Annals of Occupational and Environmental Medicine

Case Report

A case of syncope in a villager with hypertrophic cardiomyopathy after hydrogen sulfide exposure by an unauthorized discharge of wastewater: Hyeonjun Kim, Seunghyeon Cho, Inho Jung, Sunjin Jung, Won-Ju Park; Ann Occup Environ Med 2023;35:e34. Published online August 21, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e34

Abstract Abstract in Korean PDF PubReader ePub: Background
Hydrogen sulfide is a toxic substance that humans can be exposed to occupationally, and cases of hydrogen sulfide poisoning of workers in industrial sites are commonly reported. However, there have been no cases of poisoning of the public due to an unauthorized discharge of wastewater, so it is important to describe this incident.
Case presentation
In a small village in Jeollanam-do, Republic of Korea, accounts of a terrible stench had been reported. A 26-year-old man who lived and worked in a foul-smelling area was taken to the emergency room with a headache, dizziness, nausea, and repeated syncope. A subsequent police and Ministry of Environment investigation determined that the cause of the stench was the unauthorized discharge of 9 tons of wastewater containing hydrogen sulfide through a stormwater pipe while the villagers were sleeping. The patient had no previous medical history or experience of symptoms. Leukocytes and cardiac markers were elevated, an electrocardiogram indicated biatrial enlargement, left ventricular hypertrophy, and corrected QT interval prolongation. Myocardial hypertrophy was detected on a chest computed tomography scan, and hypertrophic cardiomyopathy was confirmed on echocardiography. After hospitalization, cardiac marker concentrations declined, symptoms improved, and the patient was discharged after 7 days of hospitalization. There was no recurrence of symptoms after discharge.
Conclusions
We suspect that previously unrecognized heart disease manifested or was aggravated in this patient due to exposure to hydrogen sulfide. Attention should be paid to the possibility of unauthorized discharge of hydrogen sulfide, etc., in occasional local incidents and damage to public health. In the event of such an accident, it is necessary to have government guidelines in place to investigate health impact and follow-up clinical management of exposed residents.; 무단 방류된 황화수소 노출에 의해 비후성심근증이 악화되어 실신한 마을 주민 사례
배경
황화수소 중독은 산업현장, 하수처리시설 또는 관리되지 않는 화장실 등에서 흔하게 보고된다. 다만 폐수 무단 방류로 인해 일반 주민에게 건강 영향이 발생한 사례는 보고된 바 없어 이를 보고한다.
증례
전라남도 한 지역에서 새벽부터 심한 악취가 난다는 주민 신고가 다수 발생하였다. 경찰과 환경청의 조사 결과 악취의 원인은 새벽에 주민들이 잠든 사이 폐수처리업체에서 황화수소가 포함된 폐수 9톤을 우수관을 통해 무단으로 방류한 것으로 밝혀졌다. 심한 악취가 나는 지역에서 장시간 활동했던 26살 남성이 두통, 어지럼증, 메스꺼움과 짧은 실신을 반복하여 119를 통해 응급실로 내원하였다. 환자는 과거에 특별한 병력이나 증상 경험은 없었다. 검사상 환자의 백혈구와 심장 표지자 수치가 상승되어 있었다. 심전도에서 양측 심방 확장, 좌심실 비대 및 QTc 연장이 관찰되었다. 흉부 컴퓨터 단층 촬영 상 심근비대 소견과 심장 초음파 검사 상 비후성심근증이 확인되었다. 입원하여 대증치료 후 심장 표지자 수치는 감소하였고, 증상은 호전되어 입원 7일 만에 퇴원하였다. 퇴원 이후 추적관찰 동안 특별한 증상은 재발하지 않았다.
결과
본 사례는 환자가 이전에 인지하지 못하고 증상도 없었던 비후성심근증이 황화수소 노출로 인해 급성 악화된 것으로 판단된다. 종종 발생하는 지역의 악취 사건에 황화수소가 무단 방류되었을 가능성을 고려해야 할 것이며, 향후 이러한 화학사고 발생 시 화학물질관리법에 따른 주민 건강영향조사를 실시하여 주민 건강을 관리해야 할 것이다.

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Original Article

Environment-wide association study of elevated liver enzymes: results from the Korean National Environmental Health Survey 2018–2022: Youngchan Chi, Jong-Tae Park, Sewhan Na, Kyeongmin Kwak; Ann Occup Environ Med 2023;35:e27. Published online July 31, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e27

Abstract PDF Supplementary Material PubReader ePub: Background
Environmental exposure is characterized by low concentration, chronic, and complex exposure. Traditional epidemiological studies show limitations in reflecting these characteristics since they usually focus on a single or very limited number of exposure factors at a time. In this study, we adopted the methodology of environment-wide association study (EWAS) to figure out the association of human liver function with various environmentally hazardous substances.
Methods
We analyzed 2,961 participants from the Korean National Environmental Health Survey Cycle 4 (2018–2020). Using generalized linear model (GLM) analysis, we analyzed the association of 72 variables with 3 liver function indices (aspartate aminotransferase [AST], alanine aminotransferase [ALT], and gamma glutamyl transferase [GGT]). Finally, we visualized our results with Manhattan plot.
Results
In GLM analysis, perfluorooctanesulfonate were positively associated with ALT (odds ratio [OR]: 2.2; 95% confidence interval [CI]: 1.39–3.46; p _adjusted = 0.0147) and perfluorodecanoic acid showed positive association with GGT (OR: 2.73; 95% CI: 1.36–5.5; p _adjusted = 0.0256). Plasma mercury showed positive association with GGT (OR: 1.45; 95% CI: 1.14–1.84; p _adjusted = 0.0315). Using a plastic container while keeping food in the refrigerator was associated with elevated GGT compared to using a glass container (OR: 1.51; 95% CI: 1.16–1.95; p _adjusted = 0.0153). 2-ethyl-5-oxohexyl phthalate, showed a negative trend with all 3 indices, with AST (OR: 0.54; 95% CI: 0.39–0.73; p _adjusted = 0.00357), ALT (OR: 0.5; 95% CI: 0.34–0.75; p _adjusted = 0.036), GGT (OR: 0.55; 95% CI: 0.4–0.76; p _adjusted = 0.00697). Bisphenol S and frequent use of sunblock cream showed negative association with ALT (OR: 0.77; 95% CI: 0.66–0.89), and GGT (OR: 0.25; 95% CI: 0.11–0.55), respectively.
Conclusions
We conducted an exploratory study on environmental exposure and human liver function. By using EWAS methodology, we identified 7 factors that could have potential association with liver function.

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Original Article

Association between metabolic syndrome and shift work in chemical plant workers: Seong-Ryol Chai, Soon-Chan Kwon, Yong-Jin Lee, Eun-Chul Jang, Young-Sun Min, Su-yeon Lee; Ann Occup Environ Med 2021;33:e31. Published online October 22, 2021; DOI: https://doi.org/10.35371/aoem.2021.33.e31

Abstract Abstract in Korean PDF PubReader ePub

Background

The study aimed to determine the association between shift work and metabolic syndrome and the prevalence of metabolic syndrome in the shift and day work groups among workers working in chemical plants.

Methods

Based on medical examination data collected in February 2019, 3,794 workers working at a chemical plant in Korea were selected. Multiple logistic regression analysis was performed by adjusting for age, sex, body mass index (BMI), drinking, exercise, smoking, employment period and organic compounds exposure.

Results

The prevalence of metabolic syndrome in the entire study group was 23.4%, and the prevalence and components of metabolic syndrome in shift worker; waist circumference were higher than those of day workers (84.77 ± 8.64 vs. 83.41 ± 9.42, p < 0.001), systolic blood pressure (129.89 ± 9.47 vs. 127.57 ± 9.47, p < 0.001), diastolic blood pressure (81.22 ± 7.59 vs. 79.34 ± 7.46, p < 0.001), fasting blood glucose (99.27 ± 17.13 vs. 97.87 ± 13.07, p = 0.007), triglycerides (149.70 ± 101.15 vs. 133.55 ± 105.17, p < 0.001), and decreased high-density lipoprotein (53.18 ± 12.82 vs. 55.61 ± 14.17, p < 0.001). As a result of logistic regression analysis on the risk of metabolic syndrome, even after adjusting for age, sex BMI, drinking, smoking, exercise, employment period, organic compound exposure. the odds ratio (OR) for the shift group was 1.300 for daytime workers (Model 1, OR: 1.491; 95% confidence interval [CI]: 1.273–1.747; Model 2, OR: 1.260; 95% CI: 1.070–1.483; Model 3, OR: 1.309, 95% CI: 1.081–1.585; Model 4, OR: 1.300; 95% CI: 1.063–1.591).

Conclusions

Shift work in chemical plant workers increased the risk of metabolic syndrome, even after adjusting for general factors. To analyze the occupational cause and risk control, it is necessary to analyze the hazardous substances the workers were exposed to and their working environment. Additionally, a large-scale prospective analysis including general factors not analyzed in this study, such as eating habits, is required.

일개 화학공장 근로자에서의 교대근무와 대사증후군의 관계에 관한 연구
목적
이 연구는 화학공장에 근무하는 근로자를 대상으로 교대 근무 그룹과 주간 근무 그룹에서 대사 증후군의 유병율과 교대 근무와 대사 증후군 사이의 연관성을 확인하는 것을 목표로 했다.
방법
2019년 2월 실시한 건강검진 자료를 바탕으로 대한민국의 한 화학공장에 근무하는 근로자 3,794 명을 대상으로 선정하였다. 신장, 체중, 허리둘레, 혈압을 신체계측으로 측정하고 혈당, 콜레스테롤의 혈액학적 검사와 나이, 성별, 흡연, 음주, 운동, 근무기간, 유기화합물 노출 여부의 데이터를 수집하여 대사증후군을 진단하였다. 연구대상자의 일반적 특성, 건강 생활 행태 관련 특성에 따른 대사증후군 위험도를 검정하기 위해서 각각의 인자에 대해 단순 로지스틱 회귀 분석을 시행하였다. 이어서, 둘사이의 관계를 알기 위해 나이, 성별, BMI, 운동, 흡연, 음주, 유기화합물 노출여부, 근무기간을 조정하여 다중 로지스틱 회귀 분석을 실시하였다.
결과
전체 연구 대상 그룹에서 대사증후군의 유병률은 23.4% 로 나타났으며, 교대근무자는 대사증후군 유병률과 구성요소 – 허리둘레 (84.77±8.64 vs 83.41±9.42, p<0.001), 수축기 혈압 (129.89±9.47 vs 127.57±9.47, p<0.001), 이완기 혈압 (81.22±7.59 vs 79.34±7.46, p<0.001), 공복혈당 (99.27±17.13 vs 97.87±13.07, p=0.007), 중성지방 (149.70±101.15 vs 133.55±105.17, p<0.001), 고밀도 지단백 저하 (53.18±12.82 vs 55.61±14.17, p<0.001) 가 주간근로자에 비해 높았다. 대사증후군 위험도에 대한 로지스틱 회귀분석을 실시한 결과 나이, 성별, BMI, 흡연, 운동, 음주, 근무기간, 유기화합물 노출이 보정된 후에도 교대근무군의 교차비는 주간근로자에 대하여 1.300 으로 나타났다. (Model 1, OR: 1.491, 95% confidence interval [CI]: 1.273-1.747; Model 2, OR : 1.260, 95% CI : 1.070-1.483 ; Model 3, OR: 1.309, 95% CI: 1.081-1.585 ; Model 4, OR : 1.300, 95% CI: 1.063-1.591).
결론
화학 공장 근로자에서 교대근무는 일반적요인을 보정한 후에도 대사증후군의 위험도를 증가시켰다. 이에 대한 직업적 원인분석과 위험통제를 위해 노출되는 유해물질과 작업환경에 대한 추가 분석이 필요하며, 식습관과 같은 이번연구에서 분석하지못한 일반적 원인을 포함한 대규모 전향적 추가 분석이 필요하다.

Citations

Citations to this article as recorded by

Association between Shift Work and Metabolic Syndrome: A 4-Year Retrospective Cohort Study
Byeong-Jin Ye
Healthcare.2023; 11(6): 802. CrossRef

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Case Report

Ethylene oxide burn in a chemical plant worker: a case report: Youngwook Kim, Sangchul Roh; Ann Occup Environ Med 2021;33:e23. Published online July 1, 2021; DOI: https://doi.org/10.35371/aoem.2021.33.e23

Abstract Abstract in Korean PDF PubReader ePub: Background
Ethylene oxide is a chemical agent that is widely used for the sterilization of medical equipment and the manufacture of chemicals. Although ethylene oxide burns are frequent and can be severe, many workers are unaware of their risks.
Case presentation
A 45-year-old man presented with painful exudative lesions on the right foot after working with ethylene oxide solution in a chemical plant. The patient stated that the solution had percolated through his shoe and he had not washed the solution off for 5 hours. Symptoms, including pain and erythema, appeared after a delay of more than 12 hours from the time of initial exposure. The skin of his right foot was irrigated with saline and covered with a wet dressing and topical antibiotics in the emergency department. The patient was followed up for 4 weeks at an outpatient clinic.
Conclusions
Ethylene oxide causes skin irritation, dermatitis, and burns in severe cases. Since skin reactions can be delayed for more than 12 hours after exposure, it is important to remove contaminated shoes and clothing immediately and wash the exposed area even in the absence of symptoms. It is also necessary to provide the appropriate protective equipment and educate workers on the dangers of ethylene oxide.; 화학플랜트에서 발생한 산화에틸렌에 의한 화학화상 1예
서론: 산화에틸렌은 의료기기 살균 및 화학제품 제조에 널리 사용되는 물질이다. 산화에틸렌에 의한 화상은 빈번히 발생하며 심각한 합병증을 가져올 수 있지만 많은 근로자들은 그 위험을 인지하지 못하고 있다.
증례
45세 남성이 화학 공장에서 산화 에틸렌 용액으로 작업 한 후 오른발에 통증을 동반한 삼출성 병변을 보였다. 산화에틸렌용액이 근로자의 신발에 스며 들었고 5 시간 동안 용액을 씻어 내지 않았다. 통증 및 홍반을 포함한 증상은 초기 노출 시점으로부터 12 시간 이상 지연된 후 나타났다. 응급실 내원하여 병변 부위 식염수 세척 및 드레싱, 국소 항생제로 치료를 받았다. 그 후 4 주 동안 외래진료 및 추적 관찰 받았다.
고찰
산화 에틸렌은 피부 자극, 피부염을 유발하며 심한 경우 화상을 일으킨다. 피부 반응은 노출 후 12 시간 이상 지연 될 수 있으므로 노출 즉시 오염된 신발과 의복을 벗고, 증상이 없는 경우에도 노출 부위를 씻어내는 것이 중요하다. 또한 적절한 보호 장비를 제공하고 작업자에게 산화에틸렌의 위험에 대해 교육 해야 한다.

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Research Article

Association of phthalates and early menarche in Korean adolescent girls from Korean National Environmental Health Survey (KoNEHS) 2015–2017: One Park, Jong-Tae Park, Youngchan Chi, Kyeongmin Kwak; Ann Occup Environ Med 2021;33:e4. Published online February 1, 2021; DOI: https://doi.org/10.35371/aoem.2021.33.e4

Abstract PDF PubReader ePub

Background

Phthalates are one of renowned endocrine-disrupting chemicals, although inconsistent results are present around their effect on onset of menarche. Our hypothesis is that pre-pubertal exposure to phthalates is associated with acceleration of menarche.

Methods

We analyzed a total of 236 middle school (7th to 9th grade) girls from Korean National Environmental Health Survey 2015–2017. We used multiple linear regression to investigate impact of eight phthalate metabolites on age of menarche. We also conducted logistic regression to evaluate association between phthalate metabolite concentrations and early onset of menarche, adjusting for grade, maternal age of menarche and body mass index (BMI).

Results

In linear regression analysis, no significant association was found for any phthalate metabolites. In logistic regression analysis, however, odds ratios (ORs) of early menarche were significantly increased for mono-n-butyl phthalate (MnBP) and for sum of all phthalates. When compared to group with the lowest level, high concentration group for MnBP presented significantly increased odds of early menarche (OR: 2.09; 95% confidence interval [CI]: 1.03, 4.23) after adjusting for grade, maternal age of menarche and BMI. Furthermore, high concentrations of sum of all phthalates were associated with significant increase of OR of early menarche (OR: 2.22; 95% CI: 1.10, 4.49) after adjustment, compared to the lowest concentration group.

Conclusions

Results of our study suggest that exposure to phthalates around puberty may be associated with increased risk of early menarche.

Citations

Citations to this article as recorded by

Trends in age at menarche from 1943 through 1989 in Taiwan: A retrospective population-based analysis
Yi-Chun Lin, Hung-Rong Yen, Chung-Hsing Wang, Yu-Chi Liao, Ro-Ting Lin
Pediatrics & Neonatology.2024; 65(1): 64. CrossRef
Endocrine Disruptors and Metabolic Changes: Impact on Puberty Control
Marcela Peralta, Fernando Lizcano
Endocrine Practice.2024; 30(4): 384. CrossRef
Neighbourhood environment and early menarche among adolescent girls of five countries
Erdenetuya Bolormaa, Taemi Kim, Eunson Gwak, Seung-Ah Choe, Adriane Martin Hilber
The European Journal of Contraception & Reproductive Health Care.2024; : 1. CrossRef
PFAS and Phthalate/DINCH Exposure in Association with Age at Menarche in Teenagers of the HBM4EU Aligned Studies
Bianca Cox, Natasha Wauters, Andrea Rodríguez-Carrillo, Lützen Portengen, Antje Gerofke, Marike Kolossa-Gehring, Sanna Lignell, Anna Karin Lindroos, Lucia Fabelova, Lubica Palkovicova Murinova, Anteneh Desalegn, Nina Iszatt, Tessa Schillemans, Agneta Åkes
Toxics.2023; 11(8): 711. CrossRef
Ongoing increasing trends in central precocious puberty incidence among Korean boys and girls from 2008 to 2020
Sinyoung Kang, Mi Jung Park, Jung Min Kim, Jin-Sung Yuk, Shin-Hye Kim, Jun Mori
PLOS ONE.2023; 18(3): e0283510. CrossRef
Impact of Chemicals on the Age of Menarche: A Literature Review
Xristos Anastasiadis, Alkis Matsas, Theodoros Panoskaltsis, Panagiotis Bakas, Dimitrios T. Papadimitriou, Panagiotis Christopoulos
Children.2023; 10(7): 1234. CrossRef
Persistent high exposure to exogenous phthalates and endogenous sex hormones associated with early pubertal onset among children: A 3.5-year longitudinal cohort study in China
Jieyu Liu, Di Gao, Yanhui Li, Xinli Song, Manman Chen, Qi Ma, Xinxin Wang, Mengjie Cui, Tongjun Guo, Li Chen, Yi Zhang, Wen Yuan, Tao Ma, Jianuo Jiang, Yanhui Dong, Zhiyong Zou, Jun Ma
Ecotoxicology and Environmental Safety.2023; 262: 115199. CrossRef
Effects of Endocrine-Disrupting Chemicals on Human Health
Jun Hyung Lee, Sung-Eun Cho
Laboratory Medicine Online.2023; 13(3): 129. CrossRef
Environment-wide association study of elevated liver enzymes: results from the Korean National Environmental Health Survey 2018–2022
Youngchan Chi, Jong-Tae Park, Sewhan Na, Kyeongmin Kwak
Annals of Occupational and Environmental Medicine.2023;[Epub] CrossRef
The Possible Association between Phthalates and Bisphenol A Exposure and Idiopathic Precocious Puberty in Egyptian Girls
Rania Mohsen, Eman El-Zohairy, Mona Mamdouh Hassan, Mokhtar Fathy, Mai Magdy, Shimaa Atef, Marwa Issak, Sarah Hamed N. Taha
Open Access Macedonian Journal of Medical Sciences.2022; 10(B): 1411. CrossRef
Besinlerle alınan endokrin bozucuların pubertal gelişim üzerine etkisi
Gül Eda KILINÇ, Alev KESER
Mersin Üniversitesi Sağlık Bilimleri Dergisi.2021; 14(2): 342. CrossRef

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Case Report

Severe chemical burns related to dermal exposure to herbicide containing glyphosate and glufosinate with surfactant in Korea: Jihyun Shin, Namkyu Lim, Sangchul Roh; Ann Occup Environ Med 2020;32:e28. Published online July 20, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e28

Abstract PDF PubReader ePub

Background

Glyphosate and glufosinate use widely used as herbicide ingredients. There have been several reported cases of chemical burns caused by dermal exposure to glyphosate-containing herbicide, and patients in these cases were discharged without fatal complications. There were no cases of severe symptoms due to non-oral exposure of glufosinate-containing herbicides. Here, we report a case of fatality accompanied with severe chemical burns in an 81-year-old man who did not wash his skin for more than 48 hours after dermal exposure to herbicide containing glyphosate and glufosinate with surfactant (HGlyGluS).

Case presentation

An 81-year-old male with no underlying disease was admitted to the emergency department (ED). He had sprayed HGlyGluS with a manual knapsack sprayer 3 days ago and had not wash away the herbicide. On arrival, he was drowsy and had multiple severe corrosive skin lesions. Skin necrosis (10 × 15 cm) on the right shoulder and skin lesions with subcutaneous fat exposure (15 × 20 cm) on the right thigh were observed. Although he was treated including continuous renal replacement therapy, antibiotic apply, debridement operations, and so on, he was unable to recover and expired.

Conclusions

We suggest that prolonged dermal exposure to HGlyGluS induces fatality. Further studies including prolonged dermal exposure and ingredients of surfactants should be carried out. Also, it is necessary to educate farmers that it is very important to wash immediately after dermal exposure to pesticide.

Citations

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Prospective applications of chitosan and chitosan-based nanoparticles formulations in sustainable agricultural practices
Bhoomika M. Karamchandani, Sunil G. Dalvi, Mahima Bagayatkar, Ibrahim M. Banat, Surekha K. Satpute
Biocatalysis and Agricultural Biotechnology.2024; 58: 103210. CrossRef

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Research Article

Association between use of humidifier disinfectant and allergic rhinitis in Korean children: a cross-sectional study based on the eighth Panel Study on Korean Children (PSKC): Tae Hwan Koh, Jong-Tae Park, Daeil Kwon, Kyeongmin Kwak; Ann Occup Environ Med 2020;32:e9. Published online February 17, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e9

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Background

Rhinitis was the most frequently diagnosed disorder among users of humidifier disinfectants (HDs). The aim of our study was to investigate on the relationship between allergic rhinitis (AR) and HD uses.

Methods

Our study used the data from the eighth Panel Study on Korean Children; a total of 1,540 participants were enrolled. The χ² test and multiple logistic regression analyses were conducted to debunk the association between AR and HD uses.

Results

In our analysis, odds ratios (ORs) of doctor-diagnosed AR increased significantly when simply the response of whether HDs were used in the past was considered. When the brands of HD were considered, ORs of doctor-diagnosed AR were found to be increased significantly for those who have used polyhexamethylene guanidine phosphate/oligo(2-[2-ethoxy]-ethoxyethyl)guanidinium-containing HDs (model 3: 1.41, 95% confidence interval [CI]: 1.02–1.95). However, once duration of usage was additionally considered, ORs of doctor-diagnosed AR increased significantly only for those who have used chloromethylisothiazolinone/methylisothiazolinone-containing HDs for more than or equal to 3 months (model 3: 2.08, 95% CI: 1.17–3.69). Further, past use of HD was associated with significantly increased ORs of AR diagnosed before 2013 (model 3: 1.35, 95% CI: 1.02–1.79).

Conclusions

Results of our study suggest that past uses of HDs may be associated with an increased risk of AR.

Citations

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Exposures to humidifier disinfectant and various health conditions in Korean based on personal exposure assessment data of claimants for compensation
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BMC Public Health.2023;[Epub] CrossRef
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Nihon Shoni Arerugi Gakkaishi. The Japanese Journal of Pediatric Allergy and Clinical Immunology.2023; 37(1): 18. CrossRef
Health Effects Associated With Humidifier Disinfectant Use: A Systematic Review for Exploration
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Journal of Korean Medical Science.2022;[Epub] CrossRef
Risk factors and protective factors in pediatric patients with allergic rhinitis
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Allergy, Asthma & Respiratory Disease.2022; 10(2): 73. CrossRef
Need for individual-based evaluation to determine the association between humidifier disinfectants and health injuries
Hyeong-Cheol Kim, Hyunil Kim, Eun-Chan Mun, Yesung Lee, Soyoung Park
Annals of Occupational and Environmental Medicine.2021;[Epub] CrossRef
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Trends in prevalence of allergic diseases in Korean children: how and why?
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Research Article

Relationship between triclosan exposure and thyroid hormones: the Second Korean National Environmental Health Survey (2012–2014): Na-Young Ha, Dae Hwan Kim, Ji Young Ryu; Ann Occup Environ Med 2019;31:e22. Published online September 5, 2019; DOI: https://doi.org/10.35371/aoem.2019.31.e22

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Background

5-chloro-2-(2,4-dichlorophenoxy)phenol (triclosan) is used as an antiseptic and is a potential endocrine-disrupting chemical that can affect thyroid hormone levels. This study evaluated the relationship between triclosan exposure and thyroid hormones.

Methods

Data from the second Korean National Environmental Health Survey (2012–2014) were analyzed. Triclosan exposure was evaluated using urinary triclosan concentrations and classified into 2 groups: ‘below detection (< limit of detection [LOD])’ vs. ‘detected (≥ LOD).’ Multiple linear regression analysis was conducted to determine the relationship between triclosan exposure and the serum thyroid hormone concentrations, adjusting for age, body mass index, urinary creatinine, and smoking status.

Results

When grouped by sex, triclosan exposure was positively associated with the serum thyroid-stimulating hormone (TSH) concentrations in females with marginal significance (β = 0.066, p = 0.058). However, no significant association was identified between triclosan exposure and serum total triiodothyronine and thyroxine in both males and females, and TSH in males.

Conclusions

This study is the first human study to evaluate the relationship between triclosan exposure and serum thyroid hormone concentrations in the Korean population. There was suggestive positive association between triclosan exposure and the serum TSH in females. Further studies need to evaluate the relationship between long-term exposure to low-dose triclosan and thyroid hormones.

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Review

Environmentally induced, occupational diseases with emphasis on chronic kidney disease of multifactorial origin affecting tropical countries: Shehani A. Wimalawansa, Sunil J. Wimalawansa; Ann Occup Environ Med 2016;28:33. Published online August 5, 2016; DOI: https://doi.org/10.1186/s40557-016-0119-y

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Background

Environmentally induced, occupational diseases are increasing worldwide, especially in rural agricultural communities. Poverty-associated malnutrition, environmental hazards and pollution, and lack of access to clean water, safe sanitation, and modern healthcare facilities are often associated with these chronic illnesses.

Method

The authors systematically reviewed occupational public health issues that have been related to the environment. General interpretations of results were included as per the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Pertinent publications from research databases were reviewed on (A) the risk–benefits, (B) the prevalence of risk factors for various diseases, (C) the benefits of not ignoring the risk factors (i.e., broader evidence), and (D) the risks, effects, and outcomes of different types of interventions. The authors used chronic kidney disease of multifactorial origin (CKDmfo) as an example to explore the theme. Emphasis was given to the regions with emerging economies and developing countries located in the vicinity of the equator.

Findings

Geographical, socio-economic and aetiological similarities exist for many chronic non-communicable diseases that are affecting tropical countries around the equator. The authors identified manufacturing, mining, and agriculture as the biggest polluters of the environment. In addition, deforestation and associated soil erosion, overuse of agrochemicals, and irresponsible factory discharge (e.g., chemicals and paint, from rubber and textile factories, etc.), all contribute to pollution. To decrease the escalating incidences of environmentally induced diseases, governments should work proactively to protect the environment, especially watersheds, and take steps to minimise harmful occupational exposures and strictly enforce environmental regulations.

Conclusion

Creating public awareness of environmental issues and their relationship to public health is essential. This includes regular monitoring and periodic publication of the quality of water, air and soil; preventing deforestation and man-made soil erosion, increasing forest and ground cover, preventing occupational injuries, judicious and safe use of agrochemicals, sustainable agriculture and development programs, and implementing legislation to protect and conserve water heriage and the environment. These actions are essential both for a healthier environment and for the health of the people who live in that environment. Such measures would also decrease public health threats from such, including global-warming-related erratic environmental changes and the occurrence and the spread of non-communicable diseases, such as CKDmfo.

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Research Article

Acute respiratory symptoms and evacuation-related behavior after exposure to chlorine gas leakage: Sung-Woo Han, Won-Jun Choi, Min-Kee Yi, Seng-Ho Song, Dong-Hoon Lee, Sang-Hwan Han; Ann Occup Environ Med 2016;28:29. Published online July 4, 2016; DOI: https://doi.org/10.1186/s40557-016-0115-2

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Background

A study was performed on the accidental chlorine gas leakage that occurred in a factory of printed circuit boards manufactured without chlorine. Health examination was performed for all 52 workers suspected of exposure to chlorine gas, and their evacuation-related behaviors were observed in addition to analyzing the factors that affected the duration of their acute respiratory symptoms.

Methods

Behavioral characteristics during the incidence of the accidental chlorine gas leakage, the estimated time of exposure, and the duration of subjective acute respiratory symptoms were investigated. In addition, clinical examination, chest radiography, and dental erosion test were performed. As variables that affected the duration of respiratory symptoms, dose group, body weight, age, sex, smoking, work period, and wearing a protective gear were included and analyzed by using the Cox proportional hazard model.

Results

Of 47 workers exposed to chlorine gas, 36 (77 %) developed more than one subjective symptom. The duration of the subjective symptoms according to exposure level significantly differed, with a median of 1 day (range, 0–5 days) in the low-exposure group and 2 days (range, 0–25 days) in the high-exposure group. Among the variables that affected the duration of the acute respiratory symptoms, which were analyzed by using the Cox proportional hazard model, only exposure level was significant (hazard ratio 2.087, 95 % CI = 1.119, 3.890). Regarding the evacuation-related behaviors, 22 workers (47 %) voluntarily evacuated to a safety zone immediately after recognizing the accidental exposure, but 25 workers (43 %) delayed evacuation until the start of mandatory evacuation (min 5, max 25 min).

Conclusions

The duration of the subjective acute respiratory symptoms significantly differed between the low- and high-exposure groups. Among the 27 workers in the high-exposure group, 17 misjudged the toxicity after being aware of the gas leakage, which is a relatively high number.

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Case Report

Acute health effects of accidental chlorine gas exposure: Joo-An Kim, Seong-Yong Yoon, Seong-Yong Cho, Jin-Hyun Yu, Hwa-Sung Kim, Gune-Il Lim, Jin-Seok Kim; Ann Occup Environ Med 2014;26:29-29. Published online October 1, 2014; DOI: https://doi.org/10.1186/s40557-014-0029-9

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Objectives

This study was conducted to report the course of an accidental release of chlorine gas that occurred in a factory in Gumi-si, South Korea, on March 5, 2013. We describe the analysis results of 2 patients hospitalized because of chlorine-induced acute health problems, as well as the clinical features of 209 non-hospitalized patients.

Methods

We analyzed the medical records of the 2 hospitalized patients admitted to the hospital, as well as the medical records and self-report questionnaires of 209 non-hospitalized patients completed during outpatient treatment.

Results

Immediately after the exposure, the 2 hospitalized patients developed acute asthma-like symptoms such as cough and dyspnea, and showed restrictive and combined pattern ventilatory defects on the pulmonary function test. The case 1 showed asthma-like symptoms over six months and diurnal variability in peak expiratory flow rate was 56.7%. In case 2, his FEV1 after treatment (93%) increased by 25% compared to initial FEV1 (68%). Both cases were diagnosed as chlorine-induced reactive airways dysfunction syndrome (RADS) on the basis of these clinical features. The most frequent chief complaints of the 209 non-hospitalized patients were headache (22.7%), followed by eye irritation (18.2%), nausea (11.2%), and sore throat (10.8%), with asymptomatic patients accounting for 36.5%. The multiple-response analysis of individual symptom revealed headache (42.4%) to be the most frequent symptom, followed by eye irritation (30.5%), sore throat (30.0%), cough (29.6%), nausea (27.6%), and dizziness (27.3%).

Conclusions

The 2 patients hospitalized after exposure to chlorine gas at the leakage site showed a clinical course corresponding to RADS. All of the 209 non-hospitalized patients only complained of symptoms of the upper airways and mucous membrane irritation.

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Journal of the Korea Academia-Industrial cooperation Society.2016; 17(4): 332. CrossRef

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Research Article

Association between Workplace Risk Factor Exposure and Sleep Disturbance: Analysis of the 2nd Korean Working Conditions Survey: Yong-Seok Heo, Sei-Jin Chang, Shin-Goo Park, Jong-Han Leem, Sung-Hwan Jeon, Bum-Joon Lee, Kyung-Yong Rhee, Hwan-Cheol Kim; Ann Occup Environ Med 2013;25:41-41. Published online December 27, 2013; DOI: https://doi.org/10.1186/2052-4374-25-41

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Objectives

Sleep is essential for human beings to live and work properly. This study was conducted to investigate the relationship between occupational exposures to workplace risk factors and sleep disturbance in Korean workers.

Methods

The data were drawn from the second Korean Working Conditions Survey (KWCS); a total of 7,112 paid workers were analyzed. The independent variables were occupational exposures such as physical, chemical, biological, and psychosocial risk factor in the workplace, and psychosocial risk factor was divided into five categories (job demand, job control, social support, job insecurity, lack of reward). We estimated the relationship between various occupational exposures and sleep disturbance using multivariate logistic regression analysis.

Results

The results showed that people who exposed to physical, chemical, biological, and psychosocial (high job demand, inadequate social support, lack of reward) risk factors were more likely to increase the risk of sleep disturbance. Furthermore, after adjusting for general and occupational characteristics, we found significant positive associations between exposures to physical (odds ratios [OR] 1.47, 95% confidence interval [CI] 1.05-2.07) and psychosocial (high job demand (OR 2.93, 95% CI 2.16-3.98), inadequate social support (OR 1.57, 95% CI 1.14-2.15), lack of reward (OR 1.45, 95% CI 1.08-1.96)) risk factors and sleep disturbance.

Conclusion

These results suggest that occupational exposures to physical and psychosocial workplace risk factors are significantly related to sleep disturbance.

Citations

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Research Article

Acute Symptoms in Firefighters who Participated in Collection Work after the Community Hydrogen Fluoride Spill Accident: Seong-Yong Cho, Kuck-Hyun Woo, Jin-Seok Kim, Seong-Yong Yoon, Joo-Yong Na, Jin-Hyun Yu, Yong-Bae Kim; Ann Occup Environ Med 2013;25:36-36. Published online November 28, 2013; DOI: https://doi.org/10.1186/2052-4374-25-36

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Objectives

This study aimed to analyze the relationship between clinical status and work characteristics of firefighters and other public officers who engaged on collection duties in the site of the hydrogen fluoride spill that occurred on September 27, 2012, in Gumi City, South Korea.

Methods

We investigated the clinical status, personal history, and work characteristics of the study subjects and performed physical examination and several clinical examinations, including chest radiography, echocardiography, pulmonary function test, and blood testing in 348 firefighters, police officers, volunteer firefighters, and special warfare reserved force who worked at the hydrogen fluoride spill area.

Results

The subjects who worked near the accident site more frequently experienced eye symptoms (p = 0.026), cough (p = 0.017), and headache (p = 0.003) than the subjects who worked farther from the accident site. The longer the working hours at the accident area, the more frequently the subjects experienced pulmonary (p = 0.027), sputum (p = 0.043), and vomiting symptoms (p = 0.003). The subjects who did not wear respiratory protective devices more frequently experienced dyspnea than those who wore respiratory protective devices (p = 0.013). In the pulmonary function test, the subjects who worked near the accident site had a higher decease in forced vital capacity than the subjects who worked farther from the site (p = 0.019); however, no statistical association was found between serum calcium/phosphate level, echocardiography result, chest radiographic result, and probation work characteristics.

Conclusions

The subjects who worked near the site of the hydrogen fluoride spill, worked for an extended period, or worked without wearing respiratory protective devices more frequently experienced upper/lower respiratory, gastrointestinal, and neurological symptoms. Further follow-up examination is needed for the workers who were exposed to hydrogen fluoride during their collection duties in the chemical plant in Gumi City.

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Case Report

Multiple chemical sensitivity caused by exposure to ignition coal fumes: a case report: Myeong-Ja Yun, Dong-Mug Kang, Kyoung-Hye Lee, Young-Ki Kim, Jong-Eun Kim; Ann Occup Environ Med 2013;25:32-32. Published online November 1, 2013; DOI: https://doi.org/10.1186/2052-4374-25-32

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Background

Although multiple chemical sensitivity (MCS) is a well-known disorder caused by environmental exposures, MCS caused by occupational exposure has been reported in Korea. Therefore, we report a MCS case caused by environmental exposure to ignition coal after a differential diagnosis to exclude other diseases.

Case report

Since 2011, a 55-year-old woman had experienced edema, myalgia, and other symptoms when she smelled ignition coal near her workplace. She had been diagnosed with fibromyalgia syndrome(FMS) and was treated, with no improvement of symptoms. Since then, she showed the same symptoms after exposure to city gas, the smell of burning, and exhaust gas. To avoid triggering substances, she moved to a new house and used an air purifier. She quit her job in November 2012. After visiting our hospital, she underwent a differential diagnosis for FMS, chronic fatigue syndrome, and somatization disorder. She was diagnosed with MCS by the Korean version of the Quick Environment Exposure Sensitivity Inventory (QEESI). She was educated about the disease and to avoid triggering substances. She received ongoing treatment for her symptoms.

Conclusion

This case showed that symptoms began after smelling ignition coal. After that, her triggers was increased such as the smell of city gas, burning, and exhaust gas. This case is the first reported in Korea of MCS due to environmental exposure after ruling out other diseases.

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International Journal of Environmental Research and Public Health.2020; 17(18): 6551. CrossRef

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Research Article

Acute Symptoms after a Community Hydrogen Fluoride Spill: Joo-Yong Na, Kuck-Hyun Woo, Seong-Yong Yoon, Seong-Yong Cho, In-Ung Song, Joo-An Kim, Jin-Seok Kim; Ann Occup Environ Med 2013;25:17-17. Published online September 19, 2013; DOI: https://doi.org/10.1186/2052-4374-25-17

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Objectives

This study was conducted to describe the demographic characteristics, and clinical signs and symptoms of patients who visited a general hospital because of the release of chemically hazardous hydrogen fluoride that occurred on September 27, 2012 in Gumi City, Korea.

Methods

The medical records at 1 general hospital 9 km from the accident site were reviewed using a standardized survey format. There were 1,890 non-hospitalized and 12 hospitalized patients exposed to hydrogen fluoride between September 27 and October 13 2012.

Results

Among the 12 hospitalized patients, 11 were discharged within 1 week and the other was hospitalized for 10 days. The chief complaints were respiratory symptoms such as hemoptysis and shortness of breath, gastrointestinal symptoms, neurologic symptoms, sore throat, and lip burn.

The number of non-hospitalized patients exhibited a bimodal distribution, peaking on the first and twelfth days after the accident. Their chief complaints were sore throat (24.1%), headache (19.1%), cough (13.1%), and eye irritation (9.2%); some patients were asymptomatic (6.2%). Patients who visited the hospital within 3 days (early patients) of the spill more often had shortness of breath (27.0%) and nausea (6.3%) as the chief complaints than patients who visited after 3 days (late patients) (3.5% and 2.6%, respectively). However, cough and rhinorrhea were more common in the late patients (14.0% and 3.3%, respectively) than in the early patients (5.0% and 0.0%, respectively). Patients who were closer to the accident site more often had shortness of breath and sputum as the chief complaints than patients who were farther away. The mean serum calcium concentration was 9.37 mg/dL (range: 8.4–11.0 mg/dL); none of the patients had a decreased serum calcium level. Among 48 pulmonary function test results, 4 showed decreased lung function. None of the patients had abnormal urine fluoride levels on the eighth day after exposure.

Conclusions

Patients hospitalized due to chemical hazard release of hydrogen fluoride had acute respiratory, gastrointestinal, and neurologic health problems. Non-hospitalized patients have acute symptoms mainly related to upper respiratory irritation.

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Jong-Ju Ahn
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Comparative Analysis of Hydrogen Fluoride-Exposed Patients Based on Major Burn Criteria After the 2012 Gumi City Chemical Leak Disaster
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Lessons learned from reviewing a hospital’s disaster response to the hydrofluoric acid leak in Gumi city in 2012
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Acute Symptoms in Firefighters who Participated in Collection Work after the Community Hydrogen Fluoride Spill Accident
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Research Article

Hazard Classification of Household Chemical Products in Korea according to the Globally Harmonized System of Classification and labeling of Chemicals: Kyung-Hee Kim, Dae-Jong Song, Myeong-Hyun Yu, Yuon-Shin Park, Hye-Ran Noh, Hae-Joon Kim, Jae-Wook Choi; Ann Occup Environ Med 2013;25:11-11. Published online July 16, 2013; DOI: https://doi.org/10.1186/2052-4374-25-11

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Objectives

This study was conducted to review the validity of the need for the application of the Globally Harmonized System of Classification and Labeling of Chemicals (GHS) to household chemical products in Korea. The study also aimed to assess the severity of health and environmental hazards of household chemical products using the GHS.

Methods

135 products were classified as ‘cleaning agents and polishing agents’ and 98 products were classified as ‘bleaches, disinfectants, and germicides.’ The current status of carcinogenic classification of GHS and carcinogenicity was examined for 272 chemical substances contained in household chemical products by selecting the top 11 products for each of the product categories. In addition, the degree of toxicity was assessed through analysis of whether the standard of the Republic of Korea’s regulations on household chemical products had been exceeded or not.

Results

According to GHS health and environmental hazards, “acute toxicity (oral)” was found to be the highest for two product groups, ‘cleaning agents and polishing agents’, and ‘bleaches, disinfectants, and germicides’ (result of classification of 233 household chemical products) at 37.8% and 52.0% respectively. In an analysis of carcinogenicity assuming a threshold of IARC 2B for the substances in household chemical products, we found ‘cleaning agents and polishing agents’ to contain 12 chemical substances and ‘bleaches, disinfectants, and germicides’ 11 chemical substances.

Conclusion

Some of the household chemical products were found to have a high hazard level including acute toxicity and germ cell mutagenicity, carcinogenicity, and reproductive toxicity. Establishing a hazard information delivery system including the application of GHS to household chemical products in Korea is urgent as well.

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BMJ Open.2015; 5(11): e008823. CrossRef
Hazardous materials in buildings
Jeong Tai Kim, Chuck W. F. Yu
Indoor and Built Environment.2014; 23(1): 44. CrossRef

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Review

Multiple Chemical Sensitivity: Hong Jae Chae, Byoung Gwon Kim, Hwan Cheol Kim, Mi Young Lee, Jong Han Leem; Korean Journal of Occupational and Environmental Medicine 2012;24(4):328-338. Published online December 31, 2012; DOI: https://doi.org/10.35371/kjoem.2012.24.4.328

Abstract PDF

This article reviews newly available knowledge on multiple chemical sensitivity (MCS), a chronic medical condition characterized by symptoms in multiple organ and caused by exposure to low levels of common chemicals. Although various pathophysiological models have been proposed (including toxicological, immunological or behavioral models), the causes and underlying mechanisms of MCS are still not fully understood. Most patients with MCS were women between the ages of 30 and 50 years. The most frequently reported trigger was a newly constructed home or job site. The common symptoms are vague, non-specific complaints: fatigue, difficulty concentrating, poor memory, sneezing/runny nose, headache, and muscle pain. There are no laboratory markers or specific investigative findings for MCS. The Quick Environmental Exposure and Sensitivity Inventory (QEESI)(c) has been used as a screening questionnaire. Treatment focuses on assisting patients at the earliest possible opportunity to reduce their exposure to unique symptom triggers and known hazardous chemicals. Early comprehensive assessment, medical management, and social and financial support might avoid the deterioration of functions associated with prolonged illness.

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MCS/IEI Prevalence Rate of Workers Around an Accidental Release of Hydrogen Fluoride in Gumi Industrial Complex
Hye-Ji Han, Kuck-Hyeun Woo, Sung-Yong Choi, Byoung-Hak Jeon, Sangjun Choi
Journal of Korean Society of Occupational and Environmental Hygiene.2015; 25(4): 534. CrossRef

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Original Article

A Validation of the Korean Version of QEESI(c) (The Quick Environmental Exposure and Sensitivity Inventory): Byoung Hak Jeon, Se Hoon Lee, Hyoung Ah Kim; Korean Journal of Occupational and Environmental Medicine 2012;24(1):96-114. Published online March 31, 2012; DOI: https://doi.org/10.35371/kjoem.2012.24.1.96

Abstract PDF

OBJECTIVES
A standardized questionnaire is not available for use as a screening tool to assess individuals with MCS/IEI in Korea. The QEESI(c), originally developed by Miller & Prihoda in 1998, helps researchers, doctors, and their patients identify individuals with MCS/IEI. Therefore, this study was conducted in order to create a Korean version of the QEESI(c) and evaluate whether this Korean version could be used as an effective MCS/IEI screening tool in Korea.
METHODS
The Korean version of the QEESI(c) was developed using a six-step approach: permission, forward translation, the first quality control, backward translation, cognitive debriefing and the second quality control, final proof reading. In order to collect data, we have done a sample survey in certain parts of Korea. A household was used as the sampling unit; we extracted random samples in each survey cluster and then interviewed two adults over 19 years of age living in each sampled household. A total of 300 subjects were recruited from the general population in local community. The factor structure in the Korean version of the QEESI was analyzed with 40 items on four sub-scales except for the 10 items in masking index using principal components analysis with Varimax rotation. A convergent validity test two sub-scales: chemical intolerance and symptom severity. We carefully compared the chemical intolerance with Nordin's chemical sensitivity scale and the symptom severity with Cho's subjective symptom score.
RESULTS
The results showed that the 40 items on the four sub-scales,' chemical intolerances',' symptom severity', 'life impact', and 'other intolerances', were consistent with those reported for the US population by Miller and Prihoda. The convergent validity wes very good (r=0.4; p<0.001, r=0.5; p<0.001, respectively). A good internal consistency (Cronbach' alpha=0.86~0.96) and test-retest reliability (r=0.87~0.90) were found in all scales, except for the internal consistency in the masking index.
CONCLUSIONS
The Korean version QEESI(c) showed a good reliability and validity. It should be necessary to conduct a MCS/IEI study adopting Korean version QEESI(c).

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What initiates chemical intolerance? Findings from a large population-based survey of U.S. adults
Claudia S. Miller, Raymond F. Palmer, David Kattari, Shahir Masri, Nicholas A. Ashford, Rodolfo Rincon, Roger B. Perales, Carl Grimes, Dana R. Sundblad
Environmental Sciences Europe.2023;[Epub] CrossRef
Does improving indoor air quality lessen symptoms associated with chemical intolerance?
Roger B. Perales, Raymond F. Palmer, Rudy Rincon, Jacqueline N. Viramontes, Tatjana Walker, Carlos R. Jaén, Claudia S. Miller
Primary Health Care Research & Development.2022;[Epub] CrossRef
Disease comorbidities associated with chemical intolerance
RaymondF Palmer, Tatjana Walker, RogerB Perales, Rodolfo Rincon, CarlosRoberto Jaén, ClaudiaS Miller
Environmental Disease.2021; 6(4): 134. CrossRef
Three questions for identifying chemically intolerant individuals in clinical and epidemiological populations: The Brief Environmental Exposure and Sensitivity Inventory (BREESI)
Raymond F. Palmer, Carlos R. Jaén, Roger B. Perales, Rodolfo Rincon, Jacqueline N. Forster, Claudia S. Miller, Wen-Jun Tu
PLOS ONE.2020; 15(9): e0238296. CrossRef
MCS/IEI Prevalence Rate of Workers Around an Accidental Release of Hydrogen Fluoride in Gumi Industrial Complex
Hye-Ji Han, Kuck-Hyeun Woo, Sung-Yong Choi, Byoung-Hak Jeon, Sangjun Choi
Journal of Korean Society of Occupational and Environmental Hygiene.2015; 25(4): 534. CrossRef
Allergic Diseases and Multiple Chemical Sensitivity in Korean Adults
Inchul Jeong, Inah Kim, Hye Jung Park, Jaehoon Roh, Jung-Won Park, Jae-Hyun Lee
Allergy, Asthma & Immunology Research.2014; 6(5): 409. CrossRef

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Original Article

Relationship between Workplace Physical and Chemical Hazard Exposures and Mental Health Problems in Korea: Kee Ock Joh, Tae Jun Park, Jae Il Oh, Do Myung Paek, Jung Sun Park, Sung Il Cho; Korean Journal of Occupational and Environmental Medicine 2011;23(3):287-297. Published online September 30, 2011; DOI: https://doi.org/10.35371/kjoem.2011.23.3.287

Abstract PDF

OBJECTIVES
Mental health and work efficiency are adversely affected by exposure to physical and chemical hazards in the workplace. This study is the first large scale evaluation of the relationship between physical and chemical hazard exposure in the workplace in relation to the mental health of Korean workers.
METHODS
A national survey of a random sample of workers (n=10,043) was conducted between June and September 2006 in Korea. Physical and chemical hazards in the workplace were considered if exposure occurred over more than a quarter of the time spent at work. Mental health problems were defined as work-related depression, anxiety or insomnia. We analyzed whether physical and chemical hazards were independent risk factors for work-related mental health problems by multiple logistic regression analysis after adjusting for age, gender, employment type, education, occupation, duty schedule, work hours, smoking, and alcohol consumption.
RESULTS
The mean age of surveyed workers was 42 years and 58% were male. A total of 7.8% of workers had work-related mental health problems. Exposure to high temperature, mist, fumes, dust, chemicals, and radiation were associated with an increased risk of work-related mental health problems.
CONCLUSIONS
This study reaffirmed that physical and chemical hazard exposure in the workplace significantly elevates the risk of work-related mental health problems.

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Association between physical hazardous agent exposure and mental health in the Korean working population: the 5th Korean Working Conditions Survey
Daeil Kwon, Kyeongmin Kwak, Kiook Baek, Youngchan Chi, Sewhan Na, Jong-Tae Park
Annals of Occupational and Environmental Medicine.2021;[Epub] CrossRef
Use of Frequency Analysis of Exposure of Hazards by Occupations: Findings from the Third and Fourth Korean Working Conditions Survey
Soon-Chan Kwon
Soonchunhyang Medical Science.2019; 25(1): 37. CrossRef
Factors Associated with Depression among Workers by Socio-economic Factors, Health Behaviors, and Characteristics of Work Environment
Hyunkyung Lee, Minsung Sohn, Mankyu Choi
Korean Journal of Health Education and Promotion.2013; 30(5): 125. CrossRef

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Case Report

Hydrofluoric Acid Burns: A Case Report: Jieun Lee, Byung Seong Suh, Chanho Jo, Won Cheol Lee; Korean Journal of Occupational and Environmental Medicine 2011;23(2):225-233. Published online June 30, 2011; DOI: https://doi.org/10.35371/kjoem.2011.23.2.225

Abstract PDF

BACKGROUND
Hydrofluoric acid_(HF) is widely used in many industrial and domestic settings such as etching glass, and polishing metals. HF is one of the most corrosive inorganic acids and can produce progressive and serious tissue necrosis with severe pain. Since HF chemical burns can be asymptomatic for the first few hours, it is crucial to understand its toxicity and the early use of antidote.
CASE
A 37-year-old man presented with erythematous lesion and pain on his face, anterior neck, both forearms, both thighs, and left ankle after injury resulting from a chemical burn caused by HF. He showed normal vital signs and dyspnea, but complained of a sore throat. Liquid form of HF had splashed on his face and anterior neck first and run down his forearms and thighs while working at HF supply tanks. Some of the HF was splashed into his mouth. He immediately removed his clothes and showered with abundant water. A 4.5% calcium gluconate jel was applied to the involved area. He was given subcutaneous injection of 10% calcium gluconate solution. During 17 days of admission he didn't show any signs of systemic intoxication or deep tissue defects.
CONCLUSIONS
Immediate cleansing of the affected area with running cold water is the first critical treatment for a chemical burn due to HF. Applying calcium gluconate gel within one hour was very effective for preventing further damage to the injured area as well as systemic injury. In order to reduce the risk of accident and perform first-aid treatment quickly, it is imperative to provide workers with safety education and establish safety facilities.

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Analysis of Trend of Studies on Microneedle Treatment System (MTS)
Hea-Sun Chun, Ho-Seub Song
Journal of Pharmacopuncture.2021; 24(4): 182. CrossRef
Dermal absorption and skin damage following hydrofluoric acid exposure in an ex vivo human skin model
Kathrin Dennerlein, Franklin Kiesewetter, Sonja Kilo, Thomas Jäger, Thomas Göen, Gintautas Korinth, Hans Drexler
Toxicology Letters.2016; 248: 25. CrossRef
Characteristics of composition and surface morphology of soil particles influenced by inorganic acids with different acidity
Dong-Sung Lee, Kyo-suk Lee, Ji-Soo Shin, Jae-Bong Lee, Ri-Na Joo, Myong-Youn Lee, Se-Won Min, Doug-Young Chung
Korean Journal of Agricultural Science.2015; 42(3): 191. CrossRef

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Original Article

Change of Urinary Trans, Trans-Muconic Acid before and after Turnaround Process in a Petrochemical Plant: Seung Hyun Kim, Ji Ung Park, Jai Dong Moon; Korean Journal of Occupational and Environmental Medicine 2008;20(4):335-342. Published online December 31, 2008; DOI: https://doi.org/10.35371/kjoem.2008.20.4.335

Abstract PDF

OBJECTIVES
This study was performed to estimate the exposure to benzene, one of the most serious health hazards, in four phases of a turnaround in a petrochemical company, and to evaluate the suitability of trans,trans-muconic acid (tt-MA) to act as a biomarker of exposure to low benzene levels.
METHODS
tt-MA was determined in 152 urine samples collected in 4 phases ('before daily work', 'after daily work', 'purge', and 'inspection' of turnaround work) from 19 exposed workers involved in turnaround work and 19 clerical workers. The ambient benzene levels were monitored simultaneously during the 'purge' process of turnaround work in the exposed group.
RESULTS
The median urinary tt-MA for the 4 phases was 0.046 mg/L, 0.082 mg/L, 0.507 mg/L, and 0.468 mg/L in the exposed group and 0.050 mg/L, 0.065 mg/L, 0.269 mg/L, and 0.331 mg/L in the clerical workers, respectively. The median urinary tt-MA for the exposed group was significantly higher than that of the clerical workers during the purge process (P<0.05). In the exposed group, median urinary tt-MA for the 'before daily work' phase was significantly lower than that of the other three phases (P<0.05). Even in the clerical workers, the urinary tt-MA level for the 'before daily work' phase was significantly lower than that of the turnaround (P<0.05). There was a very significant correlation between urinary tt-MA levels and ambient benzene levels (r(s) = 0.795, P<0.01).
CONCLUSION
The turnaround process increased the benzene exposure for all workers, even the clerical workers, in a petrochemical company handling benzene. Urinary tt-MA was found to be suitable as a biomarker for the exposure to low-level benzene.

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Estimating Benzene Exposure Level over Time and by Industry Type through a Review of Literature on Korea
Donguk Park, Sangjun Choi, Kwonchul Ha, Hyejung Jung, Chungsik Yoon, Dong-Hee Koh, Seunghun Ryu, Soogeun Kim, Dongmug Kang, Kyemook Yoo
Safety and Health at Work.2015; 6(3): 174. CrossRef
The Relationship between Exposure to Benzene and the Excretion of Urinary Trans, Trans-muconic Acid in Petrochemical Factory Turnaround Process Workers
Seung Min Lee, Jong Uk Won, Chi Nyon Kim, Jaehoon Roh
Journal of Korean Society of Occupational and Environmental Hygiene.2014; 24(1): 52. CrossRef

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Case Report

Aplastic Anemia in a Petrochemical Plant Worker: Young Mann Baak, Yong Hyu Choi, Seong Kyu Kang, Ji Hong Kim, Kyoung Ah Kim, Young Lim, Joung Wook Lee; Korean Journal of Occupational and Environmental Medicine 1999;11(2):287-292. Published online June 30, 1999; DOI: https://doi.org/10.35371/kjoem.1999.11.2.287

Abstract PDF: Aplastic anemia is characterized by pancytopenia with hypocellular bone marrow. Fifty percent of the cases are idiopathic and the rest are caused by various agents including drugs, chemicals, radiation and viruses. It is difficult to link specific etiologic agents, especially chemicals to the development of aplastic anemia because multiple or unknown exposures may be involved in. Benzene, a common industrial chemical and a component of gasoline, may lead progressively to pancytopenia, aplastic anemia and leukemia when exposed. A petrochemical worker with aplastic anemia was referred to our hospital to evaluate a relationship between the job history and the disease. He worked in the petrochemical plant for .21 years and was exposed to low-level benzene. There was not any other etiologic agent except benzene and this is the case report of aplastic anemia which possibly due to benzene exposure.

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Original Article

Assessment of Genotoxic Hazard in Petrochemical Workers: Jai Dong Moon, Soon Phal Suh, Jung Sun Park, Jin Hyung Cho, Ki Won Ahn; Korean Journal of Occupational and Environmental Medicine 1998;10(1):53-60. Published online February 28, 1998; DOI: https://doi.org/10.35371/kjoem.1998.10.1.53

Abstract PDF

In order to evaluate the genotoxic hazard among workers potentially exposed to low level petrochemical substances, the analyses of micronuclei (MN) and sister chromatid exchanges (SCEs) in lymphocytes were performed in 46 male workers (as exposed group) and 46 nonexposed subjects (as control group). Mean frequencies of MN and SCEs (respectively, 12.9/1000 cells and 6.5/cell) in exposed group were very significantly higher than those (10.2/1000 cells and 5.4/cell) in control group. And there were also significant differences in mean frequencies of MN and SCEs adjusted for age, employment duration, smoking, and drinking between two groups. Median frequencies of MN and SCEs in exposed group were very significantly higher than those in control group. Frequencies of SCEs were higher in smokers than in non-smoker. Frequencies of MN in smokers, however, were similiar to those of non-smoker. Interaction between exposure and smoking on MN and SCEs induction was not observed. The results suggest that there is genotoxic hazard in high risk group like workers handling carcinogens in petrochemical plants and the analyses of MN and SCEs are useful biomarkers for the exposure to hazard substances even at the level below the exposure limit.

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Micronuclei assay: A potential biomonitoring protocol in occupational exposure studies
L. Palanikumar, N. Panneerselvam
Russian Journal of Genetics.2011; 47(9): 1033. CrossRef

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