Annals of Occupational and Environmental Medicine

Original Article

Comparing Korea Occupational Safety & Health Agency and National Health Insurance Service’s cardio-cerebrovascular diseases risk-assessment tools using data from one hospital’s health checkups: Yunrae Cho, Dong Geon Kim, Byung-Chan Park, Seonhee Yang, Sang Kyu Kim; Ann Occup Environ Med 2023;35:e35. Published online August 21, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e35

Abstract Abstract in Korean PDF PubReader ePub: Background
Cardio-cerebrovascular diseases (CVDs) are the most common cause of death worldwide. Various CVD risk assessment tools have been developed. In South Korea, the Korea Occupational Safety & Health Agency (KOSHA) and the National Health Insurance Service (NHIS) have provided CVD risk assessments with health checkups. Since 2018, the KOSHA guide has stated that NHIS CVD risk assessment tool could be used as an alternative of KOSHA assessment tool for evaluating CVD risk of workers. The objective of this study was to determine the correlation and agreement between the KOSHA and the NHIS CVD risk assessment tools.
Methods
Subjects of this study were 17,485 examinees aged 20 to 64 years who had undergone medical examinations from January 2021 to December 2021 at a general hospital. We classified subjects into low-risk, moderate-risk, high-risk, and highest-risk groups according to KOSHA and NHIS’s CVD risk assessment tools. We then compared them with cross-analysis, Spearman correlation analysis, and linearly weighted kappa coefficient.
Results
The correlation between KOSHA and NHIS tools was statistically significant (p-value < 0.001), with a correlation coefficient of 0.403 and a kappa coefficient of 0.203. When we compared risk group distribution using KOSHA and NHIS tools, CVD risk of 6,498 (37.1%) participants showed a concordance. Compared to the NHIS tool, the KOSHA tool classified 9,908 (56.7%) participants into a lower risk category and 1,079 (6.2%) participants into a higher risk category.
Conclusions
In this study, KOSHA and NHIS tools showed a moderate correlation with a fair agreement. The NHIS tool showed a tendency to classify participants to higher CVD risk group than the KOSHA tool. To prevent CVD more effectively, a higher estimation tool among verified CVD risk assessment methods should be selected and managements such as early intervention and treatment of risk factors should be performed targeting the high-risk group.; 일개 병원 건강검진 자료를 이용한 한국산업안전보건공단과 건강보험공단의 심뇌혈관질환 위험도 평가의 비교
목적
심뇌혈관질환은 전 세계적으로 가장 많은 사망원인으로, 국내외에서 다양한 위험도 예측모형이 개발되었다. 국내에서는 한국산업안전보건공단의 뇌심혈관계질환 발병위험도 평가와 건강보험공단의 심뇌혈관질환 위험 평가가 있으며, 국가건강검진과 함께 제공되고 있다. 한국산업안전보건공단은 2018년부터 건강보험공단의 심뇌혈관질환 위험 평가의 결과를 평가에 이용할 수 있도록 하고 있어, 두가지 위험도 평가도구를 비교하고 그 상관관계와 일치도를 확인하고자 하였다.
방법
이 연구는 경주의 일개 종합병원에서 2021년 1월부터 12월까지 건강검진을 시행한 17,485명의 수검자를 대상으로 하였다. 건강검진 결과를 이용하여 한국산업안전보건공단와 건강보험공단의 지침에 따라 위험도 평가를 실시하였으며, 저위험군, 중등도위험군, 고위험군, 최고위험군으로 분류하였다. 이후 각각의 위험도 평가에 따른 위험군에 대하여 교차분석 및 스피어만 상관분석, 그리고 선형가중카파를 이용한 일치도 분석을 실시하였다.
결과
한국산업안전보건공단과 건강보험공단의 위험도 평가도구의 상관관계와 일치도는 통계적으로 유의하게 나타났고(p-value < 0.001), 상관계수는 0.403, 카파계수는 0.203으로 나타났다. 두가지 도구의 위험군 분포를 비교하였을 때, 6,498명(37.2%)는 동일한 위험군으로 평가되었다. 건강보험공단의 도구에서 더 높은 위험군으로 평가한 경우는 9,908명(56.7%), 한국산업안전보건공단의 도구에서 더 높은 위험군으로 평가한 경우는 1,079명(6.2%)로 나타났다.
결론
이 연구에서 한국산업안전보건공단과 건강보험공단의 위험도 평가도구는 중간정도의 상관관계와 어느정도의 일치도를 보였다. 두가지 도구 중 한가지만 사용할 경우에는 도구와 수검자의 특성에 따른 신중한 선택이 필요하다. 두가지 도구 중 건강보험공단의 도구가 더 높은 위험군으로 평가하는 경향을 보였다. 검증된 두가지 도구 중 더 높은 위험군으로 평가하는 쪽을 선택함으로써 위험요인을 조기에 발견하고 관리한다면 심뇌혈관질환의 효과적인 예방에 도움이 될 것이다.

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Original Article

Risk assessment of heavy metals in tuna from Japanese restaurants in the Republic of Korea: Seong-Jin Bae, Kyu-Sik Shin, Chulyong Park, Kiook Baek, So-Young Son, Joon Sakong; Ann Occup Environ Med 2023;35:e3. Published online February 9, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e3

Abstract Abstract in Korean PDF Supplementary Material PubReader ePub

Background

Studies on the risk of mercury (Hg) in Korean fishery products focus primarily on total Hg levels as opposed to methylmercury (MeHg) levels. None of the few studies on MeHg in tuna investigated tuna from Japanese restaurants. Few have evaluated lead (Pb), cadmium (Cd) and arsenic (As) in tuna. Thus, this study aimed to conduct a risk assessment by evaluating heavy metal concentrations in tuna from Japanese restaurants.

Methods

Thirty-one tuna samples were collected from Japanese restaurants in the Republic of Korea. They were classified according to region and species. The concentration of heavy metals in the samples was analyzed using the Ministry of Food and Drug Safety Food Code method. The rate of exceedance of maximum residue levels (MRLs) and the risk compared to the provisional tolerable weekly intake (PTWI) set by the Joint Food and Agriculture Organization/World Health Organization Expert Committee on Food Additives (%PTWI) were evaluated for risk assessment.

Results

The mean of MeHg, Pb, Cd and As concentrations were 0.56 ± 1.47 mg/kg, 33.95 ± 3.74 μg/kg, 14.25 ± 2.19 μg/kg and 1.46 ± 1.89 mg/kg, respectively. No sample exceeded the MRLs of Pb and Cd, but 9.7% of the samples exceeded the MRL of MeHg. The %PTWIs of MeHg, Pb, Cd and As were 4.2037, 0.0162, 0.0244 and 1.1627, respectively. The %PTWI of MeHg by age group and sex was highest among men aged 19–29 years (10.6494), followed by men aged 30–49 years (7.2458) and women aged 19–29 years (4.8307).

Conclusions

We found that 3 out of 31 samples exceeded the MRL of MeHg. The %PTWI of MeHg showed significant differences based on age and sex, and the value was likely to exceed a safe level depending on individuals’ eating behaviors. Therefore, improved risk management for MeHg is required.

한국의 일식집 유통 참치의 중금속(4종) 위해성평가
목적
국내 수산물의 수은에 관한 위해성 연구는 주로 메틸수은이 아닌 총 수은을 대상으로 이루어졌다. 소수의 참치의 메틸수은에 대한 연구들 중 일식점 유통 참치에 대한 연구는 없었다. 참치의 납, 카드뮴 및 비소에 대한 연구도 거의 이루어지지 않았다. 따라서 본 연구에서는 일식점 유통 참치의 중금속 농도를 평가하여 위해성평가를 실시하고자 하였다.
방법
참치는 한국의 일식집에서 총 31개의 시료가 수집되었다. 지역과 참치의 종에 따라서 분류하였다. 시료의 중금속 농도는 식품의약품안전처의 식품공전에 따라 분석했다. 위해성평가를 위해서 식품의 잔류허용기준을 초과하는 비율과 FAO/WHO합동식품첨가물 전문가위원회가 설정한 잠정주간섭취허용과 비교한 위험도(%PTWI)를 산출하였다.
결과
메틸수은, 납, 카드뮴 및 비소 농도의 기하평균은 각각 0.56 ± 1.47 mg/kg, 33.95 ± 3.74 μg/kg, 14.25 ± 2.19 μg/kg 및 1.46 ± 1.89 mg/kg이었다. 납과 카드뮴의 경우 잔류허용기준을 초과하는 시료가 없었으나 메틸수은의 경우 시료의 9.7%가 초과했다. 메틸수은, 납, 카드뮴 및 비소의 %PTWI는 4.2037, 0.0162, 0.0244 및 1.1627이었다. 메틸수은의 %PTWI는 19-29세의 남성, 30-49세의 남성, 19-29세의 여성 순으로 높았으며, 그 값은 10.6494, 7.2458, 4.8307이었다.
결론
총 31개의 시료 중 3개에서 메틸수은의 잔류허용기준을 초과하는 것으로 나타났다. 메틸수은의 %PTWI는 연령과 성별에 따라 상당한 차이를 보였고, 그리고 그 값은 섭취행태에 따라서 안전 수준을 초과할 가능성을 보였다. 따라서, 메틸수은에 대한 개선된 안전성 관리 방안이 필요할 것으로 보인다.

Citations

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Metal Load of Potentially Toxic Elements in Tuna (Thunnus albacares)—Food Safety Aspects
József Lehel, Zita Papp, András Bartha, Péter Palotás, Rita Szabó, Péter Budai, Miklós Süth
Foods.2023; 12(16): 3038. CrossRef

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Review

A work-relatedness assessment in epidemiological case investigation of occupational cancers: I. Principles: Kihun Kim, Jungwon Kim; Ann Occup Environ Med 2020;32:e30. Published online September 1, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e30

Abstract PDF PubReader ePub

It is important to identify the causal relationship between occupational exposure and the disease in the area of compensation because most cancers have long latent period. This review presents the principles that should be considered when evaluating the work-relatedness. We reviewed reports on occupational cancers published by the International Agency for Research on Cancer, American Conference of Governmental Industrial Hygienists, National Toxicology Program, Environmental Protection Agency, European Union, which are the world's most prestigious organizations. In addition, we reviewed relevant papers and books published in Korea. The process is conducted in the order of cancer diagnosis, exposure assessment for carcinogens, and work-relatedness assessment. The probability of causation is determined stochastically rather than deterministically. There is no absolute standard for accreditation criteria and results may vary according to expert opinions and in each country or organization. Revealing the causal relationship of occupational cancers is a difficult process owing to inconsistency in relevant epidemiological studies, lack of well-established biological mechanisms, loss of objective occupational historical data, and other complexity of individual cases. Causation is unclear in many cases. Nevertheless, the data should be reviewed in detail for each case suspected of work-related cancers, and an assessment should be made through valid and plausible logic and literature evidences.

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Research Article

Performance assessment on the Korean Computerized Neurobehavioral Test using a mobile device and a conventional computer: an experimental study: Young Seok Byun, Sung Kyu Park, Joon Sakong, Man Joong Jeon; Ann Occup Environ Med 2018;30:55. Published online August 29, 2018; DOI: https://doi.org/10.1186/s40557-018-0264-6

Abstract PDF PubReader ePub

Background

The Korean Computerized Neurobehavioral Test (KCNT) is a psychological assessment tool used as part of Workers’ Special Health Examinations in Korea. Due to the spread of mobile technology, this study aimed to compare results of the KCNT administered on a tablet PC versus a desktop computer, and, therefore, assess the clinical applicability of mobile devices.

Methods

A total of 72 participants enrolled in this study. Their age, sex, and years of formal education were collected during an interview, as well as their typing speed. The test battery comprised five subtests: Simple Reaction Time test, Choice Reaction Time test, Digit Addition test, Symbol-Digit Substitution test, and Finger Tapping Speed test. Participants repeated the KCNT test battery in a randomly assigned order using four different testing systems: a desktop computer equipped with a conventional 106-key keyboard (System 1), a desktop computer equipped with a simplified keyboard (System 2), a tablet PC with a simplified 17-key on-screen keyboard (System 3), and a tablet PC equipped with a simplified keyboard (System 4).

Results

Results of the Digit Addition test did not differ significantly for different testing systems. In contrast, results of the Simple Reaction Time test, Choice Reaction Time test, Symbol-Digit Substitution test, and Finger Tapping test were lower for the tablet PC (Systems 3 and 4) compared to the desktop computer (Systems 1 and 2). Systems 1 and 2 did not show significantly different results. Performance on System 3 was inferior to that on System 4, only for the Choice Reaction Time test and Finger Tapping Speed test. There were also significant differences in performance by computer familiarity when adjusted for age and education; however, the performance of each group on the test systems showed similar patterns.

Conclusions

It is not recommended to use a tablet PC to administer the KCNT to evaluate neurobehavioral performance for the Simple Reaction Time test and Choice Reaction Time test; however, tablet PCs with an on-screen keyboard may be used to perform the Digit Addition test, and the Symbol-Digit Substitution test and Finger Tapping Speed test to a limited degree.

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R J Elbin, Nathan R D’Amico, Matthew McCarthy, Melissa N Womble, Sydne O’Connor, Philip Schatz
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Research Article

A global, cross cultural study examining the relationship between employee health risk status and work performance metrics: Ana Howarth, Jose Quesada, Peter R. Mills; Ann Occup Environ Med 2017;29:17. Published online June 12, 2017; DOI: https://doi.org/10.1186/s40557-017-0172-1

Abstract PDF Supplementary Material PubReader ePub

Background

Health risk assessments (HRA) are used by many organisations as a basis for developing relevant and targeted employee health and well-being interventions. However, many HRA’s have a western-centric focus and therefore it is unclear whether the results can be directly extrapolated to those from non-western countries. More information regarding the differences in the associations between country status and health risks is needed along with a more global perspective of employee health risk factors and well-being overall. Therefore we aimed to i) quantify and compare associations for a number of health risk factors based on country status, and then ii) explore which characteristics can aid better prediction of well-being levels and in turn workplace productivity globally.

Methods

Online employee HRA data collected from 254 multi-national companies, for the years 2013 through 2016 was analysed (n = 117,274). Multiple linear regression models were fitted, adjusting for age and gender, to quantify associations between country status and health risk factors. Separate regression models were used to assess the prediction of well-being measures related to productivity.

Results

On average, the developing countries were comprised of younger individuals with lower obesity rates and markedly higher job satisfaction compared to their developed country counterparts. However, they also reported higher levels of anxiety and depression, a greater number of health risks and lower job effectiveness. Assessment of key factors related to productivity found that region of residency was the biggest predictor of presenteeism and poor pain management was the biggest predictor of absenteeism.

Conclusions

Clear differences in health risks exist between employees from developed and developing countries and these should be considered when addressing well-being and productivity in the global workforce.

Electronic supplementary material

The online version of this article (doi:10.1186/s40557-017-0172-1) contains supplementary material, which is available to authorized users.

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Case Report

Risk assessment of gastric cancer associated with asbestosis: a case report: Soo-Hong Park, Dong-Mug Kang, Bon-Hak Koo, Young-Ki Kim, Jong-Eun Kim; Ann Occup Environ Med 2015;27:9. Published online March 13, 2015; DOI: https://doi.org/10.1186/s40557-015-0061-4

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Background

The International Agency for Research on Cancer classifies asbestos as belonging to Carcinogen Group 2A for gastric cancer. We herein report a case of gastric cancer associated with asbestosis and describe the work-related and risk assessments of asbestos exposure for gastric cancer.

Case presentation

The 66-year-old male patient in our case worked in asbestos spinning factories. His level of cumulated asbestos fiber exposure was estimated to be 38.0–71.0 f-yr/cc. Thus, the Excess Life Cancer Risk for lung cancer associated with asbestos exposure was 9,648×10⁻⁵, almost 9,600 times the value recommended by the United States of America Environmental Protection Agency (1 × 10⁻⁵). The relative risk of developing lung cancer for this patient was more than 25 f-yr/cc, a well-known criterion for doubling the risk of lung cancer.

Conclusion

The patient’s exposure to high-dose asbestos was sufficient to increase his risk of gastric cancer because as the risk of lung cancer increased, the risk of gastric cancer was due to increase as well. Therefore, occupational asbestos fiber exposure might be associated with gastric cancer in this case.

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Research Article

Public-health impact of outdoor air pollution for 2^nd air pollution management policy in Seoul metropolitan area, Korea: Jong Han Leem, Soon Tae Kim, Hwan Cheol Kim; Ann Occup Environ Med 2015;27:7. Published online February 27, 2015; DOI: https://doi.org/10.1186/s40557-015-0058-z

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Objectives

Air pollution contributes to mortality and morbidity. We estimated the impact of outdoor air pollution on public health in Seoul metropolitan area, Korea. Attributable cases of morbidity and mortality were estimated.

Methods

Epidemiology-based exposure-response functions for a 10 μg/m3 increase in particulate matter (PM_2.5 and PM₁₀) were used to quantify the effects of air pollution. Cases attributable to air pollution were estimated for mortality (adults ≥ 30 years), respiratory and cardiovascular hospital admissions (all ages), chronic bronchitis (all ages), and acute bronchitis episodes (≤18 years). Environmental exposure (PM_2.5 and PM₁₀) was modeled for each 3 km × 3 km.

Results

In 2010, air pollution caused 15.9% of total mortality or approximately 15,346 attributable cases per year. Particulate air pollution also accounted for: 12,511 hospitalized cases of respiratory disease; 20,490 new cases of chronic bronchitis (adults); 278,346 episodes of acute bronchitis (children). After performing the 2^nd Seoul metropolitan air pollution management plan, the reducible death number associated with air pollution is 14,915 cases per year in 2024. We can reduce 57.9% of death associated with air pollution.

Conclusion

This assessment estimates the public-health impacts of current patterns of air pollution. Although individual health risks of air pollution are relatively small, the public-health consequences are remarkable. Particulate air pollution remains a key target for public-health action in the Seoul metropolitan area. Our results, which have also been used for economic valuation, should guide decisions on the assessment of environmental health-policy options.

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Review

Work-related Musculoskeletal Disorders in Korea Provoked by Workers’ Collective Compensation Claims against Work Intensification: Dongmug Kang, Youngki Kim, Young-Il Lee, Sangbaek Koh, Inah Kim, Hoonkoo Lee; Ann Occup Environ Med 2014;26:19-19. Published online July 29, 2014; DOI: https://doi.org/10.1186/2052-4374-26-19

Abstract PDF PubReader ePub

This article presents the process of workers’ problems with work related musculoskeletal disorders (WMSDs), the introduction of risk assessments (RA) for their prevention, and the consequences of this process in Korea. In 1997, economic crisis caused a rapid increase of massive layoffs, worker dispatch system introduction, job insecurity, and use of irregular workers resulting in work intensification. Work intensification increased WMSDs, which created massive workers’ compensation collective claims. Workers argued for the reduction of work intensity. The RAs introduced as a consequence of the workers’ struggle is unique in the world. Whereas these RAs were expected to play a pivotal role in WMSDs prevention, they dis not due to workers’ lack of engagement after the compensation struggle. In fact, changes in the compensation judgment system and criteria have resulted in lower compensation approval rates leading to lower workers’ compensation claims. The Korean experience provides insight into WMSDs causes in a globalized world. In such a the globalized world, work intensification as the result of work flexibility could be an international trend.

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Research Article

Automation of Workplace Lifting Hazard Assessment for Musculoskeletal Injury Prevention: June T Spector, Max Lieblich, Stephen Bao, Kevin McQuade, Margaret Hughes; Ann Occup Environ Med 2014;26:15-15. Published online June 24, 2014; DOI: https://doi.org/10.1186/2052-4374-26-15

Abstract PDF PubReader ePub

Objectives

Existing methods for practically evaluating musculoskeletal exposures such as posture and repetition in workplace settings have limitations. We aimed to automate the estimation of parameters in the revised United States National Institute for Occupational Safety and Health (NIOSH) lifting equation, a standard manual observational tool used to evaluate back injury risk related to lifting in workplace settings, using depth camera (Microsoft Kinect) and skeleton algorithm technology.

Methods

A large dataset (approximately 22,000 frames, derived from six subjects) of simultaneous lifting and other motions recorded in a laboratory setting using the Kinect (Microsoft Corporation, Redmond, Washington, United States) and a standard optical motion capture system (Qualysis, Qualysis Motion Capture Systems, Qualysis AB, Sweden) was assembled. Error-correction regression models were developed to improve the accuracy of NIOSH lifting equation parameters estimated from the Kinect skeleton. Kinect-Qualysis errors were modelled using gradient boosted regression trees with a Huber loss function. Models were trained on data from all but one subject and tested on the excluded subject. Finally, models were tested on three lifting trials performed by subjects not involved in the generation of the model-building dataset.

Results

Error-correction appears to produce estimates for NIOSH lifting equation parameters that are more accurate than those derived from the Microsoft Kinect algorithm alone. Our error-correction models substantially decreased the variance of parameter errors. In general, the Kinect underestimated parameters, and modelling reduced this bias, particularly for more biased estimates. Use of the raw Kinect skeleton model tended to result in falsely high safe recommended weight limits of loads, whereas error-corrected models gave more conservative, protective estimates.

Conclusions

Our results suggest that it may be possible to produce reasonable estimates of posture and temporal elements of tasks such as task frequency in an automated fashion, although these findings should be confirmed in a larger study. Further work is needed to incorporate force assessments and address workplace feasibility challenges. We anticipate that this approach could ultimately be used to perform large-scale musculoskeletal exposure assessment not only for research but also to provide real-time feedback to workers and employers during work method improvement activities and employee training.

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Leandro Donisi, Deborah Jacob, Lorena Guerrini, Giuseppe Prisco, Fabrizio Esposito, Mario Cesarelli, Francesco Amato, Paolo Gargiulo
Bioengineering.2023; 10(9): 1103. CrossRef
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Using real-time feedback of L5/S1 compression force based on markerless optical motion capture to improve the lifting technique in manual materials handling
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Original Article

Risk Assessment for Cardiovascular Diseases in Male Workers: Comparing KOSHA Guidelines and the Framingham Risk Score System: In Yong Um, Won Jun Choi, Deul Lee, Jae Seok Oh, Min Kee Yi, Jong Wan Yoon, Sang Hwan Han; Korean Journal of Occupational and Environmental Medicine 2012;24(4):365-374. Published online December 31, 2012; DOI: https://doi.org/10.35371/kjoem.2012.24.4.365

Abstract PDF

OBJECTIVES
This study aimed to investigate the 10-year risk of cardiovascular disease (CVD) by Framingham risk score (FRS) who classified as "healthy group" by Korean Occupational Safety and Health Agent (KOSHA)' s cardiovascular risk assessment.
METHODS
The subjects of this study were 1,781 male workers in a large steel company. Health status was obtained periodically through medical examinations and questionnaires. We assessed cardiovascular risk using KOSHA guidelines and calculated the 10-year risk of cardiovascular disease using the Framingham risk score for those categorized to the "healthy group" by KOSHA guideline. A closer examination of cardiovascular risk factors was performed in 62 subjects paradoxically placed in the "healthy group" by KOSHA guidelines and the "high-risk group" by FRS.
RESULTS
Among the "healthy group" by KOSHA's cardiovascular risk assessment, 230(15.8%) subjects had more than 3 CVD risk factors and 62(4.2%) subjects were high risk group (more than 20%) in 10-years risk of CVD by Framingham risk score. Modifiable risk factors included cigarette smoking (96.8%), high serum total cholesterol (82.3%), high serum triglyceride (66.1%), insufficient physical activity (66.1%), and obesity (58.1%).
CONCLUSIONS
Among subjects with normal blood pressure, it seems that KOSHA guidelines underestimate CVD risk, identified by the Framingham risk score. For the effective prevention and management of CVD, modifiable risk factors, such as cigarette smoking, dyslipidemia, and obesity, need to be constructively controlled.

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Yunrae Cho, Dong Geon Kim, Byung-Chan Park, Seonhee Yang, Sang Kyu Kim
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Comparison of risk-assessment tools for cardio-cerebrovascular diseases (CVD) in male shipyard workers: a cross-sectional study
Jea Chul Ha, Jun Seok Son, Young Ouk Kim, Chang Ho Chae, Chan Woo Kim, Hyoung Ouk Park, Jun Ho Lee, Young Hoo Shin, Hyun Woo Park
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Original Article

The Concentration of Cadmium in Urine, and Its Role in Health-risk Assessment of Residents in the Vicinity of Abandoned Mines in Gyeongsangbuk-do, Korea: Sung Ho Yun, Chang Yoon Kim, Tae Yoon Hwang, Kyu Chang Won, Jun Young Do, Se Jin Lee, Yeong Mog Park, Kwan Soo Jun, Gae Ho Lee, Do Young Lee, Kwang Seub Park, Joon Sakong; Korean Journal of Occupational and Environmental Medicine 2010;22(3):251-261. Published online September 30, 2010; DOI: https://doi.org/10.35371/kjoem.2010.22.3.251

Abstract PDF

OBJECTIVES
This study was conducted to assess the concentration of urine cadmium and health risks of residents in the vicinity of abandoned metal mines in Gyeongsangbuk-do.
METHODS
The concentration of cadmium in the soil, water, and agricultural crops was measured in Gyeongsangbuk-do, Butdeun and Suksan, which have abandoned metal mines. We measured the concentration of cadmium in the urine of residents from the following areas: 78 from village A, 99 from village C and 147 from control areas. Other health-risk assessments were performed on each resident, such as measuring the concentration of beta2-MG and a bone density test.
RESULTS
In abandoned mine areas, the mean concentration of cadmium was higher in agricultural soil and in the crops than in that of control areas. The concentration of cadmium in the stream exceeded the guideline level. In regard to provisional tolerable daily intake (PTDI) of cadmium, the actual intake rate through crops was 33.81%, 72.74% in abandoned mine areas and 5.03%, 6.16% in control areas. Residents in abandoned mine areas, A village and C village had a geometric mean of urine Cd of 1.90 microgram/g cr and 1.45 microgram/g cr. These measurements were significantly higher than those of residents in control areas, B village and D village, 0.59 microgram/g cr and 0.65 microgram/g cr (p<0.01). Following adjustments for age, sex, smoking habit, and occupational history, the concentration of urine cadmium of residents in the Butdeun abandoned meta mine was higher by 1.62 microgram/g cr as compared with the control group (p<0.01). Residents from the Suksan abandoned metal mine also had a higher concentration by 1.07 microgram/g cr (p<0.01). A multiple linear regression analysis was performed for the factors associated with T-score, and this showed that the concentration of urine cadmium was not an influential factor.
CONCLUSIONS
Based on these measurements, areas with abandoned metal mines contaminated streams, agricultural soil, and crops of the adjacent areas, with cadmium. Because residents in the adjacent areas intake contaminated crops, their urine cadmium was increased. Despite a lack of evidence demonstrating the detrimental effect of increased urine cadmium in residents, an additional study is needed to assess the health risks of residents in the vicinity of abandoned metal mines.

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Chronic Exposure to Lead and Cadmium in Residents Living near a Zinc Smelter
HyeJeong Jo, GeunBae Kim, JunYoung Chang, Kwan Lee, ChulWoo Lee, BoEun Lee
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Journal of Odor and Indoor Environment.2018; 17(1): 78. CrossRef
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Min-Hee Lee, Yong-Hyun Kim, Sang-Hee Jo, Si-On Choi, Inyoung Sa, Ki-Hyun Kim
Journal of Korean Society for Atmospheric Environment.2014; 30(5): 492. CrossRef

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Original Article

Development of Quality Assessment Domain and its Priority in Korea's Occupational Health Services: A Special Health Examination: Yoomi Chae, Sangchul Roh, Sukchul Jung; Korean Journal of Occupational and Environmental Medicine 2010;22(3):210-220. Published online September 30, 2010; DOI: https://doi.org/10.35371/kjoem.2010.22.3.210

Abstract PDF

OBJECTIVE: The purpose of this study was to develop a quality assessment domain and to determine its priority in Korea's Occupational Health Services.
METHODS
We designed the study in a 3 phase approach. The first phase of the process encompasses making a list of measures for quality assessments by a thorough review of the literature. The second phase emcompassed the development of inclusion and priority criteria. The third phase of survey development was conducted during August 2008 and a questionnaire was administered to occupational health physicians covering 58 subjects.
RESULTS
Finally we investigated 40 quality assessment measures, including 2 for structural domain, 17 for process domain, 21 for result domain in occupational health service. The 40 quality assessment measures divided into 2 parts. The early quality assessment part was 14 measures that including 8 measures for process domains and 5 measures for result domains.
CONCLUSION
We investigate a quality assessment domain and determined the priorities of the occupational health service in Korea.

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Original Article

Comparison of Cardiovascular Disease Risk Assessment Tools by Using Coronary CT Angiography: Myeong Bo Kim, Won Ju Park, Keun Ho Jang, Dae Kwang Lee, Hong Jae Chae, Jai Dong Moon; Korean Journal of Occupational and Environmental Medicine 2010;22(2):102-113. Published online June 30, 2010; DOI: https://doi.org/10.35371/kjoem.2010.22.2.102

Abstract PDF

OBJECTIVE: The prevalence and mortality rate of cardiovascular disease (CVD) have increased among Koreans over the past 20 years. To manage and control this disease, various CVD risk assessment tools such as KOSHA (Korean Occupational Safety and Health Agent) CVD risk assessment, the presence of metabolic syndrome and the Framingham risk score (FRS) have been developed and applied to employees at the workplace. This study was designed to compare the validity of the CVD risk assessment tools mentioned above with the findings of coronary CT angiography (CCTA).
METHODS
The subjects of this study who were 490 male-workers aged between 31 and 70, and these subjects were selected among those who had visited a University Hospital for a general health examination and who underwent CCTA from January 2007 to June 2009. Chi-square tests and logistic regression analysis were used to compare and analyze the associations between the CVD risk assessment tools and the coronary artery changes such as calcification and stenosis.
RESULTS
Metabolic syndrome (OR=1.90, 95% CI 1.23-2.95) and the Framingham risk score (OR=2.71, 95% CI 1.83-4.01) were the significant and meaningful predictors of coronary artery calcification. On the analysis of the association with coronary artery stenosis, only the Framingham risk score (OR=2.21, 95% CI 1.46-3.36) turned out to be a significant and meaningful predictor.
CONCLUSION
The results suggest that the Framingham risk score is a relatively valid CVD risk assessment tool. Henceforth, to effectively manage cardiovascular diseases in the workplace, advanced tools and indicators for management should be considered and provided based on meaningful study results.

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Original Article

A Comparison of KOSHA's Cardiovascular Disease Risk Assessment and the Predicted 10-year Risk of Cardiovascular Disease Developed by Jee for a Male Workers at a Wallpaper and Floor Covering Manufacturer: Kyungjin Yi, Hyeontaeck Heo, Dongwon Kim, Inah Kim, Sooyoung Kim, Junrae Rho, Jehyeok Mun; Korean Journal of Occupational and Environmental Medicine 2009;21(2):174-183. Published online June 30, 2009; DOI: https://doi.org/10.35371/kjoem.2009.21.2.174

Abstract PDF

OBJECTIVES
This study was conducted to evaluate the relationship between KOSHA's cardiovascular disease risk assessment and the predicted 10-year risk of cardiovascular disease developed by Jee. SUBJECTS AND METHODS: Data were obtained from a structured questionnaire survey and medical examination of 509 male workers aged 30-59 years employed at a wallpaper and floor covering workplace in May 2008. We calculated KOSHA's cardiovascular disease risk assessment and Jee's predicted 10-year risk of cardiovascular disease. A high risk of cardiovascular disease was defined as the upper 10th percentile of Jee's predicted 10-year risk of cardiovascular disease. Statistical analysis was conducted using the Wilcoxon rank sum test, Kruskal Wallis test and a logistic regression model.
RESULTS
Jee's predicted 10-year risk of cardiovascular disease significantly increased as KOSHA's cardiovascular disease risk increased. Logistic regression analysis indicated that the group with 3 or more cardiovascular disease risk factors according to KOSHA's model was more likely to experience cardiovascular disease within 10 years(OR=34.4, 95% C.I.=4.4-267.2).
CONCLUSIONS
KOSHA's cardiovascular disease risk assessment was fairly well associated with Jee's predicted 10-year risk of cardiovascular disease and was believed to be a practical and convenient method of preventing cardiovascular disease at the workplace.

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Yunrae Cho, Dong Geon Kim, Byung-Chan Park, Seonhee Yang, Sang Kyu Kim
Annals of Occupational and Environmental Medicine.2023;[Epub] CrossRef
Overall and cardiovascular mortality according to 10-year cardiovascular risk of the general health checkup: the Kangbuk Samsung Cohort Study
Youshik Jeong, Yesung Lee, Eunchan Mun, Eunhye Seo, Daehoon Kim, Jaehong Lee, Jinsook Jeong, Woncheol Lee
Annals of Occupational and Environmental Medicine.2022;[Epub] CrossRef

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Original Article

The Need-Assessment of Employee Assistance Programs among Korean Manufacturing Industry Workers in Gyeongsang-do: Dae Seong Kim, Hyang Woo Ryu, Soo Chan Choi, Seong Kyeon Lim, Jong Min Woo; Korean Journal of Occupational and Environmental Medicine 2007;19(2):135-144. Published online June 30, 2007; DOI: https://doi.org/10.35371/kjoem.2007.19.2.135

Abstract PDF

OBJECTIVE: Employee Assistance Programs have recently been introduced to Korea as a potential solution to relieve workers's stress and improve their mental health. This study was conducted to determine the needs of EAPs among manufacturing industry workers in Gyeongsang-do Korea.
METHODS
Responses to structured survey questionnaires were received from 556 workers at 7 mediumsized manufacturing factories.
RESULTS
Among the 556 workers who responded to the questionnaire 'Prevention & management of work stress', 'Mental health & management of daily life stress', 'Physical exercise health promotion program'. 'Elderly care', 'Outplacement', 'Financial support for leisure activities', and 'Ensuring leisure time'were raised as the main issues and services that they expected to be provided by the company.
CONCLUSION
EAPs have recently been introduced in Korean companies. The study results will be helpful to clarify the needs of individual Korean workers and to determine what EAP services should be provided.

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Original Article

Blood Pb, Urine Cd and Health Assessment of Residents in the Vicinity of Abandoned Mines in Gyeongsangbuk-do: Jong Hak Chung, Pock Soo Kang, Chang Yoon Kim, Kyung Soo Lee, Tae Yoon Hwang, Gyu Tae Kim, Jong Seo Park, Si Young Park, Dae Seop Kim, Ou Taek Lim, Joon Sakong; Korean Journal of Occupational and Environmental Medicine 2005;17(3):225-237. Published online September 30, 2005; DOI: https://doi.org/10.35371/kjoem.2005.17.3.225

Abstract PDF

OBJECTIVES
The objective of this health assessment is to evaluate the health risks that may result from exposure to abandoned mine tailings in Gyeongsangbuk-do. The tailings are remnants from an earlier flotation mill and mining operation that was in business from the early 1930's until 1970.
METHODS
The soil, stream water, and drinking water in and around three abandoned mine areas, Soochul, Gumjang, Darock, and three control areas located in Gyeongsangbuk-do were analyzed for level of Cd, Pb, Cu, As, and Hg. Potential chronic health effects were evaluated by interview and medical examination.
RESULTS
Some soil and stream samples exceeded the Korean standard for soil contamination in farmland and the Korean standard of water contamination in streams respectively. Blood lead (5.37 microgram/dl) and urine cadmium (2.79 microgram/g Cr) levels of the residents in the vicinity of the abandoned mine sites were significantly higher than of the residents in the control areas (blood lead, 4.34 microgram/dl; urine cadmium, 1.62 microgram/g Cr). There were no significant differences between the mining and control areas in terms of blood pressure, Hb, BUN, creatinine, SGOT, SGPT, fasting blood sugar, and the prevalence of potential chronic diseases.
CONCLUSIONS
The results of the assessment suggested that the three abandoned mine sites do not pose an apparent health risk to nearby residents. Nevertheless, the elevated blood lead and urine cadmium levels in the residents of the abandoned mine site suggested that it might be an important source of heavy metals contamination. Therefore, a nationwide evaluation program is needed to assess the potential health risks of residents living in the vicinity of abandoned mine sites.

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Original Article

Effect of Toluene on Phenol and S-phenylmercapturic Acid Excretion as Urinary Metabolites of Benzene in Rats: Jong Kook Moon, Chi Nyon Kim, Jae Hoon Roh; Korean Journal of Occupational and Environmental Medicine 2002;14(2):143-153. Published online June 30, 2002; DOI: https://doi.org/10.35371/kjoem.2002.14.2.143

Abstract PDF: OBJECTIVES
This study was conducted to provide accurate exposure evaluation of workers in a biologicallymonitored state who were simultaneously exposed to benzene and toluene. For the purpose of this study, an animal experiment was conducted.
METHODS
The following concentrations of solvents were administered orally to Sprague-Dawley rats : benzene at 2.26 mg/kg body weight (equivalent concentration to the 2.5 ppm, Threshold Limit Value-ShortTerm Exposure Limit, in the USA) and 9.02 mg/kg body weight (equivalent concentration to the 10 ppm, Threshold Limit Value-TimeWeighted Average in Korea), simultaneously with toluene at 106.42 mg/kg body weight (equivalent concentration to the 100 ppm, Threshold Limit Value-TimeWeighted RESULTS: The following results were obtained from the analysis of reading taken at 3hour intervals of S-phenylmercapturic acid (SPMA) and phenol concentration in urine metabolites of benzene after oral administration for 30 hours. 1. The concentrations of phenol and SPMA in urine were markedly decreased in the initial phase of the mixed group (both benzene and toluene administered group) as compared with the benzeneonly administered group, and the concentrations were slightly elevated. 2. The total excreted amounts of phenol and SPMA in urine decreased in the mixed group compared with the benzene-only group, and these decreases were more remarkable at the benzene administration concentration of 9.02 mg/kg than at 2.26 mg/kg. 3. The urinary excretions of phenol and SPMA were delayed in the case of the mixed group, and the extent of the delay was dependent on the amount of benzene administrat CONCLUSIONS: Benzene metabolism was suppressed by toluene, and hence the excretion of phenol and SPMA as urinary metabolites of benzene was delayed. This result will have applications in the interpretation of results from future biological monitoring of workers exposed to mixed solvents. We should not underestimate the importance of carefully interpreting the results of biological monitoring data when workers are exposed to mixed solvents. We should not underestimate the importance of carefully interpreting the results of biological monitoring data when workers are exposed to mixed benzene and toluene.

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Original Article

Need Assessment for Stage of Behavior Change in Workplace Health Promotion Strategy: Kang Sook Lee, Jung Wan Koo, Hyeon Woo Yim, Hyun Sook Hong, Joung Min Lee, Won Chul Lee, Chung Yill Park, O'Donnell, M , Kwang Ho Meung; Korean Journal of Occupational and Environmental Medicine 1999;11(4):492-504. Published online December 31, 1999; DOI: https://doi.org/10.35371/kjoem.1999.11.4.492

Abstract PDF

OBJECTIVES
In order to evaluate the stage of behavior change for health promotion strategy in workplace METHODS: Questionnaire survey was carried out for 309 workers who employed in H Electronics company in Kyongin area from September to October 1998.
RESULTS
According to need assessment of four step such as precontemplation stage, contemplation stage, action stage, maintenance stage which were to change of behavior for health promotion, the percent for quitting smoking were observed 48.8%, 43.1%, 8.1%. 0 %, and for the restriction of drinking were 29.8%, 10.6%, 9.3%, 5.3%; for fitness 11.1%, 31.0%, 37.3%, 20.6% in male 26.6%, 27.8%, 26.6%, 19.0% in female, for regular diet 26.1%, 19.8%, 38.7%, 15.3% in male, 27.8%, 22.2%, 40.0%, 10.0 % in female and for stress management 5.8%, 10.6%, 8.7%, 75.0% in male, 13.6%. 22.7%, 19.7%, 44.0% in female. In heavy smoker (p=0.017) and heavy drinker, (p=0.021) the percent of precontemplation stage was significantly higher than in lower drinker and light smoker.
CONCLUSIONS
This study suggested that company support for health promotion in workplace was weak and workers of high risk group for smoking and drinking were in precontemplation stage. So before conducting the health promotion program, health risk appraisal and need assessment for stage of behavior change should be taken for the efficient heath promotion strategy.

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Gyu-Seok Hwang, Jae-Wook Choi, Seoung-Hyung Choi, Seoung-Gil Lee, Kyung-Hee Kim, Yong-Min Cho, Chungsik Yoon
Asia Pacific Journal of Public Health.2012; 24(1): 117. CrossRef

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Original Article

Effect of Shift Work on Worker's Health, Family and Social Life at a Automobile Manufacturing Plant: Hyungjoon Chun, Mi A Son, Yongchul Kim, Eunyeon Cho, Jiyong Kim, Domyung Paek; Korean Journal of Occupational and Environmental Medicine 1998;10(4):587-598. Published online December 31, 1998; DOI: https://doi.org/10.35371/kjoem.1998.10.4.587

Abstract PDF

Effect of shift work on worker's health, family and social life was investigated at a automobile manufacturing plant in Inchon. In total, 2488 shift workers and 599 non-shift workers completed self administered questionnaire in their sleep pattern, subjective gastrointestinal symptoms, prevalent chronic disease status, general well-being schedule, family and social life. More shift workers complained of sleep disturbance, poor sleep quality, tiredness at awakening, and sleepiness in work than non-shift workers. More shift workers also complained of gastrointestinal disturbance than non-shift workers. Worker's mental health was assessed by General Well-Being Schedule(GWB) questionnaire developed for the U.S. Health and Nutrition Examination Surveys(HANES I). The percentage of severely distressed shift workers was significantly higher than that of non-shift workers(p<0.01). Among subscores in General Well-Being Schedule, anxiety, depression, positive well-being, vitality, and general health subscale of shift workers were lower than those of non-shift workers (p<0.05). In terms of family and social life, there was no significant difference between two groups. Multiple logistic regression analysis was done for discrete variables which showed statistically significant difference between shift and non-shift group. The variables included in analysis were sleep disturbance symptoms, gastrointestinal complaints, and distress level calculated from GWB score. Age, tenure, smoking, alcohol drinking, and exercise were adjusted as confounding factors and odds ratios for above symptoms due to shift work were calculated. Odds ratios (ORs) for sleep disturbance symptoms ranged from 0.52 to 3.59. ORs for gastrointestinal complaints ranged from 1.19 to 1.34. OR for distress level was 1.31. We concluded that shift workers are suffered from physical and psychological ailments due to shift work and interventional methods for preventing worker's health from adverse effects of shift work are needed.

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Jae Joong Kim, Eun Jung Lee, Kyung-Ran Lee
Journal of The Korean Society of Food Culture.2016; 31(6): 587. CrossRef
The association between shift work and depression in hotel workers
Hyun Jey Moon, Sang Hyun Lee, Hee Sung Lee, Kyung-Jae Lee, Joo Ja Kim
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Kishor K. Dhande, Sunil Sharma
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Original Article

Development of a Baseline Checklist for CTD Risk Assessment: Donghyun Park, Sang Hwan Han, Dong Bin Song; Korean Journal of Occupational and Environmental Medicine 1998;10(2):251-266. Published online May 31, 1998; DOI: https://doi.org/10.35371/kjoem.1998.10.2.251

Abstract PDF: Today, CTDs (Cumulative Trauma Disorders) are one of major hazards in the US and European Industries disrupting work schedules, productivity and increasing workers compensation costs. The increase in injuries and their associated costs has led companies to form committees and implement programs to address this problem. Therefore, it is important that quantitative analysis tools help identify and assess industrial tasks that pose risk to workers. However, the process of quantifying risk in upper limb tasks is still in its infancy stage and calls for better measurement techniques are not going unheard. As the first work of quantification, baseline CTD checklist for risk assessment was developed in this study. It was mainly based on previous literature regarding CTDs. The checklist was unique in that its expected user was industrial hygienist who did not have much ergonomic background and in that it was targeted to Korean workers in various types of industries. As the first application of the checklist, some jobs in two industries (VDT, heavy Industry) were evaluated, and compared with the medical data. Eighteen out of thirty items in the checklist was univariately significant (p<0.05) on the results of medical examinations. The correlation between medical data and total risk score from the checklist was 0.62. The feasibility of its use by an industrial hygienist was also checked by comparing with the results by an ergonomist. Their correlation (on the basis of Kendall's tau-b) in terms of total risk score was 0.74. The checklist in this study shows reasonably good performance for the first trial. Further research will have to include continuous refinement and validation for many more industries and many more jobs.

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Original Article

Quality Assessment of Group Occupational Health Service for Small and Medium Scale Enterprises in Korea: Sunmean Kim, Soo Hun Cho, Chang Yup Kim, Eun Hee Ha, Yun Chul Hong, Ho Jang Kwon, Mi Na Ha, Sang Hwan Han, Young Su Ju; Korean Journal of Occupational and Environmental Medicine 1998;10(1):71-82. Published online February 28, 1998; DOI: https://doi.org/10.35371/kjoem.1998.10.1.71

Abstract PDF

Group occupational health service programme started in 1990 is one of the measures to cope with limited human and financial resources in occupational health. The programme has expanded rapidly to include 52 institutions, private as well as public, all over the country. In spite of its potential impact on health of employees and practice of occupational health in small and medium sized industries, comprehensive evaluation in terms of quality has not been tried. This study has aims to develop the criteria to assess the quality of newly developed group occupational health service programme, and to investigate the quality of institutions, and finally to develop policies for the quality improvement. 1) Criteria development : By defining occupational health services, in particular for small and medium sized industries, as one of the primary health care, followings are included as core elements of qualitative occupational health programme ; accessibility, continuity, comprehensiveness, technical quality, intersectoral collaboration, emphasis on preventive services, community participation, and adequacy. Again each element is divided into five major components of national health system infrastructure developed by the World Health Organization ; development of health resources, organized arrangement of resources, delivery of health care, economic support, and management. In turn, each component is categorized into three aspects of quality assessment, structure, process and outcome. Expert panel selected several criteria for each category to evaluate the programme. Criteria were modified according to each group of interviewees, to produce two sets of questionnaire, one for chief operating officer and another for nurses in the institutions, and the chief operating officer and workers in the workplace. 2) Subject : Of all 52 institutions, 25 voluntarily participated in the survey. At individual institution, chief operating officer and practicing nurses were interviewed in depth. After intensive education for interviewees, every interview was performed with standardized guideline and questionnaire. The quality of the 'Group occupational health service programme' was found to be lower than expected. Especially In continuity, comprehensiveness, technical quality, community participation and adequacy, lower quality in structural aspect was commonly identified throughout all the institutions. Quality in terms of accessibility and continuity highly varied among institutions. To improve quality of the programme, more comprehensive and systematic programme such as accreditation has to be introduced. In addition, human resources, governmental fund and information systems for individual workers are to be developed. As a long range plan, integration of occupational health services into the national health systems and pooling of financial resources and planned allocation should be considered.

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Bo-Young Jang, Dong-Mug Kang, Young-Ki Kim, Se-Young Kim, Kyung-Sun Ko
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Original Article

The Development of Systemic Health Management Program in the Small Scale Industry using Organic Solvents: Application of Neurobehavioral Core Test Battery(NCTB): Soo Hun Cho, Sang Hwan Han, Mi Na Ha, Dork Ro Yun, Ho Jang Kwon; Korean Journal of Occupational and Environmental Medicine 1995;7(2):258-268. Published online October 31, 1995; DOI: https://doi.org/10.35371/kjoem.1995.7.2.258

Abstract PDF: It is known that there appear some nonspecific and delicate changes in neuropsychiatric aspect on the workers when they are exposed for a long period to low concentrated organic solvents in the work places. Therefore, it give rise to the necessity of developing a program for the health supervisor stationed in the work place to supervise these neurobehavioral health affection. In addition to the questionnaire posed to the workers exposed to organic solvents, the study team conducted NCTB(Neurobehavioral Core Test Battery) respectively on an exposed group and a non-exposed group to organic solvents. The study team compared the results and decided whether or not to apply the results to the evaluation program of health affection. The study team divided 132 workers in 6 car repairing factories and 2 textile printing factories into exposed group and non-exposed group, pairing them off into 66 research objects according to their age, sex, and job. Neurobehavioral test was conducted on 6 items, except the POMS test, of NCTB developed by the World Health 0rganization (WHO) . The study team conducted examinations of working environment on the exposed and non-exposed groups of each work place. The analysis of the collected materials for examinations were conducted with GC-MS. The concentration of the mix-ture in the air, relative to their respective threshold limit values (TLV) was calculated according to the formula of the ACGIH and the Korean threshold limits. The results indicated that for two of eight factories samples the recommended concentration limits for mixtures was exceeded. Of the six tests, the'digit span forward','digit span backward'and'digit symbol' produced conspicuous statistical differences between the two groups (p<0.1) as a result of compairing the test values by means of paired t-test. The results of respective analysis of the car repairing factories and textile printing factories revealed that the textile printing factories had greater differences between the exposed and the non-exposed than in the car repairing factories. It is presumably because the textile printing workers are continuously exposed to the organic solvents during working hours, whereas the car repairing workers are exposed only when they are doing painting works. The NCTB is assessed very useful in examining the neurobehavioral health affection under the exposure to organic solvents, and, therefore, the study team expects that the NCTB will play an important part in the course of developing a health program for the workers exposed to organic solvents.

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