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◉ Workbear case detail — 대법원 2019두62604 · https://workbear.kr/precedents/9282 · Viewed 2026-10-27
대법원 2019두62604

Revocation of Disposition Denying Survivor Benefits and Funeral Expenses [Case on Recognition of Proximate Causation under the Industrial Accident Compensation Insurance Act (산업재해보상보험법)]유족급여및장의비부지급처분취소[산업재해보상보험법상 상당인과관계 인정 여부 사건]

Decided2020. 05. 28. Court대법원Reversed and remanded (파기환송) - the case was sent back to the lower court for reconsideration in light of the Supreme Court's reasoning, effectively favoring recognition of the death as a work-related accident.
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AI-generated English translation (summary, key points, decision summary and full text) for reference only — not an official translation and without legal effect. The Korean original below is authoritative.
AI Easy read — AI summary of this decision
AI-generated summary for reference only — the Korean original below is authoritative.

A 62-year-old shift worker suffered a first cardiovascular incident, returned to work after 11 days of medical leave, and died just before starting a night shift. The lower court had overlooked the connection to the first incident and ruled the death was not a work-related accident (업무상 재해), but the Supreme Court reversed and remanded the case for further review.

Key takeaways
  • CaseA 62-year-old shift worker suffered a cardiovascular incident, returned to work 11 days later, and died just before his next night shift.
  • OutcomeThe Supreme Court reversed the lower court's denial of survivor benefits, ruling that the second incident (death) could be a natural aggravation of the first work-related incident.
  • LessonWhen evaluating work-related accident claims, decision-makers must consider prior related health incidents cumulatively, especially for older workers with demanding shift schedules and chronic conditions.
Issues
  • Whether a causal link exists between the first and second cardiovascular incidents, and whether both should be recognized as work-related accidents (업무상 재해)
  • Whether there is proximate causation between long-term shift work, overwork, and the aggravation of a pre-existing cardiovascular disease
  • What degree of proof is required to establish causation for recognition of a work-related accident
Key reasoning

The Supreme Court held that if the first cardiovascular incident is recognized as a work-related accident, the subsequent death can reasonably be viewed as a natural progression or aggravation stemming from that first incident, rather than an unrelated event. It found it reasonable to conclude that the worker's long-term shift work and overwork, combined with his advanced age of 62, accelerated his pre-existing cardiovascular disease beyond its natural course. The Court emphasized that proximate causation (상당인과관계) for work-related accidents does not require strict scientific proof, but may be established through a reasonable and probable connection based on the overall circumstances, including workload, age, and health history. By ignoring the first incident entirely, the lower court failed to properly assess this cumulative causal relationship.

Summary of Decision (English, AI translation)

[1] To recognize “death due to occupational cause” as defined in Article 5, Subparagraph 1 of the Industrial Accident Compensation Insurance Act (산업재해보상보험법), there must be a causal relationship between the work and the disease that caused the death. However, even if the main cause of the disease is not directly related to the performance of duties, if work-related overwork or stress at least overlapped with the main cause of the disease to induce or aggravate the disease, a causal relationship between them should be recognized. Such causal relationship need not be clearly proven medically or scientifically; proof shall be deemed to exist even where, considering all the circumstances, a proximate causal relationship between the work and the disease can be inferred. Proof shall also be deemed to exist in cases where an underlying disease or pre-existing disease, which would normally allow for ordinary work, has rapidly worsened beyond its natural progression due to excessive workload or other causes. Whether there is a causal relationship between the work and the disease or death must be determined not on the basis of an ordinary average person, but on the basis of the health and physical condition of the worker concerned.

[2] If the first accident constitutes an occupational accident having a proximate causal relationship with the work, it is highly likely that the subsequent second accident occurred as a natural aggravation of the first accident, and if that is the case, there is sufficient room to view the second accident as also being an occupational accident caused by the work. Therefore, in determining whether the second accident constitutes an occupational accident, the focus should be placed on whether the first accident constitutes an occupational accident and whether the deceased was in a state of objective overwork at the time of the first accident.

[3] In a case where Gap, who performed work packing and loading/unloading PVC pipes (10 to 30 kg) while working day and night shifts alternately, showed symptoms of moderate dyspnea due to cardiovascular chest pain while resting at his lodging after finishing a day shift and was transported to the hospital (the first accident), was diagnosed as a suspected case of angina pectoris, recuperated at home for 11 days, and then went back to work, but was found collapsed in the restroom of the dormitory just before starting a night shift and was transported to the hospital but died (the second accident): the deceased, who was 62 years old at the time of the first accident and had a cardiovascular disease, had accumulated physical and mental fatigue due to long working hours and prolonged day-and-night shift work, and exposure to the winter cold while working outdoors on the day of the first accident also had an effect, such that there is substantial room to view the first accident as having occurred because the pre-existing disease rapidly worsened beyond its natural progression; and it appears that, even after the first accident, due to economic circumstances and other reasons, the deceased did not properly recuperate and resumed night shift work, resulting in the second accident and his death. Nevertheless, the lower court, overlooking the fact that the first accident constituted an occupational accident, held—on the premise that the deceased had taken sufficient rest for two weeks after the occurrence of the first accident and was therefore not in a state of objective overwork at the time of the occurrence of the second accident—that it was difficult to recognize a proximate causal relationship between the deceased’s work and the disease that caused his death. The Supreme Court held that the lower court’s judgment was unlawful for misapprehending the legal principles concerning proximate causation in occupational accidents, among other errors.

Full text (English, AI translation) 10,345 chars

[Plaintiff, Appellant] Plaintiff (Attorney Lim Chae-hong, counsel)
[Defendant, Appellee] Korea Workers' Compensation and Welfare Service
[Judgment Below] Seoul High Court Decision 2019Nu37471 decided November 26, 2019

[Order]

The judgment below is reversed, and the case is remanded to the Seoul High Court.

[Reasoning]

The grounds of appeal (to the extent that the descriptions in each supplemental brief on the grounds of appeal, submitted after the expiration of the period for submitting the grounds of appeal, supplement the grounds of appeal) are examined.

1. In order to recognize "death due to occupational cause" as provided in Article 5, Item 1 of the Industrial Accident Compensation Insurance Act (산업재해보상보험법), there must be a causal relationship between the work and the disease that caused the death. However, even if the primary cause of the disease is not directly related to the performance of duties, if occupational overwork or stress, at the very least, was superimposed on the primary cause of the disease and induced or aggravated the disease, a causal relationship between them should be recognized. Such causal relationship need not necessarily be clearly proven medically or scientifically; it should be deemed proven even where, in light of all the circumstances, a proximate causal relationship between the work and the disease can be inferred. This also includes cases where an underlying disease or pre-existing disease, which would normally permit normal work performance, rapidly worsened beyond its natural progression due to excessive workload or other work-related causes. Whether there is a causal relationship between work and disease or death must be determined not on the basis of an average person but on the basis of the health and physical condition of the worker in question (see, e.g., Supreme Court Decision 2018Du32125 decided May 15, 2018).

2. According to the reasoning of the judgment below and the record, the following facts can be ascertained.

A. The deceased Nonparty (hereinafter "the Deceased"), the spouse of the Plaintiff, was born on (date of birth omitted) and worked at Hongil Sanwoo Co., Ltd. from March 8, 2010 to October 3, 2013, and from January 27, 2014 to February 22, 2018, performing day and night shift work in which he, working in pairs, packed PVC pipes (10 to 30 kg) at 30-minute intervals in the factory and outdoor storage yard and loaded/unloaded them.

B. The Deceased worked in a pattern of approximately two consecutive weeks of daytime work without a day off, followed by two days of rest, then approximately two consecutive weeks of nighttime work without a day off, followed by two days of rest, and then again approximately two weeks of daytime work, repeating this cycle. The Deceased's daytime working hours were from 7:30 to 19:00 (11 hours and 30 minutes, including meal and rest time), and his nighttime working hours were from 19:00 to 7:30 (12 hours and 30 minutes, including meal and rest time).

C. At around 20:40 on February 8, 2018, after finishing his daytime shift, while resting at his dormitory, the Deceased exhibited moderate respiratory distress due to cardiovascular chest pain, and was transported by 119 ambulance to ○○○○ Hospital upon a report by a fellow worker (hereinafter "the First Accident"). At the time, the Deceased was suspected of having angina pectoris and was advised to be hospitalized, but he declined, citing personal circumstances that made hospitalization difficult. On that day, the highest temperature was 3.4℃, the lowest temperature was -11.2℃, and the average temperature was -4.6℃.

D. The Deceased recuperated for 11 days from February 9, 2018 to February 19, 2018, including the Lunar New Year holidays, and then began night shift work from around 17:40 on February 20, 2018. At around 18:38 on February 22, 2018, just before starting his night shift, he was found collapsed in the bathroom of the dormitory. The Deceased was transported by the 119 rescue team while receiving CPR, having no consciousness, respiration, or pulse, and arrived at △△△△△□□ Hospital at around 19:36, but could not be revived from cardiac asystole and died at around 19:45 (hereinafter "the Second Accident").

E. The Deceased's death certificate lists the cause of death as "unknown," and the death examination report lists cardiopulmonary arrest as the immediate cause of death, acute heart failure (suspected) as the intermediate antecedent cause, and heart disease (ischemic heart disease, etc.) as the underlying antecedent cause. No autopsy was performed.

F. Around November 2009, the Deceased had received medical treatment for essential hypertension and unspecified angina pectoris, and thereafter had received treatment on several occasions for unspecified asthma, unspecified dyspnea, bronchiectasis, and constrictive (congestive) heart failure.

3. Examining these circumstances in light of the legal principles set forth above, there is substantial room to recognize a proximate causal relationship between the Deceased's work and the disease that caused his death. The reasons are as follows.

A. Although no autopsy was performed after the Second Accident, considering the Deceased's medical history and the diagnostic content of the physicians who treated the Deceased comprehensively, it can be readily inferred that both the First Accident and the Second Accident resulted from the aggravation of the Deceased's underlying cardiovascular disease.

B. If the First Accident constitutes an occupational accident with a proximate causal relationship to the work, then the Second Accident, which occurred thereafter, is highly likely to have resulted from the natural aggravation of the First Accident, and if that is the case, there is ample room to view the Second Accident as also an occupational accident attributable to the work (see Supreme Court Decision 95Nu14282 decided January 26, 1996). Therefore, in determining whether the Second Accident constitutes an occupational accident, the focus should be on whether the First Accident constitutes an occupational accident and whether the Deceased was in a state of objective overwork at the time of the First Accident.

C. At the time of the First Accident, the Deceased was of advanced age, 62 years old, and had performed day and night shift work repeating at approximately two-week intervals for about 12 hours each, over a period of 7 years and 8 months, appearing to be in a state of chronic physical and mental fatigue. It is widely known that day and night shift work causes fatigue and stress due to irregular sleep hours, sleep deprivation, and disruption of life rhythms and biorhythms, and that such fatigue and stress may themselves trigger disease, or accumulated fatigue and stress may lower the body's immunity, negatively affecting the onset or aggravation of disease (see, e.g., Supreme Court Decision 2002Du8145 decided January 10, 2003, Supreme Court Decision 2006Du4912 decided April 12, 2007).

Furthermore, even according to the Defendant's method of calculation, the Deceased's average weekly working hours during the 12 weeks prior to the onset of the First Accident amounted to approximately 64 hours, and during the 4 weeks prior to the onset, approximately 66 hours.

Considering that the Deceased habitually performed long working hours and prolonged day and night shift work in this manner, even under the "Matters Necessary for Determining Recognition of Cerebrovascular or Cardiac Diseases and Musculoskeletal Diseases as Occupational Diseases" (Ministry of Employment and Labor Notice No. 2017-117, promulgated December 29, 2017), the relationship between the work and the First Accident can be regarded as strong.

D. The date of the First Accident falls on a relatively cold day even by the standards of Korean winter weather. Exposure to cold in winter is known to be a risk factor that rapidly aggravates cardiovascular disease and increases the risk of onset of acute myocardial infarction (see, e.g., Supreme Court Decision 2018Du32125 decided May 15, 2018, Supreme Court Decision 2017Du35097 decided June 19, 2018).

E. Although the Deceased had pre-existing conditions such as essential hypertension, unspecified angina pectoris, and constrictive heart failure, which can be regarded as risk factors for acute cardiac death, considering that the Deceased had worked without significant problems prior to the First Accident, it is difficult to conclude that these pre-existing conditions were so severe as to cause acute cardiac death solely through their natural course of progression.

F. In conclusion, there is substantial room to view that, while suffering from cardiovascular disease, the Deceased accumulated physical and mental overwork due to long working hours and prolonged day and night shift work, and that exposure to winter cold while performing outdoor work on the date of the First Accident also had an effect, causing the pre-existing disease to rapidly worsen beyond its natural rate of progression, resulting in the First Accident. It also appears that, after the First Accident, the Deceased was unable to properly recuperate due to economic circumstances and resumed night shift work, which led to the occurrence of the Second Accident and his death.

4. Nevertheless, the court below, overlooking the point that the First Accident constitutes an occupational accident, determined, on the premise that the Deceased took sufficient rest for two weeks after the occurrence of the First Accident and was not in a state of objective overwork at the time of the occurrence of the Second Accident, that it is difficult to recognize a proximate causal relationship between the Deceased's work and the disease that caused his death. Such determination by the court below contains an error of law that affected the judgment by misapprehending the legal principles concerning proximate causation in occupational accidents and by failing to conduct the necessary examination.

5. Therefore, the judgment below is reversed, and the case is remanded to the court below for further hearing and determination. This Decision is rendered by the unanimous opinion of the Justices involved, as stated in the Order.

Justice Ahn Cheol-sang (Presiding Justice), Park Sang-ok, No Jeong-hui, Kim Sang-hwan (Justice in charge)

【판결요지】

[1] 산업재해보상보험법 제5조 제1호에서 정한 ‘업무상의 사유에 따른 사망’으로 인정하려면 업무와 사망의 원인이 된 질병 사이에 인과관계가 있어야 한다. 하지만 질병의 주된 발생원인이 업무수행과 직접적인 관계가 없더라도, 적어도 업무상의 과로나 스트레스가 질병의 주된 발생원인에 겹쳐서 질병을 유발 또는 악화시켰다면 그 사이에 인과관계가 있다고 보아야 한다. 그 인과관계는 반드시 의학적·자연과학적으로 명백히 증명하여야 하는 것은 아니고 제반 사정을 고려할 때 업무와 질병 사이에 상당인과관계가 있다고 추단되는 경우에도 증명이 있다고 보아야 하며, 또한 평소에 정상적인 근무가 가능한 기초 질병이나 기존 질병이 직무의 과중 등이 원인이 되어 자연적인 진행속도 이상으로 급격하게 악화된 때에도 증명이 있는 경우에 포함된다. 업무와 질병 또는 사망과의 인과관계 유무는 보통 평균인이 아니라 당해 근로자의 건강과 신체조건을 기준으로 판단하여야 한다.

[2] 1차 재해가 업무와 상당인과관계 있는 업무상 재해에 해당한다면, 그 후에 발생한 2차 재해는 1차 재해가 자연발생적으로 악화되어 발생될 가능성이 크고, 만약 사정이 그러하다면 2차 재해도 업무에 기인한 업무상 재해라고 볼 여지가 충분하다. 따라서 2차 재해가 업무상 재해에 해당하는지 여부를 판단할 때에는 1차 재해가 업무상 재해에 해당하는지, 1차 재해 당시에 망인이 객관적 과로 상태에 있었는지 여부에 초점을 맞추어야 한다.

[3] PVC 파이프(10 내지 30kg)를 포장하여 상하차하는 업무를 수행하면서 주야간 교대 근무를 하던 甲이 주간근무를 마친 후 숙소에서 휴식 중 심혈관 흉통으로 중증도 호흡곤란 증세를 보여 병원에 후송되어(1차 재해) 협심증 의심 진단을 받고 집에서 11일간 요양한 후 다시 출근하였다가 야간근무를 하기 직전 기숙사 내 화장실에서 쓰러져 있는 상태로 발견되어 병원으로 후송되었으나 사망한(2차 재해) 사안에서, 망인은 1차 재해 발병 당시 만 62세의 고령으로 심혈관질환을 가진 상태에서 장시간 근로와 장기간의 주야간 교대제 근무로 육체적·정신적 과로가 누적되었고, 1차 재해일에 야외 작업을 하면서 겨울철의 추위에 노출된 점도 영향을 미쳐 기존 질환이 자연적인 진행속도 이상으로 급격하게 악화되어 1차 재해가 발생한 것으로 볼 여지가 크고, 1차 재해 이후에도 경제적 형편 등으로 제대로 요양을 하지 못한 상태에서 다시 야간근무를 시작하였다가 2차 재해가 발생하여 사망에 이른 것으로 보이는데도, 1차 재해가 업무상 재해에 해당한다는 점을 간과한 채, 1차 재해 발생 후 2주간 충분한 휴식을 취하여 2차 재해 발생 당시에는 망인이 객관적 과로 상태가 아니었다는 전제에서 망인의 업무와 사망의 원인이 된 질병 사이에 상당인과관계를 인정하기 어렵다고 본 원심판단에 업무상 재해의 상당인과관계에 관한 법리오해 등의 위법이 있다고 한 사례.

【참조조문】

[1] 산업재해보상보험법 제5조 제1호, 제37조 제1항

[2] 산업재해보상보험법 제5조 제1호, 제37조 제1항

[3] 산업재해보상보험법 제5조 제1호, 제37조 제1항

【참조판례】

[1] 대법원 2018. 5. 15. 선고 2018두32125 판결 / [2] 대법원 1996. 1. 26. 선고 95누14282 판결(공1996상, 810)

【주문】·【이유】 전문 4,047자 · 펼쳐 보기

【원고, 상고인】 원고 (소송대리인 변호사 임채홍)

【피고, 피상고인】 근로복지공단

【원심판결】 서울고법 2019. 11. 26. 선고 2019누37471 판결

【주 문】

원심판결을 파기하고, 사건을 서울고등법원에 환송한다.

【이 유】 상고이유(상고이유서 제출기간이 지난 후에 제출된 각 상고이유보충서의 기재는 상고이유를 보충하는 범위 안에서)를 판단한다.

1. 산업재해보상보험법 제5조 제1호에서 정한 ‘업무상의 사유에 따른 사망’으로 인정하려면 업무와 사망의 원인이 된 질병 사이에 인과관계가 있어야 한다. 하지만 질병의 주된 발생원인이 업무수행과 직접적인 관계가 없더라도, 적어도 업무상의 과로나 스트레스가 질병의 주된 발생원인에 겹쳐서 질병을 유발 또는 악화시켰다면 그 사이에 인과관계가 있다고 보아야 한다. 그 인과관계는 반드시 의학적·자연과학적으로 명백히 증명하여야 하는 것은 아니고 제반 사정을 고려할 때 업무와 질병 사이에 상당인과관계가 있다고 추단되는 경우에도 그 증명이 있다고 보아야 하며, 또한 평소에 정상적인 근무가 가능한 기초 질병이나 기존 질병이 직무의 과중 등이 원인이 되어 자연적인 진행속도 이상으로 급격하게 악화된 때에도 그 증명이 있는 경우에 포함된다. 업무와 질병 또는 사망과의 인과관계 유무는 보통 평균인이 아니라 당해 근로자의 건강과 신체조건을 기준으로 판단하여야 한다(대법원 2018. 5. 15. 선고 2018두32125 판결 등 참조).

2. 원심판결 이유와 기록에 의하면, 다음과 같은 사실들을 알 수 있다.

가. 원고의 배우자인 망 소외인(이하 ‘망인’이라 한다)은 (생년월일 생략)생으로 2010. 3. 8.부터 2013. 10. 3.까지, 2014. 1. 27.부터 2018. 2. 22.까지 주식회사 홍일산업에서 공장과 야적장에서 PVC 파이프(10 내지 30kg)를 2인 1조로 30분 단위로 포장하여 상하차하는 업무를 수행하면서 주야간 교대 근무를 하였다.

나. 망인은 약 2주간 휴일 없이 연속으로 주간근무를 하고 2일간 휴식 후 약 2주간 휴일 없이 연속으로 야간근무를 하고 2일간 휴식 후 다시 약 2주간 주간근무하는 것을 반복하는 형태로 근무하였다. 망인의 주간 근무시간은 7시 30분부터 19시까지(11시간 30분, 식사 및 휴게시간 포함)이고, 야간 근무시간은 19시부터 7시 30분까지(12시간 30분, 식사 및 휴게시간 포함)였다.

다. 망인은 2018. 2. 8. 20:40경 주간근무를 마친 후 숙소에서 휴식 중 심혈관 흉통으로 중증도 호흡곤란 증세를 보여 동료 근로자의 신고로 119응급차로 ○○○○병원에 후송되었다(이하 ‘1차 재해’라 한다). 망인은 당시 협심증이 의심된다는 등의 이유로 입원을 권유받았으나 개인적 사정으로 입원이 어렵다고 하며 응하지 않았다. 그날의 최고기온은 영상 3.4℃, 최저기온은 영하 11.2℃, 평균기온은 영하 4.6℃였다.

라. 망인은 2018. 2. 9.부터 2018. 2. 19.까지 설 연휴를 포함하여 11일간 요양한 후 2018. 2. 20. 17:40경부터 야간근무를 하기 시작하였는데, 2018. 2. 22. 18:38경 야간근무를 하기 직전 기숙사 내 화장실에서 쓰러져 있는 상태로 발견되었다. 망인은 의식, 호흡, 맥박이 없는 상태로 119구급대에 의하여 심폐소생술을 받으며 후송되어 △△△△△□□병원에 19:36경 도착하였으나 심장무수축 상태에서 소생하지 못하고 19:45경 사망하였다(이하 ‘2차 재해’라 한다).

마. 망인의 사망진단서에는 사인이 ‘미상’으로 기재되어 있고, 사체검안서에는 직접사인으로 심폐정지, 중간선행사인으로 급성 심부전(의증), 선행사인으로 심질환(허혈성심질환 등)이 기재되어 있으며, 부검은 시행되지 않았다.

바. 망인은 2009. 11.경 원발성 고혈압, 상세불명의 협심증으로 각 진료를 받은 적이 있고, 이후 수차례 상세불명의 천식, 상세불명의 호흡곤란, 기관지확장증, 수축성(울혈성) 심부전 등으로 진료를 받았다.

3. 이러한 사정들을 앞서 본 법리에 비추어 살펴보면, 망인의 업무와 사망 원인이 된 질병 사이에 상당인과관계를 인정할 여지가 크다. 그 이유는 다음과 같다.

가. 비록 2차 재해 후 부검은 시행되지 않았으나, 망인의 병력과 망인을 진료한 의사의 진단 내용 등을 종합하면, 1차 재해와 2차 재해는 모두 망인의 지병인 심혈관질환이 악화된 것으로 넉넉히 추단할 수 있다.

나. 1차 재해가 업무와 상당인과관계 있는 업무상 재해에 해당한다면, 그 후에 발생한 2차 재해는 1차 재해가 자연발생적으로 악화되어 발생될 가능성이 많고, 만약 사정이 그러하다면 2차 재해도 업무에 기인한 업무상 재해라고 볼 여지가 충분하다(대법원 1996. 1. 26. 선고 95누14282 판결 참조). 따라서 2차 재해가 업무상 재해에 해당하는지 여부를 판단할 때에는 1차 재해가 업무상 재해에 해당하는지, 1차 재해 당시에 망인이 객관적 과로 상태에 있었는지 여부에 초점을 맞추어야 한다.

다. 망인은 1차 재해 발병 당시 만 62세의 고령으로 7년 8개월 동안 약 12시간씩 2주 간격으로 반복되는 주야간 교대제 근무를 하여 만성적인 육체적·정신적 피로상태에 있었던 것으로 보인다. 주야간 교대 근무가 취침시간의 불규칙, 수면부족, 생활리듬 및 생체리듬의 혼란으로 피로와 스트레스를 유발하여, 그 자체로 질병을 촉발하거나 또는 누적된 피로와 스트레스가 신체의 면역력을 저하시켜 질병의 발병·악화에 부정적인 영향을 미칠 수 있다는 점은 널리 알려져 있다(대법원 2003. 1. 10. 선고 2002두8145 판결, 대법원 2007. 4. 12. 선고 2006두4912 판결 등 참조).

또한 망인의 업무시간은 피고의 계산방법에 의하더라도 1차 재해일을 기준으로 발병 전 12주 동안 1주 평균 업무시간이 약 64시간이고, 발병 전 4주 동안 1주 평균 업무시간이 약 66시간에 달한다.

이처럼 망인이 평소 장시간 근무와 장기간의 주야간 교대 근무를 수행한 점을 고려하면, 「뇌혈관 질병 또는 심장 질병 및 근골격계 질병의 업무상 질병 인정 여부 결정에 필요한 사항」(2017. 12. 29. 고용노동부 고시 제2017-117호)에 의하더라도, 업무와 1차 재해 사이의 관련성이 강한 것으로 볼 수 있다.

라. 1차 재해일은 우리나라의 겨울철 날씨로도 비교적 추운 편에 속한다. 겨울철의 추위에의 노출은 심혈관질환을 급격하게 악화시켜 급성 심근경색의 발병 위험을 증가시키는 위험인자로 알려져 있다(대법원 2018. 5. 15. 선고 2018두32125 판결, 대법원 2018. 6. 19. 선고 2017두35097 판결 등 참조).

마. 망인에게 원발성 고혈압, 상세불명의 협심증, 수축성 심부전 등 급성 심장사의 위험인자라고 볼 수 있는 기존 질환이 있었으나, 망인이 1차 재해 이전에는 별 이상 없이 근무해온 점을 고려하면, 이러한 기존 질환이 자연적인 진행경과만으로 급성 심장사를 일으킬 정도로 위중했다고 단정하기 어렵다.

바. 결국 망인은 심혈관질환을 가진 상태에서 장시간 근로와 장기간의 주야간 교대제 근무로 육체적·정신적 과로가 누적되었고, 1차 재해일에 야외 작업을 하면서 겨울철의 추위에 노출된 점도 영향을 미쳐 기존 질환이 자연적인 진행속도 이상으로 급격하게 악화되어 1차 재해가 발생한 것으로 볼 여지가 크다. 또한 망인은 1차 재해 이후에도 경제적 형편 등으로 인하여 제대로 요양을 하지 못한 상태에서 다시 야간근무를 시작하였다가 2차 재해가 발생하여 사망에 이른 것으로 보인다.

4. 그런데도 원심은, 1차 재해가 업무상 재해에 해당한다는 점을 간과한 채, 1차 재해 발생 후 2주간 충분한 휴식을 취하여 2차 재해 발생 당시에는 망인이 객관적 과로 상태가 아니었다는 전제에서 망인의 업무와 사망의 원인이 된 질병 사이에 상당인과관계를 인정하기 어렵다고 판단하였다. 이러한 원심판단에는 업무상 재해의 상당인과관계에 관한 법리를 오해하고 필요한 심리를 다하지 않음으로써 판결에 영향을 미친 위법이 있다.

5. 그러므로 원심판결을 파기하고, 사건을 다시 심리·판단하게 하기 위하여 원심법원에 환송하기로 하여, 관여 대법관의 일치된 의견으로 주문과 같이 판결한다.

대법관 안철상(재판장) 박상옥 노정희 김상환(주심)

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