Work-related Cardiovascular Diseases and Insurance Compensation

Excessive job demands and long working hours can increase cardiovascular disease mortality. Cardiovascular disease (CVD) is a compensable disease in Korea, when it is exacerbated by job stress or heavy workloads.  CVD was not included in the list of occupational diseases until 1993. In the early 1990s, a case of cerebral infarction was accepted as occupational disease by the Supreme Court. The decision was based on the concept that workers’ compensation system is one of the social security systems. In 1994, the government has established a diagnostic criterion of CVD. The compensated cases dramatically increased and reached its peak in 2003. Since then, many preventive activities were performed by the government and employers. As a result, the compensated cases have slowly decreased since 2003 and sharply decreased after 2008 when the diagnostic criterion was amended.  To be compensated for a work-related CVD, one should satisfy two conditions; one is cardio-cerebrovascular disease and the other is a working condition that is proven to be stressful or too much work for the worker. Working condition can be categorized as the following: 1) In cases where a significant physiologic change occurs due to sudden work environment change during the past 24 hours before occurrence, 2) When there is physical and mental overload, where the level of disturbance negatively affects the normal function of cerebral and cardiac vessels due to rapid increase in workload during the past 7 days before occurrence, 3) In the cases where physical and mental burden significantly impacts on normal function of cerebral and cardiac vessels due to chronic overloads during past 3 months before occurrence.  In conclusion, the strategic approach for prevention of CVDs in occupational health is essentially needed regardless of the work-relatedness because they are common, serious and preventable diseases, which lead to economic burden to society.