Annals of Occupational and Environmental Medicine

Original Article

The acclimatization of Haenyeo to a cold environment and occupational characteristics evaluated by orexin and irisin levels: Inho Lee, Yong-Jin Lee, Eun-Chul Jang, Soon-Chan Kwon, Young-Sun Min, Jisuk Yun, Taehwan Park, Hye-Jin Lee, Eonah Choo, Jeong-Beom Lee; Ann Occup Environ Med 2022;34:e28. Published online October 13, 2022; DOI: https://doi.org/10.35371/aoem.2022.34.e28

Background

Haenyeo is a woman who has the job of collecting seafood in the Jeju Sea at an average temperature of 13°C–14°C. The purpose of this study was to examine the cold acclimatization and occupational characteristics of Haenyeo through biomarkers such as orexin and irisin related to heat generation in the body.

Methods

Twenty-one Haenyeo and 25 people with similar age, body type, and body mass index were selected as the control group (Control G). In the cold exposure experiment, a climate chamber was set to 5°C and both feet were immersed in a 15°C water tank for 30 minutes. Tympanic temperature (T_ty) and skin temperature (T_sk) were measured, and the mean body temperature (mT_b) was calculated. Blood samples were collected before and immediately after the examination. Orexin and irisin levels were analyzed.

Results

Orexin levels were elevated after cold stimulation from 12.17 ± 4.44 to 12.95 ± 4.53 ng/mL (Haenyeo group [Haenyeo G], p < 0.01) and 10.37 ± 3.84 to 11.25 ± 4.02 ng/mL (Control G, p < 0.001). Irisin levels were elevated after cold stimulation from 4.83 ± 2.28 to 5.36 ± 2.23 ng/mL (Haenyeo G, p < 0.001) and 3.73 ± 1.59 to 4.18 ± 2.04 ng/mL (Control G, p < 0.001). The difference between Haenyeo G and Control G values in orexin and irisin appears not only in pre-exposure but also in post-exposure (p < 0.05).

Conclusions

Our experimental results suggest that Haenyeo G were relatively superior in cold tolerance to Control G under cold exposure conditions. Haenyeo’s cold acclimatization is due to the basic differences in pyrogens regarding body temperature control such as orexin and irisin. This means that Haenyeo are advantageous for cold survival.

해녀의 혈중 오렉신 및 이리신 수치를 통한 한랭환경 적응 및 직업적 특성에 관한 연구
목적
해녀는 산소공급장치 없이 바다에서 해산물을 채취하는 직업을 가진 여성으로 2016년 유네스코 인류무형문화유산에 '제주 해녀문화'로 등재됐다. 해녀 여성들은 제주 바다에서 평균 13~14°C의 온도에서 일하며 오랜 세월 동안 추운 환경 적응과 기후 적응의 환경 생리 반응을 발달시켰다. 본 연구의 목적은 체내 발열과 관련된 오렉신, 이리신 등의 생체지표를 통해 한랭적응시 체온유지에 사용되는 해녀의 한랭적응 및 직업적 특성을 조사하고자 하였다.
방법
해녀 21명 및 해녀와 유사한 연령과 체형, 체질량지수를 가진 25명을 선정하여 실험하였다. 한랭 부하 실험에서는 기후 챔버를 5°C로 설정하고 양발을 15°C의 물탱크에 30분간 담갔다. 고막 온도(Tty)와 피부 온도(Tsk)를 측정하고 평균 체온(mTb)을 계산하였다. 실험 전후로 혈액을 채취해 오렉신과 이리신 수치를 분석하였다.
결과
한랭 부하 실험 후 오렉신 수치는 해녀군은 12.17 ± 4.44 에서 12.95 ± 4.53 ng/mL (P < 0.01)으로, 대조군은 10.37 ± 3.84에서 11.25 ± 4.02 ng/mL(P < 0.001)으로 상승하였다. 이리신 수치도 해녀군은 4.83 ± 2.28에서 5.36 ± 2.23 ng/mL(P < 0.001)으로, 대조군은 3.73 ± 1.59에서 4.18 ± 2.04 ng/mL(P < 0.001)으로 상승하였다. 또한 실험 전 오렉신 및 이리신 수치가 대조군에 비해 해녀군에서 높았으며, 실험 후 대조군과 해녀군을 비교하였을 때에도 해녀군이 대조군에 비해 오렉신 및 이리신 수치가 유의미하게 높았음을 알 수 있다. (P < 0.05)
결론
저온 노출 조건에서 직업력 50년 이상인 해녀가 대조군에 비해 추위 내성이 높음을 알 수 있다. 본 연구에서 해녀의 한랭적응은 오렉신 및 이리신 등 발열에 관여하는 바이오마커의 기본적 차이가 존재하기 때문이라 설명된다. 따라서 해녀는 추위 생존에 있어 유리한 지위에 있다 할 것이다.

Citations

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Differential mitochondrial adaptation and FNDC5 production in brown and white adipose tissue in response to cold and obesity
Gabriela Neira, Ana Wenting Hernández‐Pardos, Sara Becerril, Beatriz Ramírez, Víctor Valentí, Rafael Moncada, Victoria Catalán, Javier Gómez‐Ambrosi, María A. Burrell, Camilo Silva, Javier Escalada, Gema Frühbeck, Amaia Rodríguez
Obesity.2024; 32(11): 2120. CrossRef

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Review

Technetium-99m hand perfusion scintigraphy (Raynaud’s scan) as a method of verification in hand arm vibration syndrome: a review: Taewoong Ha, Hyeoncheol Oh, Jungwon Kim; Ann Occup Environ Med 2022;34:e26. Published online October 11, 2022; DOI: https://doi.org/10.35371/aoem.2022.34.e26

Abstract Abstract in Korean PDF

It is important to assess the blood flow of fingers in the verification of hand-arm vibration syndrome. In the Republic of Korea, most assessments of the blood flow in the fingers are performed using a cold provocation test with finger skin color change. However, this test is a non-objective method with a relatively low sensitivity, leading to possible social and legal problems. Thus, we reviewed the characteristics of several tests that assess the blood flow in the fingers. Among these tests, using the radioactive isotope method, Raynaud’s scan has a relatively higher sensitivity and specificity than other tests, provides objective results, and is approachable in many hospitals. So we suggest using Raynaud's scan as an alternative test when cold provocation test with finger skin color change is negative in vibration exposed worker.

테크네튬-99m 레이노 스캔을 이용한 수완진동 증후군 진단 리뷰
수완진동증후군의 검증에서는 손가락의 혈류를 평가하는 것이 중요하다. 대한민국에서는 레이노증후군의 업무관련성 평가 시 대부분 손가락의 혈류량 평가를 냉각부하 손가락 피부색 변화 검사만으로 시행하고 있다. 그러나 이 검사는 상대적으로 민감도가 낮은 주관적인 검사방법으로 사회적, 법적 문제가 발생할 수 있다. 따라서 우리는 손가락의 혈류를 평가할 수 있는 여러 검사의 특성을 검토하였다. 이 검사 방법들 중, 방사성 동위원소법을 이용한 레이노스캔은 객관적인 결과를 제공하며 다른 검사방법들에 비하여 상대적으로 민감도와 특이도가 높고 많은 병원에서 접근성이 좋다. 따라서 진동노출작업자에서 냉각부하 손가락 피부색 검사 결과가 음성인 경우 대안검사로서 레이노스캔을 사용할 것을 제안한다.

Citations

Citations to this article as recorded by

Raynaud’s Phenomenon: A Current Update on Pathogenesis, Diagnostic Workup, and Treatment
Hirut Yadeta Ture, Nan Young Lee, Na Ri Kim, Eon Jeong Nam
Vascular Specialist International.2024;[Epub] CrossRef

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Research Article

Application of cold intolerance symptom severity questionnaire among vibration-exposed workers as a screening tool for the early detection of hand-arm vibration syndrome: a cross-sectional study: A Ram Kim, Dae Yun Kim, Ji Soo Kim, Heun Lee, Joo Hyun Sung, Cheolin Yoo; Ann Occup Environ Med 2019;31:6. Published online March 1, 2019; DOI: https://doi.org/10.1186/s40557-019-0284-x

Abstract PDF

Background

The detection rate of hand-arm vibration syndrome (HAVS) is very low in South Korea compared with other countries. The absence of uniform consensus and guidelines for diagnosing HAVS has been presumed to be one of the reasons. The HAVS has various manifestations including cold intolerance and its severity can be measured using the cold intolerance symptom severity (CISS) questionnaire. This study aimed to determine whether the CISS questionnaire, being used as a screening tool, can aid in the early detection of HAVS.

Methods

A total of 76 male workers with vibration-induced symptoms were enrolled as the final study participants. To compare the CISS score of healthy individuals, 41 men who had never been exposed to local vibration were included in the study. In addition to the former medical questionnaire, the participants answered the CISS questionnaire. A statistical analysis was conducted to identify the association of CISS scores with vibration induced symptom and to determine its cut off value.

Results

The reliability of the CISS questionnaire was proven to be good, with a total Cronbach’s alpha of 0.922. The mean CISS score of the exposed group increased in every vascular stage [stage 0 = 42.6 (18.5); stage 1 = 59.4 (14.1); and over stage 2 = 60.2 (21.6)]. They were significantly higher than that of the non-exposed group. The result was fairly consistent with those in the sensorineural stage. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under curve (AUC) of 30 were 88.5, 65.3, 76.1, 82.1 and 0.769, respectively. From the result of logistic regression, the adjusted odds ratio of both components increased by the CISS score grouped by 30s.

Conclusions

The self-reported CISS questionnaire, used to measure the degree of cold intolerance, showed high agreement with the Stockholm classification of HAVS. Hence, we recommend the use of this questionnaire to assess the level of cold intolerance among vibration-exposed workers and detect individuals who are at risk of vibration-induced impairment with a cutoff value of 30.

Trial registration

IRB No. 2018–07–040-001. Registered on 4 September 2018.

Citations

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Jeongsoo Kim, Joon Cha, Sheung Nyoung Choi, Gang Heo, Yongjae Yoo, Jee Youn Moon
Anesthesia & Analgesia.2025; 140(3): 665. CrossRef
A Scoping Review on Occupational Noise Mitigation Strategies and Recommendations for Sustainable Ship Operations
Kresna Febriyanto, Joana Cristina Cardoso Guedes, Luis João Rodrigues Das Neves Correia Mourão
International Journal of Environmental Research and Public Health.2024; 21(7): 894. CrossRef
Cold intolerance and hand-arm vibration syndrome
Roger Anthony Cooke, Ian James Lawson
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Yongjae Yoo, Chang-Soon Lee, Jungsoo Kim, Dongwon Jo, Jee Youn Moon
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Hand-arm vibration management: an operational health and safety strategy framework
David John Edwards, Igor Martek, Obuks Ejohwomu, Clinton Aigbavboa, M. Reza Hosseini
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Kenneth R. Means, Rebecca J. Saunders
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Original Article

The Relationship between Job Stress and the Common Cold: Dong Hyun Kim, Shin Goo Park, Hwan Cheol Kim, Eui Cheol Lee, Jeong Hoon Kim, Jong Han Leem; Korean Journal of Occupational and Environmental Medicine 2008;20(2):74-80. Published online June 30, 2008; DOI: https://doi.org/10.35371/kjoem.2008.20.2.74

Abstract PDF: OBJECTIVES
To investigate the relationship between job stress and the common cold which is one of the most common infectious disease.
METHODS
A KOSS (Korean Occupational Stress Scale)-based questionnaire survey was conducted targeting 6,699 workers, of which 4,637 questionnaires were returned and the data for 237 were excluded due to poor response and having pulmonary disease other than common cold. Consequently, 4,400 (65.7%) returned questionnaires were analyzed. Multiple logistic regression analysis and multiple linear regression, adjusted for daily life stress, confounding variables and both, were used to evaluate the relationship between job stress and the common cold.
RESULTS
After adjustment for confounding variables and daily life stress, most of the subscales of job stress contributed to an increased risk of common cold.
CONCLUSIONS
These results indicated that job stress may play a significant role in increasing the risk of the common cold and that further preventive efforts and studies are needed to reduce job stress and address infectious disease caused by job stress among Korean employees.

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Case Report

Cold Sensitization Occurring in a Worker of a Cold Storage Warehouse: Hyun Sul Lim, Kwan Lee, Jong Min Lee; Korean Journal of Occupational and Environmental Medicine 2002;14(2):204-212. Published online June 30, 2002; DOI: https://doi.org/10.35371/kjoem.2002.14.2.204

Abstract PDF: OBJECTIVES
The following is a report on a case of cold sensitization in a worker who served as a forklift truck driver in a cold storage warehouse for 5 years from 1996.
METHODS
We examined the patient's blood chemistry and infrared computerized thermographic measurements. We also reviewed the environmental temperatures at his workplace and interviewed other workers.
RESULTS
The worker was a 32-year-old male who had worked in a cold storage warehouse for 5 years (1996-2000). He complained of headaches, arthralgia, and slight dyspnea after 2 years work serving as a forklift truck driver in a cold storage facility. In the laboratory record of his blood and those of others, the C-reactive protein, rheumatoid facror, anti-nuclear antibody, cryoglobulin and other blood chemistries were all negative except that the anti-streptolysin O titer was reactive and alkaline phosphatase was also increased. The radiologic findings were normal. Using infrared computerized thermographic measurements, the patient's hands were at around 30 degrees C and below in the first infrared image and around 27 degrees C in the third image. Accordingly, he was diagnosed as having cold sensitization, which occurs in persons exposed to cold for long time, especially below freezing point.
CONCLUSIONS
We confirmed that the cold sensitization occurred in this patient as an occupational disease due to an exposure to cold. To prevent cold injury, we must modify work procedures, begin comprehensive medical surveillances, educate workers on risks of cold, and increase workers awareness of safety regulations in the workplace.

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Original Article

Evaluation of Finger Skin Temperature by Cold Provocation Test for Diagnosis of Hand-Arm Vibration Syndrome: Cheol In Yoo, Ji Ho Lee, Choong Ryeol Lee, Hun Lee, Young Hee Choi, Yang Ho Kim; Korean Journal of Occupational and Environmental Medicine 2002;14(2):124-133. Published online June 30, 2002; DOI: https://doi.org/10.35371/kjoem.2002.14.2.124

Abstract PDF

OBJECTIVES
Various objective tests have been widely used worldwide for diagnosing the hand-arm vibration syndrome. Among these, the cold provocation test has been frequently used to confirm the presence of Raynaud's phenomenon. This study was carried out in order to evaluate finger skin temperature by cold provocation test(10 degrees C for 10 minute) for the diagnosis of hand-arm vibration syndrome METHODS: Fifty-eight workers who had been exposed to local vibration were examined. Information concerning age, occupation, types of vibration tools used, presence of subjective symptoms such as vibration induced white finger(VWF), and numbness and tingling were collected. The subjects were classified into three groups according to their symptoms(Vascular, Neural, and No symptom group). In order to examine the applicability of the cold provocation test using water at 10 degrees C for 10 minute, we compared finger skin temperature between the groups.
RESULTS
The mean value of the finger skin temperature at 5 minutes and 10 minutes after cold provocation as well as the recovery rate in the vascular group were significantly lower than that seen in the other groups.
CONCLUSIONS
The evaluation of finger skin temperature by cold provocation test is very useful method for the diagnosis of hand-arm vibration syndrome. The test results will assist in confirming the diagnosis of the hand-arm vibration syndrome.

Citations

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The Health Effects of Whole Body Vibration
Soo-Jin Lee, Soo-Yong Roh
Journal of the Ergonomics Society of Korea.2013; 32(4): 297. CrossRef

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Original Article

The Relationship between Cold-Exposure and Hypertension: Tae Won Jang, Yoon Gyu Kim, Dong Young Yoon, Chang Hee Lee, Young Seoub Hong, Hae Rim Shin, Kab Yeul Jung, Joon Youn Kim; Korean Journal of Occupational and Environmental Medicine 2001;13(4):376-384. Published online December 31, 2001; DOI: https://doi.org/10.35371/kjoem.2001.13.4.376

Abstract PDF

OBJECTIVES
This study was carried out to suggest preventive methods for hypertension in cold-exposed workers.
METHODS
In 11 refrigeration industries, 68 workers working in refrigerated areas more than one time per day were selected as the exposed group, and 68 workers not exposed to cold were selected as the control group. We interviewed the subjects with a questionnaire covering occupational history, and conducted clinical and laboratory tests including measurements of blood pressure and core temperature.
RESULTS
The systolic blood pressure in the exposed group(130.0+/-13.3 mmHg) was significantly higher than that recorded in the control group(118.3+/-12.1 mmHg), as was the diastolic blood pressure in the exposed group(82.7+/-8.5 mmHg) versus the control group(77.4 +/-8.7 mmHg). The core temperature in the exposed group(36.1+/-0 . 7degrees C) was significantly lower than that experienced in the control group(36.4+/-0 . 5degrees C). In logistic regression analysis, age, cold exposure severity and milk intake were significant variables, with odds ratios of 5.204(95 % CI 1.440~18.812), 2.674(95 % CI 1.080~6.618), and 0.364(95 % CI 0.141~0.942), respectively.
CONCLUSIONS
Our study suggests that cold-exposed workers have higher a higher risk of hypertension, and that their core temperature is lower. Risk factors affecting hypertension of cold-exposed workers include age, cold exposure severity and milk intake. For the prevention of hypertension, cold-exposed workers should minimize cold-exposure time as much as possible.

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Comparison of Changes in Physiological and Perceptual Indices of Cold Stress under Normal Clothing and Thermal Insulation Clothing among Automotive Service Workers in Isfahan
Fatemeh Naghdi, Zohreh Mohebian, Habibollah Dehghan
International Journal of Environmental Health Engineering.2023;[Epub] CrossRef

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Case Report

6 Cases of Hand Arm Vibration Syndrome in Grinding Workers Exposed to Hand-arm Vibration: Shang Hyuk Yim, Rokho Kim, Gil Seung Yang, Jung In Yang, Sang Sup Kim, Hyoung Joon Chun, Si Bog Park; Korean Journal of Occupational and Environmental Medicine 2000;12(3):421-429. Published online September 30, 2000; DOI: https://doi.org/10.35371/kjoem.2000.12.3.421

Abstract PDF

OBJECTIVES
To confirm the HAVS in workers exposed to hand-arm vibration with using the objective diagnostic methods METHODS: Several tests were used to help substantiate a clinical diagnosis of HAVS. Some other diseases were excluded by a medical interview, hematologic assessment, urinalysis, X-rays. The hand-arm vibration acceleration level of the grinder was evaluated for considering HAVS. Peripheral vascular changes were examined by a cold provocation test. An electromyography was implemented to ascertain the peripheral neural changes.
RESULTS
8 workers with symptoms in hands & fingers, exposed to hand-arm vibration were examined. Some other diseases(primary Raynauds disease, secondary Raynauds disease in not occupational origin) were excluded by a medical interview, hematologic assessment, urinalysis, X-rays. The hand-arm vibration acceleration level of the grinder was 7. 9 m/sec2. The recovery time of a skin temperature followed finger cooling was significantly prolonged in 6 workers with HAVS. The nerve conduction velocity was reduced in 6 workers with HAVS.
CONCLUSIONS
So we report 6 cases of HAVS in grinding workers exposed to hand-arm vibration diagnosed objectively by an exclusion of some other disease, handarm vibration acceleration level, cold provocation test, electromyography.

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Severity of grinder injuries and related factors compared with other high-rotation cutting tool injuries: a multicenter retrospective study from 2011 to 2018
Juni Song, Yang Bin Jeon, Jae Ho Jang, Jin Seong Cho, Jae Yeon Choi, Woo Sung Choi
Journal of Trauma and Injury.2023; 36(1): 32. CrossRef
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Jung-Wan Koo
Journal of the Ergonomics Society of Korea.2013; 32(4): 303. 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

A Study on Health Hazards of Cold Exposed Workers: Ho Chu Park, Seol Mi Jung, Deog Hwan Moon, Jong Tae Lee, Dae Hwan Kim, Jung Ho Kim, Jae Il Choi, Yong Shik Hwang, Yong Hee Lee, Chae Un Lee; Korean Journal of Occupational and Environmental Medicine 1999;11(1):80-94. Published online March 31, 1999; DOI: https://doi.org/10.35371/kjoem.1999.11.1.80

Abstract PDF

In order to evaluate the status of cold exposure and its health hazards of workers at cold storage workplaces and to provide basic data for effective health care, the author measured core temperature and also observed clinical symptoms and signs, past and present history, and general health examination data on 99 cold exposed workers for exposure group and 96 non-exposed workers for control group working at 2 food refrigerating companies in Pusan area from January 6, 1998 to February 24, 1998. The results were as follows : 1. There was statistically significant difference in water intake between the exposure and control group and increased urine volume, urine frequency in exposure group without statistically significant difference. 2. Past and present illness in exposure group were hypertension (18.2%), hepatopathy(8. 1%). gastro-intestinal disease(7. 1%). arthritis (4.0%), intervertebral disc herniation(4.0%). and so on, and hypertension, arthritis was statistically significant difference compared to control group. 3. Symptoms inexposure group were. fatigue(89.9%), headache (64.6%), drowsy(63.6%), neck stiffness(59.6%), excessive food intake (59.6%). general weakness(58.6%), hunger(58. 6%), numbness(54. 5%), and so on, and there was statistically significant difference between the exposure and control group except fatigue, drowsy. 4. As results of clinical test abnormality rate of the systolic, diastolic blood pressure and electrocardiogram were significantly higher in exposed group that control. 5. Core temperature in exposure group was statistically significantly lower than control group and the highest statistically significant inverse correlation with the working hours and working frequency of daily mean cold storage. As above results, the author suggested that the further studies should be conducted to evaluate the health status of workers about chronic health effects in cold workplaces and to establish effective health care methods for them.

Citations

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Physiological Reaction to Work in Cold Microclimate
Alicja Bortkiewicz, Elżbieta Gadzicka, Wiesław Szymczak, Agata Szyjkowska, Wiesława Koszada-Włodarczyk, Teresa Makowiec-Dąbrowska
International Journal of Occupational Medicine and Environmental Health.2006;[Epub] CrossRef
The Relationship between Cold Exposure and Hypertension
Joon‐Youn Kim, Kap‐Yeol Jung, Young‐Seoub Hong, Jung‐Il Kim, Tae‐Won Jang, Jung‐Man Kim
Journal of Occupational Health.2003; 45(5): 300. CrossRef

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