Annals of Occupational and Environmental Medicine

Eun A Kim

9 Articles

An Occupational Erythema Multifome Case of a Worker Exposed to Dichlone and 3,3'-Dichlorobenzidine in a Dye Manufacturing Process: Jae Seung Yong, Jung Won Kim, Eun A Kim; Korean Journal of Occupational and Environmental Medicine 2012;24(3):311-318. Published online September 30, 2012; DOI: https://doi.org/10.35371/kjoem.2012.24.3.311

Abstract PDF: BACKGROUND
In Korea, the only case of occupational erythema multiforme was found to be due to Bolivian rosewood, but there has been no case due to occupational chemicals in the manufacturing industry. Here, we report a case of erythema multiforme caused by dichlone and 3,3'-dichlorobenzidine(DCB) in a dye worker.
CASE
REPORT: We report a 43-year-old male worker manifesting erythema multiforme-like skin lesions during the DCB synthesis, The patient's dermatitis was relieved when he avoided the process, and it became aggravated when he restarted his work. Patch and prick tests confirmed positive irritant reactions to two chemicals.
CONCLUSION
This case was diagnosed as erythema multiforme based on clinical manifestations. Symptoms worsened upon exposure to chemicals while avoiding exposure improved symptoms. Skin test results showed that dichlone and 3,3'-dichlorobenzidine induced irritant reactions. We assume that erythema multiforme occurring in workers is an occupational skin disease likely caused by dichlone and 3,3'-dichlorobenzidine.

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The Prevalence of Work Related Sickness Absences According to the Second Korean Working Condition Survey: Ki Hun Hong, Dae Seong Kim, Oh Jun Kwon, Eun A Kim; Korean Journal of Occupational and Environmental Medicine 2011;23(4):428-438. Published online December 31, 2011; DOI: https://doi.org/10.35371/kjoem.2011.23.4.428

OBJECTIVES
Worker's health is an important index used to evaluate working conditions and to prioritize prevention policies. However, this index has never before been calculated in Korea. The purpose of this study was to calculate the prevalence of health problems caused by work related sickness absences using the second Korean Working Condition Survey (KWCS) conducted in 2010.
METHODS
The second KWCS was conducted from June to October 2010 as a household survey for employed workers. The work related sickness absence rate was estimated using gender, age, business size, occupational status, level of education, and level of income. A logistic regression was performed in order to evaluate the relationship of the work related sickness absence with general characteristics and work-related conditions.
RESULTS
The rate of work related sickness absence was 1.8(+/-0.2)% for all workers, with 6.0(+/-0.3)% of it being in agriculture, forestry, and fishing, and 2.2(+/-0.5)% in manufacturing. Musculoskeletal disorders (MSD) were the most common work related disorder [1.01(+/-0.12)%], followed by psychiatric disorders [0.18(+/-0.05)%], and respiratory disorders [0.14(+/-0.04)%]. The highest odds ratio (OR) for the work related sickness absence rate was in self-employed workers with employees (OR=2.23, 95%CI=1.05~4.74).
CONCLUSIONS
The work related sickness absence rate for all workers, both self-employed and employed, including agriculture, forestry and fishing workers, and wholesale and retail trade workers was 1.8(+/-0.2)%. Because the KWCS was based on a self-reported questionnaire survey, this figure might be overestimated. In addition, it might omit chronic occupational disease and death cases.

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Association of Exposure to Chemicals with Dyspnea among Employed Workers: Analysis of the 3rdKorean Working Conditions Survey
Moon-Young Park, Sung-Ho Hwang, Kimyong Hong, Se-Eun Oh, Kyoung-Mu Lee
Journal of Korean Society of Occupational and Environmental Hygiene.2016; 26(1): 64. CrossRef

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Hot Tub Lung Due to Mycobacterium Avium Complex in a Public Bath: Chung Won Kang, Yun Kyung Chung, Hye Eun Lee, Eun A Kim, Yun Chul Hong, Soo Hun Cho; Korean Journal of Occupational and Environmental Medicine 2010;22(2):166-172. Published online June 30, 2010; DOI: https://doi.org/10.35371/kjoem.2010.22.2.166

Abstract PDF: BACKGROUND
Hot tub lung is a hypersensitivity pneumonitis caused by nontuberculous mycobacteria (NTM); the primary causative agent is Mycobacterium avium complex (MAC) post contaminated water exposure. Recently, 2 cases of hot tub lung were found in public bath bodyscrubbers working in Korea. However, the disease causing NTM was not identified in these cases. Here, we reported one case, along with clinical diagnostic approach to occupational medicine throughout worksite investigation.
CASE
A 53 year-old woman working in the public bath for 13 months' duration developed shortness of breath. She had been cleaning the locker room, several pools and floors every day, and using scrubbers with detergent and warm water. After examination, the patient was diagnosed with hypersensitivity pneumonitis based on high resolution computerized tomography and lung biopsy. Because the Mycobacterium avium was identified in both the patient's sputum and the warm pool, she was diagnosed with hot tub lung due to MAC.
CONCLUSION
Hot tub lung due to MAC was confirmed in public bath housekeeper. However, few cases have been reported, even though there are many cases. To prevent damages caused by hot tub lung, general environmental management such as ventilation and cleaning is important for bath operators. Likewise, awareness needs to be increased in workers with potential NTM environmental exposure and in clinicians through education about hot tub lung in order to reduce adverse harm from misdiagnosis and mistreatment of tuberculosis.

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One Case of Parkinson's Syndrome in a Shipyard Painter Exposed to Mixed Organic Solvents: Min Heui Jo, Hyung Woo Ryu, Eun A Kim; Korean Journal of Occupational and Environmental Medicine 2009;21(2):192-200. Published online June 30, 2009; DOI: https://doi.org/10.35371/kjoem.2009.21.2.192

Abstract PDF

BACKGROUND
It is well-known that organic solvents can cause various neurologic toxicities, and in particular, it had been reported that Parkinson's syndrome can be caused by organic solvents.
CASE
REPORT: A 53-year-old man who had worked for 13 years as a shipyard spray and brush painter and manifested with moderate cognitive disorder and was diagnosed with chronic toxic encephalopathy. We can assume he had had considerable exposure to organic solvents considering the estimates of the amounts of organic solvents in his work place. He had no specific medical history. The Minnesota Multiphasic Personality Inventory (MMPI) showed mild cognitive deficit, depression, and anxiety. Single Photon Emission Computed Tomography (SPECT) indicated a slightly decreased flow at the edge of the left temporal brain area, while T2 brain Magnetic Resonance Imaging (MRI) showed no specific signs except for ischemic changes in small vessels in the periventricular and subcortical white matter. He was also diagnosed with both carpal tunnel syndrome and peripheral neuropathy through a neuroconductive study. Several years later, he developed progressive bradykinesia and rigidity and, later, resting tremors in the left hand. He was diagnosed with Parkinson's disease and treated with dopaminergic agents, but there was no effect. After that, he was given deep brain stimulation, both. As a result, his tremor is improved. but, the rigidity remained. Three years later, He has continuously received dopaminergic therapy. but, he complains about tremors in both hands and more greatly reduced cognitive function.
CONCLUSION
In this case, we assumed by patient's work history and exposure estimates that he was exposed to excessive levels of organic solvents. The clinical symptoms of this patient were very similar to those from Parkinson's disease, but the psychological symptom appeared earlier than the other symptoms and there was no response to dopaminergic agents. We conclude that this case is likely Parkinson's syndrome caused by organic solvents.

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Overview of occupational cancer in painters in Korea
Jun-Pyo Myong, Younmo Cho, Min Choi, Hyoung-Ryoul Kim
Annals of Occupational and Environmental Medicine.2018;[Epub] CrossRef
The Work Environment and Wearing Conditions of Industrial Protective Clothing in Shipbuilding Workshops
Hyun-Sook Bae, Min-Young Kim
Journal of the Korean Society of Clothing and Textiles.2012; 36(5): 512. CrossRef
Occupational Neurological Disorders in Korea
Eun-A Kim, Seong-Kyu Kang
Journal of Korean Medical Science.2010; 25(Suppl): S26. CrossRef

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Exposure Level of Trichloroethylene in Stevens-Johnson Syndrome Due to Occupational Exposure: 3 Case Reports and a Review of Other Cases: Sun Wung Lee, Eun A Kim, Dae Sung Kim, Dong hee Koh, Seong Kyu Kang, Byung Kyu Kim, Min Ki Kim; Korean Journal of Occupational and Environmental Medicine 2008;20(2):132-146. Published online June 30, 2008; DOI: https://doi.org/10.35371/kjoem.2008.20.2.132

Abstract PDF

BACKGROUND
Trichloroethylene (TCE) has been reported to be related to severe generalized exfoliative dermatitis frequently accompanied by toxic hepatitis. The measurements of environmental exposure were limited in the previous case reports and the reported exposure values were also diverse. We reviewed three cases of Stevens-Johnson syndrome associated with TCE. The work environment was measured by the Korea Occupational Safety and Health Agency (KOSHA) after the cases occurred. From the study results, we intended to clarify the relationship between TCE exposure level and Stevens- Johnson syndrome.
CASE
REPORT: Case 1. A 24-year-old Filipino female worker developed a skin rash 35 days after starting to use TCE for degreasing. The skin rash developed into a bullous eruption and the liver function findings were abnormal. She was diagnosed with Stevens-Johnson syndrome and toxic hepatitis. She died of hepatic failure 39 days after the onset of the first symptom. She had no previous history of taking medicine or viral infection. The work environment measured 22.0 to 32.3 ppm (personal exposure level) with TWA. Case 2. A 47-year-old Korean male worker developed a skin rash, 20 days after starting to use TCE for degreasing. The skin rash developed into a bullous eruption and the liver function findings were abnormal. He was diagnosed with Stevens-Johnson syndrome, toxic hepatitis and sepsis. He died of hepatic failure and sepsis 42 days after the onset of the first symptom. He had no previous history of taking medicine or viral infection. The work environment measured 30.1 ppm (personal exposure level) and 116.5~229.7 ppm (area exposure level close to the degreasing machine) with TWA. Case 3. A 22-yearold Vietnamese female worker developed a skin rash 30 days after starting to use TCE for degreasing. The skin rash developed into a bullous eruption and the liver function findings were abnormal. She was diagnosed with Stevens-Johnson syndrome and toxic hepatitis. Her symptoms improved and she was discharged 37 days after the onset of the first symptom. She had no previous history of taking medicine or viral infection. The work environment measured 107.2 ppm (personal exposure level) with TWA.
DISCUSSION
These three case reports and the previously reported cases indicated that the majority of people susceptible to TCE develops Stevens-Johnson syndrome after high-level TCE exposure (above the TWA occupational exposure limit of 50 ppm). Therefore, work environmental survey and improvements to the TCE degreasing process are essential to prevent high exposure. Furthermore, considering the consistency of the latency period in symptoms and the possibility of sensitization in low-level exposure, we recommend that the first specific health examination also should be conducted 1 month after workers have commenced working.

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Occupational Inhalation Health Risk Assessment of TCE Exposure in the Korean Manufacturing Industry
Sueji Seo, Saemi Shin, Sanghoon Byeon
Applied Sciences.2024; 14(13): 5510. CrossRef
A case report of toxic hepatitis caused by chloroform in automotive parts manufacturer coating process
Jong Hyun Hwang, Jung Il Kim
Annals of Occupational and Environmental Medicine.2022;[Epub] CrossRef
Trichloroethylene Hypersensitivity Syndrome: Should Be Considered When Diagnosing DRESS Syndrome
Young Joong Kang, Jihye Lee, Jungho Ahn, Soonwoo Park, Mu Young Shin, Hye Won Lee
Journal of Korean Medical Science.2018;[Epub] CrossRef
Acute Occupational Poisoning in Korea
Hyunjoo Kim, Jia Ryu
The Ewha Medical Journal.2016; 39(4): 99. CrossRef
Late-onset trichloroethylene-induced hypersensitivity syndrome after intermittent exposure to low-dose trichloroethylene
Seung Yun Lee, Se Hwan Oh, Hyuck Jae Choi, Woo Young Choi, Jee Young Han, Hong-Lyeol Lee, Cheol-Woo Kim
Allergy, Asthma & Respiratory Disease.2016; 4(2): 145. CrossRef
Compensation for Work-Related Hematologic, Liver, and Infectious Diseases
Jung-Won Kim, Dong-Mug Kang
Journal of Korean Medical Science.2014; 29(Suppl): S66. CrossRef
Occupational Hepatic Disorders in Korea
Hyoung Ryoul Kim, Tae Woo Kim
Journal of Korean Medical Science.2010; 25(Suppl): S36. CrossRef
Extensive changes to occupational exposure limits in Korea
Jee Yeon Jeong, Sangjun Choi, Young Lim Kho, Pan Gyi Kim
Regulatory Toxicology and Pharmacology.2010; 58(2): 345. CrossRef
Occupational Diseases in Korea
Seong-Kyu Kang, Eun A Kim
Journal of Korean Medical Science.2010; 25(Suppl): S4. CrossRef
Current status of liver diseases in Korea: Toxic and alcoholic liver diseases
Kyung-Ah Kim
The Korean Journal of Hepatology.2009; 15(Suppl 6): S29. CrossRef

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Prevalence of Occupational Asthma and Exposure Level of Pharmaceutical Dust of Workers in a Pharmaceutical Company: Sung Soo Oh, Yong Hyu Choi, Eun A Kim, Young Mok Lee, Jae Kil Jang, Jang Jin Yoo, Seung Hyun Park, Soo Young Jung, Tae Kyun Kim, Kyoo Sang Kim, Seong Kyu Kang; Korean Journal of Occupational and Environmental Medicine 2006;18(2):94-102. Published online June 30, 2006; DOI: https://doi.org/10.35371/kjoem.2006.18.2.94

Abstract PDF

OBJECTIVES
After the investigation of one worker with occupational asthma, we surveyed the prevalence of occupational asthma and the exposure level of pharmaceutical dust of 32 workers in a pharmaceutical company.
METHODS
Thirty-two of the 90 employees participated in the survey which consisted of questionnaire, blood sampling, spirometry and skin prick tests with 8 common allergens as well as 9 antibiotics and 2 enzymes. Various indices of the working environment were also measured. Subjects who had a symptom suggestive of work-related asthma or positive skin prick test were further investigated by PC20 methacholine. Nine subjects who had a PC20 result of 16 mg/ml or less (n=7) or had work-related symptoms and positive skin prick test (n=2) were referred to undergo a specific bronchial provocation test to pharmaceutical dust in an academic allergic disease center.
RESULTS
Eleven of 32 workers (34.4%) had a work-related symptom suggestive of occupational asthma. Ten (31.2%) showed positive skin prick test. 8 (25.0%) had a PC20 result of 16 mg/ml or less (indicative of significant bronchial hyperresponsiveness), and 5 (15.6%) had a positive result on the specific bronchial provocation test. Exposure levels of stuffing, input of raw materials and screening process were relatively high.
CONCLUSIONS
This survey showed that pharmaceutical workers have an increased risk of occupational asthma. Although pharmaceutical factories maintain a relatively good working environment, careful control of respiratory tract exposures, especially during stuffing, input of raw materials and screening process, is important to prevent occupational asthma. Pharmaceutical workers need to undergo regular skin prick and methacholine bronchial provocation tests, as well as asthmatic symptom survey, to ensure the early detection and prevention of occupational asthma.

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Occupational Diseases in Korea
Seong-Kyu Kang, Eun A Kim
Journal of Korean Medical Science.2010; 25(Suppl): S4. CrossRef

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Risk Factor Assessment Using Surface Electromyography and Electrogoniometer among Automobile Part Manufacturers: Dongmug Kang, Cheol Ho Yee, Yong Chul Shin, Eun A Kim, Ji Hoon Woo, Byung Mann Cho, Su Ill Lee; Korean Journal of Occupational and Environmental Medicine 2005;17(4):267-277. Published online December 31, 2005; DOI: https://doi.org/10.35371/kjoem.2005.17.4.267

Abstract PDF

OBJECTIVES
As automobile part manufacturing is characterized by high speed and high repetition, observation methods which are usually utilized for static posture are inappropriate to evaluate musculoskeleatal risk factors. This study quantified the risk factors of musculoskeletal disorders on the forearm and suggested exposure limits by estimating the risk factors using surface electromyography (EMG) and electrogoniometer.
METHODS
Ten percent of the total workers at 3 automobile part manufacturing factories were randomly selected, and 99 male workers were recruited as study subjects. The study was conducted during May 2003 to September 2004. The workers were equipped with electrogoniometers on the wrist and the elbow, surface EMGs on the skin of the flexor digitorum superficialis (FDS) and extensor carpi radialis (ECR) muscles, and the heart beat recorder during work as indicators of joint movement, local muscle tension and physical work load, respectively.
RESULTS
After controlling for age, body mass index and job stress, wrist flexion maximum angle, FDS relative activity (RA) and ECR RA were significantly associated with forearm musculoskeletal symptoms. The odds ratios of the forearm were 5.0(95% CI: 1.1-22.7), 14.0(95% CI: 1.5-128.8) and 7.3(95% CI: 1.1-49.4) for wrist flexion maximum angle more than 76 degrees, FDS RA more than 2.8%, and ECR RA more than 3.5%, respectively.
CONCLUSIONS
Joint angle and focal muscle activity were associated with forearm musculoskeletal symptoms. To reduce forearm musculoskeletal symptoms among automobile part manufacturers, the wrist flexion angle, and FDS and ECR activity need to be reduced below the guidelines recommended in this study.

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Quantification of physical stress experienced by obstetrics and gynecology sonographers: A comparative study of two ultrasound devices
Yong-Ku Kong, Min-Uk Cho, Chae-Won Park, Seoung-Yeon Kim, Min-Jung Kim, Junpil Moon, Sungwon Lim, Byung-Mo Oh, Banseok Han, JunHee Choi, Kyeong-Hee Choi
Applied Ergonomics.2022; 100: 103665. CrossRef

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Monitoring of Polycyclic Aromatic Hydrocarbons and the metabolites in Workers using Coal tar Paints: Eun A Kim, Jong Tae Lee, Eun Hye Kwon, Jong Seong Lee, Yong Hack Lee, Hyun Seok Kwag, Seong Bong Choi, Iu Jin Lee, Jae Hoon Shin, Kwang Jin Shim, Sang Hwa Urm, Sung Jun Kim, Hae Sook Shon, Jin Ho Chun; Korean Journal of Occupational and Environmental Medicine 2005;17(3):161-172. Published online September 30, 2005; DOI: https://doi.org/10.35371/kjoem.2005.17.3.161

Abstract PDF

OBJECTIVE: In this study, the exposure levels of polycyclic aromatic hydrocarbons (PAHs) and urinary 1-hydroxypyrene(1-OHP) were surveyed among the workers using coal tar paint.
METHOD
The study subjects for the exposed group were 107 male coal tar workers in 10 factories, and for the comparison group were 201 male clerk workers who had never been exposed to coal tar paint. Ambient PAHs, and pre-shift and end-shift urinary 1-OHP were sample and 16 PAHs were analysed. Smoking history was recorded during the survey day.
RESULTS
The geometric mean of ambient concentration of total PAHs was 120.17 microgram/m3. Naphthalene had the highest level among the 16 PAHs. The pre-shift 1-OHP in the exposed group (8.89 micro mol/mol creatinine) was significantly higher than that in the control group (0.29 micro mol/mol creatinine). The end-shift 1-OHP in the exposed group (19.02 micro mol/mol creatinine) was significantly higher than that in the pre-shift (8.89 micro mol/mol creatinine) (Ed- confirm). 1-OHP of smokers was significantly higher than that of non-smokers in both groups. The difference between pre-shift and end-shift 1-OHP in smokers (12.40 micro mol/mol creatinine) was twice as high as that in non-smokers (6.06 micro mol/mol creatinine). The difference of 1-OHP between smokers and nonsmokers was 7.59 micro mol/mol creatinine in pre-shift and 13.96 micro mol/mol creatinine in end-shift. Thus, the effect of smoking and exposure to PAHs on 1-OHP may not be additive. In regression analysis for 1-OHP, the significant independent variables were pre-shift 1-OHP and PAHs. The direction of these variables was positive. When the analysis was performed in workers exposed to higher PAHs, smoking was significant independent variable.
CONCLUSION
The above results suggest that not only ambient PAHs but also smoking, one of the most important non-occupational PAHs source, influenced the level of 1-OHP. Moreover, the effect of smoking to 1-OHP changed according to the exposure level of PAHs.

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Overview of occupational cancer in painters in Korea
Jun-Pyo Myong, Younmo Cho, Min Choi, Hyoung-Ryoul Kim
Annals of Occupational and Environmental Medicine.2018;[Epub] CrossRef
A study of the status of exposure to polycyclic aromatic hydrocarbons (PAHs) in relation to its metabolites among workers in a Korean chemical factory
Kwan Lee, Hyun-Sul Lim, Heon Kim
Ciência & Saúde Coletiva.2014; 19(12): 4809. CrossRef

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The Work-Related Cases among Bronchial Asthma Diagnosed at a University Hospital in Incheon: Chang Ho Chae, Seung Won Choi, Youg Hyu Choi, Young Woo Jin, Eun A Kim, Seong Kyu Kang; Korean Journal of Occupational and Environmental Medicine 1999;11(2):174-180. Published online June 30, 1999; DOI: https://doi.org/10.35371/kjoem.1999.11.2.174

Abstract PDF

Bronchial Asthma could be developed by occupational origin. 4-16% of bronchial asthmas are known to be related to occupational exposure. However, occupational asthma has not been reported from the periodic occupational health examination, but reported through case report from clinicians. The authors analysed hospital records to find out work-related bronchial asthma and their occupational characteristics at a university hospital in Jnchon. All records which were confirmed as bronchial asthma in adult by an allergist from June, 1996 to May, 1998 were selected. Through record reviewing, any suspected work related asthma was selected and the interview was done by phone or at the out-patient clinic. The possible cases were confirmed by additional tests including specific bronchial provocation test. Sixteen(3. 9%) out of 411 bronchial asthma were confirmed as work-related asthma. Eight cases out of 16 worked at furniture industry, three worked at dye manufacturing and two worked at musical instrument manufacturing industry. Others worked at farm and machinary industry. The confirmed asthmogen were toluene diisocyante(8), reactive dye(3), and grain dust(1). None of the cases was detected as work-related asthma in the periodic health examination. Twelve out of sixteen occupational asthma patients discontinued their work. The results suggested that many patients with occupational asthma were not reported and the periodic health examination was not an effective system for detecting the workrelated asthma. Thus, setting up the surveillance system involving allergist or pulmonologist would be important to detect and prevent occupational asthma.

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Clinical Importance of Work-Exacerbated Asthma: Findings From a Prospective Asthma Cohort in a Highly Industrialized City in Korea
Woori Jo, Kwang Won Seo, Hwa Sik Jung, Chui Yong Park, Byung Ju Kang, Hyeon Hui Kang, Seung Won Ra, Yangjin Jegal, Jong Joon Ahn, Soon Eun Park, Moon Sik Jung, Ju Ik Park, Eun Ji Park, Chang Sun Sim, Tae-Bum Kim, Taehoon Lee
Allergy, Asthma & Immunology Research.2021; 13(2): 256. CrossRef
Work-Related Asthma in Korea - Findings from the Korea Work-Related Asthma Surveillance (KOWAS) program, 2004-2009
Soon-Chan Kwon, Jaechul Song, Yong-kyu Kim, Geoffrey M. Calvert
Allergy, Asthma & Immunology Research.2015; 7(1): 51. CrossRef
Occupational Asthma in Korea
Sung Soo Oh, Kyoo Sang Kim
Journal of Korean Medical Science.2010; 25(Suppl): S20. CrossRef
Occupational Diseases in Korea
Seong-Kyu Kang, Eun A Kim
Journal of Korean Medical Science.2010; 25(Suppl): S4. CrossRef

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