주일간의 근무시간, 발병 전 12주 기간의 4주 평균 근무시간, 직종, 성별, 연령, 상병명, 사망유무, 동반질환, 흡연유무에 있어서 승인율이 통계적으로 유의한 차이가 있었다. 통계적으로 유의한 차이가 없었던 요인으로는 근무기간, 근무형태, 업무수행 중 발병여부이었다. 다변량 로지스틱분석에서 발병 전 1주일 근무시간이 길수록 승인율이 높았다(OR 1.24, 95%CI 1.20~1.28). 상병명은 뇌경색에 비해 뇌출혈만이 통계적으로 유의하게 높았고(OR 2.26, 95%CI 1.14~4.48), 발병후 생존한 경우보다 사망한 경우가 승인율이 높았다(OR 2.92, 95%CI 1.49~5.72). 동반질환이 없는 경우가 동반질환이 있는 경우보다 승인율이 높았고(OR 2.50, 95%CI 1.47~4.28), 성별의 경우 남자가 여자보다 승인율이 높았으며(OR 2.72, 95%CI 1.26~5.88), 담배를 피지 않는 사람이 담배를 피는 사람에 비해 승인율이 높았다(OR 2.16, 95%CI 1.27~3.67). 지역별 승인율의 차이는 6개 지역 중 승인율이 가장 낮은 지역에 비해 가장 높은 지역간에 큰 차이를 보였다(OR 10.68, 95%CI 3.69~29.18). 연령과 직종에 따른 승인율은 통계적으로 유의한 차이가 없었다. 결론: 만성과로로 뇌심혈관질환의 산재요양신청 사례중 인정에 영향을 주었던 요인들은 발병 전 1주일간 근무시간, 뇌출혈, 동반질환 여부, 흡연여부, 사망여부, 성별, 지역이었다. 인정기준에 있어서 만성과로에 대한 근무시간 기준, 업무스트레스와 업무강도에 대한 추후 연구가 필요할 것으로 판단된다.

Keywords

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