Occupational Health Issues and Social Security
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1 Occupational Health Issues and Social Security October 27, 2012 Seong-Kyu Kang Director General, Seoul Regional Office KOSHA (Korea Occupational Safety and Health Agency) Collegium Ramazzini
2 Collegium Ramazzini
3 Collegium Ramazzini
4 Collegium Ramazzini
5 Issues Cancers developed during employment or after leaving from work are not compensated as an occupational disease. Compensation system Independent insurance system - Responsibility of workplace (cause of disease) Tax-financed system - Covering a disease itself (outcome) Collegium Ramazzini
6 Compensation for Workers 1 st step Causal relationship between work and disease 2 nd step Unproven or unknown cases Social judgment or social consensus for compensation - Case of cerebrovascular diseases in Korea Collegium Ramazzini
7 Background A case of Leukemia in a semiconductor ind ustry Claimed for compensation in 2007 There was no known hematopoietic carcinogens - Benzene, Ionizing radiation One more case in the same unit Question Is the incidence or mortality of leukemia high in the semiconductor industry? Does any hematopoietic substances or agents exist in the factory? Collegium Ramazzini
8 Occupational Exposure Level of Benzene 1 ppm in most countries including Korea (amended in 2003 from 10 ppm) SPH SNU/SK Kang KOSHA 8
9 Epidemiologic Study Case review (2008) Cohort study (2008-9) Follow-up study ( ) Work Environment Work environment measurement (2007) Detailed Measurement (2007, 2011) Collegium Ramazzini
10 Chemicals in Assembly Processes : Will be published Collegium Ramazzini
11 Type of Sampling By floor: 1 st and 2 nd By time: two independent days By type: active sampling vs passive By period: TWA vs Short-term Collegium Ramazzini
12 Collegium Ramazzini
13 No significant exposure to hematopoietic carcinogenic substances Result Collegium Ramazzini
14 Collegium Ramazzini
15 Collegium Ramazzini
16 Case review didn t show any significant finding aggregation of cancer exposure to carcinogenic substances Collegium Ramazzini
17 Collegium Ramazzini
18 Methods Subjects All workers in the semiconductor industry - Current and retired Data sources Death certificate from National Statistical Office Cancer Registry Observation period Mortality ( ): 113,443 persons, 832,513 person-year Incidence study ( ): 108,943 persons, 718,849 person-year Collegium Ramazzini
19 Collegium Ramazzini
20 Collegium Ramazzini
21 Results Collegium Ramazzini
22 Study result There was no increase of leukemia Result (2008) Increase risk of Non-Hodgkins Lymphoma in female workers Collegium Ramazzini
23 Dispute about Benzene (2009) The investigation by an academia reported detection of benzene 8.9 ppm in a bulk sample Raised the public concern on the reliability of the epidemiologic study Action Detailed work environment measurement Lowered the detection limit of analysis from ppm to ppm - In 2009: Fabrication line - In 2011: Assembly line Collegium Ramazzini
24 Collegium Ramazzini
25 Collegium Ramazzini
26 In-depth Measurement for FAB Line (2009) Saf Health Work 2011;2: Collegium Ramazzini
27 Follow-study in 2011 (Assembly Line) factory Samples Air Benzene in Assembly line (ppm) GM AM Range B, Assembly L B, Assembly L C, Assembly P C, Assembly P Air Benzene level of the outdoor : ppm Collegium Ramazzini
28 Result Benzene is generated as a by-product during the process, but the air level is negligible Collegium Ramazzini
29 2012 FOLLOW-UP Healthy Worker Effect Mortality rate ratio between employees and general population Collegium Ramazzini
30 Employment Insurance Data Cohort ,342,815 (7,327,344(M), 4,015,471(F)) 141,442,957 person-year Mortality Rate Ratio Korea Standard Industry Classification Korea Standard Occupation Classification ICD-10 classification Reference General population from 1998 to Collegium Ramazzini
31 Preliminary Data Neoplasm (C00-D48) 96,852cases from Mortality Rate Ratio: M:0.84 ( ), 0.84 ( ) By industry High in public administration and social security, mining; low in banking and insurance in male High in swage and waste treatment, low in faming, forest and fishing in female By occupation High in simple laborers, famers and fishermen in male; low in high-ranking officers and managers, professionals By disease High in mesothelioma, respiratory cancer, endocrine cancer; low in thyroid cancer Collegium Ramazzini
32 Social Security System Occupational Non-occupational Source Industrial Accident Compensation Insurance National Health Insurance Medical expense 100% 50-80% Income loss 70% None Responsible agency Ministry of Labor Ministry of Health Collegium Ramazzini
33 Death by cancer (2010) 2010 Cause of death Number Mortality rate (per 100,000)) Hematopoietic cancer (C81-C96) 3, Non-Hodgkin s Lymphoma(C82-C85) 1, Multiple myeloma (C90) Leukemia (C91-C95) 1, Others ( C81- C96) Source: National Statistical Office Collegium Ramazzini
34 Cause of death at the age of Cause of death Occupation Non-Hodgkin s Lymphoma (C82-C85) None, housewife, student Others Worker Multiple myeloma (C90) None, housewife, student Others Worker Leukemia (C91-C95) None, housewife, student Others Worker Number of hematopoietic cancer in worker Source: National Statistical Office Collegium Ramazzini
35 Conclusions There is no excessive risk of hematopoietic cancer in the semiconductor industry. The dispute is caused by the compensation claim of the cases that the cause is not well proven or unknown in the new industry. Need to reform the social welfare system The risk of hematopoietic cancer in the semiconductor industry is questionable at present, but will be monitored and followed Collegium Ramazzini
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