Annals of Occupational and Environmental Medicine

Volume 24 (1); March 2012

Original 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).

Citations

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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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Radiotechnologists and Radiation Exposure from PET and PET/CT Systems: Hoon Hee Park, Jeongbae Rhie, Pilkyun Jung, Jong Doo Lee, Jong Uk Won, Jaehoon Roh; Korean Journal of Occupational and Environmental Medicine 2012;24(1):86-95. Published online March 31, 2012; DOI: https://doi.org/10.35371/kjoem.2012.24.1.86

Abstract PDF

OBJECTIVES
In this study, radiotechnologists who work performing PET and PET/CT methodologies were analyzed in order to find the cause for the differences in radiation exposure as they applied to general characteristics, work characteristics, knowledge, and exposure recognition or conduct.
METHODS
From April 15th, 2010 to May 14th, 2010, we conducted a retrospective analysis on 80 radiotechnologists using data garnered from their individual general characteristics, work characteristics, knowledge, and exposure recognition or conduct. Their average annual radiation exposure dosages were measured using a thermoluminescence dosimeter. A multiple regression analysis was performed as a statistical tool.
RESULTS
Regarding the general PET and PET/CT characteristics, when the work experience was short, the exposure dose was higher. The factors of age, marriage, work experience in nuclear medicine, PET, PET/CT, and sex were found to have statistically significant effects. The knowledge, recognition, and conduct factors for the radiotechnologists were affected by unsecure radiation exposure at the moment of carrying, unsecure radiation exposure at the moment of injection, the application of protection at the moment of injection, and the use of auto distributor. It was found that, the use of an auto distributor, efforts in reducing the radiation exposure, unsecure exposure when with a patient, and the application of protective procedures at the moment of injection affected the overall factor of radiotechnologists radiation exposure dose.
CONCLUSIONS
We believe that if radiotechnologists would reduce their radiation exposure by using auto distributors, make efforts to reduce the chance of exposure, and be conscious of radiation, they would be able to reduce the radiation exposure dose even during unavoidable circumstances.

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Yunjeong Heo, Hosun Chun, Seonghoon Kang, Wonjin Lee, Taewon Jang, Jongtae Park
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A Comparative Study on the Radiation Awareness of University Students Gender in Chungbuk Area
Jae-Seon Jang, Seong-Hee Hwang
The Korean Journal of Food And Nutrition.2015; 28(3): 486. CrossRef

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The Relationship of Physical and Psychosocial Risk Factors to Work-related Musculoskeletal Upper Extremity Symptoms amongst Male Automobile Manufacturing Workers: Ki Hyun Lee, Jin Ha Yoon, Sung Kyung Kim, In Jung Cho, Sung Soo Oh, Sung Hoon Kim, Sei Jin Chang, Bong Suk Cha, Sang Baek Koh; Korean Journal of Occupational and Environmental Medicine 2012;24(1):72-85. Published online March 31, 2012; DOI: https://doi.org/10.35371/kjoem.2012.24.1.72

Abstract PDF

OBJECTIVES
The objective of this study was to determine the relationship of physical and psychosocial risk factors to work-related musculoskeletal upper extremity symptoms amongst automobile manufacturing workers.
METHODS
The cross-sectional study was conducted using male automobile manufacturing workers in order to examine the relationship of physical and psychosocial risk factors to work-related musculoskeletal upper extremity symptoms. A total of 1,793 male workers were asked to complete a self-administered questionnaire. The questionnaire consisted of questions regarding general characteristics, health related behaviors, work-related characteristics, job stress, ergonomic risk factors, and the presence of musculoskeletal symptoms (neck, shoulder, arm, and hand). Work-related musculoskeletal symptoms were evaluated using the National Institute of Occupational Safety and Health (NIOSH) surveillance criteria. In order to measure the physical risk factors, the American National Standard Institute (ANSI) Z-365 Quick checklist was incorporated into the questionnaire. Job stressors were measured using the Korean Occupational Stress Scale (KOSS). A binary logistic regression analysis was performed that examined the relationship of physical and psychosocial risk factors to musculoskeletal symptoms.
RESULTS
The result showed that the physical and psychosocial risk factors were associated with musculoskeletal upper extremity symptoms. The workers with high physical risk factors reported more musculoskeletal symptoms than those having low physical risk factors (OR: 2.37, 95% CI: 1.56~3.62). The workers with high job stress were more likely to have an increased risk of musculoskeletal upper extremity symptom compared to those with normal job stress (OR: 2.65, 95% CI: 2.03~3.47). A significant relationship between the combined effects of physical and psychosocial risk factors on musculoskeletal upper extremity symptoms was also found. The workers exposed to high physical risk factors, high job stress, and long working hours were more likely to report musculoskeletal symptoms than those having low physical risk factors, normal job stress and moderate working hours(OR: 2.37, 95% CI: 1.56~3.62).
CONCLUSIONS
The results suggest that some physical and psychosocial risk factors increase the risk of work-related musculoskeletal upper extremity symptoms amongst automobile manufacturing workers. In order to prevent or reduce musculoskeletal disorders amongst automobile manufacturing workers, it is strongly recommended to manage the physical psychosocial risks occurring in the workplace.

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Effect of an Active Tailored Exercise Program on Pain and Oswestry Disability Index in Automobile Manufacturing Workers with Musculoskeletal Symptoms of the Low Back
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Urinary Hippuric Acid and trans,trans-Muconic Acid Levels According to Commuting Mode and Duration, Residential Environment, and Intake of Preservative-Added Foods and Beverages in University Students: Kyoung Mee Kim, Sang Yong Eom, Dong Hyuk Yim, Sun In Moon, Yong Dae Kim, Heon Kim; Korean Journal of Occupational and Environmental Medicine 2012;24(1):61-71. Published online March 31, 2012; DOI: https://doi.org/10.35371/kjoem.2012.24.1.61

Abstract PDF

OBJECTIVES
Automobile exhaust gases contain benzene and toluene, which are excreted in human urine as trans,trans-muconic acid and hippuric acid, respectively. Sorbic acid and benzoic acid, used as food preservatives, are also metabolized into trans,trans-muconic acid and hippuric acid in the human body. The purpose of this study is to estimate the level of benzene and toluene exposure according to the commuting mode and duration, residential environment, and preservative-added foods intake in university students who are not occupationally exposed to benzene or toluene.
METHODS
Spot urine samples were collected from 211 university students who had no occupational exposure to volatile organic compounds. Information about their smoking history, residence type, traffic environments, commuting mode and duration, and their intake of bottled or canned food or beverages was gathered through a self-administered questionnaire. Urinary concentrations of trans,trans-muconic acid and hippuric acid were measured and statistically correlated to the individual's life style factors.
RESULTS
There was no significant difference in the urinary concentrations of trans,trans-muconic acid or hippuric acid according to the smoking history. Mean urinary concentration of hippuric acid in females was higher than that found in males. Subjects living in districts with a population density of 1,000~4,999 people/km2 showed the highest urinary hippuric acid level; individuals living in cities of 5,000~9,999 people/km2 population density were next. The mean urinary trans,trans-muconic acid concentration was higher in students who were living where traffic jams are common compared to those who did not, and in subjects whose residence were within 149 m from a 4-lane road compared to those whose residence was not. However, neither mode nor duration of the commute showed any effect on the urinary trans,trans-muconic acid or hippuric acid concentrations of the students. Urinary hippuric acid levels increased when consuming canned fruit or canned coffee, and urinary trans,trans-muconic acid levels increased when consuming fruit juices or pickled radishes.
CONCLUSIONS
The inhalation of vehicle exhaust and the ingestion of canned or pickled food may increase urinary hippuric acid and trans,trans-muconic acid levels in individuals who are not occupationally exposed to benzene or toluene.

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Journal of Environmental Health Sciences.2024; 50(1): 25. CrossRef
Association of Urinary Benzene Metabolite and the Ratio of Triglycerides to High-Density Lipoprotein Cholesterol: A Cross-Sectional Study Using the Korean National Environmental Health Survey (2018–2020)
Seungju Baek, Eunjung Park, Eun Young Park
Toxics.2023; 11(12): 985. CrossRef
Concentration of volatile organic compounds(VOCs) in ambient air and level of residents in industrial area
Kyungsook Woo, Heejin Park, Tackshin Kang, Geunbae Kim, Junmin Jeon, Bongki Jang, Jongwha Lee, Busoon Son
Journal of Korean Society of Occupational and Environmental Hygiene.2015; 25(1): 104. CrossRef

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The Relationship between Shift Work and Work-related Injuries among Korean Workers: Tae Jun Park, Do Myung Paek, Kee Ock Joh, Jung Sun Park, Sung il Cho; Korean Journal of Occupational and Environmental Medicine 2012;24(1):52-60. Published online March 31, 2012; DOI: https://doi.org/10.35371/kjoem.2012.24.1.52

Abstract PDF

OBJECTIVES
The aim of this study was to evaluate the relationship between shift work and work-related injuries in a representative sample of Korean workers.
METHODS
We used data from the Korean Working Condition Survey of 2006. The participants were 7,075 Korean workers 15 to 64 years of age. Logistic regression was employed to estimate the relationship between shift work and work-related injury using the SAS version 9.2 program.
RESULTS
Shift work was significantly related to work-related injuries compared to non-shift workers(OR 2.40, 95% CI=1.65~3.48). When personal and occupational risk factors were accounted for, shift work had a statistically meaningful relationship with work-related injuries compared to non-shift work(OR 1.79, 95% CI=1.20~2.66).
CONCLUSIONS
In this study, shift workers appear to have a higher risk of work-related injuries compared to non-shift workers. Work-related injuries in shift workers could be attributed to circadian rhythm disorder and sleep problems. Suitable arrangements that ensure flexible working times are needed for shift workers. Further study will be needed to identify and mitigate work-related injuries among shift workers.

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The Effects of Aircraft Noise Exposure upon Hearing Loss, Anxiety, and Depression on Subjects Residing Adjacent to a Military Airbase: Yu Rim Jeong, Jae Beom Park, Kyoung Bok Min, Chan Lee, Hyun Gwon Kil, Won Wook Lee, Kyung Jong Lee; Korean Journal of Occupational and Environmental Medicine 2012;24(1):40-51. Published online March 31, 2012; DOI: https://doi.org/10.35371/kjoem.2012.24.1.40

Abstract PDF

OBJECTIVES
To determine the level of aircraft noise exposure and how it relates to hearing loss, and to investigate the association between noise exposure and anxiety and depression in subjects residing adjacent to a military airbase.
METHODS
The study was conducted upon 898 inhabitants between the ages of 30-79, living near the military airbase in Jeonra-do. The subjects were divided into three noise-exposure groups: high-exposure, low-exposure, and a control group. The cut-values were 80 and 60 on the Weighted Equivalent Continuous Perceived Noise Level scale. A self-administered questionnaire including the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI) were completed. Pure tone audiometry tests were performed.
RESULTS
Hearing loss prevalence was defined by a >40 dB loss in bilateral ears or in one ear; the difference of <15 dB compared to the better side was 30.8%. The mean BAI/BDI score was 18.9+/-14.3/18.7+/-11.6, the number of abnormal subjects with BAIs > or =22 was 317 (35.3%), with BDIs > or =21 was 347 (38.6%). The pure tone average, BAI, and BDI scores were higher in the noise-exposure groups compared to the control. The BAI/BDI abnormal subjects showed a higher hearing threshold shift level compared to the normal scored subjects. The odd ratios for anxiety was significantly high in both noise exposure groups and the hearing loss, for depression was significantly high in high-exposure group and hearing loss.
CONCLUSIONS
Anxiety and depression were higher when exposure to high-level noise and further complicated by hearing loss. Further investigation is needed to determine the cause-effect relationship.

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Sukyung Noh, Sang-Yong Eom
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Anxiety symptoms and occupational stress among young Korean female manufacturing workers
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The Relationship between Job Stress and the Will to Cease Tobacco Smoking for Small and Medium Scale Industry Male workers: Seung Jun Lee, Shin Goo Park, Hwan Cheol Kim, Dong Hoon Lee, Gi Woong Kim, Jong Han Leem, Seong Hwan Jeon, Yong Seok Heo; Korean Journal of Occupational and Environmental Medicine 2012;24(1):33-39. Published online March 31, 2012; DOI: https://doi.org/10.35371/kjoem.2012.24.1.33

Abstract PDF

OBJECTIVES
The aim of this study was to investigate the relationship between job stress and the willingness of male workers in small and medium scale industry to cease smoking.
METHODS
A structured self-reported questionnaire was used to assess each respondent's socio-demographics, job stress, and the will to cease smoking. A KOSS (Korean Occupational Stress Scale)- based questionnaire survey was conducted which targeted 4,435 male workers at 69 small and medium scale industries. 2,840 men returned these questionnaires with 1,663 of them being smokers. We analyzed 1,345 of the smoker returns. We estimated the relationship between the will to cease smoking and the employee job stress factors using logistic regression analyses.
RESULTS
After adjusting for education, exercise, and tobacco use per day, the logistic regression analysis revealed a significantly positive association with the will to cease smoking and job stress. The odds ratios regarding insufficient job control were at 1.69 (95% CI, 1.26~2.27), organizational system at 1.37 (95% CI, 1.03~1.82), and lack of reward at 1.37 (95% CI, 1.03~1.82).
CONCLUSIONS
These results indicated that job stress may play a significant role in the will to cease smoking. Further preventive efforts and studies are needed in order to reduce job stress.

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The Differences the Relationship According to Body Part between Occupational Stress and Self-reported Musculoskeletal Disorder Symptoms as Seen in Surveys of Public Office Workers Using VDT: Han Soo Song, Chul Gab Lee; Korean Journal of Occupational and Environmental Medicine 2012;24(1):20-32. Published online March 31, 2012; DOI: https://doi.org/10.35371/kjoem.2012.24.1.20

Abstract PDF

OBJECTIVES
The investigation of the degree of the relationship according to body part between occupational stress and musculoskeletal symptoms in the neck, shoulder, elbow, and hands of workers performing computer tasks.
METHODS
In August and September 2009, we conducted a survey of 529 public office workers employed by the National Health Insurance Corporation using structured questionnaires in order to find demographic factors, work related factors, job stress, physical computer task load and musculoskeletal symptoms. Nordic musculoskeletal questionnaire, Quick DASH (Disabilities of the Arm, Shoulder and Hand Score), and the Northwick Park neck pain questionnaire were all used to evaluate their musculoskeletal symptoms. The presence of symptoms segregated by body part determined the dependent variables. The degree of job stress and other confounder variables determined the independent variables. We calculated the odds ratio employing multiple logistic regressions.
RESULTS
A score of > or =5 in the VAS (Visual Analogue Scale) 10-point scale and the presence of symptoms lasting at least 1 week determined the musculoskeletal symptom group in regards to the Nordic musculoskeletal questionnaire. The neck pain odds ratio was adjusted by sex, age, work hours, employment duration, physical computer task load and depression. It was determined to be 2.92 (95% CI 1.76~4.84) in the higher to lower occupational stress group. The shoulder pain odds ratio was 1.96 (95% CI 1.18~3.24), elbow pain 0.55 (95% CI 0.21~1.43), and hand pain 1.71 (95% CI 0.99~2.95). A score of > or =10 in the 100-unit scale determined the musculoskeletal symptom group in regards to the Northwick Park neck pain questionnaire and the Quick DASH. The neck symptom odds ratio was 2.73 (95% CI 1.66~4.49) and the upper extremity symptom figure was 2.18 (95% CI 1.29~3.68).
CONCLUSIONS
This study suggests that the relevance between neck and shoulder symptoms and occupational stress was obvious, however the relevance between elbow and hand pain and job stress was not as clear or ambiguous.

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Prevalence and Risk Factors of Work-related Low Back Pain Among Operators and Drivers of Transportation Vehicle: Kyong Sok Shin, Yun Kyung Chung, Hye Eun Lee; Korean Journal of Occupational and Environmental Medicine 2012;24(1):11-19. Published online March 31, 2012; DOI: https://doi.org/10.35371/kjoem.2012.24.1.11

Abstract PDF

OBJECTIVES
This study is conducted to investigate the prevalence of work-related back pain among Driving and Transport Related Occupations and to identify the risk of mechanical factors and psychosocial factors.
METHODS
Subjects were 779 operators and drivers of transportation vehicles selected from respondents from the 1st Korean Working condition survey. The occupation risk factors, including socioeconomic, ergonomic, psychosocial factors, were investigated. We used the multiple logistic regression analysis to determine the relationship between risk factors and low back pain.
RESULTS
The prevalence of self-reported work-related low back pain was 27.7%. Adjusting for confounding factors, we determined that whole body vibration(OR 1.64 95% CI: 1.09~2.48), tiring posture(OR 5.18, 95% CI: 3.01~8.93), extended work(OR 1.91, 95% CI: 1.20~3.04), night-time work(OR 2.79, 95% CI: 1.86~4.19), evening work(OR 2.82, 95% CI: 1.78~4.46), shift work(OR 2.35, 95% CI: 1.30~4.26), job dissatisfaction (OR 2.65, 95% CI: 1.76~3.99), and experiencing physical violence at work(OR 5.31, 95% CI: 1.25~22.67) had meaningful relationships with low back pain.
CONCLUSIONS
We found that the psychosocial risk factors were the most significant factors among drivers of transportation vehicles in Korea. Therefore, we suggest a health promotion program to relieve Job stress as a solution to prevent and control low back pain among drivers of transportation vehicles in Korea.

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The Prevalence of Asbestos Related Pleural Plaque among Residents Living Near Asbestos Mines in Korea: Yong Jin Lee, Chan Ho Park, Yong Bae Kim, Eun Chul Jang, Seung Hwan Kim, Young Sik Shin, Jeung Sook Kim; Korean Journal of Occupational and Environmental Medicine 2012;24(1):1-10. Published online March 31, 2012; DOI: https://doi.org/10.35371/kjoem.2012.24.1.1

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OBJECTIVES
The investigation of the prevalence of pleural diseases in regards to those living within 1 km of 14 asbestos mines in Chungnam province.
METHODS
We enrolled 4,057 residents (male: 1,887, female: 2,170) living within 1km of asbestos mines in Chungcheong province. They received checkups from Soonchunhyang Environmental Health Center for asbestos related diseases between March 2009 and December 2009. Chest X-rays were taken from all subjects and read by two experts according to International Labor Organization guidelines. Those subjects suspected of asbestos related lesions were further checked with HRCT(high-resolution computed tomography). The determination was done by two experts after reviewing the resulting data.
RESULTS
The 4,057 exposed residents underwent the checkup, 859 of whom further underwent the HRCT(high-resolution computed tomography) check. The prevalence of pleural plaque was found to be 11.3% (29.2% non-occupational, 8.0% occupational) from the chest X-rays. The HRCT(high-resolution computed tomography) results revealed that 227 subjects (26.4%) out of the 859 positive subjects (110 (18.8%) non-occupational, 117 (42.9%) occupational) showed evidence of pleural plaque. The statistical analysis showed that the prevalence of pleural plaque increased with increases in age, residence time, and occupational family exposure to asbestos (p<0.05).
CONCLUSIONS
We recommend better control of asbestos in the soil and mines. We also recommend that all affected residents living near asbestos mines receive medical checkups as mandated by the asbestos health damage relief policy.

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