OBJECTIVES To report cubital tunnel syndrome due to repetitive motions. METHODS A worker complaining muscle weakness and atrophy of the right hand intrinsic muscles admitted to a hospital. We evaluated him with blood tests, neurophysiologic studies (NCV & EMG), plain X-ray and US at the both elbows. We investigated his occupational history, and videotaped his work motions based on the work cycle at his previous work site. Finally, an ergonomics expert analyzed the motions using rapid upper limb assessment (RULA). RESULTS NCV & EMG studies reveals slow conduction velocity on both ulnar nerve across the elbow, more severely in the right side. US shows us compatible finding with diffuse neuritis of both ulnar nerves at both elbows. RULA score is 7. CONCLUSION We confirmed that the workers symptoms were related to his previous jobs demanding repetitive motions using the elbow joints. It is necessary that we should prepare appropriate measures to evaluate, prevent, rehabilitate, and help injured workers to return to work.
OBJECTIVES Lung injuries due to exposure to nitrogen oxides can occur in various process in industry. We experienced a case of chemical pneumonitis induced by accidental inhalation of nitrogen oxides emitted from the bath in an acid dipping operation. CASE Dyspnea, cough and blood-tinged sputum production, cyanosis, and tachypnea occurred after exposure to oxides of nitrogen.
There were bilateral diffuse ground glass opacities in simple chest radiography and high resolutional computed tomography, hypoxemia in arterial blood gas analysis, mixed ventilation defect and reduced diffusion capacity in spirometry. As an oxygen and supportive therapy, after hospitalization, was given, the patient recovered completely from the lung injury on the 8th day after admission. There was no evidence of delayed onset of bronchiolitis obliterance or pulmonary edema in a follow-up for about 6 months. CONCLUSIONS Acid dip operation require more efficient hooding and exhausting system for the prevention of lung injuries caused by inhalation of nitrogen oxides. Also health education for worker need.
Seong Kyu Kang, Kyoo Sang Kim, Yangho Kim, Jung Keun Choi, Yeon Soon Ahn, Yeong Woo Jin, Byong Soon Choi, Jeong Sun Yang, Euna Kim, Chang Ho Chae, Yong Hue Choi, Dae Seong Kim, Jung Sun Park, Ho Keun Chung
Korean Journal of Occupational and Environmental Medicine 2000;12(2):292-301. Published online June 30, 2000
OBJECTIVES Pneumoconisis and noise-induced hearing loss(NIHL) have been reported as main occupational diseases by the Special Health Examination. The Industrial Accident Compensation Insurance has reported various work-related diseases, however, these two diseases occupied almost a half of compensated cases. Therefore, it was not well known about the status of occupational diseases other than pneumoconiosis, NIHL, and cardiocerebrovascular accident(CVA). This study was conducted to analyze claimed cases as an occupational disease, that was requested to the Korea Industrial Safety and Health Agency (KOSHA). METHODS The local office of the Korea Labor Welfare Corporation(KLWC) has asked the KOSHA for confirmation of claimed cases as an occupational disease. We analyzed 379 cases requested from KLWC, the Ministry of Labor, employers, unions and occupational health agencies from 1992 to 1999. RESULTS Male was 80. 7 % of the requested cases. Their mean age was 42 years old and 75. 5 % of them were more than 35 years old.
The requested cases were increased rapidly from 25 cases in 1992 to 108 cases in 1999 and the accept rate was 50. 7 %. The majority of requested cases were respiratory diseases(22.4 %), cancers(18.5 %), Neuropsychiatric problems (14. 5 %), and musculoskeletal problems (13. 5 %). The accept rate was high in reproductive, respiratory, musculoskeletal and digestive disorders and low in neuropsychiatric, renal and otologic problems and occupational cancers. 73. 6 % of them were caused by chemical agents, especially 28. 5 % were by organic solvents. 67 % of them were clinically confirmed at university hospitals. A half of the cases were from KyongIn area, even the request came from the whole country. CONCLUSIONS A claim was common in workers whose age was over 35 years old and exposure history was over 10 years.
The respiratory diseases and neuropsychiatric disorders were still main problems in occupational health and occupational cancers was increasing even though its accept rate was not high yet.
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OBJECTIVES The purpose of study was to define the clinical and epidemiological factors of HNP and to provide the meaningful sources for establishing a prognosis and a rationale for clinical management of occupational low back problem. METHODS This study was performed at eight branch hospitals of Catholic University of Korea and several governmental hospitals f or occupational disorders around the Kyunggi province of Korea since Jan. 1985. We analyzed the several factors about lumbar HNP through comparative study of the hospital admission series of each 200 patients in both occupation- and nonoccupation related, subjected to epidemiologic and clinical investigation, respectively. RESULTS 1. Mean age of occupational HNP was younger(30.9+/-8.8) than non-occupational HNP(35.2+/-10.5) (p<0.05). 2.
The duration of clinical symptom before admission was longer in non-occupational HNP(19.9+/-22.8 Mo.) than in occupational HNP(6.9+/-12.4 Mo.) (p<0.05). 3. The symptomatic attack before admission was more frequent in non-occupational HNP(3.7+1.9) than in occupational HNP(2.5+/-0.9) (p<0.05). 4. There were no significant differences in physical findings between two groups, except for low rate(63%) of straight leg raising test(SLR) limitation in occupational HNP compared to non-occupational HNP(83%) (p<0.05). 5. Even though The main reason for operative intervention was a failure of conservative treatment in both groups(p<0.05), extruded subligamentous type was predominant(50%) in occupational HNP(p<0.05), whereas extruded transligamentous type occupied major portion(67.8%) in non-occupational HNP(p<0.05). CONCLUSION The clinical results were poor in occupational HNP in both conservative and operative management groups, compared to non-occupational HNP(p<0.05) and mean durations admission and re-admission rate was higher in occupational HNP, compared to non-occupational HNP (p<0.05).
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OBJECT: This study was performed to increase the sensitivity and specificity for screening the examinee of second hearing test. METHODS Study subjects were 219 workers who exposed more than average 80dB. They were taken the hearing test two times, before noise exposure and at 1 hour to 4 hours after worksite noise exposure. To investigate the ambient noise workers who were taken the hearing test in the test room which ambient noise was less than 45dB were classified Group I and the others were classified Group E. To calculate the sensitivity and specificity we made it gold standard whether worker had noise induced hearing loss. RESULTS Difference of hearing loss between before and after noise exposure for left and right ear was 11. 4 dB and 11. 7 dB respectively at 500 Hz, 8. 7 dB and 9. 6 dB at 1, 000 Hz, 6. 3 dB and 6. 9 dB at 2, 000 Hz and 6. 9 dB and 7. 4 dB at 4, 000 Hz in Group I. That for left ear and right ear was 5.8 dB and 4.9 dB at 500 Hz respectively, 5.4 dB and 6.4 dB at 1,000 Hz, 6.3 dB and 5.3 dB at 2,000 Hz, and 5.5 dB and 5.8 dB at 4,000 Hz in Group E. The sensitivity was 100 in both Groups and the specificity was increased to 58. 3 and 71. 8 in Group I and Group 3 respectively until 10 dB was deducted from hearing level at 1, 000 Hz and 4, 000 Hz. CONCLUSION When the screening hearing test was performed at worksite, we might deduct 10 dB from measured hearing level to increase the specificity without reduction of sensitivity.
OBJECTIVES The aim of this study was to examine the association of prenatal environmental exposure and pregnancy outcomes. METHODS Self-administered questionnaire survey was conducted for pregnant women with gestational age of 16-18 weeks, who visited the outpatient department of Dankook University Hospital from May 1995 to June 1999. Of all 1170 women, 762 women answered the questionnaires and the response rate was 65 %. Among them, 471 cases which has delivered at our hospital were included in this study. RESULTS Comparing the environmental risk factors and the pregnancy outcomes, there was an association between delivery of small for gestational age infants and the ingestion of herb medicine and caffeine-containing nutritional beverages. Pregnant women with occupation were more likely exposed to environmental tobacco smoking, to ingestion of nutritional drinks and green teas, to use of video display terminals and to diagnostic radiation. CONCLUSIONS We could get precise information from prospectively conducted questionnaire study. It is necessary to extend the study population to verify the influence of prenatal environmental factors on pregnancy outcomes.
OBJECTIVES This study, using case-crossover design, search a relationship between changing levels of air pollutants and asthma attack in asthma patients. METHODS We searched the daily total number of asthmatic patients at hospital' s emergency room in Seoul, Korea by investigating total 49 general hospitals emergency room records. Otherwise, We investigated medical records of asthmatic patients at one of the 49 hospitals we have searched. We investigated addresses that they are living, diagnosis, smoking history, whether respiratory infection or not, medications. We analyzed the data by 1:m conditional logistic regression used when matched case-control study is analyzed. Control periods were chosen by bidirectional paired matching technique 7, 14 days before and after case periods. RESULTS the relative risk of asthmatic attack by 100 ppm ozone increase between June and September were 1.348(95 % CI = 1.010~1.619). Between November and February, the relative risk by 100 /m TSP increase, 100ppb sulfur dioxide and nitrogen dioxide were respectively 1.278(1.010~1.619), 1.237(1.019~1.502), 1.285(1.006~1.640). In stratified analysis, the relative risk were significant when the asthmatic patients were children aged 15 years or below, when there were respiratory infection, and when the patients took medications irregularly CONCLUSIONS: There was statistically significant association between ambient levels of air pollutants and asthmatic attack. So, we have to exert our efforts to minimize the air pollution effectively, to protect public health from air pollution.
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OBJECTIVES In order to evaluate the relationship between daily mortality and air pollution in Deagu for the period by the data from January 1993 to December 1997. METHODS Deaths from accident(International Classification of Disease, Revision 9; 800-999 and Revision 10; V01- Y89) were excluded, Daily counts of deaths were analysed by general additive poisson model on the current day to 5 days before death, with controlling for effects of year, season, weather, weekday and holiday. The air pollutants examined included total suspended particulate (TSP), sulfur dioxide (SO,), nitrogen dioxide (NO,), carbon monoxide (CO) and ozone (03). RESULTS Mortality was associated with NO, SO and CO in the air. Total mortality was estimated to increase by 1. 6 % (95 % CI 0. 3-3 %) with each 10 ppb rise in NOy on the current day and the preceding 1 day, 9. 4 % (95 % CI 7 13 %) with each 100 ppb rise in SOy and 2. 7 % (95 % CI 0. 1 5 %) with each 1 ppm rise in CO on the current day. The NO was more evident for the elderly who were 65 years and more.
Cardiovascular-specific mortality was associated with the levels of CO on the current day. Respiratory-specific mortality was associated with the levels of TSP and NO 5 days before death. Excess mortality risk is clearly evident in the upper range of NO levels and increased monotonically with NO. CONCLUSIONS This study suggested that the air pollution status below the current Korean ambient air quality standard might have an adverse effect on daily mortality. Then, it is impertive that the strategy for control of the air pollution-related daily mortality should be developed.
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OBJECTIVES We tried to establish a Regional Occupational Surveillance System (ROSS) for estimating the prevalence and monitoring the trend of occupational dermatitis among 718 manufacturing workers exposed to organic solvents and nonmetallic chemicals in small and medium sized businesses of 1,2 industrial complex area of taejon City. METHODS Through the report from the nurses of Group Occupational Health Management System, we made a case referral and immediate health examination system with occupational medical clinics. We also performed a survey for detecting occupational dermatitis by a self-administered questionnaire. Case must meet 3 criteria; 1) He/She must have one or more significant cutaneous signs and symptoms. 2) The symptom should be changed by the work condition or caused by risk chemicals. 3) Dermatitis should be diagnosed by a doctor. Results Among the 131 workers(17. 7 %) with significant symptoms screened by the questionnaire, 4 workers(0. 6 %) met the case definition criteria. And among the 45 workers (6. 3 9o) referred to the immediate diagnosed system, 14 workers (l. 9 %) were Strongly suspected to have occupational dermatitis. CONCLUSIONS These prevalence rates were quite underestimated because of deficient recognition of the disease severity among the workers, reversibility of the target diseases, and life-threathening mood due to nationwide economic crisis and the socioeconomic withdrawal of each business. Ultimately, harmonized activities of government, industry, labor unions, volunteer organization and academy relating to occupational health in a community should be encouraged to do creative, consistent efforts for evolution and development of this first trial of ROSS.
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OBJECTIVES A study was conducted for investigating the status of simple X-rays on lumbosacral regions at pre-employment health examination and analysing the effectiveness of simple X-rays on lumbosacral regions. METHODS The study data were pre-employment health examination data in a university hospital from Jan 3, 1993 through October of 1997. And, 97 newly employed workers who claimed no low back pain at pre-employment health examination of a certain company were follow-up survey about low back pain and related factors in April, 1995 and October of 1997. The data were collected by a self-reported questionnaire and a medical examination with a rehabilitation specialist. RESULTS Taking the simple X-rays on lumbo-sacral regions was 1, 591 workers(10.5%) among 15,166 pre-employment health examination from Jan 3, 1993 through October of 1997. And yearly application rates of these X-ray tests have been significantly statistical increasing (p<0.01). 2. The abnormal findings of simple X-rays on lumbo-sacral regions at pre-employment health examination were 40 workers. But, there was not significantly statistical difference between normal and abnormal group for the complaint rate of low back pain. 3. The number of case with symptoms of low back pain at the follow-up survey were 46, so the incidence density was 37. 1 persons/ 100 person-years. And the incidence density was not significantly statistical difference between normal and abnormal group of simple X-rays on lumbo-sacral regions. 4.
Through the multivariate logistic regression, significantly associated factors with low back pain were found to be tenure(OR=0.36, 95%CI: 0.17-0.79), lifting of heavy materials(OR=5. 86, 95%CI: l. 58-21. 74). CONCLUSION The simple X-rays on lumbo-sacral regions at pre-employment health examination is required further research for utilizing pre-employment health examination according to above results.
OBJECTIVES The aim of this study is to find out the activity of autoproliferation of ratfibroblast exposed to crystalline silica and the role of mediators secreted from rat fibroblast. METHODS The effect of alpha-quartz on production of growth factor (platelet-derived growth factor-AA and transforming growth factor beta)from rat fibroblasts were evaluated by ELISA and immunocytochemical analysis.
Gene expression of these growth factors in rat fibrobast exposed to crystalline silica was evaluated by RT-PCR.
Furthermore, fibroblast proliferation by culture supernatant of rat fibroblast was assayed by the neutral red test. RESULTS The amounts of H2O2 and growth factors synthesized in rat fibroblasts were significantly increased by the stimulation of crystalline silica(alpha-quartz), which showed the dose-dependent manner to the concentration of alpha-quartz with the maximum response at the dosage of 100 microgram/cm2. The result of RT-PCR demonstrated that alpha-quartz induced gene expression of PDGF-AA and TGFbeta in rat fibroblast. We also found that supernatant of alpha-quartz-cocultured rat fibroblast induced a significant proliferation of fibroblast. CONCLUSION Crystalline silica directly induce functional change in fibroblast such as increased release of reactive oxygen species and growth factors. The products of these functional change promote fibroblast proliferation via autocrine loop.
OBJECTIVES The chrome-induced olfactory alterations is caused by inhalation of chromic acid, a highly corrossive and toxic materials. And nasal septum perforation(NSP) has been suspected with possible causative factor of olfactory alterations. To our knowledge, there has been no report of the detailed findings of the olfactory alterations in chrome exposed subjects without nasal septum perforation(NSP). So we present the results of olfactory function test measured by T&T olfactometer and olfactometer perception test among chromium exposed workers without NSP. METHODS We performed this study in 25 study subjects and 25 control subjects matched with age, alcohol and smoking.
All of subjects are man. We performed olfactory function test measured by T&T olfactometer and olfactometer perception test. RESULTS 1) The age distribution of the subjects involved in this study was from 20 to 54 years old (average 33.3 years old) and the mean duration exposed to chromium was from 64. 9 months. 2) The olfactory function was checked by detection and recognition thresholds in five odorants. The detection thresholds of exposed group dealing with chromium were significantly increased in A and B ordorants than nonexposed group. The recognition thresholds of exposed group were significantly increased in D ordorants than nonexposed group. 3) The mean threshold of olfactometer perception test of exposed group were more increased than nonexposed group.
But thresholds difference did not show statistical significance, 4) The detection thresholds of A and D ordorants, recognition threshold of C ordorants and thresholds of olfactometer perception test were increased in the relation with duration of chrome exposure. CONCLUSIONS There has been no remarkable alterations in olfactory sense (TkT olfactometer and Olfactometer Perception Test) in subjects without nasal septum perforation(NSP) exposed to chromic acid.
OBJECTIVES The purpose of the study was to assess the risk factors assumed to be related to the high frequency hearing loss in the noise-exposed male workers. METHODS 712 occupationally noise-exposed male workers were included in this cross sectional study. The subjects filled out a questionnaire on the history of noise exposure, hearing protection, otologic diseases, tobacco smoking, and were tested on height, weight, hematocrit, serum total cholesterol level, fasting plasma glucose level and arterial blood pressure level. Pure tone audiometry and otoscopy were conducted and the subjects were allocated into two groups according to whether they had 4000 Hi hearing loss or not. RESULTS The multiple logistic regression analysis showed that military noise exposure, poor wearing status of the hearing protection devices, increased age, long noise exposure duration, mean arterial pressure less than 80mmHg, high fasting plasma sugar are the factors significantly related to high frequency hearing loss (P<0.05). On the contrary, there was no significant relationship between noise intensity, body mass index, serum total cholesterol level, smoking and high frequency hearing loss. Low hematocrit was shown to be a significant factor with a p-value less than 0.1. CONCLUSIONS High frequency hearing loss in the noise-exposed male workers is related to military noise exposure, use of hearing protection devices, age, noise exposure length, fasting glucose level and mean arterial pressure, in this order. Appropriate use of the hearing protection devices has a great impact on the prevention of the noise-induced hearing loss.
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OBJECTIVE: This study was carried out to determine the effects of occupational pesticides exposure on the level of serum Luteinizing Hormone(LH), Follicle Stimulating Hormone(FSH), testosterone in male workers. METHODS Twenty-two male workers exposed to pesticides were compared with twenty-eight male workers at same factory who were not exposed to pesticides. The selected variables for studying reproductive hormones were LH, FSH and testosterone. As part of the baseline health status, subjects were asked medical history. RESULTS There were no statistically significant differences on the level of LH, FSH, testosterone between the exposed and non-exposed group. Also the level of sex hormones were not significant difference with each department in exposed group. And the level of LH, FSH positively correlated with age. CONCLUSIONS These results indicate that there are no alterations in LH, FSH, testosterone at workers exposed to pesticides. But our findings are highly preliminary because of a small sample size. Thus it calls for furthur investigation of the hormonal effects at workers exposed to pesticides.
OBJECTIVES We evaluated demographic, socioeconomic, smoking-related, other health behavior, and disease factors associated with smoking cessation. METHODS This study included 5,493 male employees in a steel manufacturing industry, who smoked at health examination underwent in 1998. Quitters were defined as those who had stopped smoking at least one month prior to re-examination in 1999. The information on related factors was collected by self-administered questionnare. RESULTS At 12 months of follow-up, 1,955 patients (35.6 %) had quit smoking. The quit rate was higher in middle-aged, white collar, and high rank personnels. The quit rate increased with decreasing amount of cigarette, decreasing duration of smoking, and increasing age of starting smoking. There were higher quit rates among smokers who drank less or exercise. However, the existence of disease did not affect the quit rate. CONCLUSION This study showed that many demographic, socioeconomic, smoking-related and other health behaviors associated with smoking cessation. These results could be of use in the other worksite smoking cessation campaigns to enhance the quit rate.
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OBJECTIVES The increased prevalence of asthma over the last 30 years has been reported from many different countries, including Korea. The increased prevalence may be due to increased exposure to indoor air pollutants. METHODS In this study, the relationship between residential environments and airway hyper-responsiveness has been examined among 280 family members. The bronchial hyper-responsiveness was expressed as the log-transformed slope of FEV decrease over the log-transformed dose of methacholine concentration(BRindex). Simple regression analysis was done for the effect of sex, age, atopic status, and residential environments including active and passive smoking exposures on airway responsiveness. Based on simple regression results, multiple rwegression analysis was performed for total group and also according to sex. RESULTS The mean of BRindex of residents living in gas boiler heating houses was higher than that of central heating system (p=0.014). Smoking status was a significant determinant of bronchial hyper-responsiveness in both genders; male(p=0.017), female (p%.022). In the male group the mean of BRindex of current smokers was significantly higher than those of ex-smokers and non-smokers, and the mean of BRindex of passive smokers was higher than that of non-smokers, but statistical significance was border-line(p=0.069). In female group, the mean of BRindex of kerosene stove users was higher than that of non-users(p=0.057). CONCLUSIONS This study suggests that indoor air pollutants including type of heating, passive smoking and kerosene stove use can contribute to the increase in asthma prevalence in Korea.