Annals of Occupational and Environmental Medicine

Volume 20 (3); September 2008

Case Report

A Case of Chronic Renal Failure and Renal Cancer in a Worker Exposed to Lead: Somin Park, Jongeun Kim, Jungwon Kim, Daegyun Hong, Sangbum Ye, Dongmug Kang, Euna Kim; Korean Journal of Occupational and Environmental Medicine 2008;20(3):272-281. Published online September 30, 2008; DOI: https://doi.org/10.35371/kjoem.2008.20.3.272

Abstract PDF: INTRODUCTION: Studies evaluating rats and mice have provided convincing evidence that renal adenoma and carcinoma are induced by oral doses of lead acetate and lead subacetate, as well as by parenteral doses of lead phosphate. In addition, at least 2 cases of kidney cancer associated with heavy exposure to lead have been reported. However, there is still not enough information to confirm or rule out an association between kidney cancer and exposure to lead.
CASE
REPORT: In this study, we describe a case of kidney cancer in 54-year-old male worker that was exposed to lead-stearate while employed in the polyvinyl chloride processing industry for 17 years. The patient presented with gout and hypertension. Further examination revealed proteinuria, glucose in the urine and elevated blood urea nitrogen/creatinine levels. Renal ultrasonography, renal computed tomography and renal biopsy revealed chronic renal failure and renal cell cancer.
CONCLUSION
We concluded that the gout and chronic renal failure in this case was caused by chronic lead exposure. However, further study is required to determine if the renal cancer was induced by lead exposure.

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Original Articles

The Relationship between Work Ability and Job Stress Factors in Manufacturing Industries: Sangbum Ye, Dongmug Kang, Youngki Kim, Minjeong Son, Jongeun Kim, Somin Park; Korean Journal of Occupational and Environmental Medicine 2008;20(3):260-271. Published online September 30, 2008; DOI: https://doi.org/10.35371/kjoem.2008.20.3.260

Abstract PDF

OBJECTIVE: This study was performed to investigate the association between work ability and job stress factors in three manufacturing industries.
METHODS
The data were gathered from 705 workers of 3 manufacturing industries, from August 2007 to January 2008. A structured, self-reported questionnaire was used to access the demographic, socioeconomic and work related characteristics. Work ability and job stress factors were determined using two questionnaires: the work ability index (WAI) of the Finnish Institute of Occupational Health and the Korean Occupational Stress Scale (KOSS), respectively.
RESULTS
According to the logistic regression analysis results, WAI was related to job stress factors after adjustment for age, shift work, employment type and exercise. Of the eight subscales, job demand, interpersonal conflict, lack of reward, occupational climate and total score were significantly associated with WAI. In the analysis of each factory, interpersonal conflict, job insecurity and lack of reward were significantly associated with WAI in factory II, and organizational system, lack of reward and total score in factory III, but there was no significant association in factory I.
CONCLUSIONS
Job stress factors were significantly associated with WAI in two of the three manufacturing industries. Further and more detailed study needs to be conducted to reduce the job stress and improve the work ability.

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Factors that determine the Work Ability Index of street cleaners
Jung Won Kim, Seonhee Yang, Insung Chung, Mi-Young Lee
Yeungnam University Journal of Medicine.2019; 36(3): 219. CrossRef

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Prevalence of Baker's Asthma among Workers in an Industrial Bakery: Jeong Min Kim, Young Jun Kwon, Young Su Ju, Hyoung June Im, Tae Kyung Lee, Hye Ryun Kang, Do Myung Paek; Korean Journal of Occupational and Environmental Medicine 2008;20(3):245-259. Published online September 30, 2008; DOI: https://doi.org/10.35371/kjoem.2008.20.3.245

Abstract PDF

OBJECTIVES
To determine the prevalence of baker's asthma due to flour dust in an industrial bakery in Korea.
METHODS
Of the 596 active workers, 380 were allocated to a category of either direct exposure (DE) or indirect exposure (IE) to flour dust and completed a modified ISAAC questionnaire. Of the 380 participants, 233 were screened by an occupational physician interview, a skin prick test, and an ELISA for serum-specific IgE antibodies to wheat flour extracts. Selected workers received serial monitoring of peak expiratory flow rate (PEFR), and positive PEFR respondents received a methacholine challenge test. The diagnosis of baker's asthma was confirmed by a specific inhalation challenge with wheat flour extracts.
RESULTS
The prevalence of sensitization to wheat flour and baker's asthma was 21.0% (25.9% DE, 13.3% IE) and 3.2% (5.1% DE, 1.8% IE), respectively. DE had an increased risk of sensitization to wheat flour (OR 2.15, 95% CI = 1.03~4.51). Sensitization to wheat flour and the prevalence of baker's asthma correlated significantly (PR 38.63, 95% CI = 6.14~243.22).
CONCLUSIONS
These findings indicate a considerable prevalence of baker's asthma among flourexposed workers in Korea. Future studies will be required to survey the situation in flour mill companies and seek ways to protect the health and socioeconomic position of flour industry workers.

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Occupational Diseases in Korea
Seong-Kyu Kang, Eun A Kim
Journal of Korean Medical Science.2010; 25(Suppl): S4. CrossRef

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Lifestyle and Work related Factors Associated with Serum PFOA among Workers at Manufacturing Companies: Sang Hwan Jang, Chae Kwan Lee, Dae Hwan Kim, Kwon Bok Kim, Jin Hong Ahn, Hwi Dong Kim, Chang Hee Lee, Jeong Ho Kim, Jong Tae Lee; Korean Journal of Occupational and Environmental Medicine 2008;20(3):233-244. Published online September 30, 2008; DOI: https://doi.org/10.35371/kjoem.2008.20.3.233

Abstract PDF

OBJECTIVES
The objective of this study was to determine serum perfluorooctanoic acid (PFOA) concentrations and to investigate the relationship of lifestyle, health status and work-related factors among workers at manufacturing companies with possible occupational exposure to PFOA.
METHODS
The study subjects were 315 workers (male 203, female 112) of manufacturing companies with possible exposure to PFOA from August to December, 2007. A questionnaire was administered to investigate lifestyle and work-related factors. Serum PFOA concentrations were analyzed by LCMS/ MS, and liver function and total cholesterol were also tested.
RESULTS
Serum PFOA concentrations ranged from 1.0 to 40.9 ng/mL (mean 8.0 ng/mL). Serum PFOA concentrations increased with age. Male workers had higher PFOA concentration than female workers (male 9.0 ng/mL; female 6.3 ng/mL). According to stepwise multiple regression analysis, factors significantly associated with PFOA concentration were male, being older, higher total cholesterol, and lower body mass index. Adjusted for age and gender by logistic regression, dyeing and finishing textiles had significantly higher odds ratio (OR) of 6.16, and moulding patterns, moulds and industrial patterns (OR=4.84), sections for ships (OR=3.87), and plastics synthetic leather (OR=10.05) had marginally significantly high odds ratios.
CONCLUSIONS
This study demonstrated the factors affecting serum PFOA concentration of workers at manufacturing companies. Further study is needed to ensure the effect of occupational exposure on serum PFOA concentration.

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The relationships between sixteen perfluorinated compound concentrations in blood serum and food, and other parameters, in the general population of South Korea with proportionate stratified sampling method
Hee-Young Kim, Seung-Kyu Kim, Dong-Mug Kang, Yong-Sik Hwang, Jeong-Eun Oh
Science of The Total Environment.2014; 470-471: 1390. CrossRef
Concentration of PFOA and PFOS in Whole Blood and Factors Controlling Their Exposure Among Koreans
Chun-Hui Suh, Chae-Kwan Lee, So-Ryong Lee, Mi-Hee Park, Jong-Tae Lee, Byung-Chul Son, Jeong-Ho Kim, Kun-Hyung Kim
Korean Journal of Environmental Health Sciences.2012; 38(2): 105. CrossRef

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Low-dose Gamma-irradiation Effect on Early Stage Development and Lifespan in Various Strains of Drosophila melanogaster: Jin Woo Lee, Ki Moon Seong, Cha Soon Kim, Seon Young Nam, Kwang Hee Yang, Young Woo Jin; Korean Journal of Occupational and Environmental Medicine 2008;20(3):225-232. Published online September 30, 2008; DOI: https://doi.org/10.35371/kjoem.2008.20.3.225

Abstract PDF

OBJECTIVES
Although ionizing radiation is recognized as being harmful to humans, debate continues regarding the effects of low doses of ionizing radiation. Some studies have reported that low doses of ionizing radiation have a bio-positive effect, namely hormesis, and many researchers have attempted to find concrete and scientific evidence to prove this. To determine whether the discrepancy in effects of low doses of ionizing radiation arises from genetic differences, a study with a multicellular organism system such as fruit flies is needed.
METHODS
After irradiation at a low-dose rate of gamma radiation with chronic (0.2 Gy) and acute (0.2, 0.75 and 4 Gy), the pupa rate, eclosion rate and life span were examined with various wild type strains of Drosophila melanogaster such as W1118, Oregon-R, and Canton-S.
RESULTS
The life span of Oregon-R exposed to both acute and chronic, low-dose radiation (0.2 Gy) was increased. Although there was some difference in the longevity between the acute and chronic radiation rate, no other differences were found. In Canton-S, only acute dose (0.75 Gy) increased the life span, but it did not in W1118.
CONCLUSIONS
Although there were some differences between wild type fruit fly strains in longevity, the low doses of ionizing radiation extended the life span of D. melanogaster. Further studies need to be carried out to explain the difference according to dose and dose rate of radiation in the tested strains.

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Association between Occupational Stress and Depression, Anxiety, and Stress Symptoms among White-collar Male Workers in an Automotive Company: Kyu Chul Park, Kyung Jong Lee, Jae Beom Park, Kyoung Bok Min, Kyu Won Lee; Korean Journal of Occupational and Environmental Medicine 2008;20(3):215-224. Published online September 30, 2008; DOI: https://doi.org/10.35371/kjoem.2008.20.3.215

Abstract PDF

OBJECTIVES
To investigate the relationship between occupational stress and depression, anxiety, and stress symptoms among white-collar male workers in an automotive company.
METHODS
A cross-sectional study involving 286 white-collar male workers was conducted with the Korean Occupational Stress Scales (KOSS) and Depression Anxiety Stress Scales (DASS) questionnaire.
RESULTS
According to the DASS cut-off value (> or =78 percentile scores), the prevalence of depression, anxiety and stress symptoms was 57.7%, 37.7% and 42.2%, respectively. By logistic regression analysis, organizational system was the factor most strongly associated with depression (OR=4.83, 95% C.I.=2.43-9.58), while job demand was strongly associated with anxiety (OR=3.21, 95% C.I.=1.77-5.85) and stress (OR=4.66, 95% C.I.=2.53-8.58).
CONCLUSIONS
Occupational stress was positively associated with depression, anxiety, and stress symptoms among white-collar male workers in an automotive company. A prospective study is warranted to delineate the causal relationships between job stress and psychiatric disorders.

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Kang Ho Lee, Chang Ho Chae, Young Ouk Kim, Jun Seok Son, Ja-Hyun Kim, Chan Woo Kim, Hyoung Ouk Park, Jun Ho Lee, Young Saeng Jung
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Mi-Ra Lee
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Jung-Wan Koo
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Validity of NIOSH- and Nordic-style Questionnaires in the Screening and Surveillance of Neck and Upper Extremity Work-related Musculoskeletal Disorders: Won Jun Choi, Nak Jung Sung, Young Joong Kang, Sang Hwan Han; Korean Journal of Occupational and Environmental Medicine 2008;20(3):205-214. Published online September 30, 2008; DOI: https://doi.org/10.35371/kjoem.2008.20.3.205

Abstract PDF

OBJECTIVES
The study aimed to compare the validity of two questionnaires (NIOSH- and Nordic-style) which are used for the screening and surveillance of neck and upper extremity work-related musculoskeletal disorders. To evaluate the validity, clinical examination was used as the reference.
METHODS
Two types of questionnaire were filled out by 208 workers from three different plants in Incheon, Korea. Workers underwent clinical examination by three occupational physicians. The presence of a symptom or sign in at least one body region was regarded as positive in both results of questionnaire and case definition using clinical examination. Validity was evaluated by sensitivity, specificity, positive predictive value, negative predictive value and agreement (Kappa coefficient). For the Nordic-style questionnaire, the sum of the symptom scores was used to yield the ROC curve.
RESULTS
The results of the NIOSH-style questionnaire were sensitivity 59.5%, specificity 68.0%, positive predictive value 68.0%, negative predictive value 59.5%, and Kappa coefficient 0.27(95% confidence interval [CI]=0.14~0.40). The results of the Nordic-style questionnaire were sensitivity 73.9%, specificity 68.0%, positive predictive value 72.6%, negative predictive value 69.5%, and Kappa coefficient 0.42 (95% CI=0.30~0.54). For the Nordic-style questionnaire, sensitivity was 72.1% and specificity was 70.1% based on the sum of the symptom scores > or =2.
CONCLUSIONS
Both questionnaires demonstrated appropriate validity for the screening and surveillance of work-related musculoskeletal disorders. The selection of questionnaire may depend on the purpose of investigation and characteristics of the work place.

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Posttraumatic Stress Symptoms and Related Factors in Firefighters of a Firestation: Soon Chan Kwon, Jaechul Song, Soo Jin Lee, Inah Kim, Jaewoo Koh, Hyunchul Ryou, Seok Hyun Kim, Daeho Kim, Seung Ah Jung; Korean Journal of Occupational and Environmental Medicine 2008;20(3):193-204. Published online September 30, 2008; DOI: https://doi.org/10.35371/kjoem.2008.20.3.193

Abstract PDF

OBJECTIVES
To investigate the factors related with posttraumatic symptoms and to estimate the prevalence of posttraumatic disorder of urban male firefighters.
METHODS
From a study sample comprising 260 male firefighters from one fire station, the responses from 146 who had experienced one or more traumatic events, responded to the 'Impact of Event Scale-Revised Korean version' (IES-R-K) and didn't show any evidence of depression were analyzed. We surveyed the firefighters using a self-administered questionnaire including general characteristics, job-related characteristics, IES-R-K, and a 'Firefighters and paramedics' incident stressor'.
RESULTS
The mean value of IES-R-K in this study was 11.3 and it was higher in the married firefighters than in the unmarried firefighters (p=0.005) and in the 24-hr shift workers than in the ordinary day shift workers (p=0.032). The frequency of posttraumatic stress disorder (PTSD) of the firefighters in this study using IES-R-K was 13.7%, with a cutoff point of 24/25. The overall number of experiences of 25 traumatic events was larger in emergency medical personnel and rescue workers than in other work functions (p=0.000).
CONCLUSIONS
The prevalence of PTSD symptoms in firefighters was estimated to 13.7% using IES-RK and was higher than the prevalence of PTSD in the general population. A program to manage the mental health and provide early detection for mental illness for firefighters is needed.

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The Association of Occupational Stress with Self-perceived Fatigue in White Collar Employees: Kyoung Tae Cha, Il Whoi Kim, Sang Baek Koh, Sook Jung Hyun, Jun Ho Park, Jong Ku Park, Bong Suk Cha, Sei Jin Chang; Korean Journal of Occupational and Environmental Medicine 2008;20(3):182-192. Published online September 30, 2008; DOI: https://doi.org/10.35371/kjoem.2008.20.3.182

Abstract PDF

BACKGROUND
& OBJECTIVES: A growing body of research has documented that occupational stress is closely associated with increased risk of fatigue. This study was conducted in an effort to assess the relationship of occupational stress to self-perceived fatigue among Korean white collar employees.
METHODS
Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project, 2002-2004). Among them, a total of 4,502 white collar employees were recruited. A structured questionnaire was employed to evaluate the participants' sociodemographics, job-related factors, health-related behaviors, occupational stress, and self-perceived fatigue. Occupational stress and self-perceived fatigue were assessed using the Korean Occupational Stress Scale-Short form (KOSS-SF) and the Multidimensional Fatigue Scale (MFS), respectively.
RESULTS
In logistic regression analyses, occupational stress was associated with an increased risk of fatigue, and some domains of occupational stress had different effects on fatigue by gender (job demand, job insecurity, and lack of reward for men, job demand, lack of reward, and discomfort in occupational climate for women), which indicates that occupational stress may perform a slightly different role in increasing the risk of fatigue by gender.
CONCLUSION
The results of this study suggest that occupational stress is a determinant predictor of selfperceived fatigue. Thus, a stress management program for the reduction of occupational stress, and the promotion of white collar worker's health and quality of life is strongly recommended. Some limitations of this study and considerations for future studies were also discussed.

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The Actual Implementing Status of the Preplacement Medical Examination after the Annulment of the Preemployment Medical Examination: Chunhui Suh, Jong Tae Lee, Dae Hwan Kim, Byung Chul Son, Chang Hee Lee, Hui Dong Kim, Jin Hong Ahn; Korean Journal of Occupational and Environmental Medicine 2008;20(3):174-181. Published online September 30, 2008; DOI: https://doi.org/10.35371/kjoem.2008.20.3.174

Abstract PDF

OBJECTIVES
We investigated the status of the preplacement medical examination after the revision of the industrial safety and health law on Oct. 7, 2005 by the Ministry of Labor.
METHODS
Preplacement medical certificates of 6,507 recruits issued by two hospitals in Busan, Kyeongnam Province from Jan. 1 to Dec. 31, 2006 were reviewed. Telephone interviews were performed to the recruits with disease and self-reported questionnaires were administrated to health and safety personnel from May 1 to Sep. 30, 2007.
RESULTS
Interviews were conducted with 185(56.1%) recruits with disease, 51(27.4%) of whom were rejected for employment due to the preplacement medical certificate. The questionnaire survey for the health and safety personnel revealed that 39(22.9%) personnel were unaware of the annulment of the preemployment medical examination. Eighty(48.8%) of the health and safety personnel answered that they performed a preplacement medical examination after employment, and 63(37.3%) made a practical application of the workers' placement. The recruits with chronic conditions were refused employment: 20 (11.8%) due to hypertension, 21(12.4%) diabetes mellitus and 22(13.0%) hyperlipidemia. The recruits with work-related diseases were also refused employments: 76(44.4%) due to lumbar spine abnormality and 75(43.8%) hearing loss.
CONCLUSIONS
Despite the annulment of the pre-employment medical examination, a preplacement medical examination was often used to discriminate among healthy and diseased recruits. Employers must respect the law for the point of time of the preplacement medical examination and the payment of cost. The government should publicize the revision of the objectives of the law. We suggest that health professionals elucidate the job fitness through the development of the assessment tools and maintain the confidentiality of recruits.

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Junghye Choi, Chunhui Suh, Jong-Tae Lee, Segyeong Lee, Chae-Kwan Lee, Gyeong-Jin Lee, Taekjoong Kim, Byung-Chul Son, Jeong-Ho Kim, Kunhyung Kim, Dae Hwan Kim, Ji Young Ryu
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A Study on the Association between Blood Lead Levels and Habitual Tobacco and Alcohol Use in Koreans with No Occupational Lead Exposure: Ji Ung Park, Se Won Oh, Seung Hyun Kim, Yang Hyun Kim, Ryoung Jin Park, Jai Dong Moon; Korean Journal of Occupational and Environmental Medicine 2008;20(3):165-173. Published online September 30, 2008; DOI: https://doi.org/10.35371/kjoem.2008.20.3.165

Abstract PDF

OBJECTIVES
The purpose of this study was to estimate the normal blood lead (PbB) levels in a group of Korean subjects and to evaluate the association between PbB levels and habitual tobacco and alcohol use.
METHODS
We recruited 532 adults (320 males and 212 females) with no history of occupational exposure to lead, as study subjects.
RESULTS
PbB levels ranged between 0.43 microgram/dl and 9.45 microgram/dl. The adjusted geometric mean PbB in men was 3.19 microgram/dl, which was significantly higher than that seen in women: 2.66 microgram/dl (P=0.017). Geometric mean PbBs were not significantly different between urban and rural patients. The adjusted geometric mean PbB in smokers was 3.31 microgram/dl, which was significantly higher than that seen in nonsmokers: 2.64 microgram/dl (P=0.035). The adjusted geometric mean PbB in drinkers was 3.10 microgram/dl, which was significantly higher than that seen in non-drinkers: 2.75 microgram/dl (P=0.049).
CONCLUSIONS
The PbB levels of some Korean adults seem to be comparable to those seen in foreign countries. Our results suggest that tobacco and alcohol cessation will be helpful in decreasing the harmful effect of lead.

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