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Original Article
Development of standard job classification codes for building a job-exposure matrix for police officers
Sangjun Choi, Ju-Hyun Park, Inah Kim, Jungwon Jang, Jeehee Min, Sang Baek Koh, Seongwon Kim, Yeji Sung, Kyoung Yoon Ko, Su Min Oh, Un-Yeol Jeon
Korean Journal of Occupational and Environmental Medicine 2025;e10.   Published online April 28, 2025
DOI: https://doi.org/10.35371/aoem.2025.37.e10    [Accepted]
AbstractAbstract PDF
Background
This study aimed to develop standard job categories for constructing a job-exposure matrix (JEM) for police officers in South Korea and to evaluate their applicability.
Methods
We examined standard job codes related to police personnel management and compared them with job classifications from police publications. Using R Shiny, we developed a web-based search tool for standard codes. A pilot survey of 130 police officers assessed the codes' applicability and relevance to health-related hazardous factors.
Results
Eighty-seven standard functional codes used in the police personnel management system POOL were organized into minor categories as the basic units of standard jobs. These were grouped into 20 sub-major categories and further consolidated into 10 major categories to develop the standard job codes. The responses to the standard job codes in the pilot survey were 75% accurate compared with the final expert evaluation results and 99.2% accurate compared with the algorithm-based automatic allocation results. The results of the job-hazardous factor network analysis revealed that the most frequently reported hazardous factor was emotional labor, followed by night shifts and electromagnetic waves. Emotional labor was identified as the top hazardous factor in six out of the nine standard job categories.
Conclusions
The standard job codes developed in this study were designed in connection with the personnel management system for police officers, making them well-suited for constructing a comprehensive JEM for the entire police force.

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Original Article
Relationship between long-term PM2.5 exposure and myopia prevalence in adults: analysis of the Korea National Health and Nutrition Examination Survey–Air Pollution Linked Data, 2020
Minju Jung, Hyungdoo Kim, Ji Hoon Kim, Dong-Jae Seo, Jong-Han Leem, Shin-Goo Park, Dong-Wook Lee, Hwan-Cheol Kim
Ann Occup Environ Med 2025;37:e8.   Published online April 16, 2025
DOI: https://doi.org/10.35371/aoem.2025.37.e8
AbstractAbstract AbstractAbstract in Korean PDFSupplementary Material
Background
PM2.5 (particulate matter less than 2.5 μm) causes various health problems. Recent studies suggest that long-term exposure to PM2.5 may have a negative impact on vision. This study examined the effects of long-term exposure to concentrations of PM2.5 exceeding Korean standards on myopia prevalence.
Methods
This study was conducted on adults aged 40–69 years. The PM2.5 concentrations were calculated as the 1–5-year moving averages based on the participants' residential areas. The relationships between the PM2.5 levels, categorized by the annual average concentration standard in Korea, and the prevalence of myopia were analyzed using binary logistic regression. The results were evaluated using the 95% confidence interval.
Results
PM2.5 concentrations averaged over 1–3 years were not significantly associated with the prevalence of myopia. On the other hand, the prevalence of myopia was significantly higher in areas where the 4–5-year moving average PM2.5 levels exceeded the Korean standards. These findings suggest that long-term exposure to PM2.5 may have a detrimental effect on vision.
Conclusions
This study revealed the impact of long-term PM2.5 exposure on the prevalence of myopia, highlighting the importance of managing PM2.5 levels. Nevertheless, further cohort studies focusing on adults and in-depth research into the effects of long-term exposure will be necessary.
장기 PM2.5 노출과 근시 유병률 간의 관계: 국민건강영양조사-대기오염 연계자료, 2020
목적
초미세먼지(PM2.5)는 다양한 건강 문제를 유발하며, 특히 장기 노출이 시력에 부정적인 영향을 미칠 수 있다는 연구가 제기되고 있다. PM2.5는 염증 반응과 산화 스트레스를 유발하여 눈 조직에 손상을 줄 수 있으며, 이는 근시를 포함한 다양한 안구 질환과 관련이 있다. 기존 연구는 주로 학령기 아동을 대상으로 했으나, 최근 연구에서는 40세 이상의 성인에서도 PM2.5 노출이 근시 유병률에 영향을 미칠 가능성이 제시되었다. 한국의 PM2.5 연간 기준은 15㎍/㎥로, WHO 기준보다 3배 높으나 이에 기반한 연구는 드물다. 본 연구는 한국의 PM2.5 기준을 바탕으로 성인의 근시 유병률과의 관계를 장기적으로 분석하였다.
방법
연구는 2020년 국민건강영양조사-대기오염 연계자료를 활용해 진행되었으며, 대상은 40-69세 성인이다. 연구 참여자의 거주지에서 PM2.5 농도의 1년-5년 이동평균을 계산하고, 이를 한국 연간 기준인 15㎍/㎥를 기준으로 나누어 분석했다. 근시는 자동굴절검사를 통해 정의되었으며, 이분형 로지스틱 회귀분석으로 근시 유병률과 PM2.5 농도의 관계를 평가했다. 혼란 변수로 성별, 연령, 교육 수준, 음주 및 흡연 여부 등이 포함되었으며, SPSS를 사용해 통계 분석을 진행했다. 분석 결과는 오즈비(odds ratio)와 95% 신뢰구간으로 제시되었다.
결과
PM2.5의 1년-3년 이동평균은 근시 유병률과 유의미한 관계를 보이지 않았으나, 4년-5년 이동평균이 기준치를 초과한 지역에서는 근시 유병률이 유의미하게 증가했다. 5년 이동평균 PM2.5 농도의 오즈비는 4.038(95% CI: 1.295-12.595)로 나타나, 장기 노출이 근시 발생 위험을 크게 높이는 것으로 확인되었다.
결론
본 연구는 장기간 PM2.5 노출이 근시 유병률에 미치는 누적 손상 효과를 규명하며, 특히 4년-5년 이상의 노출이 중요한 요인임을 밝혔다. 이는 기존 연구와 달리 한국의 PM2.5 기준을 적용하여 현실적이고 특화된 결과를 도출한 점에서 의미가 있다. PM2.5 노출은 염증 반응과 산화 스트레스를 통해 안구 건강에 악영향을 미치며, 이는 성인뿐만 아니라 다양한 연령층에서도 고려해야 할 문제다. 단면 연구로 인과관계를 확정할 수는 없지만, 대기 오염 관리와 장기 코호트 연구의 필요성을 강조한다. 후속 연구에서는 다양한 대기오염 물질의 복합적인 영향을 분석해야 할 필요가 있다.
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Case Report
Glioblastoma in a paper industry worker exposed to high concentrations of formaldehyde: a case report
Youngshin Lee, Jiwoon Kwon, Miyeon Jang, Seongwon Ma, Kyo Yeon Jun, Minjoo Yoon, Shinhee Ye
Ann Occup Environ Med 2024;36:e17.   Published online July 5, 2024
DOI: https://doi.org/10.35371/aoem.2024.36.e17
AbstractAbstract AbstractAbstract in Korean PDFSupplementary Material
Background

Formaldehyde was classified as a Group I Carcinogen by the International Agency for Research on Cancer (IARC) in 2006. While the IARC has stated that there is a lack of evidence that formaldehyde causes brain cancer, three meta-analyses have consistently reported a significantly higher risk of brain cancer in workers exposed to high levels of formaldehyde. Therefore, we report a case of a worker who was diagnosed with glioblastoma after being exposed to high concentrations of formaldehyde while working with formaldehyde resin in the paper industry.

Case presentation

A 40-year-old male patient joined an impregnated paper manufacturer and performed impregnation work using formaldehyde resin for 10 years and 2 months. In 2017, the patient experienced a severe headache and visited the hospital for brain magnetic resonance imaging, which revealed a mass. In the same year, the patient underwent a craniotomy for brain tumor resection and was diagnosed with glioblastoma of the temporal lobe. In 2019, a craniotomy was performed owing to the recurrence of the brain tumor, but he died in 2020. An exposure assessment of the work environment determined that the patient was exposed to formaldehyde above the exposure threshold of 0.3 ppm continuously for more than 10 years and that he had high respiratory and dermal exposure through performing work without wearing a respirator or protective gloves.

Conclusions

This case report represents the first instance where the epidemiological investigation and evaluation committee of the Occupational Safety and Health Research Institute in Korea recognized the scientific evidence of work-related brain tumors due to long-term exposure to high concentrations of formaldehyde during impregnated paperwork. This case highlights the importance of proper workplace management, informing workers that prolonged exposure to formaldehyde in impregnation work can cause brain tumors and minimizing exposure in similar processes.

고농도 포름알데히드에 노출된 제지 산업 근로자에서 발생한 교모세포종: 사례보고
배경
포름알데히드는 2006년 국제암연구소(IARC)에서 1군 발암 물질로 분류되었다. IARC는 포름알데히드가 뇌종양을 유발한다는 증거가 부족하다고 밝혔지만, 세 건의 메타 분석에서 고농도의 포름알데히드에 노출된 근로자의 뇌종양 위험도가 상당히 높다고 일관되게 보고했다. 이에 포름알데히드 수지를 사용하는 제지 산업에서 근무하던 중 고농도의 포름알데히드에 노출되어 교모세포종 진단을 받은 근로자의 사례를 보고하고자 한다.
증례
40세 남성 환자는 함침지 제조업체에 입사하여 10년 2개월 동안 포름알데히드 수지를 사용한 함침 작업을 수행했다. 2017년 9월, 환자는 심한 두통을 느껴 병원을 방문하여 촬영한 뇌 자기공명영상(MRI)의 결과에서 종양이 발견되었다. 같은 해에 환자는 뇌종양 절제를 위해 개두술을 시행하였고 측두엽의 교모세포종을 진단받았다. 2019년 뇌종양 재발로 개두술을 시행하였지만 치료에도 불구하고 2020년 사망하였다. 환자의 작업환경 노출 평가 결과, 10년 이상 지속적으로 노출 기준치인 0.3ppm 이상의 포름알데히드에 노출되었고, 호흡기나 보호 장갑을 착용하지 않고 작업을 수행해 호흡기 및 피부 노출이 높았던 것으로 확인되었다.
고찰
본 사례는 국내 산업안전보건연구원 역학조사평가위원회가 함침 작업 중 고농도 포름알데히드에 장기간 노출되어 업무상 뇌종양이 발생하였다는 과학적 근거를 인정한 첫 사례이다. 이 사례를 통해 함침 작업에서 포름알데히드에 장기간 노출되면 뇌종양이 발생할 수 있음을 근로자에게 알리고 유사한 공정에서 노출을 최소화하는 등 적절한 작업환경관리의 필요성을 강조한다.
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Original Article
Association between serum perfluoroalkyl substances concentrations and non-alcoholic fatty liver disease among Korean adults: a cross-sectional study using the National Environmental Health Survey cycle 4
Yong Tae Park, Eui Yup Chung, Chang Ho Chae, Young Hoon Lee
Ann Occup Environ Med 2024;36:e10.   Published online April 8, 2024
DOI: https://doi.org/10.35371/aoem.2024.36.e10
AbstractAbstract AbstractAbstract in Korean PDF
Background

Perfluoroalkyl substances (PFAS) are widely used in industry and daily life due to their useful properties. They have a long half-life, accumulate in the body, and there is evidence that they are associated with biomarkers of lipid metabolism and liver damage. This may suggest non-alcoholic fatty liver disease (NAFLD) caused by PFAS. However, since there has been no study analyzing the relationship between PFAS and NAFLD in the entire population in Korea. We sought to confirm the relationship between serum PFAS concentration and NAFLD prevalence in Korean adults using the Korean National Environmental Health Survey (KoNEHS) cycle 4.

Methods

The study was conducted on 2,529 subjects in 2018–2019 among KoNEHS participants. For the diagnosis of NAFLD, the hepatic steatosis index (HSI) was used, and the geometric mean and concentration distribution of serum PFAS were presented. Logistic regression was performed to confirm the increase in the risk of NAFLD due to changes in PFAS concentration, and the odds ratio and 95% confidence interval (CI) were calculated.

Results

In both adjusted and unadjusted models, an increased odds ratio was observed with increasing serum concentrations of total PFAS and perfluorooctane sulfonate (PFOS) in the non-obese group. In the adjusted model, the odds ratios for serum total PFAS and PFOS were 6.401 (95% CI: 1.883–21.758) and 7.018 (95% CI: 2.688–18.319).

Conclusions

In this study, a higher risk of NAFLD based on HSI was associated with serum total PFAS, PFOS in non-obese group. Further research based on radiological or histological evidence for NAFLD diagnosis and long-term prospective studies are necessary. Accordingly, it is necessary to find ways to reduce exposure to PFAS in industry and daily life.

대한민국 성인의 혈청 과불화화합물 농도와 비알코올성 지방간 질환의 연관성 : 제4기 국민환경보건 기초조사를 이용한 단면연구
목적
과불화 화합물(이하 PFAS)는 그 유용한 특성들로 인하여 산업 및 일상생활에 널리 사용되는 물질이다. 이들은 긴 반감기를 지녀 생체 내에 축적되며, 지질 대사 및 간 손상의 바이오마커들과 연관이 있다는 여러 증거들이 있다. 이는 PFAS와 비알코올성 지방간(이하 NAFLD)의 연관성을 시사할 수 있다. 그러나 국내 전체 인구를 대상으로 PFAS와 NAFLD간의 연관성을 분석한 연구는 없었기에 제4주기 국민환경보건 기초조사를 이용하여 대한민국 성인에서 혈청 PFAS의 농도와 NAFLD 유병률 간의 연관성을 확인하고자 하였다.
방법
제4주기 국민환경보건 기초조사 참여자 중 2018-2019년 대상자 2595명을 대상으로 연구를 진행하였다. NAFLD의 진단을 위해 Hepatic Steatosis Index(이하 HSI)를 사용하였으며, 혈청 PFAS의 기하평균 및 농도 분포를 제시하였다. PFAS의 농도 변화에 따른 NAFLD의 위험도 증가를 확인하기 위하여 로지스틱 회귀분석을 시행하였으며 이에 대한 교차비와 95% 신뢰구간을 산출하였다.
결과
조정되지 않은 모델 및 조정된 모델의 비만하지 않은 그룹에서 혈청 총 PFAS, PFOS의 농도 증가에 따른 교차비의 증가를 확인할 수 있었다. 조정된 모델에서 혈청 총 PFAS 및 PFOS의 교차비는 각각 6.401 (95% CI 1.883–21.758) and 7.018 (95% CI 2.688-18.319)으로 나타났다.
결론
본 연구에서 HSI에 기초한 NAFLD의 더 높은 위험은 비만하지 않은 군에서 혈청 총 PFAS 및 PFOS와 유의한 연관성을 보였다. PFAS에 의한 NAFLD 발생의 위험에 대한 영상 또는 조직 병리에 기반한 추가 연구가 필요하며, 일상 생활 및 산업 전반에 있어 PFAS에의 노출을 줄이기 위한 방법의 모색이 필요하다.

Citations

Citations to this article as recorded by  
  • Effects of mixed exposure to PFAS on adolescent non-alcoholic fatty liver disease: Integrating evidence from human cohorts, toxicogenomics, and animal models to uncover mechanisms and potential target sites
    Xiushuai Du, Dan-Lin Li, Xueming Xu, Yitian Wu, Zhiyuan Du, Gang Liang, Yue-Zu Li, Ya-Jie Zheng, Yu Qin, Kelei Qian, Jing Xu, Liping Gao, Gonghua Tao, Chen-Wei Pan, Weiwei Zheng
    Journal of Hazardous Materials.2025; 485: 136854.     CrossRef
  • Per- and polyfluoroalkyl substances exposures are associated with non-alcoholic fatty liver disease, particularly fibrosis
    Se-Hyun Hwang, Yun-Hee Choi, Da-An Huh, Lita Kim, Kangyeon Park, Jiyoun Lee, Hyeon Jeong Choi, Woohyun Lim, Kyong Whan Moon
    Environmental Pollution.2025; 372: 126085.     CrossRef
  • Diabetes and male fertility disorders
    Andrea Graziani, Raffaele Scafa, Giuseppe Grande, Alberto Ferlin
    Molecular Aspects of Medicine.2024; 99: 101303.     CrossRef
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Original Article
Cardiometabolic diseases according to the type and degree of hearing loss in noise-exposed workers
KyooSang Kim, Sun-Haeng Choi
Ann Occup Environ Med 2024;36:e3.   Published online February 19, 2024
DOI: https://doi.org/10.35371/aoem.2024.36.e3
AbstractAbstract AbstractAbstract in Korean PDF
Background

This study aimed to determine the association between cardiometabolic diseases, including metabolic syndrome, hypertension, and diabetes, and the type and degree of hearing loss in noise-exposed workers.

Methods

A total of 237,028 workers underwent air conduction pure tone audiometry in 2015 to assess their health and diagnose cardiometabolic diseases. The study defined metabolic syndrome, hypertension, and diabetes using blood pressure, fasting blood sugar, cholesterol, and triglyceride levels. Mid-frequency hearing loss was defined as ≥ 30 dB at 2,000 Hz, whereas high-frequency hearing loss was ≥ 40 dB at 4,000 Hz. The average air conduction hearing thresholds at these frequencies were used to determine hearing loss degrees.

Results

The odds ratio (OR) of combined exposure to noise and night-shift work in all cardiometabolic diseases was higher than that of noise exposure alone. The risk of cardiometabolic diseases was dose-response, with higher hearing loss causing higher ORs. The ORs of hypertension compared with the normal group were 1.147 (1.098–1.198), 1.196 (1.127–1.270), and 1.212 (1.124–1.306), and those of diabetes were 1.177 (1.119–1.239), 1.234 (1.154–1.319), and 1.346 (1.241–1.459) for mild, moderate, and moderate-severe hearing loss, respectively.

Conclusions

Workers who are exposed to noise tend to demonstrate high risks of hearing loss and cardiometabolic diseases; thus, bio-monitoring of cardiometabolic diseases, as well as auditory observation, is necessary.

소음 노출 근로자의 난청 유형 및 정도에 따른 심혈관대사성 질환
목적
본 연구는 소음 노출 근로자의 사회인구학적 특성, 직업적 특성, 야간 근무 및 난청 여부에 따른 대사증후군, 고혈압, 당뇨병을 포함한 심장-대사성 질환과의 관련성을 파악하고자 하였다.
방법
2015년 237,028명의 근로자들의 기도 순음청력검사를 시행하여 난청 유형과 정도를 평가하고 심장-대사성 질환을 진단하였다. 이 연구는 혈압, 공복 혈당, 콜레스테롤 및 중성지방 수치를 이용하여 대사증후군, 고혈압 및 당뇨병을 정의하였다. 중음역 난청은 2000 Hz에서 30 dB 이상으로 정의한 반면 고음역 난청은 4000 Hz에서 40 dB 이상으로 정의하였다. 난청의 중증도는 이들 주파수의 기도 순음 청력역치의 평균으로 정하였다.
결과
모든 심장-대사성 질환에서 소음 노출과 야간 교대근무에 복합 노출된 경우 소음에만 노출된 경우보다 오즈비가 높았다. 청력손실이 클수록 유의하게 오즈비가 높으며 심장-대사성 질환과의 용량-반응 관계를 보였다. 정상군에 비해 고혈압의 오즈비는 경도 난청의 경우 1.147 (1.098 - 1.198), 중등도 난청의 경우 1.196 (1.127 - 1.270), 중등고도 난청의 경우 1.212(1.124 - 1.306)였다. 정상군에 비해 당뇨병의 오즈비는 경도 난청의 경우 1.177 (1.119 - 1.239), 중등도 난청의 경우 1.234 (1.154 - 1.319), 중등고도 난청의 경우 1.346 (1.241 - 1.459)이었다.
결론
소음에 노출된 근로자는 난청 및 심혈관계 질환의 위험이 높은 경향이 있으므로 청각적 관찰 뿐만 아니라 심혈관계 질환에 대한 생체 모니터링이 필요하다.
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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
AbstractAbstract PDFSupplementary Material
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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  • Exposome-wide association study of cognitive function in US older adults using the NHANES data
    Hyuna Jang, Jiyun Lee, Vy Kim Nguyen, Hyeong-Moo Shin
    Exposome.2025;[Epub]     CrossRef
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Original Article
Association of heavy metal complex exposure and neurobehavioral function of children
Minkeun Kim, Chulyong Park, Joon Sakong, Shinhee Ye, So young Son, Kiook Baek
Ann Occup Environ Med 2023;35:e23.   Published online July 6, 2023
DOI: https://doi.org/10.35371/aoem.2023.35.e23
AbstractAbstract AbstractAbstract in Korean PDFSupplementary Material
Background

Exposure to heavy metals is a public health concern worldwide. Previous studies on the association between heavy metal exposure and neurobehavioral functions in children have focused on single exposures and clinical manifestations. However, the present study evaluated the effects of heavy metal complex exposure on subclinical neurobehavioral function using a Korean Computerized Neurobehavior Test (KCNT).

Methods

Urinary mercury, lead, cadmium analyses as well as symbol digit substitution (SDS) and choice reaction time (CRT) tests of the KCNT were conducted in children aged between 10 and 12 years. Reaction time and urinary heavy metal levels were analyzed using partial correlation, linear regression, Bayesian kernel machine regression (BKMR), the weighted quantile sum (WQS) regression and quantile G-computation analysis.

Results

Participants of 203 SDS tests and 198 CRT tests were analyzed, excluding poor cooperation and inappropriate urine sample. Partial correlation analysis revealed no association between neurobehavioral function and exposure to individual heavy metals. The result of multiple linear regression shows significant positive association between urinary lead, mercury, and CRT. BMKR, WQS regression and quantile G-computation analysis showed a statistically significant positive association between complex urinary heavy metal concentrations, especially lead and mercury, and reaction time.

Conclusions

Assuming complex exposures, urinary heavy metal concentrations showed a statistically significant positive association with CRT. These results suggest that heavy metal complex exposure during childhood should be evaluated and managed strictly.

소아 신경 행동 기능과 중금속 복합 노출의 관련성
목적
중금속 노출은 많은 국가에서 공중보건 관련해서 큰 과제이다. 중금속 노출에 따른 신경계의 영향을 보기 위한 과거 연구들 에서는 노출의 경우 단일 중금속에 대한 노출을, 노출에 따른 결과로는 임상적 징후 또는 질환의 진단을 중점으로 이루어졌다. 본 연구는 중금속 복합 노출과 준임상적 수준을 포함한 신경 행동 기능의 관계를 확인하기 위해 계획되었다.
방법
소변 중 수은, 납, 카드뮴 분석과 한국형 컴퓨터 신경행동검사중 부호 숫자 짝짓기 검사와 선택 반응 시간 검사를 211명의 10-12세의 소아들에게 시행한 자료를 바탕으로, 반응 시간과 소변 중 중금속 수치를 성별과 연령을 보정하여 편상관분석과 회귀분석으로 분석하였다. 그 중 유의미한 결과가 확인되는 항목에 대해 복합노출에 대한 분석을 Bayesian Kernel Machine regression, Weighted Sum Regression analysis, Quantile G-computation 기법을 활용하여 심층 분석하였다.
결과
부호숫자 짝짓기 검사의 경우 203건, 선택반응 검사의 경우 198건에 대해 분석을 수행하였다. 부호숫자 짝짓기 검사의 경우 단일 중금속과 편상관분석 및 다중회귀분석에서 유의미한 관련성이 보이지 않았다. 선택반응 검사의 경우 편상관분석상 개별 중금속과는 별다른 관계를 보이지 않았으나 다중회귀분석에서 수은 및 납과 유의미한 관련성을 보였다. 복합노출에 대한 분석방법인 Bayesian Kernel Machine regression, Weighted Sum Regression analysis, Quantile G-computation 기법에서 소변 중 중금속과 선택 반응 시간 검사의 반응시간 간에 양의 상관관계를 보였으며, 세 분석에서 비교적 일관되게 복합노출 시 수은과 납이 선택 반응 시간 검사의 반응시간에 양의 상관관계를 보였다. 카드뮴의 경우 뚜렷한 양의 상관관계를 보이지 않거나 그 기여도가 적었다.
결론
본 연구 샘플의 요중 수은, 납, 카드뮴의 범위는 임상적인 증상을 나타낼 수 있는 것으로 알려진 여러 기준 수준에 비해 매우 낮은 수준에 있으나, 그 범위 내에서도 선택 반응 검사와 중금속의 복합노출은 통계적으로 유의한 반응시간 차이를 보였다. 위 결과는 소아 중금속 복합 노출이 매우 낮은 농도 수준에서도 신경계에 영향을 미친다는 가능성을 제시하며, 이는 중금속 노출에 대한 더욱 민감하고 엄격한 관리가 필요함을 보여주는 결과이다.

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  • Associations of Serum Manganese, Zinc, Copper, and Selenium Concentrations With Autism Spectrum Disorders in Chinese Children: A Case–Control Study
    Yong Zhang, Fang Xie, Sheng Li, Ying Li, Liting Yang, Zhen Wang, Jinlin Lei, Huailan Guo
    Autism Research.2025; 18(2): 427.     CrossRef
  • Environmental disease monitoring by regional Environmental Health Centers in Korea: a narrative review
    Myung-Sook Park, Hwan-Cheol Kim, Woo Jin Kim, Yun-Chul Hong, Won-Jun Choi, Seock-Yeon Hwang, Jiho Lee, Young-Seoub Hong, Yong-Dae Kim, Seong-Chul Hong, Joo Hyun Sung, Inchul Jeong, Kwan Lee, Won-Ju Park, Hyun-Joo Bae, Seong-Yong Yoon, Cheolmin Lee, Kyoung
    The Ewha Medical Journal.2025;[Epub]     CrossRef
  • The impact of unfavorable and toxic environmental conditions on autonomic tone modulations while wearing N95 face masks
    Valery Erkudov, Andrey Pugovkin, Kenjabek Rozumbetov, Azat Matchanov, Shanika Arachchi, Upaka Rathnayake
    Case Studies in Chemical and Environmental Engineering.2024; 9: 100619.     CrossRef
  • Association Between Multiple Heavy Metal Exposures and Cholesterol Levels in Residents Living Near a Smelter Plant in Korea
    Sun-In Moon, Dong-Hyuk Yim, Kyunghi Choi, Sang-Yong Eom, Byung-Sun Choi, Jung-Duck Park, Heon Kim, Yong-Dae Kim
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
  • Sex-Specific Effects of Combined Heavy Metal Exposure on Blood Pressure: A Bayesian Kernel Machine Regression Analysis
    In-Gwon Kim, Seonmi Hong, Sojeong Yim, Jang-Hun Jeong, Kyunghi Choi, Ju-Hee Lee, Young-Seoub Hong, Sang-Yong Eom, Heon Kim, Yong-Dae Kim
    Atmosphere.2024; 15(10): 1157.     CrossRef
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Original Article
Occupational exposure to polycyclic aromatic hydrocarbons in Korean adults: evaluation of urinary 1-hydroxypyrene, 2-naphthol, 1-hydroxyphenanthrene, and 2-hydroxyfluorene using Second Korean National Environmental Health Survey data
Dong Hyun Hong, Jongwon Jung, Jeong Hun Jo, Dae Hwan Kim, Ji Young Ryu
Ann Occup Environ Med 2023;35:e6.   Published online March 24, 2023
DOI: https://doi.org/10.35371/aoem.2023.35.e6
AbstractAbstract AbstractAbstract in Korean PDF
Background

Polycyclic aromatic hydrocarbons (PAHs) are occupational and environmental pollutants generated by the incomplete combustion of organic matter. Exposure to PAHs can occur in various occupations. In this study, we compared PAH exposure levels among occupations based on 4 urinary PAH metabolites in a Korean adult population.

Methods

The evaluation of occupational exposure to PAHs was conducted using Second Korean National Environmental Health Survey data. The occupational groups were classified based on skill types. Four urinary PAH metabolites were used to evaluate PAH exposure: 1-hydroxypyrene (1-OHP), 2-naphthol (2-NAP), 1-hydroxyphenanthrene (1-OHPHE), and 2-hydroxyfluorene (2-OHFLU). The fraction exceeding the third quartile of urinary concentration for each PAH metabolite was assessed for each occupational group. Adjusted odds ratios (ORs) for exceeding the third quartile of urinary PAH metabolite concentration were calculated for each occupational group compared to the “business, administrative, clerical, financial, and insurance” group using multiple logistic regression analyses.

Results

The “guard and security” (OR: 2.949; 95% confidence interval [CI]: 1.300–6.691), “driving and transportation” (OR: 2.487; 95% CI: 1.418–4.364), “construction and mining” (OR: 2.683; 95% CI: 1.547–4.655), and “agriculture, forestry, and fisheries” (OR: 1.973; 95% CI: 1.220–3.191) groups had significantly higher ORs for 1-OHP compared to the reference group. No group showed significantly higher ORs than the reference group for 2-NAP. The groups with significantly higher ORs for 1-OHPHE than the reference group were “cooking and food service” (OR: 2.073; 95% CI: 1.208–3.556), “driving and transportation” (OR: 1.724; 95% CI: 1.059–2.808), and “printing, wood, and craft manufacturing” (OR: 2.255; 95% CI: 1.022–4.974). The OR for 2-OHFLU was significantly higher in the “printing, wood, and craft manufacturing” group (OR: 3.109; 95% CI: 1.335–7.241) than in the reference group.

Conclusions

The types and levels of PAH exposure differed among occupational groups in a Korean adult population.

한국 성인의 다환 방향족 탄화수소에 대한 직업적 노출: 제 2기 국민환경보건기초조사 자료를 이용한 요중 1-하이드록시피렌, 2-나프톨, 1-하이드록시페난트렌 및 2-하이드록시플루오렌 평가
목적
다환 방향족 탄화수소(Polycyclic Aromatic Hydrocarbons, PAHs)는 유기물의 불완전 연소로 인해 발생하는 직업 및 환경 오염 물질이다. PAHs에 대한 노출은 대표적으로 석탄 가스화 공정 등 특정 업무 및 직업과 관련하여 발생하는 것으로 알려져 있지만, 그 외 다양한 직업들에서도 노출이 일어날 수 있다. 본 연구는 제2기 국민환경보건기초조사(2012-2014) 자료의 4가지 요중 PAH 대사 산물들을 이용하여 한국 성인 인구에서 여러가지 직업들에서의 PAH 노출 수준을 비교하였다.
방법
제 2기 국민환경보건기초조사에 참여한 성인 남녀 6,478명을 대상으로 PAHs에 대한 직업적 노출을 평가하였다. 직업군은 직능 유형을 기준으로 분류하였다. PAHs 노출에 대한 평가를 위해 요중 PAH 대사산물인 1-하이드록시피렌, 2-나프톨, 1-하이드록시페난트렌, 그리고 2-하이드록시플루오렌을 사용하였다. 각 직업군에서 각각의 요중 PAH 대사산물 농도의 제 3사분위수를 초과하는 비율을 구하였다. 이후 로지스틱 회귀 분석을 사용하여 "비즈니스, 행정, 사무, 금융 및 보험" 그룹과 비교해 각 직업군에서 요중 PAH 대사산물 농도의 제 3사분위수를 초과하는 비율에 대한 보정된 교차비를 구하였다.
결과
1-하이드록시피렌의 경우, "경비 및 보안" (교차비: 2.949, 95% 신뢰구간: 1.300–6.691), "운전 및 운송" (교차비: 2.487, 95% 신뢰구간: 1.418–4.364), "건설 및 광업" (교차비: 2.683, 95% 신뢰구간: 1.547–4.655), 그리고 "농업, 임업 및 어업" (교차비: 1.973, 95% 신뢰구간: 1.220–3.191) 그룹에서 참조 그룹과 비교하여 유의하게 높은 교차비를 보였다. 2-나프톨의 경우, 참조 그룹보다 유의하게 높은 교차비를 보이는 직업군은 없었다. 1-하이드록시페난트렌의 경우, "요리 및 음식 서비스" (교차비: 2.073, 95% 신뢰구간: 1.208–3.556), "운전 및 운송" (교차비: 1.724, 95% 신뢰구간: 1.059-2.808), 그리고 "인쇄, 목재 및 공예품 제조"(OR: 2.255, 95% CI: 1.022–4.974) 그룹에서 참조그룹에 비해 유의하게 높은 교차비를 보였다. 2-하이드록시플루오렌의 경우, "인쇄, 목재 및 공예품 제조" (OR: 3.109, 95% CI: 1.335–7.241)그룹에서 참조 그룹에 비해 유의하게 높은 교차비를 보였다.
결론
한국 성인 인구에서 PAH 노출수준과 노출되는 PAH의 종류는 직업군에 따라 달랐으며, 그에 따른 추가적인 평가 및 보호조치가 필요하다.
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Original Article
Occupational factors affecting the decline in pulmonary function among male farmers using occupational pesticide in Gyeonggi-do, South Korea
Sooyeon Lee, Jiyoung Han, Seung Hee Woo, Soo-Jin Lee
Ann Occup Environ Med 2022;34:e42.   Published online December 8, 2022
DOI: https://doi.org/10.35371/aoem.2022.34.e42
AbstractAbstract AbstractAbstract in Korean PDF
Background

Occupational pesticide exposure is a potential risk for respiratory health effects. Most clinical studies on pesticide exposure were related to acute exposure, and only a few studies on chronic exposure have been conducted. This study investigated the chronic respiratory health status and the chronic effects of occupational pesticide exposures of farmers in Gyeonggi-do.

Methods

Surveys and pulmonary function tests were conducted on 1,697 farmers in 16 regions of Gyeonggi-do. The structured questionnaire included demographic characteristics, medical history, recent respiratory symptoms and diseases, and work-related conditions, and was conducted through one-on-one interviews. The prevalence of respiratory diseases was compared by the odds ratios (ORs) at 95% confidence intervals (CIs) estimated by logistic regression analysis. Additional multivariate logistic regression analysis was also conducted.

Results

Pesticide work groups showed significant association with an obstructive pattern in the lung function test (unadjusted OR, 2.38; 95% CI, 1.17–5.52). Selected work-related variables of pesticide exposure were ‘start age,’ ‘cumulative duration,’ ‘mixing pesticides,’ and ‘protection(goggle).’ The obstructive pattern of lung function test showed significant associations with mixing pesticides (OR, 2.30; 95% CI,1.07–5.46), and protection (goggle) use (OR, 0.34; 95% CI, 0.12–0.79).

Conclusions

Mixing two or more pesticides showed a significant association. Wearing goggles can be seen as an indicator of awareness of the protective equipment and proper wearing of protective equipment, and loss of pulmonary function can be prevented when appropriate protection is worn.

한국 경기도 지역의 남성 농업인 폐기능 감소에 영향을 주는 직업적요인들
목적
직업적 농약노출은 호흡기 건강영향에 대해 잠재적인 위험을 갖고 있다. 과거 농약노출에 대한 임상연구는 대부분 급성 농약노출에 대한 것이었다. 이번 연구에서는 농약의 직업적 노출에 대한 만성적 호흡기 건강영향을 조사하며, 농약사용에 있어서 어떤 작업변수가 실제 영향을 미치는지 조사한다.
방법
2013년부터 2015년까지 경기도 16개 지역에서 농작업을 하는 농업인 1697명을 대상으로, 농작업현황과 인구학적 정보를 포함한 구조화된 설문조사를 일대일 대면 인터뷰형태로 실시했으며, 동시에 폐기능검사를 실시하였다. 통계적분석방법은 로지스틱 회귀분석으로 95% 신뢰구간에 대하여 폐기능검사에서의 폐쇄성형태, 제한성형태와 최근 6개월의 호흡기증상의 유병률을 오즈비를 구하여 비교하였다. 농약작업과의 세부관계성을 밝히기 위하여 추가적인 다변량-로지스틱회귀분석을 수행하였다.
결과
농약 작업군에서 폐쇄성패턴과 유의한 연관성을 보였다(오즈비: 2.38, 1.17-5.52). 다변량-로지스틱회귀분석 결과, 농약 사용패턴 중 유의미한 변수는 '누적노출년도', '농약작업 시작나이', '농약 혼합', '보호구착용(고글)'로 나타났으며, 폐쇄성패턴과 농약혼합행태, 보호구착용이 유의한 연관성을 보여주었다.
결론
농약에 노출된 농업인은 폐기능감소에 있어 유의한 기능감소를 보여주었다. 농약관련 변수 중에는 양적인 변수들이 유의한 관련성이 있었으며, 고글착용은 적절한 보호구착용의 지표로 볼 수 있으며, 보호효과가 있었다.

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  • Occupational status and chronic respiratory diseases: a cross-sectional study based on the data of the Rafsanjan Cohort Study
    Zahra Bagheri-Hosseinabadi, Ali Bahreyni, Hosein Basirat, Parvin Khalili, Alireza Vakilian, Fatemeh Amin
    BMC Pulmonary Medicine.2024;[Epub]     CrossRef
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Original Article
The health effects of low blood lead level in oxidative stress as a marker, serum gamma-glutamyl transpeptidase level, in male steelworkers
Su-Yeon Lee, Yong-Jin Lee, Young-Sun Min, Eun-Chul Jang, Soon-Chan Kwon, Inho Lee
Ann Occup Environ Med 2022;34:e34.   Published online November 2, 2022
DOI: https://doi.org/10.35371/aoem.2022.34.e34
AbstractAbstract AbstractAbstract in Korean PDF
Background

This study aimed to investigate the association between lead exposure and serum gamma-glutamyl transpeptidase (γGT) levels as an oxidative stress marker in male steelworkers.

Methods

Data were collected during the annual health examination of workers in 2020. A total of 1,654 steelworkers were selected, and the variables for adjustment included the workers’ general characteristics, lifestyle, and occupational characteristics. The association between the blood lead level (BLL) and serum γGT level was investigated by multiple linear and logistic regression analyses. The BLL and serum γGT values that were transformed into natural logarithms were used in multiple linear regression analysis, and the tertile of BLL was used in logistic regression analysis.

Results

The geometric mean of the participants’ BLLs and serum γGT level was 1.36 μg/dL and 27.72 IU/L, respectively. Their BLLs differed depending on age, body mass index (BMI), smoking status, drinking status, shift work, and working period, while their serum γGT levels differed depending on age, BMI, smoking status, drinking status, physical activity, and working period. In multiple linear regression analysis, the difference in models 1, 2, and 3 was significant, obtaining 0.326, 0.176, and 0.172 (all: p < 0.001), respectively. In the multiple linear regression analysis stratified according to drinking status, BMI, and age, BLLs were positively associated with serum γGT levels. Regarding the logistic regression analysis, the odds ratio of the third BLL tertile in models 1, 2, and 3 (for having an elevated serum γGT level within the first tertile reference) was 2.74, 1.83, and 1.81, respectively.

Conclusions

BLL was positively associated with serum γGT levels in male steelworkers even at low lead concentrations (< 5 μg/dL).

제철소 남성근로자들의 저농도 납노출이 산화스트레스 지표인 혈청 감마지티에 미치는 건강영향
목적
본 연구의 목적은 일개 제철소에 근무하는 남성 근로자들의 납 노출 수준과 산화스트레스 지표로서의 혈청 감마지티와의 연관성을 확인하는 것이다.
방법
본 연구는 2020년 시행된 근로자 건강검진 자료를 이용하였으며, 총 1,654명의 남성 근로자가 최종 연구대상으로 선정되었다. 일반적 특성, 생활양식 및 직업적 특성을 나타내는 변수를 설정하여 보정하였으며, 혈중납수준과 혈청 감마지티의 연관성을 알아보기 위해 다중선형회귀분석 및 로지스틱회귀분석을 실시하였다. 다중선형회귀분석에서는 자연로그로 변환된 혈중납 및 혈청 감마지티값을, 로지스틱회귀분석에서는 혈중납 3분위수를 이용하였다.
결과
연구대상자의 혈중납 및 혈청 감마지티의 기하평균은 각각 1.36 μg/dL, 27.72 IU/L 이었으며, 혈중납수준은 연령, 체질량지수, 흡연, 음주, 교대근무, 근무기간에 따라 차이가 있었고, 혈청 감마지티는 연령, 체질량지수, 흡연, 음주, 신체활동, 근무기간에 따라 차이를 보였다. 다중선형회귀분석에서는 모형 1,2,3 에서 혈중납수준과 혈청감마티지의 유의미한 연관성을 보여주었으며 (Model 1, β : 0.326, p < 0.001 ;Model 2, β: 0.176, p< 0.001;Model 3, β: 0.172 p< 0.001), 음주상태, 연령, 체질량지수, 음주 및 흡연 통합변수로 층화하여 분석하였을 때에도 혈중납수준과 혈청감마지티의 연관성은 유의하였다. 로지스틱회귀분석은 혈중납 3분위수와 혈청 감마지티 상승위험의 연관성을 보여주었다. (Model 1, OR: 2.74, 95% CI: 1.764.28 ;Model 2, OR: 1.83, 95%CI:1.132.95 ; Model 3, OR 1.81, 95%CI:1.122.92)
결론
일개 제철소 남성근로자를 대상으로 실시된 본 연구는 혈중납 5μg/dL 이하의 저농도 노출수준에서도 혈중납 수준과 혈청 감마지티 수치가 연관성이 있음을 보여준다.

Citations

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  • Occupational Lead Exposure Among Civilian Indoor Shooting Range Workers in Korea: A Report of Blood Lead Levels and Airborne Lead
    Sungjin Park, Jaeyoung Park, Bumjoon Lee, Yi-Ryoung Lee, Jiho Kim, Younmo Cho, Hyeongyeong Choi, Kyeongyeon Kim
    Journal of Korean Medical Science.2025;[Epub]     CrossRef
  • The Association Between Blood Lead Levels and Urgency Urinary Incontinence Among Adult Females: A Retrospective Study Based on NHANES 2005–2020
    Junwei Wang, Cunming Zhang, Aiwei Zhang
    Biological Trace Element Research.2024;[Epub]     CrossRef
  • The Association Between Blood Lead Levels and Coronary Artery Calcium Score Determined by Using Coronary Computed Tomography Angiography
    Eunyoung Park, Suwhan Kim, Seunghyeon Cho, Hyeonjun Kim, Inho Jung, Jai-Dong Moon, Won-Ju Park
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
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Case Report
Electrocardiogram abnormalities in antimony exposed workers in the automotive brake lining manufacturing industry: a case report
Ha-ram Jo, Seongyong Yoon, Jinseok Kim, Seong-yong Cho, Jong-min An, Gayoung Kim
Ann Occup Environ Med 2022;34:e16.   Published online June 27, 2022
DOI: https://doi.org/10.35371/aoem.2022.34.e16
AbstractAbstract AbstractAbstract in Korean PDF
Background

Antimony is used in catalysts, pesticides, brake systems, pharmaceuticals, and synthetic fire retardants in the plastic, paint, and rubber industries. Accumulation of trivalent antimony compounds in the body can cause cardiotoxic effects and increase the risk of electrocardiogram (ECG) abnormalities and sudden death. Antimony exposure can result in action potential prolongation, causing a cardiac repolarization delay, which appears as QTc prolongation and T-wave abnormalities on the ECG. There are no studies on antimony-associated cardiac toxicity in Korea.

Case presentation

Accordingly, the present study reports cases of ECG abnormalities in workers handling antimony trisulfide at a company located in the Gyeongsangbuk-do region. Nineteen workers employed at an automobile brake lining manufacturer were exposed to antimony trisulfide dust through thermoforming, grinding, and drilling processes. In 2020, the workers were reported to work 12-hour shifts, 5 days a week. The time-weighted average (TWA) of antimony trisulfide exposure measured in workers was 0.0028 mg/m3. Two workers were excluded from the analysis due to pre-existing medical conditions (cardiovascular disease). Of the remaining 17 workers, ECG abnormalities were found in 41% (seven out of 17: four with QTc prolongation and T-wave abnormalities; two with only T-wave abnormalities; and one with only QTc prolongation).

Conclusions

This case report outlines the first few cases in Korea in which potential cardiac toxicity caused by occupational exposure to antimony was identified. However, data regarding cardiac toxicity caused by antimony exposure are still lacking in Korea; thus, additional studies are needed to identify causal relationships.

자동차 브레이크 라이닝 제조업에 근무하는 안티몬 노출 근로자의 심전도 이상: 사례 보고서
배경
안티몬은 촉매, 살충제, 브레이크 시스템 및 의약품에 사용되며 플라스틱, 페인트 및 고무 산업에서 합성 난연제로 사용된다. 3가 안티몬 화합물이 체내에 축적되면 심장 독성 효과를 일으켜 심전도(ECG) 이상 및 급사의 위험이 증가할 수 있다. 3가 안티몬 화합물의 직업적 노출은 활동 전위 연장을 일으켜 심장 재분극 지연을 유발할 수 있으며, 이는 QTc 연장과 T파 이상으로 나타난다. 아직 국내에서는 3가 안티몬 화합물 노출과 관련된 심장 독성에 관한 연구는 없다. 이에 본 연구에서는 경상북도 지역에 위치한 회사에서 삼황화 안티몬을 취급하는 작업자의 심전도 이상 사례를 보고한다.
증례
자동차 브레이크 라이닝 제조업체에 고용된 19명의 작업자가 열성형, 연삭 및 드릴링 공정을 통해 삼황화 안티몬 분진에 노출되어 왔다. 2020년에 삼황화 안티몬에 노출 공정 근로자 19명은 주 5일 12시간 교대로 근무하였다. 근로자에게서 측정한 삼황화 안티몬 노출의 시간 가중 평균(TWA)은 0.0028 mg/m3였다. 2명의 근로자는 심장질환 과거력으로 인해 분석에서 제외되었다. 나머지 17명의 작업자 중 41%에서 ECG 이상이 발견되었다(17명 중 7명의 작업자: QTc 연장 및 T 파 이상 4명, T 파 이상 2명, QTc 연장 1명).
고찰
이 증례 보고서는 국내 최초로 직업상 안티몬 노출로 인한 잠재적인 심장 독성이 확인된 증례에 관해 설명한다. 그러나 우리나라에서는 안티몬 노출에 의한 심장 독성에 대한 자료가 아직 부족한 실정이다. 따라서 인과관계를 규명하기 위해서는 추가적인 연구가 필요하다.
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Case Report
Assessment of risks for breast cancer in a flight attendant exposed to night shift work and cosmic ionizing radiation: a case report
Dong Joon Park, Sungkyun Park, Seong Won Ma, Hoekyeong Seo, Sang Gil Lee, Kyung-Eun Lee
Ann Occup Environ Med 2022;34:e5.   Published online March 22, 2022
DOI: https://doi.org/10.35371/aoem.2022.34.e5
AbstractAbstract AbstractAbstract in Korean PDFSupplementary Material
Background

Some epidemiological studies have estimated exposure among flight attendants with and without breast cancer. However, it is difficult to find a quantitative evaluation of occupational exposure factors related to cancer development individually in the case of breast cancer in flight attendants. That is, most, if not all, epidemiological studies of breast cancer in flight attendants with quantitative exposure estimates have estimated exposure in the absence of individual flight history data.

Case presentation

A 41-year-old woman visited the hospital due to a left breast mass after a regular check-up. Breast cancer was suspected on ultrasonography. Following core biopsy, she underwent various imaging modalities. She was diagnosed invasive ductal carcinoma of no special type (estrogen receptor positive in 90%, progesterone receptor positive in 3%, human epidermal growth factor receptor 2/neu equivocal) with histologic grade 3 and nuclear grade 3 in the left breast. Neoadjuvant chemotherapy was administered to reduce the tumor size before surgery. However, due to serious chemotherapy side effects, the patient opted for alternative and integrative therapies. She joined the airline in January, 1996. Out of all flights, international flights and night flights accounted for 94.9% and 26.2, respectively. Night flights were conducted at least four times per month. Moreover, based on the virtual computer program CARI-6M, the estimated dose of cosmic radiation exposure was 78.81 mSv. There were no other personal triggers or family history of breast cancer.

Conclusions

This case report shows that the potentially causal relationship between occupational harmful factors and the incidence of breast cancer may become more pronounced when night shift workers who work continuously are exposed to cosmic ionizing radiation. Therefore, close attention and efforts are needed to adjust night shift work schedules and regulate cosmic ionizing radiation exposure.

국제항공 승무원에서 발생한 유방암 사례와 업무관련성 평가
배경
유방암은 여성에게 가장 흔하게 진단되는 암으로, 전리방사선과 야간교대근무와 같은 직업환경적 위험을 포함한 다양한 요인에 의해 영향을 받는다. 항공승무원은 우주 전리 방사사선과 야간교대근무 환경에 노출되는 대표적인 직업군으로 일반인구집단 대비 유방암의 발병 위험이 높다고 몇몇 역학연구에서는 보고되고 있다. 그러나 항공승무원의 유방암 사례에서 암 발병과 관련된 직업적 노출요인에 대하여 정량적으로 평가한 사례는 찾기 어렵다. 본 연구에서는 질환발병의 업무관련성을 인정받은 항공승무원 종사자의 유방암 사례에서 질환 발병과 관련된 직업적 요인들의 노출 수준을 정량적인 평가하였다.
증례
41세의 여성 환자는 항공승무원 재직 중 정기건강검진에서 우연히 발견된 좌측 유방종괴를 주소로 병원에 내원하였다. 초음파 검사 및 조직생검 등의 검사결과 유방의 침습암종(조직 및 핵분화도 3기), 을 진단 받았다. 환자는 유방 보존술을 위한 선행화학요법 시행 중에 부작용이 발생하여 수술적 치료를 시행하지 못하고 보존적 치료를 유지중이다. 환자는 1996년 1월 항공사에 입사하여, 20년 2개월간 항공승무원으로 종사하였다. 총 비행기 탑승 이력 중 94.9%는 국제선에 탑승하였고 총 비행시간의 26.2%는 야간 비행으로 한 달에 네 번 이상 야간 비행업무를 수행하였다. 컴퓨터 시뮬레이션 프로그램인 CARI-6M을 이용하여 추정한 근로자의 우주 방사선 누적노출 추정량은 78.81 mSv였다. 유방암에 대한 개인적 유발 요인 및 가족력은 없었다. 역학조사평가위원회는 이 여성 승무원에서 발생한 유방암은 20년 2개월 간의 야간교대근무와 78.81 mSv의 우주 방사선 노출을 근거로 업무관련성이 상당하다고 평가하였다.
고찰
이번 사례는 항공 승무원 집단에서의 높은 유방암 발병률은 야간교대근무와 함께 기체 탑승 중 우주 전리방사선의 복합적 노출에 의해 기인될 수 있음을 보여준다. 항공 승무원 집단에서의 야간교대근무와 우주 전리방사선 복합노출에 따른 건강영향을 최소화하기 위해서는 더많은 노출평가 사례 및 집단 역학조사를 통한 비행일정 관리기준의 근거마련이 필요하다.

Citations

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  • Cosmic Radiation Exposure: A Review of Recent Research on the Incidence and Prevention of Cancer in Aircrews
    Lisa D. Eckhardt
    Health Physics.2025; 128(4): 291.     CrossRef
  • Influence of occupational factors on the development of gynecologic pathology in flight attendants in civil aviation
    Nailya I. Nasyrova, Artem Y. Yurovskiy, Aleksei V. Overko, Lyudmila A. Ozolinya
    V.F.Snegirev Archives of Obstetrics and Gynecology.2024; 11(2): 137.     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
AbstractAbstract AbstractAbstract in Korean PDF
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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Case Report
Parkinson's disease in a worker exposed to insecticides at a greenhouse
Yangwoo Kim, Inah Kim, Jung-Min Sung, Jaechul Song
Ann Occup Environ Med 2021;33:e6.   Published online February 5, 2021
DOI: https://doi.org/10.35371/aoem.2021.33.e6
AbstractAbstract PDF
Background

Parkinson's disease (PD) is a rare, neurodegenerative disease with various occupational and environmental risk factors. Exposure to specific pesticides contributes significantly to the incidence of PD. However, it is difficult to measure the level of pesticide exposure in workers. This study presents the first case recognized the work-relatedness between PD and pesticide exposure.

Case presentation

A 68-year-old male was diagnosed with PD after working with pesticides at a tomato greenhouse for 12 years and 5 months. From the results of a field study, it was reasonable to assume that the patient had been exposed to a significant level of various insecticides. In the present report, we described the first accepted case of work-relatedness between PD and exposure to pesticides. The evaluation was conducted using the following steps: we ruled out other possible risk factors including additional occupational history and personal risk factors, we assessed the work environment, surveyed possible exposures, found proper epidemiological evidence, and calculated the probability of causation. The work-relatedness was determined through the review of epidemiological evidence and estimation of exposure situation and level, and biological plausibility. We also decided work-relatedness based on the exposure of PD related pesticides with identified biologically plausible and the presumption that the exposure level would be high due to the working process.

Conclusions

In this case, the field study and epidemiological results supported the work-relatedness of PD and exposure to pesticides. Moreover, the results of previous studies have confirmed a causal relationship between exposure to pesticides and PD.


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  • The neuroprotective effect of 1,25-dyhydroxyvitamin D 3 (calcitriol) and probiotics on the rotenone-induced neurotoxicity model in SH-SY5Y cells
    Fatma Hazan Gul, Nuh Mehmet Bozkurt, Nalan Hakime Nogay, Gokhan Unal
    Drug and Chemical Toxicology.2025; 48(1): 72.     CrossRef
  • Rotenone-Induced Model of Parkinson’s Disease: Beyond Mitochondrial Complex I Inhibition
    María Teresa Ibarra-Gutiérrez, Norma Serrano-García, Marisol Orozco-Ibarra
    Molecular Neurobiology.2023; 60(4): 1929.     CrossRef
  • Food Contamination: An Unexplored Possible Link between Dietary Habits and Parkinson’s Disease
    Giulia Caioni, Annamaria Cimini, Elisabetta Benedetti
    Nutrients.2022; 14(7): 1467.     CrossRef
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Review
A work-relatedness assessment in epidemiological case investigation of occupational cancers: II. Practice: an upper urinary tract cancer in a dyer
Kihun Kim, Hyeoncheol Oh, Jungwon Kim
Ann Occup Environ Med 2020;32:e31.   Published online September 1, 2020
DOI: https://doi.org/10.35371/aoem.2020.32.e31
AbstractAbstract PDF

An epidemiological case investigation of occupational cancer is conducted to determine the causation between the cancer and the worker's job. This review describes the overall process of work-relatedness assessment of the epidemiological case investigation through a case of upper urinary tract cancer (UUTC) in benzidine exposed worker in dyeing industry. Medical referrals, occupational history, material safety data sheet, and working environment monitoring submitted by the Korea Workers' Compensation and Welfare Service were reviewed. We further investigated literatures about the cotton dyeing industry, the domestic law and working environment monitoring reports. Benzidine was listed as an International Agency for Research on Cancer risk factor only for bladder cancer among urinary tract cancers, requiring different logical grounds for establishing causation. A literature review was conducted on the metabolic pathways of benzidine to establish biological plausibility. In addition, several papers were investigated that UUTC and bladder cancer share risk factors to extrapolate the epidemiological studies of bladder cancer. Epidemiologic studies of benzidine and bladder cancer were investigated. The worker is a 71-year-old man and performed dyeing and transporting at several dyeing factories for 29 years. The worker was diagnosed with UUTC based on radiologic and histologic results. It was critical to consider that he worked as a dyer for 3 years. The cancer was diagnosed in 2018, with a latent period of approximately 35 years. The worker performed cotton dyeing, and benzidine-based dye was mainly used. The quantitative exposure level of benzidine was reported from non-detection to 397.4 µg/m3. In biological metabolisms, N-acetylhydroxylamine changes DNA structure of urothelium. As a result of reviewing 4 epidemiological studies, the standardized incidence ratio and standardized mortality ratio were significantly high with 3 years of exposure. Work-relatedness was finally assessed as probable based on biological mechanisms and epidemiological evidence. This review will help solutions for work-relatedness assessment processes.


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

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


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  • 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
    Annals of Occupational and Environmental Medicine.2022;[Epub]     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
AbstractAbstract PDF
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.


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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
  • Overview of human health effects related to glyphosate exposure
    Flavia Silvia Galli, Marta Mollari, Valentina Tassinari, Cristian Alimonti, Alessandro Ubaldi, Camilla Cuva, Daniele Marcoccia
    Frontiers in Toxicology.2024;[Epub]     CrossRef
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Research Article
Mercury concentration in shark meat from traditional markets of Gyeongsangbuk-do, South Korea
Han Cheol Heo, Yeon Hee Lim, Young Seok Byun, Joon Sakong
Ann Occup Environ Med 2020;32:e3.   Published online January 2, 2020
DOI: https://doi.org/10.35371/aoem.2020.32.e3
AbstractAbstract PDF
Background

Although unusually high levels of blood mercury have been reported in the North Gyeongsang Province (Gyeongsangbuk-do), mercury contents from shark meat distributed in this region have not been assessed yet. Thus, this study aims to identify the hazard by evaluating the mercury contents of the shark meat sold in the traditional market of Gyeongsangbuk-do.

Methods

The shark meat in the form of muscle meat was obtained from 15 traditional markets of Gyeongsangbuk-do in the summer and winter of 2013. Out of 105 samples in total, 49 were collected in the summer and 56 in the winter. The total mercury concentration was measured by the combustion-gold amalgamation method using an automatic mercury analyzer (Milestone DMA-80, Milestone).

Results

The average mercury concentration of shark meat was 2.29 ± 1.77 µg/g, ranging between 0.06–8.93 µg/g with a geometric mean of 1.44 µg/g, which is higher than those reported in many countries. The mercury concentration in 77 of 105 shark meat samples exceeded 1 µg/g. Mercury concentration ranged between 0.09–8.93 µg/g (geometric mean: 1.45) in the summer and 0.06–6.73 µg/g (geometric mean: 1.48) in the winter.

Conclusions

Shark meat sold in the market contained a substantial amount of mercury. This suggests that it is difficult to reduce mercury intake by simply strengthening the standard level of mercury concentration in shark meat. Therefore, it is need to communication and awareness programs with consumers about hazardous effects of mercury inherent in shark meat.


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  • Assessment of heavy metals concentration and health risk in four species of Persian Gulf sharks in Hormozgan Province
    Hassan heidarieh, Amin Gholamhosseini, Siyavash Soltanian, Marzieh Heidarieh, Mahdi Banaee, Nima Shiry
    Journal of Trace Elements in Medicine and Biology.2025; 87: 127581.     CrossRef
  • Monitoring of Cadmium, Lead, and Mercury Levels in Seafood Products: A Ten-Year Analysis
    Luisa Garofalo, Marcello Sala, Claudia Focardi, Patrizio Pasqualetti, Daniela Delfino, Francesca D’Onofrio, Barbara Droghei, Francesca Pasquali, Valentina Nicolini, Flavia Silvia Galli, Paola Scaramozzino, Alessandro Ubaldi, Katia Russo, Bruno Neri
    Foods.2025; 14(3): 451.     CrossRef
  • Metallic Makos: Metal and Metalloid Levels and Human Health Risks Arising from the Consumption of Shortfin Makos (Isurus oxyrinchus) from Southeastern Brazil
    Júlia Vianna de Pinho, Isabel Quental Willmer, Amanda Pontes Lopes, Regina Fonsêca, Tatiana Dillenburg Saint’Pierre, Patricia Charvet, Acácio Ribeiro Gomes Tomas, Rachel Ann Hauser-Davis
    Biological Trace Element Research.2025;[Epub]     CrossRef
  • Association of Blood Mercury Level with Liver Enzymes in Korean Adults: An Analysis of 2015–2017 Korean National Environmental Health Survey
    Jin-Wook Chung, Dilaram Acharya, Jitendra Kumar Singh, Joon Sakong
    International Journal of Environmental Research and Public Health.2023; 20(4): 3290.     CrossRef
  • Increase of blood mercury level with shark meat consumption: A repeated-measures study before and after Chuseok, Korean holiday
    Kiook Baek, Chulyong Park, Joon Sakong
    Chemosphere.2023; 344: 140317.     CrossRef
  • Mercury cycling in Australian estuaries and near shore coastal ecosystems: Triggers for management
    William Maher, Frank Krikowa, Michael Ellwood, Detlev Helmig, Ruoyu Sun
    Elementa: Science of the Anthropocene.2020;[Epub]     CrossRef
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Research Article
Relationship between occupational sunlight exposure and the incidence of renal cancer
Hyun-Suk Jang, Jong-Han Leem, Seong Soo Jeon, Shin-Goo Park, Sangyoon Lee, Yangwon Kang, Go Choi, Hyung Doo Kim, Hyeonwoo Ju, Sung Wook Jang, Youna Won, Hwan-Cheol Kim
Ann Occup Environ Med 2019;31:e32.   Published online November 7, 2019
DOI: https://doi.org/10.35371/aoem.2019.31.e32
AbstractAbstract PDF
Background

The risk factors for renal cancer include smoking, obesity, hypertension, and exposure to trichloroethylene. Recent studies have shown that low sunlight exposure increases the risk of developing a range of cancers, including renal cancer. Given that most of the daytime is spent at work, a lack of occupational sunlight exposure can be a risk factor for renal cancer. Therefore, this study examined the relationship between occupational sunlight exposure and the incidence of renal cancer.

Methods

This was a university hospital-based case-control study on renal cancer. Of the 706 newly diagnosed patients with renal cell carcinoma (RCC), 633 cases were selected; 73 who had no occupational history were excluded. In addition, 633 controls were selected from the general population after 1:1 matching with respect to sex, age (within 5 years), and residential area (constituency-level). Information on sunlight exposure by the occupational group was referred to data from France. To estimate the association between occupational sunlight exposure and the RCC risk, the odds ratios (ORs) were calculated using conditional logistic regression analysis.

Results

Sunlight exposure was divided into quartiles and the risk of RCC was analyzed. The adjusted OR of RCC (OR: 0.664, 95% confidence interval: 0.449–0.983) was significantly lower for the Q4 group than Q1 group but the Q2 and Q3 groups did not show significant results. The risk of RCC tended to decrease with increasing exposure to sunlight (p for trend < 0.028).

Conclusions

Higher occupational sunlight exposure reduces the risk of RCC.


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Research Article
Second hand smoke exposure in workplace by job status and occupations
Hyunhee Park, Sung-il Cho, Changhun Lee
Ann Occup Environ Med 2019;31:3.   Published online January 28, 2019
DOI: https://doi.org/10.1186/s40557-019-0282-z
AbstractAbstract PDF
Background

The objective of this study is to evaluate the risk of exposure to second hand smoke (SHS) during working hours by job status and occupation.

Methods

Using the 4th Korean Working Conditions Survey (KWCS), 49,674 respondents who answered the question about SHS were studied. A chi-square test was carried out to determine whether there is a significant different in SHS exposure frequency by general and occupational characteristics and experience of discrimination at work and logistic regression analysis was carried out to identify the risk level of SHS exposure by variables.

Results

In this study, we found that male workers in their 40s and 50s, workers employed in workplaces with fewer than 50 employees, daily workers, and people working outdoors had a higher rate of exposure to SHS than the others. The top five occupations with the highest SHS exposure were construction and mining-related occupations, metal core-makers-related trade occupations, wood and furniture, musical instrument, and signboard-related trade occupations, transport and machine-related trade occupations, transport and leisure services occupations. The least five exposed occupations were public and enterprise senior officers, legal and administrative professions, education professionals, and health, social welfare, and religion-related occupations.

Conclusion

Tobacco smoke is a significant occupational hazard. Smoking ban policy in the workplace can be a very effective way to reduce the SHS exposure rate in the workplace and can be more effective if specifically designed by the job status and various occupations.


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  • Second-Hand Smoke Exposure and Risk of Lung Cancer Among Nonsmokers in the United States: A Systematic Review and Meta-Analysis
    Safa Elkefi, Gabriel Zeinoun, Achraf Tounsi, Jean-Marie Bruzzese, Corina Lelutiu-Weinberger, Alicia K. Matthews
    International Journal of Environmental Research and Public Health.2025; 22(4): 595.     CrossRef
  • A Comparison of Measured Airborne and Self-Reported Secondhand Smoke Exposure in the MADRES Pregnancy Cohort Study
    Karl O’Sharkey, Yan Xu, Jane Cabison, Marisela Rosales, Thomas Chavez, Mark Johnson, Tingyu Yang, Seung-Hyun Cho, Ryan Chartier, Deborah Lerner, Nathana Lurvey, Claudia M Toledo Corral, Myles Cockburn, Meredith Franklin, Shohreh F Farzan, Theresa M Bastai
    Nicotine and Tobacco Research.2024; 26(6): 669.     CrossRef
  • Association Between Temporary Employment and Current Smoking and Change in Smoking Behaviors: A Prospective Cohort Study From South Korea (2009–2018)
    Seong-Uk Baek, Min-Seok Kim, Myeong-Hun Lim, Taeyeon Kim, Jin-Ha Yoon, Yu-Min Lee, Jong-Uk Won
    Journal of Epidemiology.2024; 34(10): 459.     CrossRef
  • A Comparison of Measured Airborne and Self-Reported Secondhand Smoke Exposure in the Madres Pregnancy Cohort Study
    Karl O'Sharkey, Yan Xu, Jane Cabison, Marisela Rosales, Thomas Chavez, Mark Johnson, Tingyu Yang, Seung-Hyun Cho, Ryan Chartier, Claudia M. Toledo Corral, Myles Cockburn, Meredith Franklin, Shohreh F. Farzan, Theresa Bastain, Carrie V. Breton, Rima H
    SSRN Electronic Journal .2022;[Epub]     CrossRef
  • Exposure to Secondhand Smoke: Inconsistency between Self-Response and Urine Cotinine Biomarker Based on Korean National Data during 2009–2018
    Boram Sim, Myung-Bae Park
    International Journal of Environmental Research and Public Health.2021; 18(17): 9284.     CrossRef
  • Self-reported secondhand smoke exposure following the adoption of a national smoke-free policy in Poland: analysis of serial, cross-sectional, representative surveys, 2009–2019
    Mateusz Jankowski, Vaughan Rees, Wojciech Stefan Zgliczyński, Dorota Kaleta, Mariusz Gujski, Jarosław Pinkas
    BMJ Open.2020; 10(9): e039918.     CrossRef
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Research Article
Relationship between simultaneous exposure to ergonomic risk factors and work-related lower back pain: a cross-sectional study based on the fourth Korean working conditions survey
Jae-Yeop Kim, Ji-Su Shin, Myeong-Seob Lim, Hyeon-Gyeong Choi, Sung-Kyeong Kim, Hee-Tae Kang, Sang-Baek Koh, Sung-Soo Oh
Ann Occup Environ Med 2018;30:58.   Published online September 5, 2018
DOI: https://doi.org/10.1186/s40557-018-0269-1
AbstractAbstract PDF
Background

It is well known that ergonomic risk factors and back pain are related. However, few studies have examined the relationship between simultaneous exposure to these risk factors and back pain in a Korean population. We aimed to investigate the relationship between simultaneous exposure to ergonomic risk factors and work-related lower back pain (LBP) based on the fourth Korean Working Conditions Survey (KWCS).

Method

The fourth KWCS (2014) was used for this study. Chi-square tests and logistic regression were used to assess relationship between 5 ergonomic risk factors and work-related LBP. We also analyzed the relationship between simultaneous exposure to 2 risk factors and work-related LBP.

Results

All 5 ergonomic risk factors (fatigue-inducing and painful posture; lifting or moving people; dragging, pushing, or moving heavy objects; standing posture; and repetitive hand or arm movements) were significantly correlated with work-related LBP in the severe exposure group (adjusted odd ratios [aOR] 5.09, 95% confidence interval [CI] 4.46–5.83; aOR 1.98, 95% CI 1.62–2.42; aOR 2.09, 95% CI 1.82–2.40; aOR 1.79, 95% CI 1.60–2.01; aOR 2.04, 95% CI 1.82–2.30, respectively). When exposed to 2 risk factors simultaneously, the relationship between exposure and work-related LBP was not greater than exposure to only 1 risk factor in our study (usually exposed to ‘fatigue-inducing or painful posture’ aOR 2.17, 95% CI 2.02–2.34; high exposure to both ‘fatigue-inducing or painful posture’ and ‘dragging, pushing, or moving heavy objects’ aOR 2.00, 95% CI 1.82–2.20).

Conclusions

There was a strong relationship between severe exposure to each ergonomic risk factor and work-related LBP. However, when exposed to 2 ergonomic risk factors simultaneously, the relationship between exposure and work-related LBP was not stronger than when exposed to only 1 risk factor in our study.


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  • Association between commuting time and work-related low back pain with respect to sports and leisure activities in Korean workers
    Jaehyuk JUNG, Jae Bum PARK, Kyung-Jong LEE, Youngwook SEO, Inchul JEONG
    Industrial Health.2024; 62(2): 133.     CrossRef
  • Low Back Pain in Resident Doctors with Standardized Training in China: A Cross-Sectional Study
    Han-Wen Zhang, Hong-Ping Tan, Qiu-Xia Feng
    Risk Management and Healthcare Policy.2023; Volume 16: 2459.     CrossRef
  • Prevalence and Associated Factors of Low Back Pain Among Healthcare Professionals at University of Gondar Comprehensive and Specialized Hospital, Northwest Ethiopia: Cross-Sectional Study
    Nini Asfaw Negash, Azmeraw Tadele, Abebaw Jember Ferede
    Journal of Pain Research.2022; Volume 15: 1543.     CrossRef
  • Gender differences in associating musculoskeletal complaints, housework, electronic device usage and physical exercise for administrative workers
    Tânia M. Lima, Denis A. Coelho
    International Journal of Occupational Safety and Ergonomics.2022; 28(2): 1189.     CrossRef
  • Predictors of Satisfaction With Work Environment in the Context of a Mismatch in Working Hours: A Nationwide, Large-Scale, Cross-Sectional Study
    Robert Kim
    INQUIRY: The Journal of Health Care Organization, Provision, and Financing.2022;[Epub]     CrossRef
  • Working from home during the COVID‐19 pandemic, its effects on health, and recommendations: The pandemic and beyond
    Canan Birimoglu Okuyan, Mehmet A. Begen
    Perspectives in Psychiatric Care.2022; 58(1): 173.     CrossRef
  • Lumbopelvic sagittal standing posture associations with anthropometry, physical activity levels and trunk muscle endurance in healthy adults
    George A. Koumantakis, Antonios Malkotsis, Stefanos Pappas, Maria Manetta, Timotheos Anastopoulos, Apollon Kakouris, Eleutherios Kiourtsidakis
    Hong Kong Physiotherapy Journal.2021; 41(02): 127.     CrossRef
  • A pilot study to assess a risk of a high-risk group of low back pain membership in workers who perform the manual material handling tasks
    Sungho Lee, Seongchan Heo, Jong-Young Lee
    Annals of Occupational and Environmental Medicine.2021;[Epub]     CrossRef
  • Association between Occupational Noise and Vibration Exposure and Insomnia among Workers in Korea
    Fatima Nari, Yun Kyung Kim, Soo Hyun Kang, Eun-Cheol Park, Sung-In Jang
    Life.2020; 10(4): 46.     CrossRef
  • Association of Exposure to a Combination of Ergonomic Risk Factors with Musculoskeletal Symptoms in Korean Workers
    Jungsun Park, Yangho Kim
    International Journal of Environmental Research and Public Health.2020; 17(24): 9456.     CrossRef
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Review
Radiation-related occupational cancer and its recognition criteria in South Korea
Songwon Seo, Dalnim Lee, Ki Moon Seong, Sunhoo Park, Soo-Geun Kim, Jong-Uk Won, Young Woo Jin
Ann Occup Environ Med 2018;30:9.   Published online February 2, 2018
DOI: https://doi.org/10.1186/s40557-018-0219-y
AbstractAbstract PDF

Ionizing radiation is a well-known carcinogen, and is listed as one carcinogenic agent of occupational cancer. Given the increase in the number of workers exposed to radiation, as well as the increase in concern regarding occupational cancer, the number of radiation-related occupational cancer claims is expected to increase. Unlike exposure assessment of other carcinogenic agents in the workplace, such as asbestos and benzene, radiation exposure is usually assessed on an individual basis with personal dosimeters, which makes it feasible to assess whether a worker’s cancer occurrence is associated with their individual exposure. However, given the absence of a threshold dose for cancer initiation, it remains difficult to identify radiation exposure as the root cause of occupational cancer. Moreover, the association between cancer and radiation exposure in the workplace has not been clearly established due to a lack of scientific evidence. Therefore, criteria for the recognition of radiation-related occupational cancer should be carefully reviewed and updated with new scientific evidence and social consensus. The current criteria in Korea are valid in terms of eligible radiogenic cancer sites, adequate latent period, assessment of radiation exposure, and probability of causation. However, reducing uncertainty with respect to the determination of causation between exposure and cancer and developing more specific criteria that considers mixed exposure to radiation and other carcinogenic agents remains an important open question.


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  • Association between occupational exposure of laboratory technicians to ionizing radiation and impact on blood biomarkers
    Vaneeza Rahim, Noor Ul Haq, Afrasiab Khan Tareen, Imrana Niaz Sultan, Sanam Zeib Khan, Muhammad Waseem Khan
    Radiation Physics and Chemistry.2025; 233: 112713.     CrossRef
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    Jeong-In Park, Seung-Youn Jung, Kyung-Hee Song, Dong-Hyeon Lee, Jiyeon Ahn, Sang-Gu Hwang, In-Su Jung, Dae-Seog Lim, Jie-Young Song
    International Journal of Molecular Medicine.2024;[Epub]     CrossRef
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    Nikolay Aleexevich Korenevskiy, Riad Taha Al-Kasasbeh, Evgenia A. Krikunova, Sofia N. Rodionova, Ashraf Shaqdan, Osama M. Al-Habahbeh, Sergey Filist, Mahdi Salman Alshamasin, Mohammad S. Khrisat, Maksim Ilyash
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Review
Review of carcinogenicity of hexavalent chrome and proposal of revising approval standards for an occupational cancers in Korea
Jungwon Kim, Sangyun Seo, Yangho Kim, Dae Hwan Kim
Ann Occup Environ Med 2018;30:7.   Published online January 31, 2018
DOI: https://doi.org/10.1186/s40557-018-0215-2
AbstractAbstract PDF
Background

The objective of this study is to suggest revised recognition standards for occupational disease due to chromium (VI) by reflecting recent domestic and international research works and considering domestic exposure status with respect to target organs, exposure period, and cumulative exposure dose in relation to the chromium (VI)-induced occupational disease compensation.

Methods

In this study, the reports published by major international institutions such as World Health Organization (WHO) International Agency for Research on Cancer (IARC) (2012), Occupational Safety and Health Administration (OSHA) (2006), National Institute for Occupational Safety and Health (NIOSH) (2013), American Conference of Governmental Industrial Hygienists (ACGIH) (2004), National Toxicology Program (NTP) (2014), and Agency for Toxic Substances and Disease Registry (ASTDR) (2012) were reviewed and the recent research works searched by PubMed were summarized.

Results

Considering the recent research works and the domestic situation, only lung cancer is conserved in the legislative bill in relation to chromium (VI), and the exposure period is not included in the bill. Nasal and paranasal sinus cancer was excluded from the list of cancers that are compensated as the chromium (VI)- induced occupational disease, while lung cancer remains in the list. In the view of legislative unity, considering the fact that only the cancers having sufficient evidence are included in the conventional list of cancers compensated as occupational disease, nasal and paranasal sinus cancer having limited evidence were excluded from the list.

The exposure period was also removed from the legislative bill due to the insufficient evidence. Recent advices in connection with cumulative exposure dose were proposed, and other considerable points were provided with respect to individual occupational relevance.

Conclusions

It is suggested that the current recognition standard which is “Lung cancer or nasal and paranasal sinus cancer caused by exposure to chromium (VI) or compounds thereof (exposure for two years or longer), or nickel compounds” should be changed to “Lung cancer caused by exposure to chromium (VI) or compounds thereof, and lung cancer or nasal and paranasal sinus cancer caused by exposure to nickel compounds”.


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Research Article
Carbon disulfide exposure estimate and prevalence of chronic diseases after carbon disulfide poisoning-related occupational diseases
Hweemin Chung, Kanwoo Youn, Kyuyeon Kim, Kyunggeun Park
Ann Occup Environ Med 2017;29:52.   Published online October 26, 2017
DOI: https://doi.org/10.1186/s40557-017-0208-6
AbstractAbstract PDF
Background

In Korea, Carbon disulfide (CS2) toxicity was an important social problem from the late 1980s to the early 1990s but there have been few large-scale studies examining the prevalence of diseases after CS2 exposure discontinuance. So we investigated past working exposure to CS2 characteristics from surviving ex-workers of a rayon manufacturing plant including cumulative CS2 exposure index. Furthermore, we studied the prevalence of their chronic diseases recently after many years.

Methods

We interviewed 633 ex-workers identified as CS2 poisoning-related occupational diseases to determine demographic and occupational characteristics and reviewed their medical records. The work environment measurement data from 1992 was used as a reference. Based on the interviews and foreign measurement documents, weights were assigned to the reference concentrations followed by calculation of individual exposure index, the sum of the portion of each time period multiplied by the concentrations of CS2 during that period.

Results

The cumulative exposure index was 128.2 ppm on average. Workers from the spinning, electrical equipment repair, and motor repair departments were exposed to high concentrations of ≥10 ppm. Workers from the maintenance of the ejector, manufacturing of CS2, post-process, refining, maintenance and manufacturing of viscose departments were exposed to low concentrations below 10 ppm. The prevalence for hypertension, coronary artery disease, cerebrovascular disease, diabetes, arrhythmia, psychoneurotic disorder, disorders of the nervous system and sensory organ were 69.2%, 13.9%, 24.8%, 24.5%, 1.3%, 65.7%, 72.4% respectively.

Conclusions

We estimated the individual cumulative CS2 exposure based on interviews and foreign measurement documents, and work environment measurement data. Comparing the work environment measurement data from 1992, these values were similar to them. After identified as CS2 poisoning, there are subjects over 70 years of average age with disorders of the nervous system and sensory organs, hypertension, psychoneurotic disorder, cerebrovascular disease, diabetes, coronary artery disease, and arrhythmia. Because among ex-workers of the rayon manufacturing plant, only 633 survivors recognized as CS2 poisoning were studied, the others not identified as CS2 poisoning should also be investigated in the future.


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  • Ultrafast Luminescence Detection with Selective Adsorption of Carbon Disulfide in a Gold(I) Metal−Organic Framework
    Haruka Yoshino, Masaki Saigo, Takumi Ehara, Kiyoshi Miyata, Ken Onda, Jenny Pirillo, Yuh Hijikata, Shinya Takaishi, Wataru Kosaka, Ken‐ichi Otake, Susumu Kitagawa, Hitoshi Miyasaka
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Research Article
The relationship between spontaneous abortion and female workers in the semiconductor industry
Heechan Kim, Ho-Jang Kwon, Jeongbae Rhie, Sinye Lim, Yun-Dan Kang, Sang-Yong Eom, Hyungryul Lim, Jun-Pyo Myong, Sangchul Roh
Ann Occup Environ Med 2017;29:49.   Published online October 9, 2017
DOI: https://doi.org/10.1186/s40557-017-0204-x
AbstractAbstract PDF
Background

This study investigated the relationship between job type and the risk for spontaneous abortion to assess the reproductive toxicity of female workers in the semiconductor industry.

Methods

A questionnaire survey was administered to current female workers of two semiconductor manufacturing plants in Korea. We included female workers who became pregnant at least 6 months after the start of their employment with the company. The pregnancy outcomes of 2,242 female workers who experienced 4,037 pregnancies were investigated. Personnel records were used to assign the subjects to one of three groups: fabrication process workers, packaging process workers, and clerical workers. To adjust for within-person correlations between pregnancies, a generalized estimating equation was used. The logistic regression analysis was limited to the first pregnancy after joining the company to satisfy the assumption of independence among pregnancies. Moreover, we stratified the analysis by time period (pregnancy in the years prior to 2008 vs. after 2009) to reflect differences in occupational exposure based on semiconductor production periods.

Results

The risk for spontaneous abortion in female semiconductor workers was not significantly higher for fabrication and packaging process workers than for clerical workers. However, when we stratified by time period, the odds ratio for spontaneous abortion was significantly higher for packaging process workers who became pregnant prior to 2008 when compared with clerical workers (odds ratio: 2.21; 95% confidence interval: 1.01–4.81).

Conclusions

When examining the pregnancies of female semiconductor workers that occurred prior to 2008, packaging process workers showed a significantly higher risk for spontaneous abortions than did clerical workers. The two semiconductor production periods in our study (prior to 2008 vs. after 2009) had different automated processes, chemical exposure levels, and working environments. Thus, the conditions prior to 2008 may have increased the risk for spontaneous abortions in packaging process workers in the semiconductor industry.

Electronic supplementary material

The online version of this article (10.1186/s40557-017-0204-x) contains supplementary material, which is available to authorized users.


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Review
Estimations of the lethal and exposure doses for representative methanol symptoms in humans
Chan-Seok Moon
Ann Occup Environ Med 2017;29:44.   Published online October 2, 2017
DOI: https://doi.org/10.1186/s40557-017-0197-5
AbstractAbstract PDF
Background

The aim of this review was to estimate the lethal and exposure doses of a representative symptom (blindness) of methanol exposure in humans by reviewing data from previous articles.

Methods

Available articles published from 1970 to 2016 that investigated the dose-response relationship for methanol exposure (i.e., the exposure concentration and the biological markers/clinical symptoms) were evaluated; the MEDLINE and RISS (Korean search engine) databases were searched. The available data from these articles were carefully selected to estimate the range and median of a lethal human dose. The regression equation and correlation coefficient (between the exposure level and urinary methanol concentration as a biological exposure marker) were assumed from the previous data.

Results

The lethal human dose of pure methanol was estimated at 15.8–474 g/person as a range and as 56.2 g/person as the median. The dose-response relationship between methanol vapor in ambient air and urinary methanol concentrations was thought to be correlated. An oral intake of 3.16–11.85 g/person of pure methanol could cause blindness. The lethal dose from respiratory intake was reported to be 4000–13,000 mg/l. The initial concentration of optic neuritis and blindness were shown to be 228.5 and 1103 mg/l, respectively, for a 12-h exposure.

Conclusion

The concentration of biological exposure indices and clinical symptoms for methanol exposure might have a dose-response relationship according to previous articles. Even a low dose of pure methanol through oral or respiratory exposure might be lethal or result in blindness as a clinical symptom.


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Research Article
The associations between blood mercury levels and shark meat intake among workers in Gyeongsangbuk-do
Gun Il Park, Young Seok Byun, Man Joong Jeon, Joon Sakong
Ann Occup Environ Med 2017;29:29.   Published online June 27, 2017
DOI: https://doi.org/10.1186/s40557-017-0185-9
AbstractAbstract PDF
Background

Shark meat is used as sacrificial food in Gyeongsangbuk-do, and is a major source of dietary mercury. This study aimed to evaluate the effects of shark meat intake or the ritual of Jesa on blood mercury levels within workers living in Gyeongsangbuk-do.

Methods

This study was conducted from September 2016 to October 2016 in two cities of Gyeongsangbuk-do. To compare the differences between urban and rural areas, two workplaces each in Daegu as the urban area and Yeongcheon as the rural area were selected. General characteristics and characteristics related to shark meat consumption of the workers were acquired by personal interviews during their health examination. Blood mercury concentrations were analyzed by the gold amalgamation method using a direct mercury analyzer (DMA-80; Milestone Inc., Shelton, CT, USA).

Results

The shark consumption group had a higher blood mercury concentration than the non-consumption group. The levels of blood mercury increased with the frequency, annual intake, as well as most recent date of shark meat consumption. Moreover, the levels of mercury in blood increased according to the annual frequency of participation in Jesa (times per year) and the annual frequency of shark meat consumption during Jesa (times per year).

Conclusions

Shark meat intake and the ritual of Jesa contributed to an increase in the blood mercury levels of workers in Gyeongsangbuk-do. Therefore, it is necessary to evaluate dietary exposure, occupational as well as other factors that may influence blood mercury concentrations in workers during their health examination, particularly in regions with high mercury exposures.


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  • Association between Blood Mercury and Seafood Consumption in Korean Adults: KoNEHS Cycle 4 (2018~2020)
    Ji-Eun Oh, Tae-Hyeong Kim, Eun-Hee Lee
    Biomedical Science Letters.2024; 30(1): 24.     CrossRef
  • Association of Blood Mercury Level with Liver Enzymes in Korean Adults: An Analysis of 2015–2017 Korean National Environmental Health Survey
    Jin-Wook Chung, Dilaram Acharya, Jitendra Kumar Singh, Joon Sakong
    International Journal of Environmental Research and Public Health.2023; 20(4): 3290.     CrossRef
  • Increase of blood mercury level with shark meat consumption: A repeated-measures study before and after Chuseok, Korean holiday
    Kiook Baek, Chulyong Park, Joon Sakong
    Chemosphere.2023; 344: 140317.     CrossRef
  • Mercury concentration in shark meat from traditional markets of Gyeongsangbuk-do, South Korea
    Han Cheol Heo, Yeon Hee Lim, Young Seok Byun, Joon Sakong
    Annals of Occupational and Environmental Medicine.2020;[Epub]     CrossRef
  • Mercury poisoning in a fisherman working on a pelagic fishing vessel due to excessive tuna consumption
    Ji-Sung Ahn, Kyung Wook Kang, Won-Yang Kang, Hyeong-Min Lim, Seunghyeon Cho, Jai-Dong Moon, Won-Ju Park
    Journal of Occupational Health.2018; 60(1): 89.     CrossRef
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Research Article
Levels of blood lead and urinary cadmium in industrial complex residents in Ulsan
Sang Hoon Kim, Yang Ho Kim, Hyun Chan An, Joo Hyun Sung, Chang Sun Sim
Ann Occup Environ Med 2017;29:26.   Published online June 26, 2017
DOI: https://doi.org/10.1186/s40557-017-0179-7
AbstractAbstract PDF
Background

Populations neighboring industrial complexes are at an increased health risk, due to constant exposure to various potentially hazardous compounds released during industrial production activity. Although there are many previous studies that focus on occupational exposure to heavy metals, studies that focused on environmental exposure to lead and cadmium are relatively rare. The purpose of this study is to evaluate the extent of the environmental exposure of heavy metals in residents of industrial area.

Methods

Four areas in close proximity to the Ulsan petrochemical industrial complex and the Onsan national industrial complex were selected to be included in the exposure group, and an area remotely located from these industrial complexes was selected as the non-exposure group. Among the residents of our study areas, a total of 1573 subjects aged 20 years and older were selected and all study subjects completed a written questionnaire. Blood and urine samples were obtained from about one third of the subjects (465 subjects) who provided informed consent for biological sample collection. Total 429 subjects (320 subjects from exposure area, 109 subjects from non-exposure area) were included in final analysis.

Results

The geometric mean blood lead level among the subjects in the exposed group was 2.449 μg/dL, which was significantly higher than the non-exposure group’s level of 2.172 μg/dL. Similarly, the geometric mean urine cadmium levels between the two groups differed significantly, at 1.077 μg/g Cr. for the exposed group, and 0.709 μg/g Cr. for the non-exposure group.

In a multiple linear regression analysis to determine the relationship between blood lead level and related factors, the results showed that blood lead level had a significant positive correlation with age, the male, exposure area, and non-drinkers. In the same way, urine cadmium level was positively correlated with age, the female, exposure area, and smokers.

Conclusions

This study found that blood lead levels and urine cadmium levels were significantly higher among the residents of industrial areas than among the non-exposure area residents, which is thought to be due to the difference in environmental exposure of lead and cadmium. Furthermore, it was clear that at a low level of exposure, differences in blood lead or urine cadmium levels based on age, gender, and smoking status were greater than the differences based on area of residence. Therefore, when evaluating heavy metal levels in the body at a low level of exposure, age, gender, and smoking status must be adjusted, as they are significant confounding factors.


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Case Report
Cases of acute mercury poisoning by mercury vapor exposure during the demolition of a fluorescent lamp factory
Sang Yoon Do, Chul Gab Lee, Jae Yoon Kim, Young Hoon Moon, Min Sung Kim, In Ho Bae, Han Soo Song
Ann Occup Environ Med 2017;29:19.   Published online June 20, 2017
DOI: https://doi.org/10.1186/s40557-017-0184-x
AbstractAbstract PDF
Background

In 2015, workers dismantling a fluorescent lamp factory in Korea were affected by mercury poisoning from exposure to mercury vapor.

Case presentation

Eighteen out of the 21 workers who participated in the demolition project presented with symptoms of poisoning and, of these, 10 had persistent symptoms even at 18 months after the initial exposure to mercury vapor. Early symptoms of 18 workers included a general skin rash, pruritus, myalgia, sleep disturbance, and cough and sputum production. Following alleviation of these initial symptoms, late symptoms, such as easy fatigue, insomnia, bad dreams, and anxiety disorder, began to manifest in 10 out of 18 patients. Seven workers underwent psychiatric care owing to sleep disturbance, anxiety disorder, and depression, and three workers underwent dermatologic treatment for hyperpigmentation, erythematous skin eruption, and chloracne-like skin lesions. Furthermore, three workers developed a coarse jerky movement, two had swan neck deformity of the fingers, and two received care at an anesthesiology clinic for paresthesia, such as burning sensation, cold sensation, and pain. Two workers underwent urologic treatment for dysfunction of the urologic system and impotence. However, symptomatic treatment did not result in satisfactory relief of these symptoms.

Conclusion

Awareness of the perils of mercury and prevention of mercury exposure are critical for preventing health hazards caused by mercury vapor. Chelation therapy should be performed promptly following mercury poisoning to minimize damage.


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    Kyle Dack, Mariona Bustamante, Caroline M. Taylor, Sabrina Llop, Manuel Lozano, Paul Yousefi, Regina Gražulevičienė, Kristine Bjerve Gutzkow, Anne Lise Brantsæter, Dan Mason, Georgia Escaramís, Sarah J. Lewis
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    Mercy Wendy Wanyana, Friday E. Agaba, Deogratias K. Sekimpi, Victoria N. Mukasa, Geoffrey N. Kamese, Nkonge Douglas, John C. Ssempebwa
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Case Report
Systemic sclerosis due to crystalline silica exposure among jewelry workers in Korea: two case reports
Jae Yoon Kim, Sang Yoon Do, Young Hoon Moon, Chul Gab Lee, Yun Sung Kim, Byung Soon Choi, Eun-A Kim, Han Soo Song
Ann Occup Environ Med 2017;29:18.   Published online June 19, 2017
DOI: https://doi.org/10.1186/s40557-017-0176-x
AbstractAbstract PDF
Background

Occupational exposure to crystalline silica is a potential risk factor for various systemic autoimmune diseases including systemic sclerosis. The etiology of systemic sclerosis is not conclusively known, but there are epidemiological studies that show the relationship between exposure to crystalline silica and risk of systemic sclerosis. Here we report, for the first time, two cases of crystalline silica-related systemic sclerosis in patients who worked in crystal processing in the jewelry-manufacturing field.

Case presentation

Case 1 is a 57-year-old man who had worked mainly in crystal processing for multiple jewelry-processing companies for 17 years, since the age of 15 years. He contracted tuberculosis at the age of 25 years and showed Raynaud’s phenomenon of both the hands and feet at age 32 years. Digital cyanosis and sclerosis developed at approximately age 41 years. The patient was diagnosed with systemic sclerosis at age 48 years.

Case 2 is a 52-year-old man who worked in crystal processing for various jewelry-processing companies for 7 years, since the age of 23 years. He first showed signs of cyanosis in the third and fourth digits of both hands at age 32 years, was diagnosed with Raynaud’s syndrome at age 37 years, and was diagnosed with systemic sclerosis at age 38 years.

Crystal processing is a detailed process that involves slabbing and trimming the selected amethyst and quartz crystals, which requires close proximity of the worker’s face with the target area. In the 1980s and 1990s, the working hours were 12 h per day, and the working environment involved 15 workers crowded into a small, 70-m2 space with poor ventilation.

Conclusion

Two workers who processed crystals with a maximum crystalline silica content of 56.66% developed systemic sclerosis. Considering the epidemiological and experimental evidence, exposure to crystalline silica dust was an important risk factor for systemic sclerosis. An active intervention is necessary to reduce exposure in similar exposure groups in the field of jewelry processing.


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