Annals of Occupational and Environmental Medicine

Research Article

Evaluation of the prevalence of musculoskeletal symptoms, presumptive diagnosis, medical care use, and sick leave among female school meal service workers: Young Hoon Moon, Young Joon Yang, Sang Yoon Do, Jae Yoon Kim, Chul Gab Lee, Hong Jae Chae, Soo Hyeon Kim, Han Soo Song; Ann Occup Environ Med 2019;31:1. Published online January 15, 2019; DOI: https://doi.org/10.1186/s40557-019-0281-0

Background

Most of the school meal service workers in Korea are middle-aged individuals. They have high workload, which increases their incidence of musculoskeletal disorders. This study aimed to evaluate the prevalence and risk factors of subjective musculoskeletal symptoms, presumptive diagnosis, medical care use, and sick leave among female school meal workers.

Methods

We analyzed the results of musculoskeletal disease screening of 1581 female school meal workers. The screening consisted of self-administered questionnaire, history taking by occupational physicians, and physical examination. The prevalence of subjective musculoskeletal symptoms, presumptive diagnosis after initial examination by occupational physicians, use of medical care for more than 7 days, and sick leave due to musculoskeletal diseases during the past year were evaluated in this study. The relative risk of four outcome indicators of musculoskeletal disorders was compared with respect to potential factors, such as age, subjective physical loading, present illness, injury experience, and type of school, using log-binomial regression.

Results

The prevalence of subjective musculoskeletal symptom was 79.6%; presumptive diagnosis, 47.6%; hospital visits over 7 days, 36.4%; and sick leave, 7.3%. The relative risk of musculoskeletal symptoms by age (≥50 years vs < 50 years) was 1.04 (95% confidence interval (CI): 1.00–1.09); presumptive diagnosis of musculoskeletal disease, 1.17 (95% CI: 1.06–1.30); hospital visits over 7 days, 1.26 (95% CI: 0.85–1.85); and sick leave, 1.17 (95% CI: 1.02–1.34). The relative risk of musculoskeletal symptoms due to subjective physical loading (very hard vs low) was 1.45 (95% CI: 1.33–1.58); presumptive diagnosis, 2.92 (95% CI: 2.25); hospital visits over 7 days, 1.91 (95% CI: 1.02–3.59); and sick leave, 2.11 (95% CI: 1.63–2.74).

Conclusions

Subjective physical loading was a more important factor in musculoskeletal disorders than the age of female school meal workers.

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Review

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

Abstract PDF

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

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

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Case Report

A Suspicious Case of Chloroform Induced Acute Toxic Hepatitis in Laboratory Worker: Dae Gwang Lee, Chang Hwan Lee, Keun Ho Jang, Hong Jae Chae, Jai Dong Moon; Korean Journal of Occupational and Environmental Medicine 2012;24(3):304-310. Published online September 30, 2012; DOI: https://doi.org/10.35371/kjoem.2012.24.3.304

Abstract PDF

OBJECTIVES
To report upon a case of toxic hepatitis in a worker exposed to chloroform.
METHODS
A 28-year-old female who had worked as chemical analysis engineer in a laboratory using chloroform was hospitalized due to nausea, vomiting and generalized weakness. The authors evaluated her using blood tests, abdominal CT scan and her occupational history.
RESULTS
The blood tests revealed acute toxic hepatitis. Other causes of hepatitis such as viral, drug induced or alcoholic hepatitis could be excluded. But autoimmune hepatitis couldn't be totally ruled out(ANA (++), IgG(serum) 1780 mg/dL). After admission, her symptoms improved and her liver enzyme levels(AST and ALT) were markedly reduced. She returned to her workplace after discharge. Afterwards, however, her liver enzyme levels increased again one week after returning to her workplace. Subsequent to a job change, her liver enzyme levels reduced and normalized after eight weeks. The airbone laboratory chloroform ranged from 3.155 to 9.037 ppm.
CONCLUSIONS
The authors presume that this patient's liver injury was related to an interaction of chloroform toxicity and a predisposition to autoimmune hepatitis. The rapid improvement of the clinical symptoms and the progressive normalization of the liver function tests once the chloroform exposure eliminated supports the diagnosis.

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A Study on Fabrication of 3D Dual Pore Scaffold by Fused Deposition Modeling and Salt-Leaching Method
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Acute liver injury in two workers exposed to chloroform in cleanrooms: a case report
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Original Article

Comparison of Cardiovascular Disease Status Between Large Scale Industry Office and Self Employed Male Workers: Keun Ho Jang, Won Ju Park, Myeong Bo Kim, Dae Kwang Lee, Hong Jae Chae, Jai Dong Moon; Korean Journal of Occupational and Environmental Medicine 2011;23(2):130-138. Published online June 30, 2011; DOI: https://doi.org/10.35371/kjoem.2011.23.2.130

Abstract PDF

OBJECTIVES
The aim of this study is to compare the cardiovascular disease status between large scale industry office and self employed male workers who have gaps in their intensive health management.
METHODS
The cross sectional study was carried out with subjects composed of 244 shipyard office male workers and 381 self employed male workers, aged 30 to 55 years. They were given a health exam in a general hospital from January 2007 to June 2009. Information was based on data from self-administered questionnaires, physical examination and laboratory results on blood samples. The degree of coronary artery calcification and stenosis was evaluated by a 64 channel multi-detector computed tomography angiography.
RESULTS
The prevalence of hypertension(p<0.01) and diabetes mellitus(p=0.02) and waist circumference(p<0.01) was significantly lower in the shipyard office workers than in self employed workers. Proper drinking(p<0.01) was more commmon in shipyard office workers. The rates of coronary artery calcification and stenosis were estimated to be 18.4% and 11.5% respectively for shipyard office workers and were significantly lower than the 26.5% and 21.5% for self employed workers. After adjustment for age, the probability of coronary artery stenosis in shipyard office workers was lower than in self employed workers (OR=0.56, 95% CI=0.35~0.90).
CONCLUSIONS
The study results verified the benefits of a health promotion and intervention program and the healthy worker effect for cardiovascular diseases. More specifically, it verified the benefits regarding coronary artery stenosis in large scale industry office workers. This result should encourage the establishment of health promotion programs and the study of occupational epidemiology.

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The effect of employment transitions on physical health among the elderly in South Korea: A longitudinal analysis of the Korean Retirement and Income Study
Juyeon Lee, Myoung-Hee Kim
Social Science & Medicine.2017; 181: 122. CrossRef
Association of Work-related Characteristics and Hypertension among White Collar Workers
Chae-Bong Kim, KyooSang Kim
Journal of Korean Society of Occupational and Environmental Hygiene.2015; 25(3): 418. CrossRef
Comparison of oral health status by metabolic syndrome risk factors in workers
In-Young Ku, Seon-Jeong Moon, Myeong-Seon Lee, Kyung-Hwan Ka
Journal of Korean society of Dental Hygiene.2013; 13(4): 581. CrossRef

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Original Article

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

Abstract PDF

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

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Won-Seok Yang, Sung-Gyu Sin, Jae-Hong Park
Journal of the Korean Society of Radiology.2012; 6(4): 275. CrossRef

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Original Article

The Relationship of Serum CEA Levels and Type of Work in Shipyard Workers: Won Ju Park, Myoung Bo Kim, Yang Hyun Kim, Ryoung Jin Park, Keun Ho Jang, Hong Jae Chae, Jai Dong Moon; Korean Journal of Occupational and Environmental Medicine 2009;21(4):293-300. Published online December 31, 2009; DOI: https://doi.org/10.35371/kjoem.2009.21.4.293

Abstract PDF

OBJECTIVES
Benign conditions have been known to cause an increase in the levels of serum carcinoembryonic antigen, a level change that is often associated with an increase in the occurrence of malignancy. The purpose of this study was to elucidate the relationship between serum CEA levels and type of work in shipyard workers.
METHODS
From July-August 2007, 637 study subjects were enrolled into the study with the following characteristics: age 37~58 years, healthy shipyard workers, and who undergone an examination in a general hospital. Data on general characteristics was gathered from self-administered questionnaires. Information on job factors was collected from company personnel data. Serum CEA levels were measured after 10 hours'fasting.
RESULTS
The level of mean serum CEA was 1.83+/-1.20 ng/mL. On univariate analysis, the mean CEA level was significantly higher in older age groups (P<0.05), current smokers, lower education, and in production workers (P<0.01). After adjusting for age, BMI, cigarette smoking, job pattern, and educational level, the serum CEA level was higher in production workers than in office workers(P<0.01). This is particularly true in the shipyard painters, who had the highest level of CEA across job groups.
CONCLUSIONS
The goal of this was to determine if there were differences in serum CEA levels according to occupational role in shipyard workers. Production shipyard workers had relatively higher level of serum CEA than office workers, most likely due to occupational exposure. This serum CEA level is influenced by occupation role. Serum CEA level could be a parameter for evaluating pollutant effects.

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The association between cadmium and lead exposure and blood pressure among workers of a smelting industry: a cross-sectional study
Hyun Chan An, Joo Hyun Sung, Jiho Lee, Chang Sun Sim, Sang Hoon Kim, Yangho Kim
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Case Report

A Case of Polyneuropathy Associated with Methyl Bromide Intoxication: Hyung Jae Lee, Se Won Oh, Jong Seong Lee, Hong Jae Chae, Jai Dong Moon; Korean Journal of Occupational and Environmental Medicine 2007;19(3):238-243. Published online September 30, 2007; DOI: https://doi.org/10.35371/kjoem.2007.19.3.238

Abstract PDF

BACKGROUND
The diagnosis and treatment of intoxication induced by methyl bromide depends on the patient's exposure history. In the present case, the patient showed various neurologic symptoms which were helpful to confirm the diagnosis and to determine the concentration of bromide ion in his body. The reduction rate of bromide ion concentration was another important clue to estimate the patient's health state in treatment.
CASE
REPORT: Some neurologic disorders were manifested in a 35-year-old man who had been engaged in a fumigation company for 12 years. Although he had been complaining of abnormal symptoms for 10 days, he had left his work only 3 days before being admitted to our hospital in serious state via the emergency department. Comprehensive clinical evaluations confirmed he was suffering from polyneuropathy, optic neuropathy and cerebellar signs. We diagnosed his condition as methyl bromide intoxication, and ruled out other possible diseases, after taking his occupational history and evaluating the elevation of bromide ion concentration in the sampled blood, urine and cerebrospinal fluid. With decreasing bromide ion concentration, his abnormal symptoms improved and he was discharged 22 days after admission without any neurologic sequela.
CONCLUSION
This case report confirmed the usefulness of measuring the concentrations of bromide ion in the diagnosis of methyl bromide intoxication. We therefore suggest that the regular measuring of bromide ion concentration be included in the occupation specified health examination.

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Journal of Korean Medical Science.2014; 29(Suppl): S59. CrossRef
Occupational Neurologic Disorders in Korea
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Case Report

A Case of Lead Poisoning After Ingestion of Herb Pills: Se Won Oh, Hyung Jai Lee, Hong Jae Chae, Sung Kwan Lee, Jai Dong Moon, Deok Cho; Korean Journal of Occupational and Environmental Medicine 2007;19(3):231-237. Published online September 30, 2007; DOI: https://doi.org/10.35371/kjoem.2007.19.3.231

Abstract PDF

BACKGROUND
Lead is a common environmental metal and has been used for various purposes for a long time, leading to frequent reports of lead poisoning. The concern about lead poisoning starts has been mostly focused on occupational exposure and is linked to the prevention and management of lead exposure in refining and manufacturing processes. Nowadays, however, there is growing concern about nonoccupational lead exposure by many pollutants. Especially, lead poisoning by herb medicine has commonly been observed in clinics in Southeast Asia and South Korea. This case report contains diagnosis of inpatients who suffered from lead poisoning from a herb medicine, arthritis remedy and who complained of abdominal symptoms and dizziness. The study purpose was to awaken our healthful interest in lead poisoning.
CASE
REPORT: A 53-year-old female patient complaining of abdominal pain, dizziness, and numbness of hand and foot came to our hospital due to the continuation of her anemic finding symptoms while undergoing treatment at a secondary hospital. Her past medical history was unremarkable except she had taken herb pills for about a year which were administered by herb medicine to treat arthritis. Physical examination was unremarkable except for oral ulcer finding. Hemoglobin was 8.5 g/dl, reticulocyte count was 4.10%, bilirubin was 1.3 mg/dl (direct 0.3 mg/dl), and Zinc protoporphyrin 169.12 ug/dl. In urinalysis results, WBC increased to 30~39 /HPF, While AST/ALT, BUN/Cr, PT/aPTT, and nerve conduction velocity were normal. Basophilic stippling was observed through peripheral blood smear. The blood lead level was 80.4 microgram/dl and the urine lead level continued to increase to 541 microgram/l. Analysis of the pills that the patient had been taking showed that they contained 30 mg/g lead. By oral chelation therapy with D-penicillamine four times per day for five days, the patient's hemoglobin increased to 11.8 g/dl, while blood lead level decreased to 39.2 microgram/dl, and urine level to 196 microgram/l. Although the soles of her feet remained cold, but other symptoms and anemia finding were improved considerably. However, after discontinuing D-penicillamine medication, the blood lead level increased to 41.4 microgram/dl again. The further administration of D-penicillamine for five days reduced the blood lead level to 31.5 microgram/dl. At two years after the discontinuance of D-penicillamine, the followup findings were normal; hemoglobin was 13.1 g/dl, hematocrit 39.6%, reticulocyte count 1.22%, blood lead level 13.3 microgram/dl, and urine lead level 9.17 microgram/l.
CONCLUSION
After taking herb medicine pills for one year, the patient was admitted to hospital chiefly complaining of abdominal pain, dizziness, and numbness of the hand and foot. The high blood and urine and lead levels and lead chemical analysis of the herb pills confirmed lead poisoning which was treated with D-penicillamine for five days. The follow-up result after two years indicated normal blood and urine lead levels.

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Original Article

Relationship of Burdened Work and Musculoskeletal Symptoms in Small-to-medium-sized Enterprises.: Sin Goo Park, Hong Jae Chae, Joo Youn Shin, Dal Young Jung, Yong Kyu Kim, Tae Jin Jung, Jong Han Leem, Hawn Cheol Kim, Yeui Cheol Lee; Korean Journal of Occupational and Environmental Medicine 2006;18(1):59-66. Published online March 31, 2006; DOI: https://doi.org/10.35371/kjoem.2006.18.1.59

Abstract PDF

OBJECTIVE: This study was performed to evaluate relationship of burdened work and musculoskeletal symptoms in small-to-medium sized enterprises.
METHOD
After a questionnaire survey was administered to 9,950 workers in 122 workplace, 7,626 workers(76.6%) were finally selected for the study analysis. Industrial hygienists visited 122 small-to-medium sized enterprises to investigate the presence of burdened works within the workplace. The selection of jobs with significant burden was based on the Ministry of Labor's recent notification in 11 types of job description associated with musculoskeletal disorders. The subjects of this study were then divided into three categories. 1) non-burdened white collar workers, 2) non-burdened blue collar workers, and 3) burdened workers (include some VDT workers). Multiple logistic regression was used to evaluate the relationship between burdened work and musculoskeletal symptoms.
RESULTS
The burdened workers reported significantly more musculoskeletal symptoms than non-burdened white collar workers and non-burdened blue collar workers(OR:1.57, 95% CI: 1.314-1.875). There was no significant difference in reports of musculoskeletal symptoms between non-burdened white and blue collar workers.
CONCLUSION
To prevent or diminish musculoskeletal disorders in small-to-medium sized enterprises, we need to better manage burdened works.

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Case Report

Subcutaneous and Gastrointestinal Exposure to Metallic Mercury: Report of 2 Cases: Sung Kwan Lee, Hyoung Jai Lee, Hong Jae Chae, Jai Dong Moon; Korean Journal of Occupational and Environmental Medicine 2003;15(4):446-451. Published online December 31, 2003; DOI: https://doi.org/10.35371/kjoem.2003.15.4.446

Abstract PDF: BACKGROUND
Mercury poisoning presents a variety of clinical pictures depending on the chemical structure, the route of exposure, the amount absorbed and other individual factors. Therefore, the ingestive and subcutaneous absorption of elemental(metallic) mercury can be considered to be relatively harmless in contrast to the inhalation of mercury vapor.
CASE REPORTS
A 72-year-old man presented to the department of urology due to tenderness, edema and a necrotic abscess of his penis after trauma. The soft tissue abscess required a surgical resection of the penis. For chelation therapy, oral D-penicillamine was administrated. 7 months later, he showed no subjective or objective signs of mercury poisoning. Another 5-yearold girl presented to the emergency department after accidental self-ingestion of elemental mercury. She was followed clinically and did not show any systemic mercury poisoning.
CONCLUSION
The Mercury concentrations in the blood and urine were elevated in the case of subcutaneous exposure, but was unchanged in the case of ingestion. Subcutaneous and gastrointestinal exposure to metallic mercury has a minimal risk for systemic mercury poisoning, which is in contrast to the exposure by inhalation.

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Case Report

Exfoliative Dermatitis and Toxic Hepatitis Associated with Occupational Exposure to Trichloroethylene: Hong Jae Chae, Seong Kwan Lee, Kang Jin Lee, Jong Youl Kim, Seung Chul Lee, Dong Hyeon Shin, Jai Dong Moon; Korean Journal of Occupational and Environmental Medicine 2003;15(1):111-117. Published online March 31, 2003; DOI: https://doi.org/10.35371/kjoem.2003.15.1.111

Abstract PDF

A 28-year-old male began working as a degreaser. The solvent used in the degreasing operation was trichloroethylene. Over the next month the man experienced fever, chills, and an erythematous skin rash and itching. At that time he had a marked elevation in his liver enzyme, with cholestasis. Over the next few days the rash persisted then peeled. There was an elevation of Ig E, and a positive patch test reaction to trichloroethylene. His dermatitis and hepatitis were considered to be mediated by a hypersensitivity mechanism.

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Occupational trichloroethylene exposure as a cause of idiosyncratic generalized skin disorders and accompanying hepatitis similar to drug hypersensitivities
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Original Article

Characteristics of Work-Related Musculoskeletal Disorders and Effect of Intervention Program in Shipyard Workers: Hong Jae Chae, Seong Kwan Lee, Kang Jin Lee, Jai Dong Moon; Korean Journal of Occupational and Environmental Medicine 2002;14(4):468-477. Published online December 31, 2002; DOI: https://doi.org/10.35371/kjoem.2002.14.4.468

Abstract PDF

OBJECTIVES
This study was conducted to estimate the characteristics of work-related musculoskeletal disorders and the effect of intervention program in shipyard workers.
METHODS
Information on work related absences,due to musculoskeletal disorders, were collected between January, 1 2000 and August, 31 2002. Age, duration of work, job type, anatomical site of disease, cause and duration of absence due to sickness were investigated.
RESULTS
From a total of 158 cases there were 108(68.4%)and 50(31.6%)cases of back, and other musculoskeletal complaints,respectively. 55(34.8%)of the cases were caused by repetitive trauma and 103(65.2%)were due to non-repetitive causes. 90(83.3%)of the back complaint cases were due to non-repetitive causes, but there was a repetitive cause of other musculoskeletal complaints in 37(74.0%)cases. Back complaints were higher in workers carrying heavy materials, but other musculoskeletal complaints were higher in painting workers.Half of workers after an absence due to sickness had returned to work within 32.0 weeks and 25.4 weeks,in the cases of back and other musculoskeletal complaints, respectively. After the application of an intervention program for musculoskeletal disease, the incidence rate of absence due to work-related musculoskeletal disorders was reduced significantly.
CONCLUSION
The introduction of a musculoskeletal intervention program reduced absences due to work-related musculoskeletal disorders.

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