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A Ram Kim 6 Articles
Cooking oil fume exposure and Lung-RADS distribution among school cafeteria workers of South Korea
Minjun Kim, Yangho Kim, A Ram Kim, Woon Jung Kwon, Soyeoun Lim, Woojin Kim, Cheolin Yoo
Ann Occup Environ Med 2024;36:e2.   Published online January 31, 2024
DOI: https://doi.org/10.35371/aoem.2024.36.e2
AbstractAbstract AbstractAbstract in Korean PDFSupplementary MaterialPubReaderePub
Background

Cooking oil fumes (COFs) from cooking with hot oil may contribute to the pathogenesis of lung cancer. Since 2021, occupational lung cancer for individual cafeteria workers has been recognized in South Korea. In this study, we aimed to identify the distribution of lung-imaging reporting and data system (Lung-RADS) among cafeteria workers and to determine factors related to Lung-RADS distribution.

Methods

We included 203 female participants who underwent low-dose computed tomography (LDCT) screening at a university hospital and examined the following variables: age, smoking status, second-hand smoke, height, weight, and years of service, mask use, cooking time, heat source, and ventilation. We divided all participants into culinary and non-culinary workers. Binomial logistic regression was conducted to determine the risk factors on LDCT of Category ≥ 3, separately for the overall group and the culinary group.

Results

In this study, Lung-RADS-positive occurred in 17 (8.4%) individuals, all of whom were culinary workers. Binary logistic regression analyses were performed and no variables were found to have a significant impact on Lung-RADS results. In the subgroup analysis, the Lung-RADS-positive, and -negative groups differed only in ventilation. Binary logistic regression showed that the adjusted odds ratio (aOR) of the Lung-RADS-positive group for inappropriate ventilation at the workplace was 14.89 (95% confidence interval [CI]: 3.296–67.231) compared to appropriate ventilation as the reference, and the aOR for electric appliances at home was 4.59 (95% CI: 1.061–19.890) using liquid fuel as the reference.

Conclusions

The rate of Lung-RADS-positive was significantly higher among culinary workers who performed actual cooking tasks than among nonculinary workers. In addition, appropriate ventilation at the workplace made the LDCT results differ. More research is needed to identify factors that might influence LDCT findings among culinary workers, including those in other occupations.

한국 학교 급식소 종사자의 조리흄 노출과 Lung-RADS 분포
목적
2021년부터 한국에서는 개별 학교 급식 종사자의 폐암 산업재해가 인정되고 있다. 본 연구에서는 급식 종사자들의 Lung-imaging reporting and data system ( Lung-RADS ) 분포를 확인하고, Lung-RADS 분포와 관련된 요인을 탐색해보고자 한다.
방법
2020년도에 울산대학병원에서 저선량 CT를 촬영한 여성 참가자 중 203명을 대상으로 나이, 흡연 여부, 간접 흡연 여부, 키, 체중, 근무 년수, 마스크 착용 여부, 조리 시간, 열원, 환기방식 등의 변수를 조사하였다. 참가자를 조리직, 비조리직으로 분류하였다. 범주 3이상에 대한 영향을 확인하기 위해 이분형 로지스틱을 전체집단 조리직 집단에 나누어 실시하였다.
결과
Lung-RADS 양성은 17 (8.4%)명에게서 발생했고 모두 조리직에 해당했다. 이분형 로지스틱 회귀분석을 시행한 결과 전체집단에서 Lung-RADS 결과에 유의미한 영향을 주는 변수는 확인할 수 없었다. Subgroup 분석에서 Lung-RADS 양성, 음성군은 직장 내 환기방식에서만 차이가 있었다. 이분형 로지스틱 회귀분석 결과 직장에서 환기를 철저히 한 것을 참고치로 했을 때 부적절한 환기에 대한 Lung-RADS 양성의 오드비가 14.89이고 가정에서 액화연료 사용을 참고치로 했을 때 전기 요리기구 사용의 오드비는 4.59이였다.
결론
실제 조리업무를 시행하는 조리직의 경우 비조리직에 비해 Lung-RADS 양성 비율이 유의하게 높았다. 또한 조리실 환경에서 환기를 철저하게 하는 것이 Lung-RADS 소견에 영향을 주었다.
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Effects of a supportive workplace environment on the success rate for smoking cessation camp
Woojin Kim, A Ram Kim, Minsu Ock, Young-Jee Jeon, Heun Lee, Daehwan Kim, Minjun Kim, Cheolin Yoo
Ann Occup Environ Med 2023;35:e48.   Published online November 22, 2023
DOI: https://doi.org/10.35371/aoem.2023.35.e48
AbstractAbstract AbstractAbstract in Korean PDFPubReaderePub
Background

This study was conducted to identify the success rate for smoking cessation over time after participation in a therapeutic smoking cessation camp, and to identify how participant characteristics, including a supportive workplace environment for smoking cessation (SWESC), affect the success rate for smoking cessation.

Methods

In all, 296 participants at smoking cessation camps in Ulsan between 2015 and 2020 were investigated. The success rates of smoking cessation after weeks 4, 6, 12, and 24 at camp were investigated. The participants were grouped as workers with an SWESC, and workers without an SWESC, and variables (age, education, household income, marital status, drinking, exercise, body mass index, morbidity, job, number of counseling sessions, cigarettes smoked per day and smoking initiation age) were investigated. Multiple logistic regression analysis was conducted at each time point. In addition, Cox regression analysis was performed to evaluate the variables affecting the success rate for smoking cessation over time.

Results

The smoking cessation success rate of workers with an SWESC at week 24 (90.7%) was higher than that for workers without an SWESC (60.5%). Multiple logistic regression was performed to determine the relationship between each variable and the success rates for smoking cessation at week 6, 12, and 24. SWESC was confirmed as significant (p < 0.05) variables for increased success rate for smoking cessation at all 3 time points. After adjusting for all variables, the Cox proportional hazards survival analysis showed a hazard ratio of 6.17 for SWESC (p < 0.001,; 95% confidence interval: 3.08–12.38).

Conclusions

At a professional treatment smoking cessation camp, participants with an SWESC showed a significantly higher success rate for smoking cessation. Supportive workplace environment for workers’ health is expected to be an important factor for smoking cessation projects as well as other health promotion projects at workplace.

직장의 금연에 대한 지지적 환경이 전문 치료형 금연 캠프의 금연성공률에 미치는 영향
목적
본 연구는 울산에서 진행된 전문 치료형 금연 캠프에 참가한 후 시간 경과에 따른 금연 성공률을 알아보고, 직장의 금연에 대한 지지적 환경 (SWESC: supportive workplace environment for smoking cessation)을 포함한 각 참가자의 특성이 금연 성공률에 어떤 영향을 미치는지 알아보기 위해 실시되었다.
방법
2015-2020년 울산 지역 금연 캠프 참가자 455명을 대상으로 자가 보고, 호기 일산화탄소, 소변 코티닌 수치를 이용하여 캠프 후 4주, 6주, 12주, 24주차 금연 성공률을 조사하였다. 캠프 참가자를 SWESC가 있는 근로자 및 SWESC가 없는 근로자로 분류하여 각 집단에서 변수 (연령, 교육 수준, 가계 소득, 배우자 유무, 음주, 운동, 체질량지수, 현병력, 직업, 상담 횟수, 하루 흡연량, 흡연 시작 연령)들의 비율을 알아보았고, 시점별 금연 성공률을 집계하였다. 변수와 금연 성공의 관계를 알아보기 위해 각 시점에서 다중 로지스틱 회귀 분석을 실시하였다. 또한 시간 경과에 따른 금연 성공률에 영향을 미치는 변수를 평가하기 위해 Cox 생존 분석을 시행하였다.
결과
SWESC가 있는 근로자의 24주 금연 성공률 (90.7%)은 SWE가 없는 근로자 (60.5%)보다 높았다. 캠프 후 6주, 12주, 24주째 금연성공률과 변수에 대하여 다중 로지스틱 회귀 분석을 실시한 결과, 세 시점에서 모두 금연에 유의한 (p < 0.05) 변수는 SWESC로 나타났다. 모든 변수를 조정하여 Cox 비례 위험 생존 분석을 실시한 결과 SWESC의 위험비는 6.17 ( 95% 신뢰구간: 3.08-12.38)였다.
결론
금연 캠프 참가자 중 SWESC가 있는 참가자는 금연 성공률이 유의하게 높았다. 근로자의 건강에 대한 지지적인 직장 환경은 금연 사업 등 보건 사업의 성공에 중요한 요인이 될 것으로 예상된다.
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Nickel dust-induced occupational contact dermatitis by welding and grinding work in shipyard workers: a report of nine cases
Daehwan Kim, A Ram Kim, Hanjun Kim, Sunghee Lee, Byeonghak Seo, Ho Seok Suh, Chang Sun Sim, Heun Lee, Cheolin Yoo
Ann Occup Environ Med 2022;34:e7.   Published online March 24, 2022
DOI: https://doi.org/10.35371/aoem.2022.34.e7
AbstractAbstract AbstractAbstract in Korean PDFPubReaderePub
Background

Occupational skin diseases are skin conditions that occur or worsen in relation to work and known to be the second most common type of occupational disease affecting individuals in the United States. In Korea, epidemiological reports related to occupational skin diseases are rare. But, no cases of occupational contact dermatitis caused by welding and grinding work have been reported previously.

Case presentation

Nine male workers working in the production department for liquefied natural gas (LNG) ships in Ulsan complained of erythematous papules/patches and itching in various areas of the body after welding and grinding work. The work environment monitoring report revealed that the amount of nickel dust exceeded the time weighted average (TWA) and poor local ventilation status. Based on the symptoms and the overall results of surveys, several tests, and work environment monitoring report, the 2 workers who had positive patch-test reactions to nickel were diagnosed with nickel dust-induced allergic contact dermatitis. The other 7 workers were diagnosed that there was a high probability that they had nickel dust-induced irritant contact dermatitis. The 2 workers who had nickel dust-induced allergic contact dermatitis were recommended to switch their jobs.

Conclusions

Nickel is one of the most common cause of allergic contact dermatitis. In this case, the dust was assumed to be created by welding work with a high nickel content new welding rod and subsequent grinding work, and the concentration of this dust exceeded the time weighted average. Thus, it is thought that the nickel dust may have caused contact dermatitis through continuous contact with the workers' exposed skin in a poorly ventilated space. Currently, several domestic shipbuilding companies are manufacturing LNG tankers using a new construction method. Consequently, it is highly likely that similar cases will occur in the future, which makes this case report meaningful.

조선소에서 용접 및 그라인더 작업 중 발생한 니켈 분진에 의한 직업성 접촉피부염 사례 : 9 cases
배경
직업성 피부질환은 업무와 관련되어 발생하거나 악화하는 피부질환을 말하며 미국에서 직업성 질환 중 2번째로 흔한 질환으로 알려져 있다. 국내에서는 직업성 피부질환과 관련하여 역학적인 보고는 가끔 있었으나, 용접/사상 작업을 하는 근로자들에게서 니켈에 의한 직업성 접촉피부염이 발생한 보고는 없었다.
증례
울산 소재의 한 조선회사의 LNG선 생산부에 근무 중인 9명의 남성 근로자가 용접/사상 작업 후 여러 국소 부위에 발진 및 가려움을 호소했다.
작업환경측정 보고에 따르면 니켈 분진의 양이 한계 수준을 초과했고 국소 환기 상태가 불량한 것으로 나타났다.
직업성 피부염의 증상, 문진, 여러 검사 결과, 작업환경측정 결과 등을 고려하였을 때 우리는 니켈에 양성 반응을 보인 2명을 니켈 분진에 의한 알레르기접촉피부염으로 진단하였다. 다른 7명은 니켈 분진에 의한 자극접촉피부염 가능성이 높음으로 진단하였다. 니켈 분진에 의한 알레르기접촉피부염으로 진단한 2명에게 작업 전환을 권고하였다.
고찰
니켈은 직업 환경 및 일반 인구에서 피부에 노출 시 발생하는 알레르기접촉피부염의 가장 흔한 원인이다. 본 사례에서 높은 니켈함유량을 가진 새로운 용접봉을 이용한 용접작업 및 이어진 사상 작업으로 인해 고농도의 니켈 분진이 발생한 것으로 추정되며, 이 분진의 농도는 기준치를 초과했다. 따라서 환기가 잘 되지 않는 공간에서 니켈 분진이 근로자들의 노출된 피부에 지속적으로 닿아 접촉피부염을 일으켰을 것으로 생각된다. 현재 국내 여러 조선사들이 새로운 공법으로 LNG 탱크를 생산하고 있다. 결과적으로 우리의 사례와 유사한 여러 사례가 향후 발생할 가능성이 매우 높아 이를 보고하는 바이다.

Citations

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  • Numerical simulation of the collection efficiency of welding fume particles in electrostatic precipitator
    Yindong Song, Yuni Zhang, Yiliang Liu, Wangyang Long, Kun Tao, Kambiz Vafai
    Powder Technology.2023; 415: 118173.     CrossRef
  • Metal Allergy: State-of-the-Art Mechanisms, Biomarkers, Hypersensitivity to Implants
    Magdalena Zemelka-Wiacek
    Journal of Clinical Medicine.2022; 11(23): 6971.     CrossRef
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Factors related to depressive symptoms in Korean self-employed workers
Hanjun Kim, Jungsun Park, A Ram Kim, Yangho Kim
Ann Occup Environ Med 2021;33:e20.   Published online June 15, 2021
DOI: https://doi.org/10.35371/aoem.2021.33.e20
AbstractAbstract AbstractAbstract in Korean PDFPubReaderePub
Background

We examined factors related to depressive symptoms in Korean self-employed workers.

Methods

This secondary analysis examined data of 14,454 self-employed individuals from the fifth Korean Working Conditions Survey (2017). Multiple logistic regression analysis was used to assess the relationship of depressive symptoms with different variables.

Results

Self-employed workers who had a good work-life balance, a good subjective health, and worked 40 to 48 hours or 48 to 60 hours/week were less likely to report depressive symptoms (all p < 0.05). However, those who always interacted with angry clients, had severe exposure to ergonomic risk factors, and were exposed to moderate or severe abusive behaviors were more likely to report depressive symptoms (all p < 0.05). Age, gender, weekly work days, and working at very fast speed were unrelated to depressive symptoms.

Conclusions

Several factors known to be related to depressive symptoms do not lead to depression in self-employed individuals. Different interventions may therefore be needed to prevent depression in self-employed workers.

한국의 자영업자에서의 우울증상과 관련된 요인
목적
한국 자영업자와 우울 증상과 관련된 요인들을 분석하였다.
방법
이 2차 분석은 5차 한국근로환경조사(2017)의 14,454명의 자영업자들의 데이터를 조사하였다. 우울 증상과 관련된 다양한 변수들에 대하여 다변량 로지스틱 회귀분석을 이용하여 분석하였다.
결과
고졸 학력, 높은 월간 수입, 좋은 일과 삶의 균형, 주간 40시간에서 48시간 및 48시간에서 60시간 근무한 자영업자들은 우울증상을 보고를 하는 경향이 적었다 (모두 P < 0.05). 그러나 화난 고객과 대하는 경우, 근골격계 위험요소에 크게 노출되는 경우, 폭력적인 행위에 중간 혹은 심하게 노출되는 경우 우울증상을 더 많이 보고하였다 (P < 0.05). 나이, 성별, 직업군, 수입 변화, 주간 근무일수, 빠른 속도의 근무환경등은 우울 증상과 관련이 적었다.
결론
전 연구들과 비교하였을 때, 몇몇 같은 인구통계학적, 사회경제적, 심리사회적 요소들이 자영업자와 임금근로자에서 우울증상을 이끌어낸다. 그러나 몇몇 요소들은 임금근로자와 다르게 나타난다. 따라서 자영업자에서 우울증을 예방하기 위해 다른 간섭이 필요할 것으로 보인다.

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    Yu‐Ting Huang, Ming‐Shyan Lin, Kathy James, Chia‐Hao Chang, Wen‐Hsuen Tsai, Yu‐Chih Lin, Mei‐Yen Chen
    Journal of Advanced Nursing.2023; 79(8): 3025.     CrossRef
  • Association between physical risk factors and sleep disturbance among workers in Korea: The 5th Korean Working Conditions Survey
    Inho Park, Seunghan Kim, Yangwook Kim, Byungyoon Yun, Jin-Ha Yoon
    Sleep Medicine.2022; 100: 157.     CrossRef
  • Changes in the Health Indicators of Hospital Medical Residents During the Four-Year Training Period in Korea
    Ji-Sung Ahn, Seunghyeon Cho, Won-Ju Park
    Journal of Korean Medical Science.2022;[Epub]     CrossRef
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Application of cold intolerance symptom severity questionnaire among vibration-exposed workers as a screening tool for the early detection of hand-arm vibration syndrome: a cross-sectional study
A Ram Kim, Dae Yun Kim, Ji Soo Kim, Heun Lee, Joo Hyun Sung, Cheolin Yoo
Ann Occup Environ Med 2019;31:6.   Published online March 1, 2019
DOI: https://doi.org/10.1186/s40557-019-0284-x
AbstractAbstract PDFPubReaderePub
Background

The detection rate of hand-arm vibration syndrome (HAVS) is very low in South Korea compared with other countries. The absence of uniform consensus and guidelines for diagnosing HAVS has been presumed to be one of the reasons. The HAVS has various manifestations including cold intolerance and its severity can be measured using the cold intolerance symptom severity (CISS) questionnaire. This study aimed to determine whether the CISS questionnaire, being used as a screening tool, can aid in the early detection of HAVS.

Methods

A total of 76 male workers with vibration-induced symptoms were enrolled as the final study participants. To compare the CISS score of healthy individuals, 41 men who had never been exposed to local vibration were included in the study. In addition to the former medical questionnaire, the participants answered the CISS questionnaire. A statistical analysis was conducted to identify the association of CISS scores with vibration induced symptom and to determine its cut off value.

Results

The reliability of the CISS questionnaire was proven to be good, with a total Cronbach’s alpha of 0.922. The mean CISS score of the exposed group increased in every vascular stage [stage 0 = 42.6 (18.5); stage 1 = 59.4 (14.1); and over stage 2 = 60.2 (21.6)]. They were significantly higher than that of the non-exposed group. The result was fairly consistent with those in the sensorineural stage. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under curve (AUC) of 30 were 88.5, 65.3, 76.1, 82.1 and 0.769, respectively. From the result of logistic regression, the adjusted odds ratio of both components increased by the CISS score grouped by 30s.

Conclusions

The self-reported CISS questionnaire, used to measure the degree of cold intolerance, showed high agreement with the Stockholm classification of HAVS. Hence, we recommend the use of this questionnaire to assess the level of cold intolerance among vibration-exposed workers and detect individuals who are at risk of vibration-induced impairment with a cutoff value of 30.

Trial registration

IRB No. 2018–07–040-001. Registered on 4 September 2018.


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The effect of diabetes on 4-year changes of hearing thresholds in male workers exposed to noise in a single company: a longitudinal study
Dae Yun Kim, A Ram Kim, Joo Hyun Sung, Choong Ryeol Lee, Jiho Lee
Ann Occup Environ Med 2019;31:e11.   Published online June 28, 2019
DOI: https://doi.org/10.35371/aoem.2019.31.e11
AbstractAbstract PDFPubReaderePub
Background

Recently, several studies have assessed the association between diabetes and hearing impairment. However, the effect of diabetes on hearing impairment is not well known in diabetic patients exposed to noise, a typical cause of hearing impairment. The aim of this study is to longitudinally analyze the effect of diabetes on hearing impairment in workers exposed to similar noise levels from 2013 to 2017 who had experienced little change in their working conditions.

Methods

The study subjects included 2,087 male workers exposed to noise in a single company and who underwent health examinations at the same hospital in Ulsan city in 2013 and 2017. Hearing impairment was defined that a pure-tone average of pure-tone audiometry (PTA) thresholds at 1,000, 2,000, 3,000, and 4,000 Hz was 25 dB and over in both ears. Statistical analyses were conducted using χ2 tests, ANOVA, and Cox proportional hazard models. We analyzed covariates that might affect hearing impairment, including age; working period; levels of total cholesterol, triglyceride, and serum creatinine; smoking and alcohol history; and noise level.

Results

The average PTA thresholds and their average changes between 2013 and 2017 were significant in the diabetes mellitus (DM) group than those in the normal and impaired fasting glucose group. Among the subjects with the same status of fasting glucose group in 2013 and 2017, the adjusted hazard ratios for incident hearing impairment among those in the DM group compared to normal group were 3.35 (95% confidence interval [CI], 1.54–7.29) in the left ear and 5.66 (95% CI, 2.01–15.98) in the right ear.

Conclusions

This study suggested that the risk of hearing impairment in the DM group was significantly higher than that in the normal group in both ears, even when exposed to similar noise levels.


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Ann Occup Environ Med : Annals of Occupational and Environmental Medicine
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