Annals of Occupational and Environmental Medicine

Volume 15 (2); June 2003

Case Report

A case of mental ill health caused by job stress after job reallocation: Jong Min Woo, Gyung Mee Kim, Seong Ah Kim; Korean Journal of Occupational and Environmental Medicine 2003;15(2):205-212. Published online June 30, 2003; DOI: https://doi.org/10.35371/kjoem.2003.15.2.205

BACKGROUND
Recently, social concern about occupational stress and disputes, which are surrounded with judgements of work relatedness for various psychiatric sequels, is increasing. OBJECTIVE: We present a case of work-related illness judgement in which panic disorder and adjustment disorder with conversion symptoms were associated with work stress due to job reallocation.
METHODS
We performed psychiatric assessment including mental status examination and neuropsychological test batteries. We also assessed job stress profiles using the Korean version of the Occupational Stress Inventory(K-OSI).
RESULTS
The patient showed no specific psychological or physical problems and had previously demonstrated suitable coping skills. However, the patients case, who was sensitive to emotional stress, suffered chronic stress symptoms after a role change from a car mechanic to office manager which required continuous interaction with customers and a strong emotional burden. Panic attack and conversion symptoms were judged to be associated with disharmony between individual characteristics and environmental needs.
CONCLUSION
It is noteworthy that this is the first reported case considered as a psychiatric illness related with psychological work stress. A further study will be attempted to assign standards of judgment for similar cases through systematic source collection and tool development.

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Original Articles

Occupational Diseases on Health Care workers Approved by Korea Labor Welfare Corporation: Hyun Sul Lim, Yeon Soon Ahn; Korean Journal of Occupational and Environmental Medicine 2003;15(2):196-204. Published online June 30, 2003; DOI: https://doi.org/10.35371/kjoem.2003.15.2.196

Abstract PDF: OBJECTIVES
This study was carried out to analyze the characteristics of occupational diseases among health care workers in Korea.
METHODS
Using the database of the Korea Labor Welfare Corporation (KLWC), 5, 460 approved occupational disease cases, between Jan 1, 1999 and Dec 31, 2000, and approved by the Jun 30, 2001, were collected. Of these, the 142 health care worker cases were investigated.
RESULTS
The proportion of health care workers among the total cases reported in 1999 and 2000 was 2.6%, respectively. The diseases were infectious in 61 (43.0%), cerebro-cardiovascular in 60 (42.3%) and musculoskeletal in 18 cases (12.6%). The distributions of the occupational diseases by sex were 59 (41.5%) and 83 cases (58.5%), in males and females, respectively. The distributions of the occupational diseases by age were 64 (45.1%), 30 (21.1%), 25 (17.6%) and 17 cases (12.0%), in their 20s, 30s, 40s and 50s, respectively. For the cases of infectious diseases by age there were 48 (78.7%) in their 20s and 12 (19.7%) in their 30s, for the cases of cerebro-cardiovascular diseases by age there were 17 (28.3%) in their 40s, 16 (26.7%) in their 50s and 12 (20.0%) in their 20s, and for the cases of musculoskeletal diseases there were 7 (38.9%) in their 30s and 4 (22.2%) in their 20s. The distributions of the cases of occupational diseases by department were 64 (45.1%), 19 (13.4%), 18 (12.7%), and 10 (7.0%) in the nursing, doctors, officers, and food services departments, respectively.
CONCLUSIONS
The major occupational diseases of health care workers, as approved by the KLWC, were the infectious, cerebro-cardiovascular and musculoskeletal diseases. A special management policy must be considered to prevent occupational diseases of health care workers in Korea.

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Impact of Subject and Time Related Factors on Reliability of Neurobehavioral Tests: Joon Sakong, Man Joong Jeon, Nak Jung Sung, Gyu Tae Kim; Korean Journal of Occupational and Environmental Medicine 2003;15(2):188-195. Published online June 30, 2003; DOI: https://doi.org/10.35371/kjoem.2003.15.2.188

Abstract PDF: OBJECTIVES
This study was conducted to select neurobehavioral tests that are more reliable and less affected by subjects characteristics and test conditions.
METHODS
Five computerized and five traditional neurobehavioral tests and retests were administered to 85 medical school students and 35 hospital workers. The computerized tests consisted of the Simple Reaction Time, Addition, Symbol Digit, Digit Span, and Finger Tapping Speed, while the traditional tests comprised the Benton Visual Retention test, Digit Symbol, Digit Span, Pursuit Aiming, and pegboard. In addition, the effects of various factors on the reliability of the neurobehavioral tests, including age, sex, educational level, computer familiarity, test intervals, and test time of day, were also evaluated.
RESULTS
Among the computerized neurobehavioral tests, the reliability of Addition, Symbol Digit, Digit Span, and Finger Tapping Speed were not affected significantly by age, sex, test interval, or computer familiarity. It was found that Finger Tapping Speed is not affected by educational level. When the time of retest was incongruous with the time of the first test, test-retest reliability was lower in most neurobehavioral tests except computerized Addition, Digit Span, and Finger Tapping Speed, and traditional Symbol Digit.
CONCLUSIONS
These results suggest that the computerized Addition, Symbol digit, Digit Span, and Finger Tapping Speed, and the traditional Digit Symbol are more satisfactory for our purposes. These results should facilitate selection of the most appropriate tests for periodical evaluation of the central nervous system of workers exposed to neurotoxic substances in Korea.

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Identification of Cross-linked 46 KDa Protein in Experimentally Induced Silicotic Nodule in Rat Lung: You Mie Kim, Young Jin Kim, Soo Young Lee; Korean Journal of Occupational and Environmental Medicine 2003;15(2):181-187. Published online June 30, 2003; DOI: https://doi.org/10.35371/kjoem.2003.15.2.181

Abstract PDF: OBJECTIVES
This study was conducted in order to understand the cellular events associated with silica-induced pathogenesis of the rat lung.
METHODS
Silicosis was induced by an intratracheal instillation of 50 mg of silica (SiO2, 0.15 - 10 micrometer) suspended in 500 microliter of a sterile saline solution in Sprague-Dawley rats weighing 200g. Silicotic nodules were excised from the rat lungs 4 weeks after silica instillation, then boiled for 4 days at 110 degrees in solution containing 2% SDS, 10 M urea and 40 mM DTT. The insoluble cellular encapsulates were electrophoresed on 4-12 % gradient SDS-PAGE, and the amino acid composition was analyzed. Affinity chromatographies of the homogenate supernatants of the control lung, silicotic nodule, and normal rat plasma were performed using rabbit IgG, anti-rat, cross-linked protein from the silicotic nodule. The amounts of N epsilon-(gamma-glutamyl) lysine cross-linked in the control lungs and silicotic nodules were determined using HPLC analysis.
RESULTS
The remaining cross-linked protein was insoluble in the 10 M urea and 40 mM sulfhydryl reagents even under prolonged boiling conditions. The encapsulate revealed the retention of silica particles within the protein whose amino acid composition showed a high percentage of alanine, leucine and glycine. A 46 KDa protein was identified as a cross-linked protein in the silicotic nodule by affinity chromatography. The level of N epsilon-(gamma-glutamyl) lysine dipeptide in the nodule digest was prominently increased compared with that in the control lung.
CONCLUSIONS
Transglutaminase (TGase)-catalyzed cross-linking appears to be involved in the silicotic nodule formation, and the 46 KDa protein may be cross-linked to itself and other extracellular matrix proteins during fibrosis and the formation of eventually insoluble nodule.

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Identification of Plasma Coagulation Factor XIII, Transglutaminase 3 and N epsilon-(gamma-glutamyl) lysine cross-Link in the Silicotic Nodule by Immunohistochemistry: You Mie Kim, Young Jin Kim, Soo Young Lee; Korean Journal of Occupational and Environmental Medicine 2003;15(2):173-180. Published online June 30, 2003; DOI: https://doi.org/10.35371/kjoem.2003.15.2.173

Abstract PDF: OBJECTIVES
This study was performed to examine the immunohistochemical distribution of TGase 1, 2, 3, coagulation factor XIII and N epsilon-(gamma-glutamyl) lysine cross-link in the silicotic nodules formed after an intratracheal instillation of the silica.
METHODS
The immunohistochemical examinations used antibodies against TGase 1, 2, 3, coagulation factor XIII and N epsilon-(gamma-glutamyl) lysine isopeptide in the silicotic nodules induced after an intratracheal instillation of 50 mg of size fractionated, crystalline silica.
RESULTS
A high level of TGase 3 was related to the severity of fibrosis in silicotic nodules and extracellular coagulation factor XIII was detected around the nodules. Expressions of both membrane-bound TGase 1 and TGase 2 were barely detected in the nodules although high expressions were detected in the intact lung. Formation of N epsilon-(gamma-glutamyl) lysine cross-links was increased in severe fibrotic nodules.
CONCLUSIONS
TGase 3 might contribute to the eventual stone-like fibrosis via formation of N epsilon-(gamma-glutamyl) lysine cross-links. Futhermore, coagulation factor XIII plays a role in the formation of a provisional matrix which results in fibrogenesis during silicotic nodule formation.

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Seasonal Variations of the Urinary N-Methylformamide Concentration among Workers at a Synthetic Leather Factory: Kwang Young Lee, Joo Hyun Byeon, Hae Rhan Song, Jin Ha Kim, Kwang Wook Ko, Yong Hwan Lee; Korean Journal of Occupational and Environmental Medicine 2003;15(2):162-172. Published online June 30, 2003; DOI: https://doi.org/10.35371/kjoem.2003.15.2.162

Abstract PDF

OBJECTIVES
This study was carried out to identify seasonal variations of urinary concentrations of N-methylformamide (NMF) among workers employed at a synthetic leather factory.
METHODS
Study subjects consisted of 16 male and 6 female workers who were involved in the direct treatment of dimethylformamide (DMF) in a synthetic leather factory. By using health examination data and the results of air measurements and biologic monitoring conducted in February and July, 2001, we identified seasonal variations of the DMF concentrations in the air and NMF concentrations in urine.
RESULTS
1) In winter and summer, average temperatures at the working sites were 3.2 degrees C and 26.5 degrees C, respectively and average humidities were 35.4 % and 84.5 %, respectively. 2) Airborne DMF concentrations were not significantly different between summer (13.78 ppm) and winter (11.55 ppm). 3) NMF concentrations in urine were found to be significantly higher in summer (96.09 mg/g creatinine) than in winter (31.23 mg/g creatinine) (p<0.001).
CONCLUSIONS
The seasonal difference in the urinary excretion values of NMF may be due to increased dermal absorption of DMF with the higher ambient temperature and humidity in summer and the increased area of exposed skin.

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Risk assessment of N,N-dimethylformamide on residents living near synthetic leather factories
Qingyu Zhang, Chanke Huang, Yumei Wei, Qi Zhu, Weili Tian, Cui Wang
Environmental Science and Pollution Research.2014; 21(5): 3534. CrossRef
Assessment of correlation between markers of ambient monitoring and biological monitoring of dimethylformamide for workers in synthetic leather manufacturing factories in Korea
Yang In Hwang, Mi-Young Lee, Yun Kyung Chung, Eun A Kim
Analytical Science and Technology.2013; 26(5): 315. CrossRef
Clinical Outcomes of Occupational Exposure to N,N-Dimethylformamide: Perspectives from Experimental Toxicology
Tae Hyun Kim, Sang Geon Kim
Safety and Health at Work.2011; 2(2): 97. CrossRef

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Health Evaluation of ex-workers occupationally exposed to Carbon disulfide: Subjective Symptoms and Related Factors according to compensation for CS2 poisoning: Kyung Jae Lee, Joo Ja Kim, Hyun Rim Choi, Gil Seong Yang, Ho Kim, Shang Hyuk Yim, Yun Geun Lee; Korean Journal of Occupational and Environmental Medicine 2003;15(2):150-161. Published online June 30, 2003; DOI: https://doi.org/10.35371/kjoem.2003.15.2.150

Abstract PDF

OBJECTIVES
To investigate the chronological subjective symptoms and related factors in ex-workers who were occupationally exposed to Carbon disulfide.
METHODS
One hundred and seventy-seven subjects (147 males and 30 females) were randomly selected among ex-workers and interviewed by well trained doctors, who filled out a structured questionnaire developed by authors on the subjective symptoms. The questionnaire was composed of symptoms in the head and neck, and those of the neuro-psychological, respiratory, endocrine, musculoskeletal, and reproductive systems. Other factors such as general and occupational characteristics including work department, work duration, duration since cessation of exposure, and compensation for occupational disease were also investigated.
RESULTS
The mean subject age was 55.4 years. The mean cumulative exposure index (CEI) was 38.96 +/- 31.18. CEI was significantly higher in the compensated group (47.61 +/- 32.51) than in the non-compensated group (26.81 +/- 24.75)(p=0.000). Symptom complaints were significantly higher in the compensated group in all organ systems, and their incidence increased gradually until 10 years after cessation of work, and then decreased. The mean duration for cessation of exposure at the time of compensation was 10.97 years. The significantly different factors between the compensated group and the non-compensated group were total cumulative exposure index and the time interval between the cessation of work and the time of compensation.
CONCLUSION
Our findings suggest that total cumulative exposure index and the time interval between the cessation of work and the time of compensation may be important factors affecting the compensation for occupational disease. Therefore, further studies will be necessary.

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Health Behavior and Health Condition of Patients Exposed to Carbon Disulfide according to Exposure Level
Hyun Joe
Soonchunhyang Medical Science.2020; 26(2): 53. CrossRef
Recognition and Using Status of Carbon Disulfide (CS2) as Fumigant for Controlling Chestnut Weevil, Curculio sikkimensis among Chestnut Farmers
Moo-Sik Lee, Eun-Young Kim, Jae-Lim Lee, Gi-Yeon Sohn
Journal of agricultural medicine and community health.2016; 41(2): 63. CrossRef

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Pain Related Factors in Upper Extremities Among Hospital Workers Using Video Display Terminals: Hyoung Ryoul Kim, Jong Uk Won, Jae Suk Song, Chi Nyon Kim, Hyun Soo Kim, Jaehoon Roh; Korean Journal of Occupational and Environmental Medicine 2003;15(2):140-149. Published online June 30, 2003; DOI: https://doi.org/10.35371/kjoem.2003.15.2.140

Abstract PDF

OBJECTIVES
This study was designed to quantify symptoms in the upper extremities and to identify the pain related factors among hospital workers using video display terminals.
METHODS
The subject-group consisted of 138 employees working at a hospital using video display terminals. A structured questionnaire was used to estimate the participants' general characteristics, and job contents. Job stress was measured using Karaseks JCQ(Job Content Questionnaire). Pain in the upper extremities was identified according to the NIOSH symptoms survey criteria. Quantification was measured using Kim Chul's method. Pearson's Correlation analysis was used to identify validity in quantification. VAS(visual analog scale) was used to compare with this method. Multiple regression analyses elucidated the relationship between quantified pain and various work factors, such as job stress. Data were analysed with SAS 6.12 program.
RESULTS
First, in quantification using Kim Chul's method, the correlation between modified PRS(pain rating score) and VAS was extremely high by 0.60(P<0.01), indicating the high validity of PRS. Second, the groups of high job demand, high job control, and females were related to an increased pain level.
CONCLUSIONS
These results suggest that the self pain assessment method, PRS, is valuable and useful in analyzing occupational musculoskeletal symptoms. High demand, job control and gender may influence the levels of pain. Prospective studies about musculoskeletal disorder are required.

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The association between long working hours and work-related musculoskeletal symptoms of Korean wage workers: data from the fourth Korean working conditions survey (a cross-sectional study)
Jae-Gwang Lee, Guang Hwi Kim, Sung Won Jung, Sang Woo Kim, June-Hee Lee, Kyung-Jae Lee
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Kyung-In Kim, Seo-Yeon Choi, Dong-Hyun Park
Journal of the Korea Safety Management and Science.2016; 18(1): 119. CrossRef
Change in Musculoskeletal Pain in Patients With Work-Related Musculoskeletal Disorder After Tailored Rehabilitation Education: A One-Year Follow-Up Survey
Dong Hun Lee, Boram Kang, Seungyoung Choi, Taikon Kim, Seong Ho Jang, Kyu Hoon Lee, Mi Jung Kim, Si-Bog Park, Seung Hoon Han
Annals of Rehabilitation Medicine.2015; 39(5): 726. CrossRef
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Jae-Yoon Lee, Byeong-Yeon Moon, Youn-Hong Jeong, Hyun-Kyung Woo
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Effect on Turnover Intention in Hotel Employees with Musculoskeletal Pains by Working Environment
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Work-related Musculoskeletal Diseases and Occupational Injuries in Health Care Workers
Jung-Yeon Hong, Jung-Wan Koo
Journal of the Korean Medical Association.2010; 53(6): 446. CrossRef
Gender-related Factors Associated with Upper Extremity Function in Workers
Kyoo Sang Kim, Min Gi Kim
Safety and Health at Work.2010; 1(2): 158. CrossRef

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Shiftwork Duration and Metabolic Risk Factors of Cardiovascular Disease: Mi na Ha, Sang Chul Roh, Jung sun Park; Korean Journal of Occupational and Environmental Medicine 2003;15(2):132-139. Published online June 30, 2003; DOI: https://doi.org/10.35371/kjoem.2003.15.2.132

Abstract PDF

AIMS: To explore the relationship between shiftwork duration and metabolic risk factors on cardiovascular disease in shiftworkers.
METHODS
The study subjects comprised of 226 nurses, from a hospital, and 130 male workers, from a diaper and feminine hygienic material manufacturing firm. The mean ages of the male workers and nurses were 29 and 28.5 years, respectively. The fasting blood sugar, serum cholesterol, blood pressure, height and weight, waist and hip circumferences (only in nurses), and number of step for a shift as indices of physical activity were measured. Using the Korean version of Karasek's job contents questionnaire, the job stress was assessed. Information about the number of years worked, duration of shiftwork, and past medical and behavioral histories, including smoking, were obtained by self-administrated questionnaires. Linear regression analyses were performed, to show the relationships between shiftwork duration and metabolic risk factors, using simple and multivariate models, adjusted for age, smoking, job strain and physical activity. The following criteria were defined: hypertension as a SBP>or160 or a DBP>or=90 mmHg at least once, hypercholesterolemia, as a serum total cholesterol >or=240 mg/dl, obesity as BMI (Body Mass Index) >or=25kg/m2 and central obesity as a WHR (Waist to Hip Ratio) >or=0.85; and the logistic regression analyses, according to years of shiftwork, were performed using simple and adjusted models.
RESULTS
The cholesterol and fasting blood sugar showed increasing trends, but without statistical significances, according to the increase in shiftwork duration of the male workers, although, the increases in the blood pressure and BMI were statistically significant. In the nurses, only the WHR showed a significant increase in relation to the shiftwork duration. In the logistic regression analyses, hypercholesterolemia and obesity showed significant increasing risks according to the number of years of shiftwork (OR=3.32 95%CI 1.27-8.72 and OR=3.21 95%CI 1.24-8.32 respectively) in the male workers, but hypertension showed no significance. In the nurses, only an increased central obesity was significant as a risk factor (OR=1.30 95%CI 1.05-1.62).
CONCLUSIONS
These results provide evidence of the associations between shiftwork and metabolic risk factors for cardiovascular disease, although healthy shiftworker effects might exist in our cross sectional study design.

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Predictors of Return to Work in Occupational Injured Workers: Won Mee Jeong, Chung Yill Park, Jung Wan Koo, Young man Roh; Korean Journal of Occupational and Environmental Medicine 2003;15(2):119-131. Published online June 30, 2003; DOI: https://doi.org/10.35371/kjoem.2003.15.2.119

Abstract PDF

OBJECTIVES
In order to obtain information useful in setting up occupational rehabilitation programs, an evaluation was conducted to determine predictive factors of workers' return to work after an occupational injury.
METHODS
13, 903 records of registered occupationally injured cases identified to have received disability compensation in 1998 were collected from the 36 branch of Korean Labor Welfare Corporation(KLWC). Through simple systematic sampling, a total of 3, 658 cases were selected as final subjects. Status of return to work, general characteristics, workplace characteristics, disability characteristics and disability outcome characteristics were collected from the KLWC and National Health Insurance Corporation records(NHIC). For statistical analyses, chi-square test and stepwise multiple logistic regression analysis were applied using the SAS software package program.
RESULTS
Negatively affecting significant predictive factors for return to work were included the female gender, age of 50 years or older, 6 month or less of work duration, 1 or less family dependents, workplace with 200 or less employees, electric, gas, waterwork companies, foot injuries compared to finger injuries, fall from elevation, high degree of disability claims(1~4 grade), and period of medical care more than 181 days.
CONCLUSIONS
The results suggest that the poor rate return to work in occupationally injured workers' is particularly affected by female gender, older-aged employees, and workers employed by electric, gas, waterwork companies. Also, it was more difficult to return to work for workers who received injuries from a fall from elevation and who had longer period of medical care(more than 181days). It is strongly recommended that more efficient and systematic occupational rehabilitation programs be set up, taking into consideration the above mentioned factors.

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Disability and Rehabilitation.2019; 41(6): 691. CrossRef
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Wanhyung Lee, Jin-Ha Yoon, Jaehoon Roh, Yeong-Kwang Kim, Hongdeok Seok, June-Hee Lee, Jong-Uk Won
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