Annals of Occupational and Environmental Medicine

Hyoung Ah Kim

6 Articles

A Validation of the Korean Version of QEESI(c) (The Quick Environmental Exposure and Sensitivity Inventory): Byoung Hak Jeon, Se Hoon Lee, Hyoung Ah Kim; Korean Journal of Occupational and Environmental Medicine 2012;24(1):96-114. Published online March 31, 2012; DOI: https://doi.org/10.35371/kjoem.2012.24.1.96

OBJECTIVES
A standardized questionnaire is not available for use as a screening tool to assess individuals with MCS/IEI in Korea. The QEESI(c), originally developed by Miller & Prihoda in 1998, helps researchers, doctors, and their patients identify individuals with MCS/IEI. Therefore, this study was conducted in order to create a Korean version of the QEESI(c) and evaluate whether this Korean version could be used as an effective MCS/IEI screening tool in Korea.
METHODS
The Korean version of the QEESI(c) was developed using a six-step approach: permission, forward translation, the first quality control, backward translation, cognitive debriefing and the second quality control, final proof reading. In order to collect data, we have done a sample survey in certain parts of Korea. A household was used as the sampling unit; we extracted random samples in each survey cluster and then interviewed two adults over 19 years of age living in each sampled household. A total of 300 subjects were recruited from the general population in local community. The factor structure in the Korean version of the QEESI was analyzed with 40 items on four sub-scales except for the 10 items in masking index using principal components analysis with Varimax rotation. A convergent validity test two sub-scales: chemical intolerance and symptom severity. We carefully compared the chemical intolerance with Nordin's chemical sensitivity scale and the symptom severity with Cho's subjective symptom score.
RESULTS
The results showed that the 40 items on the four sub-scales,' chemical intolerances',' symptom severity', 'life impact', and 'other intolerances', were consistent with those reported for the US population by Miller and Prihoda. The convergent validity wes very good (r=0.4; p<0.001, r=0.5; p<0.001, respectively). A good internal consistency (Cronbach' alpha=0.86~0.96) and test-retest reliability (r=0.87~0.90) were found in all scales, except for the internal consistency in the masking index.
CONCLUSIONS
The Korean version QEESI(c) showed a good reliability and validity. It should be necessary to conduct a MCS/IEI study adopting Korean version QEESI(c).

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What initiates chemical intolerance? Findings from a large population-based survey of U.S. adults
Claudia S. Miller, Raymond F. Palmer, David Kattari, Shahir Masri, Nicholas A. Ashford, Rodolfo Rincon, Roger B. Perales, Carl Grimes, Dana R. Sundblad
Environmental Sciences Europe.2023;[Epub] CrossRef
Does improving indoor air quality lessen symptoms associated with chemical intolerance?
Roger B. Perales, Raymond F. Palmer, Rudy Rincon, Jacqueline N. Viramontes, Tatjana Walker, Carlos R. Jaén, Claudia S. Miller
Primary Health Care Research & Development.2022;[Epub] CrossRef
Disease comorbidities associated with chemical intolerance
RaymondF Palmer, Tatjana Walker, RogerB Perales, Rodolfo Rincon, CarlosRoberto Jaén, ClaudiaS Miller
Environmental Disease.2021; 6(4): 134. CrossRef
Three questions for identifying chemically intolerant individuals in clinical and epidemiological populations: The Brief Environmental Exposure and Sensitivity Inventory (BREESI)
Raymond F. Palmer, Carlos R. Jaén, Roger B. Perales, Rodolfo Rincon, Jacqueline N. Forster, Claudia S. Miller, Wen-Jun Tu
PLOS ONE.2020; 15(9): e0238296. CrossRef
MCS/IEI Prevalence Rate of Workers Around an Accidental Release of Hydrogen Fluoride in Gumi Industrial Complex
Hye-Ji Han, Kuck-Hyeun Woo, Sung-Yong Choi, Byoung-Hak Jeon, Sangjun Choi
Journal of Korean Society of Occupational and Environmental Hygiene.2015; 25(4): 534. CrossRef
Allergic Diseases and Multiple Chemical Sensitivity in Korean Adults
Inchul Jeong, Inah Kim, Hye Jung Park, Jaehoon Roh, Jung-Won Park, Jae-Hyun Lee
Allergy, Asthma & Immunology Research.2014; 6(5): 409. CrossRef

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Effects of Respirator Use Evaluated by Urinary Hippuric Acid Concentration in Toluene-Exposed Workers: Bum Seok Kim, Chung Yill Park, Hyeon Woo Yim, Hyoung Ah Kim, Sang Yong Oh; Korean Journal of Occupational and Environmental Medicine 2001;13(4):461-469. Published online December 31, 2001; DOI: https://doi.org/10.35371/kjoem.2001.13.4.461

Abstract PDF

OBJECTIVES
This study was carried out in order to raise workers'recognition of the effects of respirator use by providing concrete and practical data.
METHODS
Twenty-six workers who dealt with toluene based ink and diluents at a gravure printing office in Seoul were investigated. The toluene exposure level and urinary hippuric acid level were monitored under respirator non-wearing(RNW) and under respiratory wearing(RW) conditions.
RESULTS
The mean concentrations of toluene exposed to each worker through the air of gravure printing office were 147.52+/-57.34 and 134.55+/-52.44 ppm on respirator non-wearing day and respirator wearing day, respectively. There was no significant difference in toluene exposure concentration for the two days. The mean concentration of urinary hippuric acid in RNW and RW groups were 1.51 (0.53) g/L and 0.49 (0.14) g/L, respectively, as measured at the end of the workday. There was a significant difference seen in urinary hippuric acid concentration between the two days. The urinary hippuric acid concentration began to increase at 4 hours after the start of the workday(13:00) in RNW. However, there was no significant increase until the end of the workday in the case of RW. The urinary hippuric acid concentration in RW reduced 89.3% as compared with the concentration seen in RNW. There was a significant correlation between the toluene concentration and the urinary hippuric acid concentration in RNW. The regression equation was Y (urinary hippuric acid concentration, g/L) = 0.007 X x(toluene concentration in the air, ppm) + 0.665.
CONCLUSIONS
Our results indicate that the respirator intercepted most toluene that may have been absorbed into the respiratory organs, and suggested that properly wearing a respiratory such as wearing the respirator during the entire workday and performing a proper fit test played an important role in the protection from toluene exposure

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Effects of Factors Associated with Urine Hippuric Acid Correction Values in Urinary Creatinine by HPLC and Jaffe Method and Specific Gravity HPLC Jaffe Method
Key-Young Kim, Jong-Gyu Kim, Ki-Nam Yoon, Wha-Me Park, Hun-Hee Park
Journal of Korean Society of Occupational and Environmental Hygiene.2015; 25(4): 493. CrossRef

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Effects of Stem Cell and Myeloperoxidase on Sister Chromatid Exchanges and Micronuclei Induction of Peripheral Lymphocytes by Styrene, Hydroquinone and Trichloroethylene: Kyung Jae Lee, Hyoung Ah Kim, Min Jung Shin, Jae Hyug Sung, Chung Yill Park, Hoon Han, Se Hoon Lee; Korean Journal of Occupational and Environmental Medicine 2001;13(3):315-324. Published online September 30, 2001; DOI: https://doi.org/10.35371/kjoem.2001.13.3.315

Abstract PDF: OBJECTIVES
The objective of this study was to identify the possible role of stem cell and myeloperoxidase (MPO) in the metabolic activation of styrene, hydroquinone and trichloroethylene, by investigating the effects of stem cell from umbilical cord blood and MPO on the frequency of sister chromatid exchange (SCE) and micronuclei (MN) induction in cultured human peripheral lymphocytes exposed to these chemicals.
METHODS
Isolated lymphocytes from whole blood were cultured for 72 hours. The cells were treated with 1.50 mM styrene, 50 microM hydroquinone and 1.50 mM trichloroethylene dissolved with acetone (30 microl in total volume) at 24 hours after the beginning of culture. Control group was treated with acetone only. Immediately after adding these chemicals, 1.3X1 06 cells/ml and 2.6X1 06 cells/ml stem cell or 1.0 and 2.0 unit MPO with H2O2 (for substrate) were added to the cultures. Slides were stained with Giemsa's solution, and acridine orange for sister chromatid exchange, and for micronucleus analysis, respectively.
RESULTS
The results were as follows: 1) Myeloperoxidase and stem cell did not significantly affect the frequencies of SCE or MN in the control group. 2) The frequency of SCE or MN with exposure to styrene did not different from control in the absence of stem cell or MPO. Sister chromatid exchange induced by styrene was significantly increased by adding stem cell or MPO in dose-dependent relationship. The frequency of MN induced by styrene significantly increased in the presence of 2.0 unit MPO. 3) The frequency of SCE was significantly increased with exposure to hydroquinone than acetone treated control in the absence of stem cell or MPO. Sister chromatid exchange induction by hydroquinone significantly increased dose-dependently in the presence of stem cell or MPO. There was a tendency of increase of the MN frequency induced by hydroquinone in the presence of stem cell or MPO, but not significant. 4) It was found that trichloroethylene itself did not increase SCE or MN frequency. Frequency of SCE induced by trichloroethylene was significantly increased with adding stem cell (low and high) and 2.0 unit MPO. Even though stem cell or MPO increased the frequency of MN of lymphocyte exposed to trichloroethylene, the difference was not significant.
CONCLUSIONS
Authors found that the frequencies of both sister chromatid exchange and micronucleus induced by styrene, hydroquinone, and trichloroethylene were increased significantly with the treatment of stem cell or myeloperoxidase. It was suggested that myeloperoxidase may therefore play an important role in the metabolic activation of styrene, hydroquinone, and trichloroethylene and myeloperoxidase probably be involved in the myelotoxicity of these chemicals.

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Performances of the WHO Neurobehavioral Core Test Battery among Mal Workers Occupationally Non-exposed to Neurotoxic Agents: Se Hoon Lee, Hyoung Ah Kim, Won Chul Lee, Seong Sil Chang, Kyung Jae Lee, Chung Yill Park, Chee Kyung Chung; Korean Journal of Occupational and Environmental Medicine 1995;7(1):139-151. Published online February 28, 1995; DOI: https://doi.org/10.35371/kjoem.1995.7.1.139

Abstract PDF: Five items among neurobehavioral core test battery of World Health Organization, including Santa Ana dexterity, pursuit aiming, digit symbol, simple reaction time, and Benton visual retention, were administered to the workers occupationally non-exposed to neurotoxic agents by operational guide for the WHO neurobehavioral core test battery. Subjects were volunteers from the industrial workers (117) and clerks (40). Detailed occupational history such as exposed agents including noise or vibration, educational level, residence, smoking and drinking habit were recorded. Most of the neurobehavioral tests were correlated with age and educational level. Smoking was correlated with pursuit aiming and digit symbol. Vibration affected pursuit aiming. Job type (industrial workers vs. clerks) and noise exposure did not affected among tested items. Multiple regression analysis was done for establishing predict equation to estimate normal ranges of the tests for male workers. Age was shown to be main independent variable affected for all tests except wrong dot of pursuit aiming. Educational level was also shown to affected most of the tests except Santa ana dexterity and wrong dot of pursuit aiming. Alcohol consumption affected Santa Ana dexterity, non-preferred hand, and smoking affected only wrong dot of pursuit aiming after multiple regression analysis.

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Current Medical Exantination Practiees for the Determination of Occupational Noise Induced Hearing Losses: Hyunurook Kim, Chee Kyung Chung, Hyoung Ah Kim, Young Man Roh, Seong Sil Chang; Korean Journal of Occupational and Environmental Medicine 1994;6(2):276-288. Published online September 30, 1994; DOI: https://doi.org/10.35371/kjoem.1994.6.2.276

Abstract PDF: Occupational hearing loss became the leading occupational disease by constituting 56% of all work-related diseases in Korea. However, the prevalence rates showed wide variations among the specific medical examination providers (SHFEPs) and were very low (0.8-1.4%) compared with those of 8.4% in Japan. This study was designed to identify sources of these variations by inyestigating current audiometric testing methods and the diagnostic criteria utilized by the ShfEPs. A questionnaire was distributed to each of 27 SMEPS selected from total 70 SMEPS. Among them, 20 ShfEPs were interviewed and the rest of them were given the questionnaire from by mail. Included in the survey from were questions concerning audiometric testing methods and procedure equipment, facility personnel and the diagnostic criteria utilized, The results were as follows: 1. Employee audiometric testings were primaTily conducted by nurses and nurse-aids who had formal training for audiometry because no training program had been established. No requirement about the quality of audiometric testing personnel was specified in the regulation. 2. Although audiometric testing equipment used by the SDfEPs should be periodically calibrated, a significant number of them were not properly calibrated. Most of the calibration services were provided by the outside contractors and were done with no uniformly established periods. No SMEPS conducted the daily functional calibration. Most of the ShfEPs did not keep their calibration records. 3. Initial audiometric testings were conducted at any available spaces in the workplace or at the testing room without considering noise level in that place. Follow-up audiometric testings were also provided without considering the worker's noise exposure. Although audiometric booths were used during tHe follow-up testinga most of them did not meet the ANSI noise reauirement for audiometric booths. 4. AltHough a standard diagnostic criterion was promulgated in the law, the criterion was not used uniffrmly by the SMEPs. In addition, some SMEPS were applying age corrections which were not incorporated into the regulation yet. Therefore wide range of prevalence in NIHU among SMEPS could have possibly been caused by variable audiometric testing procedures and methods. In conclusion, it was recommended that systematical and general measures, such as formal and regular training program for testers, quality control regulation of instnlment calibration, and establishment of standard diagnostic criteria, be established for solving current problems and assuring equity among SMEPs in diagnosing occupational hearing losses.

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Health Classification of Workers in Special Medical Examinations: Seung Han Lee, Won Chul Lee, Hyoung Ah Kim, Seung Sil Chang; Korean Journal of Occupational and Environmental Medicine 1994;6(2):289-301. Published online September 30, 1994; DOI: https://doi.org/10.35371/kjoem.1994.6.2.289

Abstract PDF: The findings of special medical examinations are not infrequently summarized in the form of health classification. This procedure seems valuable for the protection of workers'health from personal health as well as public health point of view, because health classification of workers provides occupations health workers with birds eye view informations in terms of medical, placement and educational procedures, which are to be followed after medical examinations. In this study, the authors have reviewed the existing systems of special medical examinations and Health classifications in different countries and those recommended by international organizations for the purpose of improving the current system in Korea. The important issues covered in this review in relation to health classification of workers included the categories of diseases, the examination and laboratory tests, the criteria for health level classification and the health instructions to be given at each health levels. It was found that the current health classification system in Korea could be featurea as follows : 1. Special medical examinations are always carried out in combination with general medical examinations, contributing to the detection of risk factors of occupational diseases. 2. The selection of examinees is always made on the basis of work environment monitoring, often resulting in the underdetection of exposed workers. 3. Even if the test items are properly selected according to the principles of occupational medicine, further review is required in the light of recent advances in the pathogenesis as well as early changes of occupational diseases and epidemiologic principles. 4. The criteria for the classfication of health levels are to be reviewed on the basis of clinical epidemiology. 5. The health instructions covered only medical and placement aspects, failing to introduce the concept of health promotion.

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