Effectiveness of workers' general health examination in Korea by health examination period and compliance: Retrospective cohort study using nationwide data

Background: Our study evaluated the effectiveness of the Workers' General Health Examination by health examination period and compliance. Methods: A retrospective cohort of the health examination participants in 2006 (baseline year: N = 6,527,045) was used. We identified newly occurring cardio-cerebrovascular disease over 7 years (from 2007 to 2013). After stratification by age, sex, and national health insurance type, we identified 7 years' cumulative incidence of cardio-cerebrovascular disease by health examination compliance and estimated its relative risk by health examination period and compliance. Results: The compliant group presented a lower cumulative incidence of cardio-cerebrovascular disease than the non-compliant group; this result was consistent across sex, working age (40s and 50s), and workplace policyholder. Relative risk of cardio-cerebrovascular disease by health examination period (1 and 2 years) showed statistically significant results in ischemic heart disease for male participants. Of men in their 40s, office workers (over a 2-year period) presented statistically higher relative risk of ischemic heart disease than non-office workers (over a 1-year period: 1.03; 95% confidence interval, 1.02-1.03). However, there were no consistent results in ischemic cerebrovascular disease and hemorrhagic cerebrovascular disease for men or cardio-cerebrovascular disease for women. Conclusion: A 1-year period of Workers' General Health Examinations in non-office workers had a more significant prevention effect on ischemic heart disease than a 2-year period in office workers among working age (40s-50s) men. It is, however, necessary to consider that prevention of cardio-cerebrovascular disease can be partially explained by their occupational characteristics rather than by health examination period.