OBJECTIVES Kienbock's disease, which is characterized by osteonecrosis of the lunate bone, causes progressive chronic pain and dysfunction of the hand and wrist. Even though occurrence of the disease was reported approximately 100 years ago and it is suspected to be work-related to some degree, the etiology has not been clearly discribed and the disease has rarely been considered as an occupation-related disease. As such, we submit this case as the first report of Kienbock's disease in Korea, with clinical findings, x-ray, MRI (magnetic resonance imaging) and strain index results along with a literature review. METHODS The patient was carefully interviewed and her medical records were properly reviewed by the authors with her consent. The authors also visited her factory work site to inspect and videotape the working environment and to conduct an ergonomic evaluation with a strain index. RESULTS Excessively repeated contact stress was found to be concentrated on her right hand and the environment was discovered to be hazardous from an ergonomic standpoint. The literature review revealed that heavy loads on the hand might be related to the cause or deterioration associated with Kienbock's disease. ; therefore, it is very likely that her disease is related to her work. CONCLUSIONS There is much evidence to suggest that heavy workloads involving hand and wrist intensive tasks may cause and worsen Kienbock's disease. However, to date epidemiologic studies clarifying the etiology of the disease have not been sufficiently reported. Therefore, further research focusing on the etiology and prevention of the disease are required. In addition, practical guidelines for hand and wrist intensive tasks are needed to prevent disease development and worsening.
OBJECTIVES To associate work in the semiconductor industry, including silicon wafer fabrication, with cancer risks or mortality and other adverse health effects, the operation of wafer fabrication should initially be understood. A detailed study on the fabrication operation allows retrospective exposure to be assessed and wafer fabrication workers to be classified into similar exposure groups. Therefore, the objective of this study was to comprehensively review silicon wafer fabrication operations and related hazardous materials and agents. METHODS The literatures related to semiconductor industry processes were reviewed from an occupational health viewpoint based on wafer manufacturing, wafer fabrication and packaging. The focus was especially related to the hazardous materials used in wafer fabrication industries. RESULTS During the fabrication of silicon wafers, many toxic chemicals, a strong electric field and hazardous equipment are used. The process allows the integration of a three-dimensional array of electric circuits onto a silicon wafer substrate. Wafers are sliced from single crystal silicon and subject to a series of steps during the fabrication process, which alternatively adds and then selectively removes materials in layers from the surface of the wafer to create different parts of the completed integrated circuit. There are four major steps in this process; patterning, junction formation, thin film and metallization. CONCLUSIONS In order to associate exposure to the hazard agents generated during wafer fabrication operations with adverse health effects the details of the operation should be completely studied, which will be helpful in both exposure assessments and epidemiological studies.
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OBJECTIVES The purpose of this study was to evaluate the factors which affect pulmonary function in shipyard workers in order to build a body of basic information that can be used to prevent and manage pulmonary disorders in the future. METHODS We studied the respiratory symptoms, smoking history, chest radiographies, and pulmonary functions of 793 workers associated with two shipyards from April 2009 to July 2009. The workers were subdivided into 3 groups by job type: welders, grinders, and machinist-managers. The data was analyzed according to job type and other possible impact factors. RESULTS Significant differences among job type were seen with dyspnea and coughing during working hours and in the morning. In pulmonary functions, there were significant differences in forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF), and maximal mid-expiratory flow (MMEF) (except FEV1/FVC%) among job types. Grinders especially showed significantly lower figures in the indices of FEV1, FVC, and MMEF. CONCLUSIONS Pulmonary function was significantly lower in grinders. Grinders seem to be affected by exposure to a combination of dust particles (silica, lead, and manganese) and irritant gases in the workplace. These results suggested that workers and health officials should work together to adopt technical preventive measures, such as having well- ventilated work areas and appropriate respiratory protective devices.
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OBJECTIVES This study investigated lung function in workers exposed to dusts, fumes and noxious gases at small foundries. METHODS Lung function was measured in 148 male workers from 12 small foundries and 202 unexposed male workers. Pulmonary function tests performed included: forced vital capacity (FVC), forced expiratory volume in one second (FEV1), percent of FEV1/FVC (FEV1/FVC%), maximum mid-expiratory flow (MMEF), peak expiratory flow (PEF), and forced expiratory flow at 25, 50, and 75% of expired FVC (FEF25, 50, 75). RESULTS Mean values of all ventilatory indices except FEF25 of foundry workers were significantly lower than those of controls. Specifically, following stratification by smoking habits, all ventilatory indices except FEF25 of foundry workers were significantly lower than those of controls who smoked; however, there were no significant differences observed in any ventilatory indices between nonsmoking exposed workers and controls. The results of multiple linear regression analysis indicated work duration as a significant predictor of a decrease in FVC%. CONCLUSIONS This research indicates that combined occupational exposure to dust, fumes, and gases in small foundries is associated with a reduction in lung function. Smoking may also contribute to respiratory abnormalities. These results suggested that foundry workers should be required to undergo periodic lung function tests and-in addition to not smoking, efficient use of personal protection equipment while at work is recommended.
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OBJECTIVES To date, no population-based epidemiological studies have estimated the association between physical workload (standing or walking, carrying heavy loads, carrying people, repetitive hand or arm movements, wearing protective equipment) and work-related back pain in Korea. The purpose of this study was to evaluate the relationship between physical workload and work-related back pain using a nationwide survey. METHODS We analyzed data obtained from working men and women age 15 to 64 (n=10,043) who participated in the 2006 national working condition survey of random sample workers in Korea. Using both simple and multiple logistic regression analysis, the association between physical workload and work-related back pain was evaluated. RESULTS Carrying heavy loads, repetitive hand or arm movements, and wearing protective equipment were associated with an increased risk of work-related back pain. CONCLUSIONS This study identifies that an increased risk of work-related back pain related to the nature and intensity of the physical workload of the general working population in Korea. We also found a strong association between repetitive hand or arm movements and back pain.
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OBJECTIVES Mental health and work efficiency are adversely affected by exposure to physical and chemical hazards in the workplace. This study is the first large scale evaluation of the relationship between physical and chemical hazard exposure in the workplace in relation to the mental health of Korean workers. METHODS A national survey of a random sample of workers (n=10,043) was conducted between June and September 2006 in Korea. Physical and chemical hazards in the workplace were considered if exposure occurred over more than a quarter of the time spent at work. Mental health problems were defined as work-related depression, anxiety or insomnia. We analyzed whether physical and chemical hazards were independent risk factors for work-related mental health problems by multiple logistic regression analysis after adjusting for age, gender, employment type, education, occupation, duty schedule, work hours, smoking, and alcohol consumption. RESULTS The mean age of surveyed workers was 42 years and 58% were male. A total of 7.8% of workers had work-related mental health problems. Exposure to high temperature, mist, fumes, dust, chemicals, and radiation were associated with an increased risk of work-related mental health problems. CONCLUSIONS This study reaffirmed that physical and chemical hazard exposure in the workplace significantly elevates the risk of work-related mental health problems.
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OBJECTIVES A total of 320,000 Korean soldiers in three combat units and four supporting units participated in the Vietnam War. The aim of this study was to investigate the association between Vietnam experience and mortality by comparing mortalities in Korean Vietnam War veterans to the general population. METHODS The deaths of 185,760 Vietnam veterans from January 1, 1992 to December 31, 2005 were confirmed by matching the veterans' information to death records from the National Statistical Office. Crude death rate, age adjusted rate and Standardized mortality ratios (SMRs) were calculated 95% confidence. Age was standardized to the total male population during 1992-2005 with the age of 36 to 83 years old. RESULTS The age adjusted death rate per 100,000 was 868.1 among veterans and 1226.5 among the general population. Mortality of all causes was significantly lower among veterans (SMR=0.83, 95% CI: 0.82-0.84). Mortalities from neoplasms (SMR=0.87), circulatory diseases (SMR=0.79), and external causes of deaths (SMR=0.92) were significantly lower among veterans. Mortalities from several external causes of deaths including Intentional self-harm (X60-X84), assault and accidental poisoning, angina pectoris, chronic ischemic heart diseases, prostate cancer, and malignant neoplasms of hematopoietic system including multiple myeloma, non-Hodgkin's lymphoma, and leukemia were not different between veterans and the general population. CONCLUSIONS Mortality among Vietnam veterans was lower than that among the general population. It would be explained mainly by healthy veteran effect.
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OBJECTIVES To examine whether or not there is an association between blood pressure and lifestyle habits in male express bus drivers. METHODS The study subjects were 249 male express bus drivers. The data was obtained from annual health surveillance. A structured questionnaire was used to assess smoking, alcohol consumption, exercise, daily hours of sleep, work duration and weekly working hours. The subjects' BMI (Body Mass Index) was classified using the World Health Organization diagnostic criteria for obesity in Asians, and their blood pressure was classified according to the JNC (Joint National Committee) 7 classification. Multiple cases of logistic regression modeling were used to determine associations between hypertension and the subjects' common characteristics, lifestyle habits and obesity were used as the independent variables. RESULTS We found that lack of sleep was associated with hypertension (OR 1.85, 95% CI 1.01~3.39) and obesity was also associated with hypertension (OR 2.81, 95% CI 1.59~4.98). CONCLUSIONS These results indicate that daily hours of sleep and obesity were associated with hypertension in male express bus drivers. Due to the characteristics of this job, such as long hours and lack of exercise, it can result in obesity and lack of sleep, which can in turn influence occurrences of hypertension. Therefore, consideration of lack of sleep and obesity in their workers will be helpful for the management in the prevention of hypertension.
OBJECTIVES We wanted to investigate the relationship between job stress and high-sensitivity C-reactive proteins (hsCRP) with a view to using them as a predictor of future cardiovascular events. METHODS The study subjects were 155 male bank workers. A structured, self-assesment questionnaire was used to analyze the sociodemographic characteristics and job stress of the participants. Seven levels of job stress, as described in the Korean Occupational Stress Scale-Short Form (KOSS-SF), were used to categorized the participants. We included tests for blood pressure, fasting blood sugar, blood lipid level (total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides), and hsCRP in our analysis. Multiple logistic regression modeling was used to determine an association between job stress and cardiovascular risk factors including hsCRP. RESULTS In the multiple logistic regression analyses adjusted for general and job characteristics and cardiovascular risk factors, interpersonal conflict (adjusted OR 1.69, 95% CI=1.11~2.57), job insecurity (adjusted OR 1.94, 95% CI=1.24~3.03) and, occupational climate (adjusted OR 1.89, 95% CI=1.19~3.01) were associated with hsCRP. CONCLUSION This study suggests that job stress is associated with hsCRP which is a predictor of future cardiovascular events.
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OBJECTIVES The purpose of the present study was to investigate the effects of volatile organic compounds, and formaldehyde on heart rate variability among elderly people who are vulnerable to ambient pollution. METHODS From May to August of 2009, 57 subjects older than 60 years were recruited in this study. Indoor air pollutants (volatile organic compounds and formaldehyde) were measured by a personal passive sampler. Heart rate variability (HRV) was measured in the sitting position for five minutes and assessed by time-domain and frequency-domain. RESULTS Multiple linear regression analysis showed significantly less low-frequency (LF) and high-frequency (HF) associated with elevated benzene levels. Exposure to toluene was associated with decreases in the Standard deviation of the NN intervals (SDNN) and LF. SDNN and LF were negatively associated with the increment of ethylbenzene levels. CONCLUSIONS An adverse effect on cardiovascular function caused by volatile organic compounds was observed among the elderly people of Seoul even though indoor air pollutant levels were lower than the yearly average guideline for indoor air quality in Korea.
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This article reviews newly available knowledge regarding occupational cancer based on an assessment of International Agency for Research on Cancer (IARC) Monograph program from 2006 to 2010.
The IARC reviewed the agents to evaluate the carcinogenicity in humans according to their priority. During the last five years, the IARC has reviewed many kinds of agents, including all of the Group 1 carcinogenic agents. Agents belonging to groups other than Group 1 were also reviewed. A few agents, such as shiftwork and firefighting, were reviewed for the first time after introducing the IARC Monograph Program. Most of the reassessed Group 1 agents were reaffirmed, showing that there was sufficient evidence to prove their carcinogenicity to human beings. However, some carcinogens were correlated to the new cancer site, since it was deemed that sufficient evidence was present. For example, larynx and ovary cancer deemed to have sufficient evidence of carciongenicity relating to asbestos exposure, joining lung cancer and mesothelioma. Some agents, such as benzo(a)pyrene, ortho-toluidine, 1,3-butadiene, and others belonging to Group 2A were upgraded to Group 1 based on newly identified epidemiologic findings, along with sufficient animal and mechanistic evidence. Benzo(a)pyrene and benzidine-based dyes were classified as human carcinogens based on sufficient animal and pervasive mechanistic evidence.
This new data shows that not only chemical agents but also working conditions, such as stress and shiftwork were found to apply to human carcinogenicity. The IARC listed these agents in order to prioritize their review regarding their carcinogenicity to humans. There is a great need to study these newly emerging agents suspected to relate human carcinogenicity, and deem they are worthy of notice.
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