This review examines the challenges associated with occupational disease surveillance in Korea, particularly emphasizing the limitations of current data sources such as the Industrial Accident Compensation Insurance (IACI) statistics and special health examinations. The IACI system undercounts cases due to its emphasis on severe diseases and restrictions on approvals. Special health examinations, although they cover a broad workforce, are constrained by their annual scheduling, which leads to missed acute illnesses and subclinical conditions. The paper also explores the history of occupational disease surveillance in Korea, highlighting the fragmented and disease-specific approach of earlier systems. The authors introduce the newly established Korea Occupational Disease Surveillance Center (KODSC), a comprehensive nationwide system designed to gather, analyze, and interpret data on occupational diseases through a network of regional centers. By incorporating hospital-based surveillance and focusing on acute poisonings and other sentinel events, the KODSC aims to overcome the limitations of previous systems and promote collaboration with various agencies. Although it is still in the early stages of implementation, the KODSC demonstrates potential for improving data accuracy and contributing valuable insights for public health policy.
Health and safety issues in micro and small enterprises (MSEs) are recognized as a global challenge. This study aimed to examine Workers' Health Centers (WHCs) as a representative public organization providing occupational health services to MSEs in Korea. WHCs were established in 2011 after a trial period aimed at addressing occupational diseases in MSEs with limited resources. As of 2024, there are 24 WHCs, 22 branch offices, and 23 trauma counseling centers for workers. These health centers are managed by the Korea Occupational Safety and Health Agency, with their actual operation delegated to private organizations. Each WHC employs an average of 13 staff members and is organized into four specialized teams: cardiovascular disease prevention, workplace environment improvement, musculoskeletal disease prevention, and occupational stress management. These centers also offer common basic programs along with region-specific specialized initiatives. In 2023, the total cumulative number of users reached 203,877, with employees from MSEs comprising approximately 88.5% of the total. WHCs can thus be seen as playing a pivotal role as case managers of health requirements in the workplace by fostering strong relationships with MSEs and linking them to other relevant programs through a problem-solving-oriented approach. Given the limited resources of these enterprises, proactive policies and the equitable application of safety and health regulations are essential. A balanced strategy that combines regulatory enforcement with practical assistance is critical to ensure the success of WHCs in improving health and safety conditions in MSEs.
This study explores the development, roles, and key initiatives of the Regional Environmental Health Centers in Korea, detailing their evolution through four distinct phases and their impact on environmental health policy and local governance. It chronicles the establishment and transformation of these centers from their inception in May 2007, through four developmental stages. Originally named Environmental Disease Research Centers, they were subsequently renamed Environmental Health Centers following legislative changes. The analysis includes the expansion in the number of centers, the transfer of responsibilities to local governments, and the launch of significant projects such as the Korean Children’s Environmental Health Study (Ko-CHENS ). During the initial phase (May 2007–February 2009), the 10 centers concentrated on research-driven activities, shifting from a media-centered to a receptor-centered approach. In the second phase, prompted by the enactment of the Environmental Health Act, six additional centers were established, broadening their scope to address national environmental health issues. The third phase introduced Ko-CHENS, a 20-year national cohort project designed to influence environmental health policy by integrating research findings into policy frameworks. The fourth phase marked a decentralization of authority, empowering local governments and redefining the centers' roles to focus on regional environmental health challenges. The Regional Environmental Health Centers have significantly evolved and now play a crucial role in addressing local environmental health issues and supporting local government policies. Their capacity to adapt and respond to region-specific challenges is essential for the effective implementation of environmental health policies, reflecting geographical, socioeconomic, and demographic differences.
, Shinjeong Song, Chang Mo Moon, Hye Ah Lee, Junbeom Park 
, Jeong-Ju Yoo, Sang Gyune Kim, Young Seok Kim Hepatocellular carcinoma (HCC) remains a critical health concern in Korea, ranking as the second leading cause of cancer mortality and imposing substantial economic burdens, particularly among the working-age population. This review examines recent advancements in treating advanced HCC, referencing the updated 2022 HCC guidelines and the Barcelona Clinical Liver Cancer system. Historically, first-line systemic therapies included sorafenib and lenvatinib, with regorafenib, cabozantinib, or ramucirumab serving as second-line options. Since 2020, immune checkpoint inhibitors have shown superior overall survival than sorafenib, leading to the adoption of combination therapies such as atezolizumab with bevacizumab and durvalumab with tremelimumab as first-line treatments. The IMbrave150 study demonstrated that atezolizumab–bevacizumab significantly extended median overall survival and progression-free survival, with the longest survival reported in any phase 3 trial for advanced HCC. Similarly, the HIMALAYA study indicated that durvalumab combined with tremelimumab significantly improved survival rates. Second-line therapies now include regorafenib, cabozantinib, ramucirumab, nivolumab with ipilimumab, and pembrolizumab, each offering benefits for specific patient populations. Nonetheless, these therapies are associated with side effects that require careful management. Traditional targeted therapies can lead to hypertension, cardiovascular events, and hand-foot skin reactions, whereas immune checkpoint inhibitors may cause immune-related adverse events affecting the skin, gastrointestinal tract, and endocrine system. Clinicians must be well-versed in these treatments and their potential side effects to provide optimal patient care. The emergence of combination therapies targeting complex biological pathways signifies a new paradigm in HCC treatment, emphasizing the importance of continuous education and vigilant monitoring to optimize patient outcomes.
This paper discusses the implications of South Korea's birth notification system and Protected Birth Act, which is set to take effect on July 19, 2024. The legislation aims to prevent infanticide and child abandonment by mandating birth reporting and allowing anonymous births for women in crisis. However, concerns have been raised about the Act's effectiveness in protecting both women and children, particularly regarding issues of disability and migrant families. This paper focuses on gender and healthcare issues, highlighting how the Act perpetuates discrimination against out-of-wedlock pregnancies and upholds normal family ideologies. It notes the absence of critical discussions on women's autonomy, safe pregnancy termination, and paternal responsibility. The importance of healthcare providers understanding and preparing for the Act's implementation is emphasized. The paper calls for strengthening social safety nets to improve healthcare access for vulnerable populations and eliminate discrimination against non-traditional families. Additionally, it addresses the need for comprehensive support systems for crisis pregnancies, including financial assistance, psychological support, parenting education, housing solutions, and expanded healthcare services. This paper acknowledges the Act's significance in providing a systematic state-level approach to protecting pregnant women in crisis, replacing the previous reliance on private organizations. Nonetheless, it also emphasizes the importance of continually reviewing and supplementing the system to address potential rights infringements and ensure its effectiveness. In conclusion, this paper advocates for ongoing discussions on gender and healthcare issues, and for future amendments to the law that reflect real-world circumstances and provide genuine protection for crisis pregnancies and infants.
Citations
, So Hyun Ahn, Hyeon Jong Yang, Seung Jung Kim, Yuhyeon Chu, Jihye Gwak, Naeun Im, Seoyeong Oh, Seunghyun Kim, Hye Soo Yun, Eun Hee Ha Citations
, Jin Hoon Nam, Jongmin Oh, Gyoung Tae Noh, Eunhee Ha, Ryung Ah Lee Citations
Infectious spondylitis, an infection of the vertebral body, intervertebral disc,
or paraspinal tissues, poses diagnostic and therapeutic challenges. This review
examines the clinical approach and management of infectious spondylitis in
Korea. The incidence of pyogenic spondylitis has increased, primarily due to the
aging population, more frequent use of invasive procedures, and higher
prevalence of immunocompromising conditions. Conversely, tuberculous spondylitis
has declined, reflecting shifts in population demographics and medical
practices.
, Pyoeng Gyun Choe The rise of multidrug-resistant organisms represents a serious global public health concern. In Korea, the increasing prevalence of carbapenem-resistant Enterobacterales (CRE) is particularly concerning due to the difficulties associated with treatment. Data from the Korea Global Antimicrobial Resistance Surveillance System indicate a yearly increase in CRE cases, with carbapenemase-producing Enterobacterales being the predominant type. The capacity of CRE to resist multiple broad-spectrum antibiotics leads to higher medical costs and mortality rates, underscoring the need for urgent action. Effective prevention is crucial to curbing CRE outbreaks and transmission. Antimicrobial stewardship programs (ASPs) play a key role and require commitment from healthcare professionals to minimize unnecessary antibiotic use, as well as from policymakers to ensure adherence to ASP guidelines. Given the complexity of CRE transmission, ASP efforts must be integrated with infection control strategies for maximum effectiveness. These strategies include adherence to standard and contact precautions, environmental disinfection, preemptive isolation, and comprehensive education and training for healthcare personnel. Additionally, surveillance testing for patients at high risk for CRE and the use of real-time diagnostic kits can facilitate early detection and reduce further transmission. Strategies for the prevention of CRE infection should be tailored to specific healthcare settings. Ongoing research is essential to update and refine infection control guidelines and effectively prevent CRE outbreaks.
Citations
, Yoon Jin Choi, Ji Yeon Byun, You Won Choi, Joo Young Roh, Hae Young Choi Nontuberculous mycobacterial infections, which are often acquired from environmental sources such as water and soil, exhibit a variety of cutaneous manifestations that frequently lead to misdiagnoses and delays in treatment. A 77-year-old woman presented with multiple skin lesions in a sporotricoid distribution on her right leg, which persisted despite standard antibiotic treatments. Based on the skin biopsy, revealing granulomatous inflammation with acid-fast bacilli, and PCR testing, a nontuberculous mycobacterial infection was diagnosed. Antimycobacterial drug combinations, including clarithromycin, isoniazid, and rifampicin for 4 months, complete the skin lesion's clearance. This case underscores the need for heightened suspicion and the use of appropriate diagnostic techniques, including tissue biopsies and molecular methods such as PCR.
Citations
This study analyzed drug-induced death statistics in Korea between 2011 and 2021.
Cause-of-death statistics data from Statistics Korea were examined based on the Korean Standard Classification of Diseases and Causes of Death and the International Statistical Classification of Diseases and Related Health Problems, 10th revision.
In 2021, there were 559 drug-induced deaths, marking a 172.7% increase compared to 2011, which recorded 205 deaths. The rate of drug-induced deaths per 100,000 people was 1.1 in 2021, up 153.6% from 0.4 in 2011. The mortality rate for men aged 25−34 years and women aged 35−44 years each increased fourfold from 2011 to 2021: from 0.3 to 1.2 for the former and 0.3 to 1.3 for the latter. Of the drug-induced deaths in 2021, 75.0% (419/559) were due to intentional self-harm, and 10.4% (58/559) were accidental. The number of deaths attributed to medical narcotics in 2021 was 169, a 5.5-fold increase from 2011. The most commonly implicated drugs in these deaths were sedative-hypnotic drugs, benzodiazepines, and opioids. Sedative-hypnotic drugs and benzodiazepines were frequently involved in cases of intentional self-harm, while opioids and psychostimulants were more often associated with accidental deaths.
The death rate from drug-induced causes is considerably lower in Korea than in the United States (1.1 vs. 29.2). However, the number of such deaths has increased recently. Since these deaths occur predominantly among younger age groups and are often the result of intentional self-harm, there is a clear need for systematic management and the implementation of targeted policies.
Citations
, Eun Mee Kim The Republic of Korea’s potential role in the peacebuilding process on the Korean Peninsula is explored, with the Democratic People’s Republic of Korea’s earnest efforts to denuclearize and become a normal country. The paper focuses on the United Nations (UN) agencies in the peacebuilding process, considering the UN’s engagement in the Democratic People’s Republic of Korea during the sanction years with humanitarian assistance, the UN’s legitimacy as an impartial international organization for assisting developing countries in forging peace and prosperity, and recently-adopted resolutions on sustaining peace and the Sustainable Development Goals. Policy recommendations are for the Republic of Korea to actively cooperate with the UN’s development and humanitarian agencies, conduct a thorough preparatory review and conduct research, and work towards expanding its engagement and role within key UN agencies.
Citations
, Taeyang Jang This study investigated the epidemiological and etiological trends associated with elbow pain over the past decade in South Korea.
Nationwide health statistics data from 2011 to 2020 pertaining to elbow pain-related diseases and soft tissue damages were sourced from the Healthcare Bigdata Hub with disease codes M771 (lateral epicondylitis), M770 (medial epicondylitis), S53 (elbow injury, dislocation, sprain), and G56 (mononeuropathies of the upper limb). The study assessed the annual fluctuations in the total medical cost and the number of patients associated with these codes. Trends over time were characterized by evaluating the crude and age-standardized prevalence rates and the annual percentage change. Changes in the proportion of medical expenses based on age distribution were also investigated.
A significant surge in medical costs was observed across all four codes. The M771, M770, and G56 codes experienced a pronounced increase in crude and age-standardized prevalence. Conversely, only S53 registered a significant drop in age-standardized prevalence. Moreover, within the total medical expenditures for the M771 code, the age bracket of 50 to 59 represented the largest proportion.
The data suggest that the average age of patients reporting elbow pain is rising. Given this shifting trend in South Korea's health statistics concerning elbow pain, there will be an increasing need for socioeconomic support, which will in turn necessitate improving health policies that address allocating medical expenses and resources for elbow pain.
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