Annals of Occupational and Environmental Medicine

Volume 19 (3); September 2007

Case Reports

A Case of Nitrogen Dioxide-Induced Pulmonary Edema in Oxygen Torch: Jong Joon Ahn, Yangjin Jegal, Kwang Won Seo, Woon Jung Kwon, Nari Choy, Yangho Kim; Korean Journal of Occupational and Environmental Medicine 2007;19(3):244-249. Published online September 30, 2007; DOI: https://doi.org/10.35371/kjoem.2007.19.3.244

BACKGROUND
Welders tend to be exposed to a variety of hazards including metal fumes, toxic gases, electricity, heat, noise, and radiation such as ultraviolet and infrared light. Noxious gases generated during welding include carbon monoxide, ozone, and nitrogen oxide. Although the effects of metal fumes have been well studied, few reports have investigated the influence of noxious gas exposure in welders.
CASE
REPORT: We encountered a patient who developed non-cardiogenic pulmonary edema within a day after fairing up a steel plate with an oxygen/LPG torch. The patient was a 43-year-old female who complained of dyspnea which became exacerbated the following morning. Her chest X-ray and chest CT scan showed an extensive ground glass opacity which was more prominent in the both upper lungs. Both her symptoms and chest X-ray findings improved. We attributed the patient's symptoms to non-cardiogenic pulmonary edema caused by nitrogen dioxide exposure, by reasoning that: 1) the patient's clinical course and radiologic findings suggested pulmonary edema 2) the event happened following fairing work with oxygen/LPG torch that usually induces a high concentration of nitrogen dioxide, and 3) the other possible causes of pulmonary edema could be excluded.
CONCLUSION
Nitrogen dioxide-induced pulmonary edema should be considered in oxygen torch contrary to arc welding.

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Acute Occupational Poisoning in Korea
Hyunjoo Kim, Jia Ryu
The Ewha Medical Journal.2016; 39(4): 99. CrossRef

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A Case of Polyneuropathy Associated with Methyl Bromide Intoxication: Hyung Jae Lee, Se Won Oh, Jong Seong Lee, Hong Jae Chae, Jai Dong Moon; Korean Journal of Occupational and Environmental Medicine 2007;19(3):238-243. Published online September 30, 2007; DOI: https://doi.org/10.35371/kjoem.2007.19.3.238

Abstract PDF

BACKGROUND
The diagnosis and treatment of intoxication induced by methyl bromide depends on the patient's exposure history. In the present case, the patient showed various neurologic symptoms which were helpful to confirm the diagnosis and to determine the concentration of bromide ion in his body. The reduction rate of bromide ion concentration was another important clue to estimate the patient's health state in treatment.
CASE
REPORT: Some neurologic disorders were manifested in a 35-year-old man who had been engaged in a fumigation company for 12 years. Although he had been complaining of abnormal symptoms for 10 days, he had left his work only 3 days before being admitted to our hospital in serious state via the emergency department. Comprehensive clinical evaluations confirmed he was suffering from polyneuropathy, optic neuropathy and cerebellar signs. We diagnosed his condition as methyl bromide intoxication, and ruled out other possible diseases, after taking his occupational history and evaluating the elevation of bromide ion concentration in the sampled blood, urine and cerebrospinal fluid. With decreasing bromide ion concentration, his abnormal symptoms improved and he was discharged 22 days after admission without any neurologic sequela.
CONCLUSION
This case report confirmed the usefulness of measuring the concentrations of bromide ion in the diagnosis of methyl bromide intoxication. We therefore suggest that the regular measuring of bromide ion concentration be included in the occupation specified health examination.

Citations

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Acute Occupational Poisoning in Korea
Hyunjoo Kim, Jia Ryu
The Ewha Medical Journal.2016; 39(4): 99. CrossRef
Compensation for Occupational Neurological and Mental Disorders
Dong-Mug Kang, Inah Kim
Journal of Korean Medical Science.2014; 29(Suppl): S59. 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

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A Case of Lead Poisoning After Ingestion of Herb Pills: Se Won Oh, Hyung Jai Lee, Hong Jae Chae, Sung Kwan Lee, Jai Dong Moon, Deok Cho; Korean Journal of Occupational and Environmental Medicine 2007;19(3):231-237. Published online September 30, 2007; DOI: https://doi.org/10.35371/kjoem.2007.19.3.231

Abstract PDF

BACKGROUND
Lead is a common environmental metal and has been used for various purposes for a long time, leading to frequent reports of lead poisoning. The concern about lead poisoning starts has been mostly focused on occupational exposure and is linked to the prevention and management of lead exposure in refining and manufacturing processes. Nowadays, however, there is growing concern about nonoccupational lead exposure by many pollutants. Especially, lead poisoning by herb medicine has commonly been observed in clinics in Southeast Asia and South Korea. This case report contains diagnosis of inpatients who suffered from lead poisoning from a herb medicine, arthritis remedy and who complained of abdominal symptoms and dizziness. The study purpose was to awaken our healthful interest in lead poisoning.
CASE
REPORT: A 53-year-old female patient complaining of abdominal pain, dizziness, and numbness of hand and foot came to our hospital due to the continuation of her anemic finding symptoms while undergoing treatment at a secondary hospital. Her past medical history was unremarkable except she had taken herb pills for about a year which were administered by herb medicine to treat arthritis. Physical examination was unremarkable except for oral ulcer finding. Hemoglobin was 8.5 g/dl, reticulocyte count was 4.10%, bilirubin was 1.3 mg/dl (direct 0.3 mg/dl), and Zinc protoporphyrin 169.12 ug/dl. In urinalysis results, WBC increased to 30~39 /HPF, While AST/ALT, BUN/Cr, PT/aPTT, and nerve conduction velocity were normal. Basophilic stippling was observed through peripheral blood smear. The blood lead level was 80.4 microgram/dl and the urine lead level continued to increase to 541 microgram/l. Analysis of the pills that the patient had been taking showed that they contained 30 mg/g lead. By oral chelation therapy with D-penicillamine four times per day for five days, the patient's hemoglobin increased to 11.8 g/dl, while blood lead level decreased to 39.2 microgram/dl, and urine level to 196 microgram/l. Although the soles of her feet remained cold, but other symptoms and anemia finding were improved considerably. However, after discontinuing D-penicillamine medication, the blood lead level increased to 41.4 microgram/dl again. The further administration of D-penicillamine for five days reduced the blood lead level to 31.5 microgram/dl. At two years after the discontinuance of D-penicillamine, the followup findings were normal; hemoglobin was 13.1 g/dl, hematocrit 39.6%, reticulocyte count 1.22%, blood lead level 13.3 microgram/dl, and urine lead level 9.17 microgram/l.
CONCLUSION
After taking herb medicine pills for one year, the patient was admitted to hospital chiefly complaining of abdominal pain, dizziness, and numbness of the hand and foot. The high blood and urine and lead levels and lead chemical analysis of the herb pills confirmed lead poisoning which was treated with D-penicillamine for five days. The follow-up result after two years indicated normal blood and urine lead levels.

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Sources, distribution, bioavailability, toxicity, and risk assessment of heavy metal(loid)s in complementary medicines
Shiv Bolan, Anitha Kunhikrishnan, Balaji Seshadri, Girish Choppala, Ravi Naidu, Nanthi S. Bolan, Yong Sik Ok, Ming Zhang, Chun-Guang Li, Feng Li, Barry Noller, Mary Beth Kirkham
Environment International.2017; 108: 103. CrossRef
A Case of Lead Poisoning with Drug-induced Liver Injury after Ingestion of Herbal Medicine
Gi Jung Jeon, Jongha Park, Min Sung Kim, Jong Won Yu, Jae Hyun Park, Min Sik Kim
The Korean Journal of Gastroenterology.2015; 65(6): 375. CrossRef
Adverse Events Associated with Metal Contamination of Traditional Chinese Medicines in Korea: A Clinical Review
Hyunah Kim, Peter J. Hughes, Emily M. Hawes
Yonsei Medical Journal.2014; 55(5): 1177. CrossRef

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Original Articles

The Relations between Shiftwork and Sleep Disturbance in a University Hospital Nurses: Jung Tak Lee, Kyung Jong Lee, Jae Beom Park, Kyu Won Lee, Kyu Yeob Jang; Korean Journal of Occupational and Environmental Medicine 2007;19(3):223-230. Published online September 30, 2007; DOI: https://doi.org/10.35371/kjoem.2007.19.3.223

Abstract PDF

OBJECTIVES
Nurses working in a hospital operate in a special environment where patients require a 24-hour day service. In order to meet the need for manpower, nurses in the wards, ICU, and ER work in 3 shifts per day. This study was designed to evaluate their sleeping patterns and the factors that influence them.
METHODS
The subjects were 114 female nurses working at a University Hospital in Kyungi-do. To evaluate their sleeping pattern, a survey containing 11 questions was used. Their were differentiated into insomnia, sleep deprivation, daytime sleepiness, and snoring. Statistical analysis was conducted with independent t test, chi-square test and analysis of covariance.
RESULTS
A statistical difference was found between shiftworkers and nonshiftworkers, in terms of sleep initiation time (p<0.05). The occurrences of insomnia, sleep deprivation, daytime sleepiness and snoring differed between the two groups, but not significantly.
CONCLUSIONS
Of the numerous factors affecting sleeping patterns, shiftwork has the most deteriorative effect.

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Li Lu, Ka-In Lok, Qinge Zhang, Ling Zhang, Yifan Xiang, Gabor S. Ungvari, Brian J. Hall, Feng-Rong An, Yu-Tao Xiang
PeerJ.2021; 9: e10659. CrossRef
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Night shift work and inflammatory markers in male workers aged 20–39 in a display manufacturing company
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Hye-Sim Kim, Yoon-Shin Kim, Min-Hee Hong, Jin-Uk Kim
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Dong-Kyun Lim, Ki-Ook Baek, In-Sung Chung, Mi-Young Lee
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Relationship of Shift Work to Gastrointestinal Disorders in Hospital Nurses
Eun-Ju Kim, Hye-Sun Jung, Eun-hi Choi
Korean Journal of Health Promotion.2014; 14(4): 172. CrossRef
The relationships between dietary behavior and health related factors according to shift work in nurses
Ji-Myung Kim, Bok-Hee Kang
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Seung-Lim Lee, Soo-Jin Kim
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Mi Sung Kim, Jang-Rak Kim, Ki-Soo Park, Young Sil Kang, Sung Pil Michael Choe
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Factors Influencing Health Promoting Behavior among Hospital Registered Nurses - Mood States, Resourcefulness, and Health Perception -
Eun Ja Yeun, Hee Jeong Kim, Mi Soon Jeon
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Pulmonary Function Changes of Ozone Exposed Workers in a Film Manufacturing Company: Yoomi Chae, Hyunjoo Kim, Sangchul Roh; Korean Journal of Occupational and Environmental Medicine 2007;19(3):215-222. Published online September 30, 2007; DOI: https://doi.org/10.35371/kjoem.2007.19.3.215

Abstract PDF

OBJECTIVES
To investigate the pulmonary function changes of ozone exposure in Corona and Slitter workers exposed to an ozone level ranging from 0.022~0.061 ppm.
METHODS
Forty-two subjects were exposed for 8hrs to ozone every day. We perfomed pulmonary function testing immediately before and after work and self-administered, portable peak flow meter measurements were self-conducted by the workers over a 5-day (Monday to Friday) period.
RESULTS
Ozone concentrations in the workplace ranging from 0.050~0.061 ppm at Corona and 0.022~0.023 ppm at Slitter in 2006. A small decrement in forced-vital capacity were observed among Corona workers from 93.9% to 91.3% (p=0.012) and also in employment duration below ten years. We found no significant differences in before and after FVC and FEV1 among Slitter workers. All daily (Monday to Friday) peak expiratory flow rates declined in magnitude after two days of ozone exposure, compared with first day exposure.
CONCLUSION
We concluded that daily ozone exposure in the workplace slightly decreased pulmonary function and that PEFR variability is greatest on the 2nd day of ozone exposure.

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A Study of Ozone Variations in a Semiconductor Fabrication Facility and Office Related to the Ozone Concentration in the Outdoor Air
Ji-Eun Lee, Myung-Koo Jung, Kwang-Min Choi
Journal of Korean Society of Occupational and Environmental Hygiene.2016; 26(2): 188. CrossRef

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Patient Satisfaction in Workers' Compensation Medical Care: Hwa Pyung Lee, Hyoung June Im, Young Su Ju, Young Jun Kwon, Hee Tae Kang, Jeong Min Kim, Sung Sik Cho, Tae Kyung Lee, Jongwan Yoon; Korean Journal of Occupational and Environmental Medicine 2007;19(3):204-214. Published online September 30, 2007; DOI: https://doi.org/10.35371/kjoem.2007.19.3.204

Abstract PDF

OBJECTIVES
To evaluate the patient satisfaction and its influencing factors after medical care for workrelated injuries.
METHODS
A self-reported questionnaire was mailed to 921 workers who had experienced workers' compensation medical care. The data from 335 respondents (response rate was 36.4%) were merged and analysed with the data from the Korea Labor Welfare Corporation (KLWC) which contain other general information of the respondents.
RESULTS
Dissatisfaction with their medical care was reported by 17.3% of the respondents. Overall patient satisfaction (OPS) was highly correlated with the medical treatment process such as hospital facility, medical therapy, surgical therapy, doctor's explanation and physical therapy. However, OPS was negatively influenced by three factors: 1) unsatisfactory hospital care during waiting period before the approval of workers' compensation, 2) forced end of the hospital care by the workers' compensation, and 3) end of the hospital care with no further improvement.
CONCLUSIONS
To improve the satisfaction of patients with work-related injuries, both the practice of medical treatment and also the administrative process of workers' compensation must be reformed. These reforms are needed to improve the quality of workers' compensation medical care and prevent abnormal illness behavior such as inappropriate treatment seeking.

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Workers’ experiences with compensated sick leave due to musculoskeletal disorder: a qualitative study
Min Choi, Hyoung-Ryoul Kim, Jinwoo Lee, Hye-Eun Lee, Junsu Byun, Jong Uk Won
Annals of Occupational and Environmental Medicine.2014;[Epub] CrossRef
A Study on Contributing Factors of Industrially Injured Patients' Satisfaction
Hyun-Joo Lee, Jung-In Kang
Korean Journal of Occupational Health Nursing.2011; 20(3): 319. CrossRef

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Use of Screening Dose to Evaluate the Work-relatedness of Cancers Occurring among Korean Radiation Workers: Meeseon Jeong, Young Woo Jin, Hyun Sul Lim, Chong Soon Kim; Korean Journal of Occupational and Environmental Medicine 2007;19(3):196-203. Published online September 30, 2007; DOI: https://doi.org/10.35371/kjoem.2007.19.3.196

Abstract PDF

OBJECTIVES
To propose a screening dose based on the probability of causation (PC) to simplify the evaluation procedure for the work-relatedness of the cancers occurring among Korean radiation workers.
METHODS
Under the PC uncertainty distribution, the screening dose was defined in which the maximum PC is equivalent to 50% for single exposure to radiation, after which the values were calculated according to three significance levels: 90%, 95%, and 99%. By using the screening doses for each cancer, we also predicted the number of compensations for the occupational cancers among the current Korean radiation workers to determine a reasonable criterion for the significance level.
RESULTS
If the cumulative dose received by a radiation worker with cancer is less than the screening dose, then PC can not be greater than 50%, i.e., the case can not be awarded as an occupational disease. The numbers of compensation cases for a future decade were predicted to be 3-5, 4-6, and 6-10 at the significance levels of 90%, 95%, and 99%, respectively.
CONCLUSIONS
The procedure to evaluate the occupational disease was greatly simplified by using the screening dose for evaluation. A criterion of 95% was recommended as the PC upper limit following consideration for the results of the predicted cases for compensation and the economic circumstances in Korea.

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The work-relatedness at a case of acute lymphoblastic leukemia in a radiation oncologist
Bong Hyun Kim, Young-Jun Kwon, Young-Su Ju, Bong Kyu Kim, Hyun Seok Lee, Sang-gil Lee, Yun Kyung Chung
Annals of Occupational and Environmental Medicine.2017;[Epub] CrossRef
A case of chronic myeloid leukemia in a diagnostic radiographer
Chulyong Park, Sungyeul Choi, Dohyung Kim, Jaechan Park, Saerom Lee
Annals of Occupational and Environmental Medicine.2014;[Epub] CrossRef
Ionizing Radiation-induced Diseases in Korea
Young-Woo Jin, Meeseon Jeong, Kieun Moon, Min-Heui Jo, Seong-Kyu Kang
Journal of Korean Medical Science.2010; 25(Suppl): S70. CrossRef
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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Association Between Job-Stress and VDT Work, and Musculoskeletal Symptoms of Neck and Shoulder Among White-Collar Workers: Eui Cheol Lee, Hawn Cheol Kim, Dal Young Jung, Dong Hyun Kim, Jong Han Leem, Shin Goo Park; Korean Journal of Occupational and Environmental Medicine 2007;19(3):187-195. Published online September 30, 2007; DOI: https://doi.org/10.35371/kjoem.2007.19.3.187

Abstract PDF

Objective: The purpose of this study was to evaluate and compare the association of job stress and working with video display terminal (VDT) to musculoskeletal symptoms of the neck-shoulder which were most common in white-collar workers.
METHODS
From 122 workplaces, 1,790 white-collar workers with no trauma, and no history of musculoskeletal disease were selected for the study. The questionnaire survey included general characteristics, work related characteristics, Job Content Questionnaire (JCQ) and musculoskeletal symptoms. Multiple logistic regression, adjusted for age, smoking status, drinking habit, housekeeping, work time, job tenure, and work-load change, were used to evaluate the effects of job stress and VDT-work on the symptoms.
RESULTS
The prevalence of neck-shoulder symptoms was overall 24.3% overall. The prevalence odds ratio of job demand (high/low) to neck-shoulder symptoms, adjusted for general and work-related factors, was 1.56 (95% confidence interval 1.12~2.17), and that of job strain (high strain/low strain) was 1.72 (1.07~2.79). However, VDT-work was not associated with neck-shoulder symptoms in the multiple logistic regression model.
CONCLUSIONS
To prevent musculoskeletal disorders in white-collar workers, it is important to consider psychosocial factors such as job demand and job strain, as well as VDT-work.

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Risk Factor, Job Stress and Quality of Life in Workers With Lower Extremity Pain Who Use Video Display Terminals
Sehoon Choi, Seong Ho Jang, Kyu Hoon Lee, Mi Jung Kim, Si-Bog Park, Seung Hoon Han
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Yoo-Mi Chae, Jeong-bae Rhie, Sook Lee
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Changes in job stress, self-efficacy, depression and health-related quality of life according to the degree of musculoskeletal symptoms for white-collar workers
Dae-Sik Ko, Dong-Jin Lee, Tae-Sung Ko
Journal of the Korea Academia-Industrial cooperation Society.2013; 14(6): 2935. CrossRef
The Prevalence and Characteristics of Depression in Work-related Musculoskeletal Disease
Jehwan Kwak, Hyung Kuk Kim, Taikon Kim, Seong-Ho Jang, Kyu Hoon Lee, Mi Jung Kim, Si-Bog Park, Seung Hoon Han
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Tae-Hyung Yoon, Tae-Hyun Cha, Sang-Hui Hwang
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Job Stressors in Subway Workers and Firemen: Seok Hwan Yoon, Sook Jung Choi, Dong Hoon Shin, In Sung Chung, Jung Sook Ha; Korean Journal of Occupational and Environmental Medicine 2007;19(3):179-186. Published online September 30, 2007; DOI: https://doi.org/10.35371/kjoem.2007.19.3.179

Abstract PDF

OBJECTIVES
To determine the job stress factors of subway workers and firemen and to develope appropriate stress management systems for the works places.
METHODS
The study subjects comprised 1,826 male subway workers and 538 male firemen residing in Daegu metropolitan city. The Korean Occupational Stress Scale (KOSS) questionnaire was used.
RESULTS
The median values of the study subjects were lower than the reference values. The categories of physical environment and insufficient job control were more stressful to firemen while the organization system category was stressful to both subway workers and firemen (p<0.05). There was no statistical difference in the stress factor of the interpersonal conflict category. Among the firemen, the physical environment category was more stressful to field work department workers than to desk workers (p<0.05).
CONCLUSION
The study results suggested that interpersonal conflict and organization system categories are stressful to male subway workers and firemen. Especially, effective control of firemen's physical environment stress factor is needed.

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A Review on the Job Stress Measurements in Nuclear Power Plant Workers for Human Error Prevention
Seon Soo Kim, Meiling Luo, Yeon Ju Oh, Yong Hee Lee
Journal of the Ergonomics Society of Korea.2013; 32(1): 47. CrossRef
Duty-Dependent Changes in Stress Hormones of Firefighters
Kyoo-Sang Kim, Seung-Won Yoo, Yong-Lim Won, Mi-Young Lee
Korean Journal of Environmental Health Sciences.2012; 38(3): 195. CrossRef
Job Stress Level and It's Related Factors in Firefighters
Mi-Suk Choi, Dong-Ha Ji, Jin-Woo Kim
Journal of the Korea Academia-Industrial cooperation Society.2012; 13(10): 4917. CrossRef
Effects of Perception of Job Stress and Stress Coping Style on Mental Health of Firefighters
Ho Jin Lee, Hee Sook Kim, Sang Yeon Park
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Soon-Young Yun, Dong-Choon Uhm
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Inah Kim, Jaechul Sung
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The Change of Non-smoking Knowledge and Attitude of Intensive Course of Anti-smoking Leadership Training: Seon Young Lee, Kang Sook Lee, Hyun Woo Yim, Jeong Ho Chae, Dae Jin Kim, Jong Hoo Lee, Jae Hee Yu, Sook Kyoung Choi; Korean Journal of Occupational and Environmental Medicine 2007;19(3):171-178. Published online September 30, 2007; DOI: https://doi.org/10.35371/kjoem.2007.19.3.171

Abstract PDF

OBJECTIVES
To evaluate the effectiveness of an anti-smoking readership training program on the knowledge, attitude and practice in health managers and supervisors in the workplace.
METHODS
We surveyed 482 health managers and supervisors in the workplace from April 2005 to September 2005. The questionnaire included whether or not a smoking cessation program was conducted in their workplace. We assessed before and after educations program about knowledge, attitude and practice for smoking cessation. The 10-hour education program included the benefit of quit smoking, the law for smoking restriction, cognitive therapy, stress management, nicotine addiction, replacement therapy, case study about workplace for anti-smoking policy and program.
RESULTS
For the change in the mean scores of all items in knowledge, attitude and practice were significantly increased after the intervention.
CONCLUSION
Even a short, 10-hour intervention course of anti-smoking leadership training program was effective for improving the knowledge, attitude, practice to quit smoking activity in workplace. Nevertheless, the program effectiveness would be increased by including a re-training course and website support.

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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

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