Studies on the health status according to the life style and working condition of petroleum refinery workers in South Korea (2012-2016)

Abstract

Introduction: The petroleum refinery industry handles a variety of complex chemical substances and employs a large number of people around the world. According to previous research, diseases caused by exposure to chemicals were quite common among workers in refineries until the 1980s. More recently, it is unusual for oil refinery workers to suffer from these serious diseases. However, there is a lack of research that reflects each organizational department’s characteristics regarding general diseases or health habits.

Objective: The objective of this study was to identify the occurrence level of general diseases and any differences in lifestyle habits of workers in refineries in Korea compared with the general population. The second objective was to investigate the degree to which chemical exposure affects general diseases in the workplace.

Methods: In this study, we used the results of health examinations from 2012 to 2016 for workers at a large oil refinery in South Korea. In addition, based on the results of KNHANES from 2012 to 2014 as representative of the population, hypertension, diabetes, anemia, hyperlipidemia, liver function abnormality, and kidney function abnormality were calculated using the standardized incidence rate (SIR). Data from 2012 to 2016 were analyzed using a modified generalized estimating equation (GEE), which is a logistic regression analysis method.

Results: The SIR was calculated for regular salaried workers in the KNHANES. Hypertension showed a low result with an SIR of less than 1, but that of the case of abnormal liver function group showed higher. Results analyzed using the GEE method showed significant results in hypertension with an odds ratio of 1.613 and a 95% confidence interval of 1.009-2.580 in the MEK, TDI, and welding fume exposure departments. In the trichloroethylene exposure category, the odds ratio of hyperlipidemia occurrence was 1.498, and the 95% confidence interval was 1.039 - 2.160, showing significant results. In the toluene and xylene exposure department, the odds ratio for the occurrence of hyperlipidemia was 2.618 and the 95% confidence interval was 1.460-4.694, showing significant results. A significant odds ratio of 2.613 was obtained when the results were reanalyzed for workers who had abnormal liver function.

Conclusion: This study was conducted on workers in a large oil refinery in Korea, and is the first one to identify correlations between general diseases and lifestyle habits. The workers’ occurrence rates of hypertension, hyperlipidemia, kidney dysfunction, and anemia were lower than those of ordinary salaried employees; however, their occurrence rate for abnormal liver function was markedly higher. In lifestyle habits, the smoking rate of workers was low while the alcohol consumption rate was quite high. With regard to chemical exposure in each department, when workers were exposed to toluene and xylene, the occurrence rate of hyperlipidemia was high. This study has improved the understanding of the health status of workers in a large oil refinery in Korea, and has shown the impact of chemical exposure and lifestyle habits related to the work environment on chronic diseases.

서론: 정유업은 다양한 복합 화학물질을 다루는 산업으로 세계적으로 많은 수의 근로자가 근무하고 있는 산업이다. 또한 현대 산업사회의 근간이 되는 주요 산업으로 그 중요성은 계속 높아지고 있다. 1980년대 이전까지 정유공장에서 일하는 근로자에서 화학 물질 노출에 의한 질병 발생이 흔하였으며 특히 과거에 시행된 코호트 연구들은 백혈병과 같은 중대 질병 발생과의 연관성을 규명해 왔다. 중대 질병을 발생 시키는 물질들에 대한 연구는 많이 이루어져서 현재 보호장구 착용과 물질 노출 기준이 강화 되었다. 근래에는 정유공장에 일한다고 하더라도 이러한 중대 질환에 의하여 고통받는 경우는 드물다. 그러나 일반 질병이나 건강 습관에 대한 부서별 특성을 반영한 연구는 부족한 실정이다. 외국과는 현저히 다른 우리나라 정유공장의 특성상 업무 환경을 반영한 일반 질환에 대한 건강영향을 살펴 보는 것이 본 연구의 목적 중 하나이며 또한 일반 인구 집단과 비교한 대표적인 만성 질환의 발생을 보는 것도 본 연구의 목적이 될 수 있다. 궁극적으로 이를 통하여 우리나라 대형 정유공장 근로자에서 취약한 만성 질병에 대한 실질적인 관리 대책을 마련할 수 있도록 하는 것이 본 연구의 가장 큰 목적이다. 연구목적: 이 연구의 첫번째 목적은 국민건강영양조사를 이용하여 일반근로자의 만성질환 유병률 산출을 통한 정유공장 근로자들의 만성질환 표준 유병률을 산출하여 상대적으로 취약한 질환을 확인하는 것이다. 또한 만성질환 발생에 영향을 주는 노출물질별로 분류된 부서특성의 영향을 분석하고 일반 생활습관에 따른영향을 분석한다...