Annals of Occupational and Environmental Medicine

Case Report

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

Abstract Abstract in Korean PDF Supplementary Material PubReader ePub

Background

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

Case presentation

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

Conclusions

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

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

Citations

Citations to this article as recorded by

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

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Review

Nonspecific Building Related Illnesses: Chunhui Suh, Eun Hee Ha, Yun Chul Hong, Yoo Mi Chae, Kyu Jin Chang, Jungwon Kim; Korean Journal of Occupational and Environmental Medicine 2012;24(4):319-327. Published online December 31, 2012; DOI: https://doi.org/10.35371/kjoem.2012.24.4.319

Abstract PDF: Nonspecific building related illnesses (NBRI) are an array of diverse symptoms related to working in particular buildings. There are numerous contributing factors, including basic factors (temperature, humidity and ventilation) as well as chemicals, dust, microorganisms, and psychosocial factors. At the individual level, taking a careful history is the essential first step. After ruling out other diseases, clinicians can start the symptomatic treatment for NBRI. If a relationship to the building is suspected, a walk through evaluation is very helpful. At the group level, standardized questionnaires and investigations of the building environment can be applied simultaneously. If the prevalence of symptoms are greater than that of general population, appropriate interventions have to be provided for prevention and group health care. In both approaches, it is essential to periodically follow up with symptomatic patients and work environments after an intervention. For the management of NBRI, taking care of the patient's symptoms and maintaining a good indoor environment are important. To achieve this goal, cooperation among workers, building managers, employers and occupational health staff is crucial.

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Original Article

Effects of Volatile Organic Compounds, and Formaldehyde on Heart Rate Variability among Elderly People in Seoul: Jeong Cheol Seo, Mo Yeol Kang, Soo Hun Cho, Youn Hee Lim, Jin Hee Kim, Jong Ryeul Sohn, Yun Chul Hong; Korean Journal of Occupational and Environmental Medicine 2011;23(3):253-260. Published online September 30, 2011; DOI: https://doi.org/10.35371/kjoem.2011.23.3.253

Abstract PDF

OBJECTIVES
The purpose of the present study was to investigate the effects of volatile organic compounds, and formaldehyde on heart rate variability among elderly people who are vulnerable to ambient pollution.
METHODS
From May to August of 2009, 57 subjects older than 60 years were recruited in this study. Indoor air pollutants (volatile organic compounds and formaldehyde) were measured by a personal passive sampler. Heart rate variability (HRV) was measured in the sitting position for five minutes and assessed by time-domain and frequency-domain.
RESULTS
Multiple linear regression analysis showed significantly less low-frequency (LF) and high-frequency (HF) associated with elevated benzene levels. Exposure to toluene was associated with decreases in the Standard deviation of the NN intervals (SDNN) and LF. SDNN and LF were negatively associated with the increment of ethylbenzene levels.
CONCLUSIONS
An adverse effect on cardiovascular function caused by volatile organic compounds was observed among the elderly people of Seoul even though indoor air pollutant levels were lower than the yearly average guideline for indoor air quality in Korea.

Citations

Citations to this article as recorded by

Estimating Benzene Exposure Level over Time and by Industry Type through a Review of Literature on Korea
Donguk Park, Sangjun Choi, Kwonchul Ha, Hyejung Jung, Chungsik Yoon, Dong-Hee Koh, Seunghun Ryu, Soogeun Kim, Dongmug Kang, Kyemook Yoo
Safety and Health at Work.2015; 6(3): 174. CrossRef

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Original Article

The Effects of Indoor Air Quality on the Neurobehavioral Performance of Elementary School Children: Dae Seop Kim, Sun Ju Kim, Si Young Park, Man Joong Jeon, Gyu Tae Kim, Chang Yoon Kim, Jong Hak Chung, Sung Ok Baek, Joon Sakong; Korean Journal of Occupational and Environmental Medicine 2007;19(1):65-72. Published online March 31, 2007; DOI: https://doi.org/10.35371/kjoem.2007.19.1.65

Abstract PDF

OBJECTIVES
Most studies on the indoor air quality of newly built schools have focused only on the number of schools exceeding a standard or on subjective symptoms, such as sneezing, irritated eyes and an irritated nose. However, there has been no report on how poor indoor air quality affects children's academic performance. This study evaluated the effects of indoor air quality on the neurobehavioral performance of elementary school children.
METHODS
This study measured the indoor air pollutants and compared children's performance, using a computerized neurobehavioral test, between a newly built and a 12-year-old school. In addition, a questionnaire was administered regarding the indoor air quality related symptoms of children in a newly built and a 12-year-old school.
RESULTS
In the newly built school, the formaldehyde levels in the 1st and 4th classes with an open window were 34.6 and 27.3 microgram/m3, respectively. The levels in the 1st and 4th classes with the window closed were 80.2 and 127.1 microgram/m3, respectively. In the 12-year-old school, the formaldehyde levels in 1st and 4th class with open and closed window were 12.6 and 7.5 microgram/m3, and 19.8 and 25.2 microgram/m3, respectively. With respect to total volatile organic compounds, the levels in the 1st and 4th classes with the window open in the newly built school were 87.2 and 428.2 microgram/m3, respectively. In the 1st and 4th classes with the window closed, the total volatile organic compounds were 1,283.5 and 1,715.4 microgram/m3, respectively. In the 12-year-old school, the total volatile organic compounds were 240.9 and 150.8 microgram/m3, and 371.9 and 448.0 microgram/m3 in the 1st and 4th classes, respectively. In the case of a newly built school, the performance of the students in the neurobehavioral test in the 4th class with the window closed was 8.3% lower than for those in the 1st class with the window closed, but was only 5.9% lower when the windows were open. There was a statistical significant difference in the total numbers of symptoms between the two schools.
CONCLUSIONS
These results suggest a proper evaluation of the indoor air quality within schools is required into both the level of contamination and the health effects of these contaminants toward children.

Citations

Citations to this article as recorded by

Performance assessment on the Korean Computerized Neurobehavioral Test using a mobile device and a conventional computer: an experimental study
Young Seok Byun, Sung Kyu Park, Joon Sakong, Man Joong Jeon
Annals of Occupational and Environmental Medicine.2018;[Epub] CrossRef
Occupational Neurologic Disorders in Korea
Yangho Kim, Kyoung Sook Jeong, Yong-Hun Yun, Myoung-Soon Oh
Journal of Clinical Neurology.2010; 6(2): 64. CrossRef

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Original Article

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

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

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