Annals of Occupational and Environmental Medicine

Kwan Lee

5 Articles

The Association between Trans, Trans-Muconic Acid as a Biomarker for Benzene Exposure and the Platelet Count: Young Sun Min, Kuck Hyun Woo, Jin Seok Kim, Jay Young Yoo, Kwan Lee, Hyun Sul Lim, Heon Kim; Korean Journal of Occupational and Environmental Medicine 2010;22(2):95-101. Published online June 30, 2010; DOI: https://doi.org/10.35371/kjoem.2010.22.2.95

Abstract PDF: OBJECTIVE: Recent researches suggest that trans,trans-muconic acid (t,t-MA) would be an adequate metabolic biomarker for low-level benzene exposure. Few study have investigated the association between the t,t-MA and platelet count, and this is the primary aim of this study.
METHODS
From May 2004 to June 2004, 326 chemical factory workers took part in a questionnaire survey and they underwent urinary t,t-MA and CBC assessment. The questionnaire covered general aspects of health and the occupational and smoking histories. Statistical analyses of outcomes were performed using SPSS 14.0 for Windows.
RESULTS
The subjects' urinary t,t-MA concentration (geometric mean and geometric standard deviation) was 0.28 mg/g creatinine (2.62). No significant differences between different occupations among the chemical workers were found. The urinary t,t-MA concentrations in the smokers and non-smokers were 0.32 mg/g creatinine (2.44) and 0.25 mg/g creatinine (2.77) respectively, and the difference was statistically significant (p<0.05). There was no significant difference in the platelet count based on occupation and the smoking history. There was significant correlation between log(platelet) and log(t,t-MA)(r=-0.116 p=0.039). The regression equation log(platelet) = -0.002xAge + [-0.029xlog(t,t-MA)] + 2.436, R2=0.032, was calculated from linear regression analysis with log(platelet) as the dependent variable. Cross-tabulation between 2 subgroups that were divided by the 90-percentile level of the t,t-MA (0.819 mg/g creatinine), and 2 subgroups that were divided by the 10-percentile level of the platelet count (175,000) was conducted. Higher distribution in subgroup with platelet count below 175,000 was demonstrated in the subgroup with a urinary t,t-MA above the 90-percentile, with an odds ratio of 3.01.
CONCLUSIONS
The study may be limited by not taking into account factors such as smoking quantity and sorbic acid, which may confound urinary the t,t-MA concentration as well as medication and infection that may affect the platelet count. Yet it is meaningful that the correlation between the urinary t,t-MA concentration and the platelet count was found through linear regression analysis and the chi-square test, and further, this outcome may be used as a basis for a study to establish the acceptable limit of urinary t,t-MA in Korea.

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Urinary Cotinine Concentrations of Cases with Green Tobacco Sickness: Kwan Lee, Hyun Sul Lim, Heon Kim, Si Hyun Nam; Korean Journal of Occupational and Environmental Medicine 2004;16(4):413-421. Published online December 31, 2004; DOI: https://doi.org/10.35371/kjoem.2004.16.4.413

OBJECTIVES
This study was carried out to measure the urinary cotinine concentrations of Korean tobacco harvesters with green tobacco sickness (GTS).
METHODS
We conducted a questionnaire survey and measured the urinary cotinine concentrations among the cases who visited six health subcenters and the emergency room in the Health Center and County Hospital after harvesting tobacco leaves in Cheongsong-gun, from Jul 15 to Aug 15, 2002. Ten suspected GTS cases were compared to 10 controls matched for residence, age, and sex. Urinary cotinine was analyzed with a reverse-phase high performance liquid chromatography (HPLC) system and expressed as geometric mean and standard deviation. The data collected were evaluated using the SPSS/win statistical package and the urinary cotinine concentrations between the two groups were analyzed by Mann-Whitney U test.
RESULTS
In both the 10 cases and controls, there were 3 males and 7 females. Ages ranged from 22 to 70 years old. Half of the cases were reported within the 6 hours between 12:00 pm and 17:59 pm. The median time from starting work to initially feeling ill was 4.3 hours (min. 2.5; max. 11.0). The GTS symptoms reported were nausea in 10 cases (100.0%), dizziness in 9 (90.0%), weakness in 8 (80.0%), headache in 7 (70.0%) and other symptoms. The geometric mean of urinary cotinine concentrations was significantly higher (p<0.01) in cases at 497.6 +/- 2.5 ng/ml (min. 73.1; max. 2,574.3) than in controls at 32.7 +/- 1.8 ng/ml (min. 13.3; max. 76.9).
CONCLUSIONS
Our study suggests that many tobacco harvesters may suffer from GTS in Korea. Therefore, it is very important for doctors to diagnose exactly the GTS. Also we must develop the methods which can prevent GTS, and simple methods of analysis for urinary cotinine.

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Green Tobacco Sickness Among Tobacco Harvesters in a Korean Village
Sung-Jun Park, Hyun-Sul Lim, Kwan Lee, Seok-Ju Yoo
Safety and Health at Work.2018; 9(1): 71. CrossRef
Nicotine Exposure in Green Tobacco Harvesters
Yun-Keun Lee, Won Kim, In-Ja Choi
Korean Journal of Environmental Health Sciences.2010; 36(3): 208. CrossRef

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A Study on the Occupational Hazards Associated with Chronic Renal Failure: Kwan Lee, Hyun Sul Lim, Jeong Ho Lee; Korean Journal of Occupational and Environmental Medicine 2004;16(1):25-36. Published online March 31, 2004; DOI: https://doi.org/10.35371/kjoem.2004.16.1.25

Abstract PDF: OBJECTIVE: Recently, chronic renal failure has become a major public health problem all around the world, and the number of patients in Korea affected by this disease has sharply increased since the 1980's. Between 3% and 50% of all cases of chronic renal failure may be induced by toxic agents. The purpose of our study was to investigate the occupational hazards associated with chronic renal failure, in order to use the findings as a reference for further epidemiologic studies.
METHODS
The author conducted a questionnaire and reviewed the medical records of chronic renal failure patients (161 people out of 238) in Gyeongju-si and Pohang-si from March 2 to 31, 2003. Those cases of chronic renal failure which were related to work were classified as either 'probable case' if they were of unknown origin or 'suspected case' if they were of known origin and were related to hypertension or diabetes mellitus.
RESULTS
The study subjects consisted of 92 males (57.1%) and 69 females (42.9%). The causalities listed in the medical records were diabetes mellitus in 55 cases (40.4%), hypertension in 28 cases (20.6%), chronic glomerulonephritis in 14 cases (10.3%), and other diseases. There were 10 cases (6.2%) that were believed to be related to the patients' occupations. The hazards that these 10 patients had previously been exposed to were silica, organic solvents, tin, copper, lead, cadmium, and other hazards.
CONCLUSIONS
Through this study, 10 cases that were reportedly related to occupational chronic renal failure were discovered. Further studies such as a case-control study of occupational risk factors related to chronic renal failure will be needed.

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Status of the Occupational Health and Safety Programs of Several Hospitals in Korea: Kwan Lee, Hyun Sul Lim, Soo keun Kim; Korean Journal of Occupational and Environmental Medicine 2003;15(4):351-363. Published online December 31, 2003; DOI: https://doi.org/10.35371/kjoem.2003.15.4.351

Abstract PDF

OBJECTIVES
As health care workers suffer from various hazards in hospital, an occupational safety and health program is very important to them. This study was conducted to investigate the status of the occupational safety and health programs of several hospitals in Korea.
METHODS
We conducted a questionnaire survey on 941 hospitals in Korea. All questionnaires were posted to the department of general affairs at each hospital and responses were received from 108 hospitals (11.5%). Eight responses were excluded because of insufficient data and the remaining 100 questionnaires were analyzed. The collected data were evaluated using the SPSS 10.0 statistical package and the demands for occupational safety and health programs between two groups were analyzed by RIDIT analysis.
RESULTS
The study subjects were 53 general hospitals and 47 hospitals. An occupational safety and health committee, infection control committee, safety manager, health manager, activities for vaccination, reports for needle stick injury and records related to occupational injury were more likely to be present in general hospitals than hospitals (p<0.05). Demands for occupational safety and health were higher in general hospitals than hospitals. Especially, demands for measurement of working environment, improvement of ventilatory system, management of chemical materials and supply of protective equipment were significantly higher in general hospitals than hospitals (p<0.05).
CONCLUSIONS
We concluded from the findings of our study that occupational safety and health programs are not yet sufficient in Korean hospitals. So, we expect that special management, policies and laws for health care workers will be promulgated.

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Health Disorders Caused by Physical Factors among Health Care Workers - Focusing on Ionizing Radiation -
Hyun-Sul Lim
Journal of the Korean Medical Association.2010; 53(6): 483. CrossRef

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Cold Sensitization Occurring in a Worker of a Cold Storage Warehouse: Hyun Sul Lim, Kwan Lee, Jong Min Lee; Korean Journal of Occupational and Environmental Medicine 2002;14(2):204-212. Published online June 30, 2002; DOI: https://doi.org/10.35371/kjoem.2002.14.2.204

Abstract PDF: OBJECTIVES
The following is a report on a case of cold sensitization in a worker who served as a forklift truck driver in a cold storage warehouse for 5 years from 1996.
METHODS
We examined the patient's blood chemistry and infrared computerized thermographic measurements. We also reviewed the environmental temperatures at his workplace and interviewed other workers.
RESULTS
The worker was a 32-year-old male who had worked in a cold storage warehouse for 5 years (1996-2000). He complained of headaches, arthralgia, and slight dyspnea after 2 years work serving as a forklift truck driver in a cold storage facility. In the laboratory record of his blood and those of others, the C-reactive protein, rheumatoid facror, anti-nuclear antibody, cryoglobulin and other blood chemistries were all negative except that the anti-streptolysin O titer was reactive and alkaline phosphatase was also increased. The radiologic findings were normal. Using infrared computerized thermographic measurements, the patient's hands were at around 30 degrees C and below in the first infrared image and around 27 degrees C in the third image. Accordingly, he was diagnosed as having cold sensitization, which occurs in persons exposed to cold for long time, especially below freezing point.
CONCLUSIONS
We confirmed that the cold sensitization occurred in this patient as an occupational disease due to an exposure to cold. To prevent cold injury, we must modify work procedures, begin comprehensive medical surveillances, educate workers on risks of cold, and increase workers awareness of safety regulations in the workplace.

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