Annals of Occupational and Environmental Medicine

Case Report

Occupational asthma related to indoor air pollution in a worker at an indoor air gun shooting range: a case report: Kwang Min Lee, Seungho Lee, Yoon-Ji Kim, Seung-eun Lee, Youngki Kim, Dongmug Kang, Se-Yeong Kim; Ann Occup Environ Med 2023;35:e13. Published online June 19, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e13

Abstract Abstract in Korean PDF Supplementary Material PubReader ePub

Background

Indoor air pollution can cause and exacerbate asthma. We report a previously undescribed case of occupational asthma related to indoor air pollution in a worker at an indoor air gun shooting range and highlight the potential risk of developing occupational asthma in this environment.

Case presentation

A 31-year-old man presented with dyspnea, cough, and sputum and was diagnosed with asthma complicated by pneumonia. Objective evidence of asthma was obtained by performing a methacholine bronchial provocation test. It was suspected that the patient had occupational asthma, which began one month after changing jobs to work within the indoor air gun shooting range. The highest peak expiratory flow (PEF) diurnal variability on working days was 15%, but the highest variation was 24%, with 4 days out of 4 weeks having a variation of over 20% related to workplace exposure. Conversely, the diurnal variability on the rest days was 7%, and no day showed a variation exceeding 20%. The difference in the average PEF between working and rest days was 52 L/min. PEF deterioration during working days and improvement on rest days were noted.

Conclusions

The results obtained from the in-depth analysis of the PEF were adequate to diagnose the patient with occupational asthma. Exposure to indoor air pollution and lead and the patient’s atopy and allergic rhinitis may have contributed to the development of occupational asthma.

실내 공기총 사격장 근로자의 실내공기오염관련 직업성 천식 증례보고
a배경: 실내공기오염은 천식을 유발하고 악화시킬 수 있다. 본 연구는 실내 공기총 사격장에서 일하는 근로자의 실내 공기 오염과 관련된 이전에 기술되지 않은 직업성 천식 사례를 보고하고, 이러한 환경에서 직업성 천식 발병의 잠재적 위험을 강조한다.
증례
31세 남자가 호흡곤란, 기침, 가래 증상이 나타나 내원하였고, 폐렴이 동반된 천식으로 진단되었다. 천식의 객관적인 증거는 메타콜린 기관지유발검사를 시행하여 획득하였다. 환자는 실내공기총 사격장에서 근무하기 위해 이직한지 한달만에 직업성 천식을 앓고 있는 것으로 의심되었다. 근무일의 최고호기유량(PEF) 주간 변동성은 15%였지만, 가장 높은 변동성은 24%였으며, 4주 중 4일은 작업장 노출과 관련하여 20% 이상의 변동성을 보였다. 반대로 쉬는 날의 일교차는 7%로 20%를 넘는 날은 없었다. 근무일과 휴식일 사이의 평균 최고호기유량(PEF) 차이는 52 L/min이었다. 근무일 동안 PEF 악화 및 휴식일의 개선이 주목되었다.
결론
최고호기유량(PEF)의 심층분석결과는 직업성 천식 환자를 진단하기에 적합하였다. 실내공기오염과 납 노출, 환자의 아토피와 알레르기성 비염이 직업성 천식 발병에 기여했을 가능성이 있다.

Citations

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Recent developments in occupational asthma
Claudia Blouin, Catherine Lemière
Current Opinion in Pulmonary Medicine.2024; 30(3): 281. CrossRef
Occupational agents-mediated asthma: From the perspective of autophagy
Xiu He, Dengxiang Yao, Xiaoli Yuan, Jiaqi Ban, Yuxuan Gou, Mingdan You
Science of The Total Environment.2024; 952: 175880. CrossRef

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Original Article

Association between exposure to particulate matter and school absences in Korean asthmatic adolescents: Seongmin Jo, Kiook Baek, Joon Sakong, Chulyong Park; Ann Occup Environ Med 2022;34:e21. Published online August 22, 2022; DOI: https://doi.org/10.35371/aoem.2022.34.e21

Abstract Abstract in Korean PDF Supplementary Material PubReader ePub: Background
Because particulate matter (PM) and asthma are closely related, the prevalence of school absence among adolescents with asthma can be affected by the concentration of PM. We aimed to investigate the relationship between school absences due to asthma and the total number of days that the PM concentration exceeded the standard.
Methods
We used the data from the 16th Korea Youth Risk Behavior Survey and the PM levels of 17 metropolitan cities and provinces gathered from the AirKorea. Information on the characteristics of asthmatic adolescents and the prevalence of school absence was obtained using a questionnaire, while the PM levels based on the total number of days with poor and very poor PM grades were collected from the AirKorea website. Both χ² test and logistic regression analysis were performed using the weights presented in the original dataset.
Results
In the case of particulate matter of 10 microns in diameter or smaller (PM₁₀), the odds ratio (OR) after adjusting for confounders (sex, school year, body mass index, smoking history, diagnosis of allergic rhinitis, diagnosis of atopic dermatitis and city size) was 1.07 (95% confidence interval [CI]: 1.01–1.13) for absents due to asthma when the total days of poor and very poor grades of PM₁₀ (81 μg/m³ or higher) increased by 1 day. In the analysis of particulate matter of 2.5 microns in diameter or smaller (PM_2.5), the OR after adjusting for confounders was 1.01 (95% CI: 1.00–1.03) for absents due to asthma when the total number of days with poor and very poor PM_2.5 grades (36 μg/m³ or higher) increased by 1 day.
Conclusions
A significant association was observed between the total number of days of poor and very poor PM₁₀ and PM_2.5 grades and school absence due to asthma; PM can cause asthma exacerbation and affect the academic life.; 한국 천식 청소년의 미세먼지 노출과 학교 결석과의 상관관계
목적
미세먼지와 천식은 밀접한 관련이 있기 때문에 천식을 앓고 있는 청소년들의 천식악화로 인한 결석률은 미세먼지 농도에 영향을 받을 수 있다. 이번 연구는 일정 기준의 미세먼지 농도를 초과하는 총 일수와 천식 악화로 인한 학교 결석의 관계를 조사했다.
방법
제16차 청소년건강행태조사의 설문결과 중 천식을 진단받은 청소년들을 대상으로 ‘천식으로 인한 학교 결석 여부’를 결과변수로, 에어코리아에서 제공하는 광역시·도의 미세먼지 측정 자료 중 연간 나쁨 및 매우나쁨 등급을 받은 날짜를 미세먼지의 노출 지표로 사용하여 분석하였다. 분석 시 복합표본설계에 따른 가중치를 적용한 카이-제곱 검정과 로지스틱 회귀 분석을 사용하였다.
결과
교란 변수를 보정 후, 1년간 대기 중 PM10 나쁨 및 매우나쁨 등급을 합산한 총 일수가 1일 증가할 때 천식 증상 악화로 인한 학교 결석에 대한 오즈비는 1.06 (95% 신뢰 구간: 1.01–1.13)이었다. PM2.5는 1년간 대기 중 나쁨 및 매우나쁨 등급을 합산한 총 일수가 1일 증가할 때, 천식 증상 악화로 인한 학교 결석에 대한 오즈비는 1.01 (95% 신뢰구간: 1.00–1.02)이었다.
결론
PM10과 PM10의 나쁨 및 매우나쁨 등급을 합산한 총 일수와 천식으로 인한 학교 결석 사이에 유의한 연관성이 관찰되었다.

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Research Article

Cogeneration plant and environmental allergic diseases: is it really an eco-friendly energy source?: Jinyoung Moon; Ann Occup Environ Med 2020;32:e38. Published online December 2, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e38

Abstract PDF Supplementary Material PubReader ePub

Background

Combined heat and power generation (CHP generation, also called ‘cogeneration’) is attracting public attention for its high thermal efficiency, without considering possible adverse environmental health effects.This study investigated the potential role of cogeneration plants in inducing 3 environmental diseases: asthma, allergic rhinitis, and atopic dermatitis.

Methods

From 1 January 2013 to 31 December 2017, the towns (dongs) of South Korea in which a cogeneration plant started operation were selected as study sites. For comparison, a matched control dong with the most similar Gross Regional Domestic Product for each case dong was selected. The numbers of outpatient visits, inpatient admissions, and emergency visits provided by the National Health Insurance Sharing Service (NHISS) were analyzed using an interrupted time-series design. For air pollutants, the concentrations of 5 air pollutants from the AIRKOREA dataset were used.

Results

A total of 6 cogeneration plants in 6 case dongs started operation during the study period. For overall case dongs, the pre-CHP trend was 1.04 (95% confidence interval [CI]: 1.038–1.042), and the post-CHP trend was 1.248 (95% CI: 1.244–1.253). The intercept change due to the CHP plant was 1.15 (95% CI: 1.137–1.162). For overall control dongs, the pre-CHP trend was 1.133 (95% CI: 1.132–1.135), and the post-CHP trend was 1.065 (95% CI: 1.06–1.069). The intercept change due to the CHP plant was 0.888 (95% CI: 0.878–0.899). Only for CO and NO₂, the relative risk (RR) for overall case dongs was statistically significantly increased, and the RR for the overall control dongs was statistically insignificant.

Conclusions

Possible hazardous emissions, like CO and NO_2, from cogeneration plants could induce environmental diseases in nearby community populations. The emissions from cogeneration plants should be investigated regularly by a governmental agency, and the long-term health outcomes of nearby community residents should be investigated.

Citations

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Regional impacts on air quality and health of changing a manufacturing facility’s grid-boiler to a combined heat and power system
Elaheh Safaei Kouchaksaraei, Ali Khosravani Semnani, Kody M. Powell, Kerry E. Kelly
Journal of the Air & Waste Management Association.2023; 73(10): 760. CrossRef
Risk perceptions of a population living near a municipal waste incinerator and associated factors with the prevalence of environmental disease
Dong Hyun Kim, Chae Kwan Lee, Jeong Ho Kim, Byung Chul Son, Chunhui Suh, Kunhyung Kim, Byeong Jin Ye
Annals of Occupational and Environmental Medicine.2022;[Epub] CrossRef
Assessing the Impact of Emissions of Severodonetsk Cogeneration Plant on the Health of the Urban Population
I. V. Kravchenko, O. V. Suvorin
Visnyk of V. N. Karazin Kharkiv National University series "Ecology".2021; (25): 81. CrossRef

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Case Report

A Case of Occupational Asthma in a Plastic Injection Process Worker: Jong Suk Lee, Hyun Seok Kwak, Byung Soon Choi, So Young Park; Ann Occup Environ Med 2013;25:25-25. Published online October 22, 2013; DOI: https://doi.org/10.1186/2052-4374-25-25

Abstract PDF PubReader ePub

Objectives

We report a case of death due to asthma attack in a plastic injection process worker with a history of asthma.

Methods

To assess task relevance, personal history including occupational history and medical records were reviewed. Samples of the substances utilized in the injection process were collected by visiting the patient’s workplace. The work environment with the actual process was reproduced in the laboratory, and the released substances were evaluated.

Results

The medical records confirmed that the patient’s conventional asthma was in remission. The analysis of the resins discharged from the injection process simulation revealed styrene, which causes occupational asthma, and benzenepropanoic acid, 3,5-bis(1,1-dimethylethyl)-4-hydroxy-, and octadecyl ester. Even though it was not the case in the present study, various harmful substances capable of inducing asthma such as formaldehyde, acrolein, and acetic acid are released during resin processing.

Conclusion

A worker was likely to occur occupational asthma as a result of the exposure to the harmful substances generated during the plastic injection process.

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International Journal of Environmental Analytical Chemistry.2022; 102(16): 4316. CrossRef
Non‐malignant respiratory disease among workers in the rubber manufacturing industry: A systematic review and meta‐analysis
Nirmala Thapa, Suzanne E. Tomasi, Jean M. Cox‐Ganser, Randall J. Nett
American Journal of Industrial Medicine.2019; 62(5): 367. CrossRef
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American Journal of Industrial Medicine.2017; 60(2): 163. CrossRef
Characterization of chemical contaminants generated by a desktop fused deposition modeling 3-dimensional Printer
Aleksandr B. Stefaniak, Ryan F. LeBouf, Jinghai Yi, Jason Ham, Timothy Nurkewicz, Diane E. Schwegler-Berry, Bean T. Chen, J. Raymond Wells, Matthew G. Duling, Robert B. Lawrence, Stephen B. Martin, Alyson R. Johnson, M. Abbas Virji
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Effects of high occupational physical activity, aging, and exercise on heart rate variability among male workers
Dongmug Kang, Youngki Kim, Jongeun Kim, Yongsik Hwang, Byungmann Cho, Taekjong Hong, Byungmok Sung, Yonghwan Lee
Annals of Occupational and Environmental Medicine.2015;[Epub] CrossRef

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Case Report

A Case of Occupational Asthma and Rhinitis Suspected to be Caused by Exposure to Ethyl Cyanoacrylate: Soon Woo Jang, Ki Chul Nam, Hyung Joon Jhun, Byoung Gwon Kim, Jong Tae Park; Korean Journal of Occupational and Environmental Medicine 2009;21(3):283-288. Published online September 30, 2009; DOI: https://doi.org/10.35371/kjoem.2009.21.3.283

Abstract PDF: BACKGROUND
Ethyl cyanoacrylate is used as a component of adhesives used in the industrial, domestic, and medical fields. It is known to cause mucosal irritation, contact dermatitis and respiratory discomfort. However, reports of combined occupational asthma and rhinitis are rare, especially in Korea. We report a case of occupational asthma and rhinitis suspected to be caused by exposure to ethyl cyanoacrylate.
CASE
REPORT: A 36-year-old woman presented with rhinorrhea, cough, dyspnea and chest discomfort after exposure to ethyl cyanoacrylate adhesive at an assembly area of a plastic products manufacturing company. Nasal endoscopy revealed watery rhinorrhea and hypertrophy of nasal turbinates, which were compatible with rhinitis. The methacholine provocation test showed a positive result. Daily variability of peak expiratory flow increased on work days, but decreased during non-work days. Based on these findings, we diagnosed this case as a combination of occupational asthma and rhinitis suspected to be caused by exposure to ethyl cyanoacrylate.
CONCLUSION
There needs to be increased awareness regarding occupational asth-ma and rhinitis caused by exposure to ethyl cyanoacrylate.

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Original Article

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.

Citations

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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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Original Article

The Etiologic Fraction of Isocyanate-related Asthma in Isocyanate-exposed Workers: Yeon Soon Ahn, Dong Hee Koh, Ki Tae Moon; Korean Journal of Occupational and Environmental Medicine 2007;19(4):276-284. Published online December 31, 2007; DOI: https://doi.org/10.35371/kjoem.2007.19.4.276

Abstract PDF

OBJECTIVES
Isocyanate-induced asthma is the most prevalent occupational asthma in Korea. The main purpose of this study was to estimate the etiologic fraction of isocyanate-related asthma in isocyanateexposed (EFe) workers and to measure the magnitude of preventable occupational asthma.
METHODS
Asthma admissions from 2000 to 2005 were analyzed in a cohort containing 10,861 isocyanate-exposed workers and 324,618 isocyanate non-exposed workers who underwent the specialized health examination from January, 2000 to December, 2004. The cohorts of Isocyanate and noise-exposed workers were established using the same data base of Korea Occupational Safety and Health Agency (KOSHA). Asthma admissions were investigated by matching the National Health Insurance Claim Data (NHICD). The standardized rate ratio (SRR) of admission was estimated by Poisson regression method to allow unbiased comparisons across exposure and other variables such as age and sex. The etiologic fraction for the isocyanate-exposed (EFe) workers was calculated using this formula (Efe=SRR-1/SRR).
RESULTS
Twenty-eight asthma admissions among the isocyanate-exposed workers and 321 non-exposed workers were observed during 2000~2005. The crude admission rate was 57.2 per 100,000 person-years for the isocyanate-exposed workers and 25.0 for the noise-exposed workers. Compared to the noiseexposed workers, the isocyante-exposed workers had significantly higher asthma admission (SRR=2.80 95%CI=1.89~4.14). The etiologic fraction for the isocyanate-exposed (EFe) workers was 64%.
CONCLUSIONS
This study was limited by the restriction to admission cases and the short follow-up periods. Any difference of admission accessibility between the isocyanate-exposed and non-exposed workers will lead to either over- or under-estimation of the biased etiologic fraction for the isocyanateexposed workers. The etiologic fraction for the isocyanate-exposed workers was 64% indicated that 64% of the asthma cases occurred in the isocyanate-exposed workers are preventable through occupational health management.

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The Korean Journal of Clinical Laboratory Science.2021; 53(3): 249. CrossRef

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Original Article

Prevalence of Occupational Asthma and Exposure Level of Pharmaceutical Dust of Workers in a Pharmaceutical Company: Sung Soo Oh, Yong Hyu Choi, Eun A Kim, Young Mok Lee, Jae Kil Jang, Jang Jin Yoo, Seung Hyun Park, Soo Young Jung, Tae Kyun Kim, Kyoo Sang Kim, Seong Kyu Kang; Korean Journal of Occupational and Environmental Medicine 2006;18(2):94-102. Published online June 30, 2006; DOI: https://doi.org/10.35371/kjoem.2006.18.2.94

Abstract PDF

OBJECTIVES
After the investigation of one worker with occupational asthma, we surveyed the prevalence of occupational asthma and the exposure level of pharmaceutical dust of 32 workers in a pharmaceutical company.
METHODS
Thirty-two of the 90 employees participated in the survey which consisted of questionnaire, blood sampling, spirometry and skin prick tests with 8 common allergens as well as 9 antibiotics and 2 enzymes. Various indices of the working environment were also measured. Subjects who had a symptom suggestive of work-related asthma or positive skin prick test were further investigated by PC20 methacholine. Nine subjects who had a PC20 result of 16 mg/ml or less (n=7) or had work-related symptoms and positive skin prick test (n=2) were referred to undergo a specific bronchial provocation test to pharmaceutical dust in an academic allergic disease center.
RESULTS
Eleven of 32 workers (34.4%) had a work-related symptom suggestive of occupational asthma. Ten (31.2%) showed positive skin prick test. 8 (25.0%) had a PC20 result of 16 mg/ml or less (indicative of significant bronchial hyperresponsiveness), and 5 (15.6%) had a positive result on the specific bronchial provocation test. Exposure levels of stuffing, input of raw materials and screening process were relatively high.
CONCLUSIONS
This survey showed that pharmaceutical workers have an increased risk of occupational asthma. Although pharmaceutical factories maintain a relatively good working environment, careful control of respiratory tract exposures, especially during stuffing, input of raw materials and screening process, is important to prevent occupational asthma. Pharmaceutical workers need to undergo regular skin prick and methacholine bronchial provocation tests, as well as asthmatic symptom survey, to ensure the early detection and prevention of occupational asthma.

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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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Original Article

Prevalence of Occupational Asthma in TDI-Exposed Workers: Hyoung Ryoul Kim, Cheol Woo Kim, Yun Chul Hong, Hyung Joon Chun, Chi Nyon Kim, Hyun Soo Kim, Jee Na Lee, Joo Yeon Shin, Dong Hee Koh, Jaehoon Roh; Korean Journal of Occupational and Environmental Medicine 2004;16(2):191-199. Published online June 30, 2004; DOI: https://doi.org/10.35371/kjoem.2004.16.2.191

Abstract PDF: OBJECTIVES
This study was carried out to estimate the prevalence of isocyanate-induced occupational asthma in toluene diisocyanate (TDI) exposed workers.
METHODS
We examined 170 workers who had been directly exposed to TDI through a medical questionnaire, physical examination, and pulmonary function test. Based on screening examination, workers with suspected occupational asthma were selected for further evaluation such as methacholine and TDI challenge tests.
RESULTS
Eleven (6.9%) among 170 workers complained of symptoms of occupational asthma, and 7 among these 11 symptomatic workers showed positive responses to the methacholine challenge test (4.1%). One spray painter was confirmed as having the TDI induced occupational asthma following a positive response to TDI challenge test.
CONCLUSIONS
The prevalence of TDI-induced asthma was at 0.58% was lower than that for former studies (2-20%). Improved workplace environment, lower level of TDI exposure compared to the past, and the healthy workers effect may have contributed to this low rate of asthma prevalence in workers with TDI exposure.

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Original Article

Characteristics of Occupational Asthma Reported by Surveillance System in Incheon: Hyoung Ryoul Kim, Yun Chul Hong, Jong Han Leem, Jong Uk Won, Hyung Joon Chun, Jee Na Lee, Joo Yeon Shin; Korean Journal of Occupational and Environmental Medicine 2003;15(4):344-350. Published online December 31, 2003; DOI: https://doi.org/10.35371/kjoem.2003.15.4.344

Abstract PDF

OBJECTIVES
This study was carried out to estimate the magnitude of occupational asthma and to determine its characteristics.
METHODS
We collected and analyzed 121 cases of occupational asthma reported by a surveillance system in Incheon for 5 years. The cases were classified according to industry and causing gent. We attached the data to worker's compensation records to establish the degree of agreement between the two sources.
RESULTS
The industry of musical instrument manufacture was the most common (31 cases, 25.6%), followed by furniture manufacture, dye making, and machinery manufacture. TDI was the most common causing agents (52 cases, 43%), followed by reactive dye, wood dust, and organic dust. There was poor agreement with the worker's compensation records (2 cases, 8%).
CONCLUSIONS
TDI and reactive dyes were the major materials causing occupational asthma. Most cases reported by the surveillance system were not applied to the worker's compensation system. Therefore, the surveillance system should be used to estimate the magnitude of occupational asthma and to determine its characteristics.

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Clinical Importance of Work-Exacerbated Asthma: Findings From a Prospective Asthma Cohort in a Highly Industrialized City in Korea
Woori Jo, Kwang Won Seo, Hwa Sik Jung, Chui Yong Park, Byung Ju Kang, Hyeon Hui Kang, Seung Won Ra, Yangjin Jegal, Jong Joon Ahn, Soon Eun Park, Moon Sik Jung, Ju Ik Park, Eun Ji Park, Chang Sun Sim, Tae-Bum Kim, Taehoon Lee
Allergy, Asthma & Immunology Research.2021; 13(2): 256. CrossRef
Work-Related Asthma in Korea - Findings from the Korea Work-Related Asthma Surveillance (KOWAS) program, 2004-2009
Soon-Chan Kwon, Jaechul Song, Yong-kyu Kim, Geoffrey M. Calvert
Allergy, Asthma & Immunology Research.2015; 7(1): 51. CrossRef

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Case Report

A Case of Reactive Dye Induced Asthma in an Exposed Worker near a Dye Factory: Kyoo Sang Kim, Jung Won Park, Chein Soo Hong, Seong Kyu Kang; Korean Journal of Occupational and Environmental Medicine 2002;14(3):326-333. Published online September 30, 2002; DOI: https://doi.org/10.35371/kjoem.2002.14.3.326

Abstract PDF

OBJECTIVES
Reactive dye (RD) induced bronchial asthma is a well known form of occupational asthma. We report a case of occupational asthma due to RD in an exposed worker near a dye factory.
METHODS
To evaluate the work-relatedness of bronchial asthma, we examined all possibilities by considering the working environment and performing a personal clinical survey, such as interview on the previous history of allergic diseases, clinical and immunological investigation including skin prick tests, bronchoprovocation tests, and serial peak expiratory flow rates (PEFR).
RESULTS
Occupational asthma of internal origin was excluded by the characteristics of asthma, absence of occupational allergens, and negative PEFR result in the worker's own workplace. However, specific IgE and skin prick tests with reactive dye allergens were all strongly positive. RD challenge test showed maximal 34 % fall of FEV1 at 10 minutes of exposure (PD2 0: 2.11 mg/ml).
CONCLUSIONS
We concluded that this case was an example of bronchial asthma by external occupational allergens. This case suggests that RD induced asthma may also occur in workers and inhabitants who have lived near a reactive dye manufacturing factory.

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Occupational Asthma in Korea
Sung Soo Oh, Kyoo Sang Kim
Journal of Korean Medical Science.2010; 25(Suppl): S20. CrossRef

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Original Article

Ocular, Respiratory and Skin Symptoms Among Solderers Employed in Printed Circuit Board Assembly Units: Jay Young Yu, Kuck Hyeun Woo, Jin Seok Kim, Jung Oh Ham, Tae Sung Choi, Bong Goo Ha, Sang Je Jung, Shin Goo Park, Il Ryong Kim; Korean Journal of Occupational and Environmental Medicine 2001;13(4):423-435. Published online December 31, 2001; DOI: https://doi.org/10.35371/kjoem.2001.13.4.423

Abstract PDF

OBJECTIVES
This study was conducted to evaluate the prevalence of ocular, respiratory and skin symptoms among solderers and to investigate the relationship between symptom prevalence and exposure intensity.
METHODS
We analyzed 126 eligible participants out of a population of 146 male solderers who completed the symptom questionnaires. Fourteen symptoms including 'itchy and red eyes', 'itchy or prickly nose', 'sneezing', 'rhinorrhea', 'blocked nose', 'pricklythroat', 'foreign body sensation in throat', 'sudden bouts of coughing', 'exertional breathlessness ', 'wheezing', 'sputum production', 'itchy face or hands', 'acneiform eruptions on the face'and 'red spots on the face or hands'were contained. Blood lead levels of all the 126 participants were tested and the participants'own assessments of the health risk of soldering were collected.
RESULTS
Of the 14 investigated symptoms, 'sudden bouts of coughing'was significantly more prevalent in solderers who worked 4 hours or more a day than those who worked less than 4 hours a day, as for the other symptoms, there were no significant differences in the preva1ences related to daily soldering hours. 2.8% of the solderers considered the risk of flux exposure to be serious. The mean blood lead level was 6.05 microgram/dL (maximum 15.50 microgram /dL).
CONCLUSIONS
Soldering may increase the risk of respiratory symptoms. Further investigations on the hazards of soldering processes are warranted and solderers should be educated on these hazards.

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Skin Disease Among Staff in a Large Korean Nursing Home.
DEREK RICHARD SMITH, JAE-WOOK CHOI, DONG-SOO YU, MYUNG KI, CHUN-HWA OH, ZENTARO YAMAGATA
The Tohoku Journal of Experimental Medicine.2002; 198(3): 175. CrossRef

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Case Report

A case-crossover study between air pollution and hospital emergency room visits by asthma attack: Hyoung June Im, Sang Yun Lee, Ki Jung Yun, Young Su Ju, Dae Hee Kang, Soo Hon Cho; Korean Journal of Occupational and Environmental Medicine 2000;12(2):249-257. Published online June 30, 2000; DOI: https://doi.org/10.35371/kjoem.2000.12.2.249

Abstract PDF

OBJECTIVES
This study, using case-crossover design, search a relationship between changing levels of air pollutants and asthma attack in asthma patients.
METHODS
We searched the daily total number of asthmatic patients at hospital' s emergency room in Seoul, Korea by investigating total 49 general hospitals emergency room records. Otherwise, We investigated medical records of asthmatic patients at one of the 49 hospitals we have searched. We investigated addresses that they are living, diagnosis, smoking history, whether respiratory infection or not, medications. We analyzed the data by 1:m conditional logistic regression used when matched case-control study is analyzed. Control periods were chosen by bidirectional paired matching technique 7, 14 days before and after case periods.
RESULTS
the relative risk of asthmatic attack by 100 ppm ozone increase between June and September were 1.348(95 % CI = 1.010~1.619). Between November and February, the relative risk by 100 /m TSP increase, 100ppb sulfur dioxide and nitrogen dioxide were respectively 1.278(1.010~1.619), 1.237(1.019~1.502), 1.285(1.006~1.640). In stratified analysis, the relative risk were significant when the asthmatic patients were children aged 15 years or below, when there were respiratory infection, and when the patients took medications irregularly CONCLUSIONS: There was statistically significant association between ambient levels of air pollutants and asthmatic attack. So, we have to exert our efforts to minimize the air pollution effectively, to protect public health from air pollution.

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Review of Epidemiological Research and Perspectives for Future Environmental Health Progress in Korea
Kyoung-Mu Lee, Moon-Young Park
Journal of Environmental Health Sciences.2022; 48(3): 138. CrossRef
Hybrid Deep Learning Algorithm with Open Innovation Perspective: A Prediction Model of Asthmatic Occurrence
Min-Seung Kim, Jeong-Hee Lee, Yong-Ju Jang, Chan-Ho Lee, Ji-Hye Choi, Tae-Eung Sung
Sustainability.2020; 12(15): 6143. CrossRef
Effect of outdoor air pollution on asthma exacerbations in children and adults: Systematic review and multilevel meta-analysis
Pablo Orellano, Nancy Quaranta, Julieta Reynoso, Brenda Balbi, Julia Vasquez, Qinghua Sun
PLOS ONE.2017; 12(3): e0174050. CrossRef

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Original Article

The effect of Residential Environments on the Bronchial Hyperresponsiveness: Sang Sup Kim, Hyung Joon Chun, Domyung Paek, Rokho Kim, Ho Kim; Korean Journal of Occupational and Environmental Medicine 2000;12(2):157-169. Published online June 30, 2000; DOI: https://doi.org/10.35371/kjoem.2000.12.2.157

Abstract PDF: OBJECTIVES
The increased prevalence of asthma over the last 30 years has been reported from many different countries, including Korea. The increased prevalence may be due to increased exposure to indoor air pollutants.
METHODS
In this study, the relationship between residential environments and airway hyper-responsiveness has been examined among 280 family members. The bronchial hyper-responsiveness was expressed as the log-transformed slope of FEV decrease over the log-transformed dose of methacholine concentration(BRindex). Simple regression analysis was done for the effect of sex, age, atopic status, and residential environments including active and passive smoking exposures on airway responsiveness. Based on simple regression results, multiple rwegression analysis was performed for total group and also according to sex.
RESULTS
The mean of BRindex of residents living in gas boiler heating houses was higher than that of central heating system (p=0.014). Smoking status was a significant determinant of bronchial hyper-responsiveness in both genders; male(p=0.017), female (p%.022). In the male group the mean of BRindex of current smokers was significantly higher than those of ex-smokers and non-smokers, and the mean of BRindex of passive smokers was higher than that of non-smokers, but statistical significance was border-line(p=0.069). In female group, the mean of BRindex of kerosene stove users was higher than that of non-users(p=0.057).
CONCLUSIONS
This study suggests that indoor air pollutants including type of heating, passive smoking and kerosene stove use can contribute to the increase in asthma prevalence in Korea.

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Original Article

The Work-Related Cases among Bronchial Asthma Diagnosed at a University Hospital in Incheon: Chang Ho Chae, Seung Won Choi, Youg Hyu Choi, Young Woo Jin, Eun A Kim, Seong Kyu Kang; Korean Journal of Occupational and Environmental Medicine 1999;11(2):174-180. Published online June 30, 1999; DOI: https://doi.org/10.35371/kjoem.1999.11.2.174

Abstract PDF

Bronchial Asthma could be developed by occupational origin. 4-16% of bronchial asthmas are known to be related to occupational exposure. However, occupational asthma has not been reported from the periodic occupational health examination, but reported through case report from clinicians. The authors analysed hospital records to find out work-related bronchial asthma and their occupational characteristics at a university hospital in Jnchon. All records which were confirmed as bronchial asthma in adult by an allergist from June, 1996 to May, 1998 were selected. Through record reviewing, any suspected work related asthma was selected and the interview was done by phone or at the out-patient clinic. The possible cases were confirmed by additional tests including specific bronchial provocation test. Sixteen(3. 9%) out of 411 bronchial asthma were confirmed as work-related asthma. Eight cases out of 16 worked at furniture industry, three worked at dye manufacturing and two worked at musical instrument manufacturing industry. Others worked at farm and machinary industry. The confirmed asthmogen were toluene diisocyante(8), reactive dye(3), and grain dust(1). None of the cases was detected as work-related asthma in the periodic health examination. Twelve out of sixteen occupational asthma patients discontinued their work. The results suggested that many patients with occupational asthma were not reported and the periodic health examination was not an effective system for detecting the workrelated asthma. Thus, setting up the surveillance system involving allergist or pulmonologist would be important to detect and prevent occupational asthma.

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Clinical Importance of Work-Exacerbated Asthma: Findings From a Prospective Asthma Cohort in a Highly Industrialized City in Korea
Woori Jo, Kwang Won Seo, Hwa Sik Jung, Chui Yong Park, Byung Ju Kang, Hyeon Hui Kang, Seung Won Ra, Yangjin Jegal, Jong Joon Ahn, Soon Eun Park, Moon Sik Jung, Ju Ik Park, Eun Ji Park, Chang Sun Sim, Tae-Bum Kim, Taehoon Lee
Allergy, Asthma & Immunology Research.2021; 13(2): 256. CrossRef
Work-Related Asthma in Korea - Findings from the Korea Work-Related Asthma Surveillance (KOWAS) program, 2004-2009
Soon-Chan Kwon, Jaechul Song, Yong-kyu Kim, Geoffrey M. Calvert
Allergy, Asthma & Immunology Research.2015; 7(1): 51. CrossRef
Occupational Asthma in Korea
Sung Soo Oh, Kyoo Sang Kim
Journal of Korean Medical Science.2010; 25(Suppl): S20. CrossRef
Occupational Diseases in Korea
Seong-Kyu Kang, Eun A Kim
Journal of Korean Medical Science.2010; 25(Suppl): S4. CrossRef

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Original Article

Prevalence of Allergic Diseases of Workers Exposed to Phthalic Anhydride: Hyun Sul Lim, Soo Keun Kim, Ki Sik Kim; Korean Journal of Occupational and Environmental Medicine 1998;10(4):493-504. Published online December 31, 1998; DOI: https://doi.org/10.35371/kjoem.1998.10.4.493

Abstract PDF: Phthalic anhydride (PA) is widely used in the production of alkyd and unsaturated polyester resins. It has been reported that some workers exposed to PA have developed dermatitis, rhinitis and asthma. The authors intended to investigate the prevalence of PA induced allergic diseases and to develop preventive measures of occupational diseases. Forty-five male workers from PA production and handling were selected as an exposure group. Forty-four male workers not handling PA at the same factory were chosen as a reference group. A symptom questionnaire, doctor's examination, eosinophil count, serum-total IgE and PA-specific IgE were done on the subjects. There were no significant differences in age, educational level, tenure or smoking habits between groups. Most clinical symptoms were significantly more frequent among the exposure group than the reference group: sneezing(62.2 %), rhinorrhea(57.8 %), nasal stuffiness(53.3 %), coughing(44.4 %) and nasal itching(35.6 %) were the major symptoms among the exposure group (p<0.01, p<0.05). There were no significant differences in eosinophil count and serum-total IgE between groups but the mean level in PA-specific IgE, in the exposure group, was statistically significantly higher than the reference group (p<0.01). Abnormal rates of eosinophil count, serum-total IgE and PA-specific IgE were not significantly different from each other. The prevalence rate was 68.9 % (31 cases) for allergic rhinitis in the exposure group, statistically significantly higher than the reference group (p<0.01). The prevalence rate was 6.7 %(3 cases) for bronchial asthma and contact dermatitis in the exposure group, not more statistically significant than the reference group. In the exposure group, the prevalence rate for age, educational level, tenure, smoking habits and use of protective devices are not statistically significant. In PA-specific IgE, sensitivity is 10.8 %, specificity is 100.0 %, positive predictability is 100.0 % and negative predictability is 61.2 % when criteria point is 3.5 KU/l or above. As a result, it was recognized that the exposure group had a high prevalence of PA induced allergic rhinitis. Also, in diagnosis of PA induced allergic diseases, medical histories and specific symptoms were the most important where as eosinophil count, serum total IgE are the only indirect informations. PA-specific IgE has been needed to evaluate the meanings more.

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Original Article

A Study on Risk Factors of Grain Dust-Induced Occupational Asthma in Grain Feedmill Workers: Kyoo Sang Kim, Euna Kim, Se Wi Lee, Hae Sim Park; Korean Journal of Occupational and Environmental Medicine 1997;9(4):628-640. Published online December 31, 1997; DOI: https://doi.org/10.35371/kjoem.1997.9.4.628

Abstract PDF

This study was carried out to manifest risk factors related grain dust induced asthma, especially allergic and immunologic factors. Six grain workers first diagnosed as grain dust induced asthma by specific antigen bronchial asthma challenge test (cases) and 37 grain workers showed negative finding (controls) in the same firm were selected. Questionnaire survey for respiratory symptoms, interview, physical examination, PFT, methacholine bronchial hyperresponsiveness, specific challenge tests and skin prick test for four grains (grain, corn, rye and seed dust) were conducted. To evaluate the role of specific antibodies to grain dust, we detected serum specific IgE and IgG antibodies by ELISA in 43 employees. The results were summarized as follows : 1. Compared with the group having no respiratory symptoms, odds ratio of grain dust induced asthma with respiratory symptoms was 3.04 (95% CI 0.32-28.80). 2. Compared with the group having no ventilatory impairment, odds ratio of grain dust induced asthma with ventilatory impairment was 0.54 (95% CI 0.06-5.21). 3. Compared with the group showed negative skin test for general respirable antigen, odds ratio of grain dust induced asthma with atopy was 8.02 (95% CI 0.42-153.25). 4. Compared with the group showed negative finding on specific allergic skin test, odds ratio of grain dust induced asthma with positive finding was 5.88 (95% CI 0.63-55.38). 5. In immunologic test, compared with the group not increased total IgE(<160 IU/ml), odds ratio of grain dust induced asthma with increased group (> or = 160 IU/ml) was 4.78 (95% CI 0.50-44.57). 6. Compared with the group showed negative finding on specific IgE antibody, odds ratio of grain dust induced asthma with positive finding was 2.63 (95% CI 0.43-16.16). 7. Compared with the group showed normal finding on nonspecific (methacholine) bronchial hyperresponsiveness, odds ratio of grain dust induced asthma with positive finding was 76.82(95% CI 3.37 - 1566.34). Statistically significant odds ratio were fecund for specific skin test with grain, total IgE and nonspecific (methacholine) bronchial hyperreponsiveness.

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Ventilation Operating Standard for Improving Internal Environment in Pig House Grafting Working Conditions Using CFD
Byung-Wook Oh, Hyo-Jae Seo, Il-Hwan Seo
AgriEngineering.2023; 5(3): 1378. CrossRef
The Status and Influencing Factors of Respiratory System Diseases in Korean Farmers with Disease
Hyeongyeong Lee, Kyungsu Kim, Dongphil Choi, Lockwhan Jo, Hyocher Kim, Wounjong Choi
The Korean Journal of Community Living Science.2020; 31(4): 779. CrossRef
Work-related Injuries and Diseases of Farmers in Korea
Kwan LEE, Hyun-Sul LIM
INDUSTRIAL HEALTH.2008; 46(5): 424. CrossRef

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Case Report

A Case of Occupational Asthma Associated with Chromium: Hyun Sul Lim, Ji Yong Kim, Young Hyun Lee; Korean Journal of Occupational and Environmental Medicine 1997;9(2):283-291. Published online June 30, 1997; DOI: https://doi.org/10.35371/kjoem.1997.9.2.283

Abstract PDF

Occupational asthma is an important occupation-related disease. We experienced a case of asthma induced by chromium. After discovery, chromium has been widely used in industry. Health effects of chromium and its compounds are contact dermatitis (allergic and irritant), mucosal irritation, basal septal perforation, asthma, and lung cancer. Their toxicity depends on valency, solubility, concentration, pH, exposure duration and route. The patient was a 47-year-old male and an ex-smoker. He complained of cough, sputum and dyspnea while working. Total eosinophil count was elevated but serum IgE value was normal. Bronchoprovocation test with 0.5 % (w/v) chromium solution revealed early and late asthmatic responses. Although his initial methacholine bronchial challenge test shoved a negative result, bronchial hyperresponsiveness developed after bronchoprovocation test with chromium solution. After discharge, he has complained of an intermittent dyspnea. It was suggested that chromium could induce occupational asthma in exposed workers. Further investigations are needed to clarify their pathogenetic mechanisms.

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Citations to this article as recorded by

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

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