Annals of Occupational and Environmental Medicine

Yong Wook Kwon

5 Articles

Carpal Tunnel Configuration Measured by Ultrasonography as a Risk Factor of Carpal Tunnel Syndrome in Motor Part Manufacturing Workers: Duck Soo Kim, Hae Kwan Cheong, Hyun Sul Lim, Yong Wook Kwon, Jong Min Lee, Dae Hyun Cho, Dae Seob Choi; Korean Journal of Occupational and Environmental Medicine 2002;14(3):213-226. Published online September 30, 2002; DOI: https://doi.org/10.35371/kjoem.2002.14.3.213

OBJECTIVES
This study was conducted to evaluate individual susceptibility to carpal tunnel syndrome (CTS) by ultrasonographic measurement of the carpal tunnel configuration in workers doing repetitive work.
METHODS
The study subjects consisted of 24 male and 11 female workers in a soundproof material manufacturing company in Gyeongju. We conducted a self-reported questionnaire survey, a physical examination and an electrodiagnostic study (EDS) in April 2000. After the examination, jobs were rearranged for workers with CTS. A follow up physical examination, EDS, and measurement of the carpal tunnel by ultrasonography was done six months later.
RESULTS
Of those studied, prevalence of CTS was 63.6/100 persons among women and 29.2/100 persons among men. Mean depth and width of wrist was shorter in those with CTS compareal to the controls (p<0.05). The risk of CTS was higher in workers whose carpal tunnel ratio (displacement/width) was 0.17 or higher (OR 7.13, 95 % confidence interval 1.18-43.1), and in workers whose carpal tunnel area was less than 300 mm2 (OR 8.00, 95 % confidence interval 1.18-68.5). Carpal tunnel depth and depth/width ratio had a positive correlation with motor latency of the median nerve and median-ulnar sensory latency difference (p<0.05), whereas the carpal tunnel width, displacement/depth ratio, and area (width X displacement) had a negative correlation with median nerve latencies after adjusting for gender. Workers who showed an improvement in the clinical stage of CTS after job rearrangement had a significantly lower carpal tunnel displacement/width ratio and displacement/depth ratio. They also had smaller upper carpal tunnel area ( width X displacement) and larger upper carpal tunnel area [(depth-displacement) X width] than the controls (p< 0.05 ).
CONCLUSIONS
Ultrasonographic measurement of the carpal tunnel is a good predictor of susceptibility and prognosis of CTS in workers doing repetivive work.

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The Health Effect of Hand Arm Transmitted Vibration
Jung-Wan Koo
Journal of the Ergonomics Society of Korea.2013; 32(4): 303. CrossRef
Changes in the Thickness of Median Nerves Due to Excessive Use of Smartphones
Yeon-Seop Lee, Hoe-Song Yang, Chan-Joo Jeong, Young-Dae Yoo, Gwang-Yun Jeong, Jin-Seon Moon, Min-Kung Kang, Seong-Woo Hong
Journal of Physical Therapy Science.2012; 24(12): 1259. CrossRef

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Wrist Ratio as a Risk Factor of Carpal Tunnel Syndrome: Duck Soo Kim, Hae Kwan Cheong, Yong Wook Kwon; Korean Journal of Occupational and Environmental Medicine 2001;13(3):242-252. Published online September 30, 2001; DOI: https://doi.org/10.35371/kjoem.2001.13.3.242

Abstract PDF

OBJECTIVES
To evaluate the risk factors of the carpal tunnel syndrome (CTS) and the impact of the wrist ratio on the prevalence of CTS in workers on repetitive work over a long term.
METHODS
Study subjects consisted of 45 male and 16 female workers in a company that produces soundproof material in Gyeongju. We conducted a physical examination, a self-reported questionnaire survey and a nerve conduction study. CTS cases were defined as those subjects that had a positive finding in both the nerve conduction study and the physical examination done by a doctor specializing in rehabilitation medicine.
RESULTS
Prevalence of CTS among the study subjects was 26.2/100 persons. The prevalence of CTS was positively associated with increasing age (p<0.01, using the chi-square test for trend) and female gender (OR=6.98, 95% CI=1.66-31.0), but was negatively associated with the educational level (p<0.01 by the chi-square for trend). Workers in the production area had a higher prevalence of CTS compared to those in the clerical area (OR=10.8 in the frame manufacturing process, OR=32.2 in the vacuum molding process). Patients with CTS had a narrower mean wrist width and a shorter mean hand and palm length, compared to those that had no disease (p<0.01 by the Student's t-test). The number of subjects who had a wrist ratio of 0.74 or more was significantly higher in cases of CTS (OR=4.0, 95% CI=1.01-16.3). However, a multiple logistic regression analysis showed only that the type of work was a significant variable after adjusting for the other variables.
CONCLUSIONS
The wrist ratio, a surrogate of carpal tunnel configuration, can represent individual susceptibility to CTS. However this study shows that the use of the wrist ratio for predicting CTS risk is not adequate. The development of a new carpal tunnel configuration index based on more direct measurements of the tunnel shape will provide a better predictor of individual susceptibility to CTS.

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Distribution of age, gender, and occupation among individuals with carpal tunnel syndrome based on the National Health Insurance data and National Employment Insurance data
Il-Ho Lee, Young-Ki Kim, Dong-Mug Kang, Se-Yeong Kim, In-Ah Kim, Eun-Mi Kim
Annals of Occupational and Environmental Medicine.2019;[Epub] CrossRef
A comparison of carpal tunnel syndrome between digital and paper textbook users in elementary schools
GyeongAe Seomun, Sung-Bom Pyun, Jung-Ah Lee, Eun-Jung Kim, Wonjung Noh
Work.2016; 53(4): 909. CrossRef
Factors Influencing on Fatigue in Operating Room Nurses
Eun-Seon Lee, In-Sook Kim
Korean Journal of Occupational Health Nursing.2012; 21(3): 229. CrossRef

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Evaluation of Early Neurologic Abnormalities on the Workers Exposed to Acrylamide: Seong Soon Kim, Hae Kwan Cheong, Yong Wook Kwon; Korean Journal of Occupational and Environmental Medicine 2000;12(3):367-383. Published online September 30, 2000; DOI: https://doi.org/10.35371/kjoem.2000.12.3.367

Abstract PDF

OBJECTIVES
Acrylamide is a neurotoxin inducing central-peripheral distal axonopathy. The authors evaluated several neurologic tests to screen the early effect of occupational acrylamide exposure.
METHODS
Fifty-two males working either in the production of acrylamide monomer or in the handling of acrylamide in Ulsan, Korea, were selected and subcategorized into the high-exposure group (n=10, mean age of 30. 4 years) and the low-exposure group (n=42, mean age of 28.9 years). Twenty-three males (mean age 29.4 years) from medical professionals and students were chosen as a non-exposed reference group. Symptom questionnaire, neurologic examination, electrodiagnostic test, vibrotactile threshold test, and Lanthony desaturated 15 panel test (LD-15D) were done.
RESULTS
The high-exposure group showed more number of specific symptoms on questionnaire and more abnormal two point discrimination test. High-exposure group showed a significant difference in the median motor conduction velocity, peroneal nerve motor latency, sensory amplitude of median nerve action potential, and sensory latency of sural nerve. The vibrotactile threshold of the high-exposure group was significantly higher in both hands and feet than that of the low-exposure group and the reference group. Average color confusion index on the LD-15D was significantly higher in the high-exposure group (median 22.7, range 0-135.7) than in the reference group (median 2.4, range 0-33.2).
CONCLUSIONS
The symptom questionnaire, vibrotactile threshold test, and color discrimination test are sensitive in detection of the early acrylamide-induced neuropathy, and the combination of these tests would further facilitate the effectiveness of the screening.

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Usefulness of Color Vision Test for Early Detection of Neurological Damages by Neurotoxic Substances
Eun-Hee Lee, Kyungho Choi, Hong Jae Chae, Domyung Paek
Journal of Preventive Medicine and Public Health.2008; 41(6): 397. CrossRef

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Polyneuropathy by Occupational Exposure to Acrylamide: Hae Kwan Cheong, Yong Wook Kwon, Kyung Yun Uh, Byung Joon Kim, Jeong Sun Yang, Cheol Jung, Youngwoo Jin, Mi Young Lee, Seong Kyu Kang; Korean Journal of Occupational and Environmental Medicine 1998;10(3):388-403. Published online August 31, 1998; DOI: https://doi.org/10.35371/kjoem.1998.10.3.388

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Authors report a first Korean case of polyneuropathy in an acrylamide producing factory together with an environmental and epidemiologic survey for the ten workers of the same workplace and 46 workers in the production and manufacturing acrylamide in Ulsan, Korea. The case is 30 years old man who worked in the prcduction of the acrylamide for two years. In August, 1997, he had a weakness of the lower extremity with loss of body weight of 15 Kg which progressed to paresthesia of the limbs, the loss of vibration sense, difficulty in walking, speech disturbance, dysuria, constipation, difficulty in erection and swallowing difficulty. Neurologic examination showed a complete loss of vibration and position sense, and loss of deep tendon reflex in all the limbs. There was a contact dermatitis-like skin lesion on the feet. Electrodiagnostic test showed a generalized polyneuropathy of moderate degree involving motor and sensory component of peripheral and cranial nerves. After 8 months' cessation from exposure and supportive care, his symptoms were completely resolved, but abnormality in electrodiagnostic test and vibrotactile perception threshold still persisted, although much improved than before. There were 11 workers in the same workplace of the case, producing acrylamide by microorganism as a catalyst. Environmental monitoring of the workplace revealed air-borne concentration of the acrylamide to be from 0.05 to 0.23 mg/m(3) by personal sampling and from 7.65 to 11.65 mg/m(3) by area sampling during filter exchanging process, which far exceeds TLV-TWA of 0.03 mg/m(3). However acrylamide was not detected from the plasma of the workers. Symptom questionnaire showed a markedly higher complain of neurologic symptoms, compared to the workers of the other acrylamide producing companies. Electrodiagnostic test showed a several workers are in the lower normal range without definite abnormality. Vibrotactile perception threshold by Vibratron II showed a significantly increased threshold in the workers of the same workplace compared to the other acrylamide workers and significantly decreased test score of color vision compared to normal controls. After improvement of the production process and strict wearing of the protective device, most workers reported the improvement of clinical symptoms, but vibrotactile perception threshold was not improved. These result suggests the need for the effective environmental monitoring together with a periodic biological monitoring. Development of effective screening test is urgently needed to control and assess the skin absorption of acrylamide.

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Dermal and neural toxicity caused by acrylamide exposure in two Korean grouting workers: a case report
Heeyun Kim, Sang Gil Lee, Jeongbae Rhie
Annals of Occupational and Environmental Medicine.2017;[Epub] CrossRef
Occupational Neurologic Disorders in Korea
Yangho Kim, Kyoung Sook Jeong, Yong-Hun Yun, Myoung-Soon Oh
Journal of Clinical Neurology.2010; 6(2): 64. CrossRef
Occupational Neurological Disorders in Korea
Eun-A Kim, Seong-Kyu Kang
Journal of Korean Medical Science.2010; 25(Suppl): S26. 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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Cumulative Trauma Disorders among Telephone Directory Assistance Operators: Hae Kwan Cheong, Byung Soon Choi, Ji Yong Kim, Sun Hee Yu, Hyun Sul Lim, Yong Min Kim, Kyung Yun Uh, Yong Wook Kwon; Korean Journal of Occupational and Environmental Medicine 1997;9(1):140-155. Published online February 28, 1997; DOI: https://doi.org/10.35371/kjoem.1997.9.1.140

Abstract PDF

To evaluate the prevalence of cumulative trauma disorders in relation to ergonomic evaluation of their work, 260 female directory assistance operators employed in three branch facilities of the nation-wide telecommunication company. Ergonomic evaluation of the work status was done by two industrial hygienists through inspection. Workers were surveyed with standardized self-administered questionnaire and examined by family physicians and an orthopaedician for cumulative trauma disorders. Laboratory examination of serum aspartate aminotransferase(AST), creatinine phosphokinase(CPK), aldolase and rheumatoid factor was done and X-ray of cervical spine and both shoulders was taken from all subjects and nerve conduction velocity test was done on 57 subjects with suspected nerve entrapment cases. Cumulative trauma disorders were categorized into 3 category according to work-relatedness of the disorders. On ergonomic evaluation of the working posture and work environment, improvement of work posture revealed inappropriate postures and devices. Mean age of the subjects were 39 years old and more than 80% graduated high school or above. Ninety-eight percent of the workers employed in the company for more than 15 years and 74.6% of the workers worked at the VDT job for more than 4 years. Mean daily work hours was 8.0 hours per day and mean break hours was 90.5 minutes per day with mean extra work hours of 10.7 hours per month. Mean daily calls were 1128.6 calls in maximum and 864.8 calls in minimum. On laboratory examination, 13 (5.0%) workers had abnormal AST, 53(20.4%) had abnormal CPK, and 1 (0.4%) had abnormal aldolase level. On x-ray examination of cervical spine, 111 (42.7%) had loss of or reversed normal cervical lordosis, 10(3.8%) had narrowing of intervertebral space. Nerve conduction velocity test was abnormal in 11 (19.2%) among 57 workers. Among disorders categorized as work-related, 131 (50.4%) were diagnosed to have fatigue myalgia of levator scapulae, 108 (41.5%) had cervical strain or sprain, 47 (18.1%) had fatigue arthralgia of phalangeal joints, and 47 (18.1%) had probable carpal tunnel syndrome, in 10 (3.8%) of those diagnosis was confirmed electrophysiologically. Age, seniority, work duration at present job, workload nor location of facilities were associated with the prevalence of symptoms nor specific diagnoses on simple statistical analysis and multiple logistic regression, which deems to be due to highly selected and homogeneous characteristics of the study subjects. Above results shows that cumulative trauma disorders are very prevalent among directory assistance operators and elaborate effort is needed to reduce the cumulative trauma disorders among the operators.

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Distribution of age, gender, and occupation among individuals with carpal tunnel syndrome based on the National Health Insurance data and National Employment Insurance data
Il-Ho Lee, Young-Ki Kim, Dong-Mug Kang, Se-Yeong Kim, In-Ah Kim, Eun-Mi Kim
Annals of Occupational and Environmental Medicine.2019;[Epub] CrossRef
Musculoskeletal Symptoms and Its Related Factors among Male Workers in a Nonferrous Manufacturing Industry
Yeon-Ok Jeong, Young-Chae Cho
Journal of the Korea Academia-Industrial cooperation Society.2012; 13(8): 3552. CrossRef
Risk Factors of Work-related Upper Extremity Musculoskeletal Disorders in Male Shipyard Workers: Structural Equation Model Analysis
Byung-Chan Park, Hae-Kwan Cheong, Eun-A Kim, Soo Geun Kim
Safety and Health at Work.2010; 1(2): 124. CrossRef
Prevalence of Carpal Tunnel Syndrome in Meat and Fish Processing Plants
Joon Youn Kim, Jung Il Kim, Ji Eun Son, Sung Kuk Yun
Journal of Occupational Health.2004; 46(3): 230. CrossRef

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