Work-related Cerebro-Cardiovascular Diseases in Korea

Introduction
Cerebro-cardiovascular disease (CVD) is a compensable condition in Korea as in Japan or Taiwan. However, most countries accept only cardiovascular diseases (ischemic heart diseases) as compensable occupational diseases if any, but not cerebrovascular diseases. Korea has a prescribed list of occupational diseases. CVD was not included in the list until 1993. We reviewed the history of compensation for CVD in Korea, the statistics of CVD and the government action for prevention.

Methods
To identify the effectiveness of prevention activities, we calculated the number of deaths of CVD in general and working population and compared it with the compensated work-related CVD. The data of compensated cases and all insured workers from 1996 to 2009 were obtained from our institute. Mortality data from 1983 to 2009 were obtained from Korea Nation Statistics Office.

Results
In 1994, the government has established a diagnostic criterion of CVD. The crude rate of compensated cerebrovascular disease was further decreased by 60.0% from 18.5 to 7.4 per 100,000 workers, and that of compensated coronary heart disease was decreased by 60.5% from 3.8 to 1.5 per 100,000 workers. The compensated cases of CVD dramatically increased and reached its peak in 2003. The compensated cases have slowly decreased since 2003 and sharply decreased after 2008 when the diagnostic criterion was amended.

Discussion
Korea has accepted CVD as an occupational disease, which are believed to be caused by long working hours, job stress or shift work. Increasing compensation of CVD has brought the economic burden and social concern that lead proactive prevention activities for lifestyle diseases of workers. They include controlling risk factors for the high risk group such as hypertension and health promotion for workers. Relevant legislation and guidelines for employers and employees have established.