Annals of Occupational and Environmental Medicine

Original Article

Association between sleep disturbance and occupational injury among Korean employees: Jongwoo Lee, Seong-Sik Cho, JungIl Kim, Mo-yeol Kang, Suhwan Ju, Byoung Gwon Kim, Young Seoub Hong; Ann Occup Environ Med 2021;33:e29. Published online September 10, 2021; DOI: https://doi.org/10.35371/aoem.2021.33.e29

Abstract Abstract in Korean PDF PubReader ePub

Background

Occupational injury has been a serious social problem steadily. Sleep disturbance is a risk factor for occupational injury. However, there were few researches studied on the linking between sleep disturbance and occupational injury in general working population of Korea. Therefore, we explored the association between sleep disturbance and occupational injury among Korean workers.

Methods

This study used data from the 5th Korean Working Conditions Survey. Occupational injury was assessed by asking work related injury for 12 months prior to the point of the survey. Sleep disturbance was assessed using the Minimal Insomnia Symptoms Scale (MISS). To analyze the association between sleep disturbance and occupational injury, multiple logistic regression analysis was conducted.

Results

The odds ratio (OR) of sleep disturbance group for occupational injury was 2.57 (95% confidence interval [CI]: 1.68–3.93) in the fully adjusted model. For the association between MISS score and occupational injury, it showed increasing trend that ORs increase from the 1st to the 4th quartiles. The OR of 2nd quartile was 1.10 (95% CI: 0.60–2.01), the OR of 3rd quartile was 2.27 (95% CI: 1.53–3.38) and the OR of 4th quartile was 2.80 (95% CI: 1.84–4.26).

Conclusions

Sleep disturbance was associated with occupational injury. In addition, increasing trend was observed between MISS score and occupational injury. These findings imply that developing of intervention programs to manage sleep disturbance and fatigue may be necessary to prevent occupational injury.

수면장애와 직업성 손상과의 연관성
목적
업무관련 손상은 심각한 사회적 문제이다. 그러나 한국에서 수면장애와 업무관련 손상의 연관성을 연구한 연구는 드물다. 따라서, 우리는 한국 근로자들의 수면 장애와 업무관련 손상 사이의 연관성을 조사하였다.
방법
이 연구는 제5차 한국 취업자 근로환경조사 자료를 활용했다. 업무관련 손상은 조사 시점의 1년 동안 업무관련 손상에 대해 질문함으로써 평가되었다. 수면 장애는 최소 불면증 증상 척도(MISS)를 사용하여 평가되었다. 수면 장애와 업무관련 손상 간의 연관성을 분석하기 위해 다중 로지스틱 회귀 분석을 수행하였다.
결과
보정된 모델에서 수면 장애 그룹의 오즈비는 2.57(95% CI: 1.68 - 3.93)이었다. 수면 장애의 정도와 업무관련 손상 사이의 연관성에 대해서는 오즈비가 1 사분위수에서 4 사분위로 증가한다는 노출(용량)-반응 관계를 보였다. 2분위수의 오즈비는 1.10(95% CI: 0.60–2.01)이었고, 3분위수의 오즈비는 2.27(95% CI: 1.53–3.38)이었으며, 4분위수의 오즈비는 2.80(95% CI: 1.84–4.26)이었다.
결론
수면 장애는 업무관련 손상과 관련이 있다. 또한, 수면 장애의 심각성과 업무관련 손상 사이에 노출-반응 관계가 관찰되었다. 이러한 연구 결과는 이후 전향적 코호트 형태의 연구가 필요하며, 업무관련 손상을 방지하기 위해 수면 장애와 피로를 관리하기 위한 개입 프로그램의 도입이 필요할 수 있음을 시사한다.

Citations

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The changing dynamics of work from home and its association with sleep disturbance through work–family conflict during the COVID-19 pandemic
Jaehyuk Jung, Jiyoung Lim, Yong Hyuk Cho, Jae Bum Park, Inchul Jeong
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Exploring Clinical Trials to Manage Firefighters’ Sleep Quality: A PRISMA Compliant Systematic Review
Sara Alves, Josiana Vaz, Adília Fernandes
International Journal of Environmental Research and Public Health.2023; 20(5): 3862. CrossRef
Economic costs and Predictors of occupation-related Injuries in Ethiopian sugar industries from the Employer’s perspective: top-down approach and friction method
Mitiku Bonsa Debela, Muluken Azage, Negussie Deyessa, Achenef Motbainor Begosaw
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Research Article

The association between Korean employed workers’ on-call work and health problems, injuries: Chulin Baek, Jae Bum Park, Kyungjong Lee, Jaehyuk Jung; Ann Occup Environ Med 2018;30:19. Published online March 20, 2018; DOI: https://doi.org/10.1186/s40557-018-0225-0

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Background

On-call work is a form of work that requires the person to work at any time during the on-call period. Thus, on-call work is often regarded as one of the most severe stress factors. This study investigates the associations between on-call work and health problems, injuries.

Methods

This study was based on the 3rd Korean Working Conditions Survey. Total of 29,246 employed workers who had been working for at least 1 year were included. Logistic regression analysis was performed to investigate the association between on-call work and health problems, injuries.

Results

The odds ratios for on-call workers in terms of physical health problems, psychological health problems, and injuries were 1.33 (95% confidence interval [CI] 1.22-1.44), 1.31 (95% CI 1.08-1.60), and 2.76 (95% CI 2.26-3.37), respectively. Analysis of the detailed symptoms revealed odds ratios in on-call workers of 2.06 for hearing problems (95% CI 1.63-2.62); 1.71 for skin problems (95% CI 1.38-2.12); 1.22 for back pain (95% CI 1.08-1.38); 1.23 for muscular pains in upper limbs (95% CI 1.12-1.34); 1.27 for muscular pains in lower limbs (95% CI 1.15-1.40); 1.46 for headache, eye fatigue (95% CI 1.32-1.60); 1.37 for abdominal pain (95% CI 1.02-1.85); 1.43 for depression or anxiety disorders (95% CI 1.07-1.93); 1.36 for fatigue (95% CI 1.24-1.49); and 1.41 for insomnia and general sleep difficulties (95% CI 1.13-1.76).

Conclusions

The present study found that on-call work results in an increased risk of health problems and injuries. This study is the result of analyses of broad range of the job spectrum in Korean employed workers; thus, future studies are necessary to determine the effects of on-call work in various job groups.

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Research Article

Hepatitis B vaccination coverage and the determinants of vaccination among health care workers in selected health facilities in Lusaka district, Zambia: an exploratory study: Namwaka Mungandi, Mpundu Makasa, Patrick Musonda; Ann Occup Environ Med 2017;29:32. Published online August 10, 2017; DOI: https://doi.org/10.1186/s40557-017-0191-y

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Background

Hepatitis B is a viral infection of the liver and causes both acute and chronic disease. It is transmitted through contact with an infected person’s bodily fluids. It is an occupational hazard for healthcare workers and can be prevented by the administration of a vaccine. It is recommended that healthcare workers be vaccinated against vaccine preventable diseases including hepatitis B. The study objective was to determine the prevalence and determinants of hepatitis B vaccination among healthcare workers in selected health facilities in Lusaka.

Methods

The study took place in seven health facilities across Lusaka district in Zambia. A total sample size of 331 healthcare workers was selected of which; 90 were nurses, 88 were doctors, 86 were laboratory personnel and 67 were general workers. A self-administered structured questionnaire was given to a total of 331 healthcare workers. Investigator led stepwise approach was used to select the best predictor variables in a multiple logistic regression model and all analyses were performed using STATA software, version 12.1 SE (Stata Corporation, College Station, TX, USA).

Results

Only 64(19.3%) of the healthcare workers were vaccinated against hepatitis B, with 35 (54.7%) of these being fully vaccinated and 29 (45.3%) partially vaccinated. Analysis showed that; age of the healthcare worker, sharp injuries per year and training in infection control were the variables that were statistically significant in predicting a healthcare worker’s vaccination status.

Conclusion

It is reassuring to learn that healthcare workers have knowledge regarding hepatitis B and the vaccine and are willing to be vaccinated against it. Health institutions should bear the cost for vaccinating staff and efforts should be made for appropriate health education regarding hepatitis B infection and its prevention. Establishment of policies on compulsory hepatitis B vaccination for healthcare workers in Zambia is recommended.

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Review

A socioecological framework for research on work and obesity in diverse urban transit operators based on gender, race, and ethnicity: BongKyoo Choi, Peter Schnall, Marnie Dobson, Haiou Yang, Dean Baker, YoungJu Seo; Ann Occup Environ Med 2017;29:15. Published online May 17, 2017; DOI: https://doi.org/10.1186/s40557-017-0171-2

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Urban transit (bus and rail) operators, totaling nearly 700,000 persons, are one of the heaviest occupational groups in the United States (US). Little is known about occupational risk factors for weight gain and obesity and their interrelationship with health-related behaviors, particularly among female minority (African Americans and Hispanics) transit operators who are at greater risk for obesity. As a step towards developing successful obesity interventions among urban transit operators, this paper aims to present a new socioecological framework for studying working conditions, chronic strain, health-related behaviors, weight gain/obesity, and obesity disparity in diverse urban transit operators based on gender, race, and ethnicity. Our framework is a synthesis of several different theories and disciplines: the resource-work load model (work stress), occupational ergonomics, the theory of intersectionality, and worksite health promotion. The framework was developed utilizing an extensive literature review, results from our on-going research on obesity, input from focus groups conducted with Los Angeles transit operators as well as interviews and meetings with transit operator stakeholders (management, unions, and worksite transit wellness program), and ride-along observations. Our hypotheses highlighted in the framework (see Fig. 1) are that adverse working conditions, largely characterized as a combination of high demands and low resources, will increase the risk for weight gain/obesity among transit operators directly through chronic strain and hypothalamic dysfunction (hyper-and hypo-activations), and indirectly through health-related behaviors and injuries/chronic severe pain. We also hypothesize that the observed increase in adiposity among female minority operators is due to their greater exposure to adverse occupational and non-occupational conditions that reflect their intersecting social identities of lower social class and being a minority woman in the US. Our proposed framework could greatly facilitate future transit worksite obesity studies by clarifying the complex and important roles of adverse working conditions in the etiology of weight gain/obesity and obesity disparity among transit operators and other working populations.

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Case Report

Laboratory-acquired dengue virus infection by needlestick injury: a case report, South Korea, 2014: Changhwan Lee, Eun Jung Jang, Donghyok Kwon, Heun Choi, Jung Wan Park, Geun-Ryang Bae; Ann Occup Environ Med 2016;28:16. Published online April 7, 2016; DOI: https://doi.org/10.1186/s40557-016-0104-5

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Background

Dengue fever is one of the most dominant vector-borne diseases, putting approximately 3.9 billion people at risk worldwide. While it is generally vector-borne, other routes of transmission such as needlestick injury are possible. Laboratory workers can be exposed to dengue virus transcutaneously by needlestick injury. This is the first case, to our knowledge, of dengue virus infection by needlestick injury in a laboratory environment. This paper evaluates the risk and related health concerns of laboratory workers exposed to dengue virus.

Case presentation

We evaluated a 30-year-old female laboratory worker exposed to the dengue virus by needlestick injury while conducting virus filtering. During admission, she showed symptoms of fever, nausea, myalgia, and a characteristic maculopapular rash with elevated aspartate aminotransferase (AST) of 235 IU/L and alanine aminotransferase (ALT) of 269 IU/L. She had been diagnosed by a positive nonstructural protein 1 (NS1) antigen (Ag) rapid test one day prior to symptom onset along with positive immunoglobulin M (IgM) enzyme-linked immunosorbent assay (ELISA) on the ninth day of symptom onset. Reverse transcription polymerase chain reaction (RT-PCR), also conducted on the ninth day, was negative. After proper symptomatic treatment, she recovered without any sequelae. As a result of thorough epidemiologic investigation, it was determined that she had tried to recap the needle during the virus filtering procedure and a subsequent needlestick injury occurred.

Conclusions

In the context of health promotion of laboratory workers, we suggest that the laboratory biosafety manual be revised and reinforced, and related prevention measures be implemented. Furthermore, health authorities and health care providers in Korea should be fully informed of proper dengue fever management.

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Research Article

Workers’ experiences with compensated sick leave due to musculoskeletal disorder: a qualitative study: Min Choi, Hyoung-Ryoul Kim, Jinwoo Lee, Hye-Eun Lee, Junsu Byun, Jong Uk Won; Ann Occup Environ Med 2014;26:33-33. Published online November 4, 2014; DOI: https://doi.org/10.1186/s40557-014-0033-0

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Objectives

The most common occupational disease that is compensated by Industrial Accident Compensation Insurance (IACI) in Korea is musculoskeletal disease (MSD). Although complaints about the workers’ compensation system have been raised by injured workers with MSD, studies that examine workers’ experiences with the Korean system are rare. This paper is a qualitative study designed to examine injured workers’ experiences with the workers’ compensation system in Korea. The aim of this study is to explore the drawbacks of the workers’ compensation system and to suggest ways to improve this system.

Methods

All workers from an automobile parts factory in Anseong, GyeongGi province who were compensated for MSD by IACI from January 2003 to August 2013 were invited to participate. Among these 153 workers, 142 workers completed the study. Semi-structured open-ended interviews and questionnaires were administered by occupational physicians. The responses of 131 workers were analyzed after excluding 11 workers, 7 of whom provided incomplete answers and 4 of whom were compensated by accidental injury. Based on their age, disease, department of employment, and compensation time, 16 of these 131 workers were invited to participate in an individual in-depth interview. In-depth interviews were conducted by one of 3 occupational physicians until the interview contents were saturated.

Results

Injured workers with MSD reported that the workers’ compensation system was intimidating. These workers suffered more emotional distress than physical illness due to the workers’ compensation system. Injured workers reported that they were treated inadequately and remained isolated for most of the recuperation period. The compensation period was terminated without ample guidance or a plan for an appropriate rehabilitation process.

Conclusions

Interventions to alleviate the negative experiences of injured workers, including quality control of the medical care institutions and provisions for mental and psychological care for injured workers, are needed to help injured workers return to work earlier and more healthy.

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Original Article

The Relationships between Enterprise-scale Levels, Safety and Health Information Provisions in the Workplace, and the Consequential Attack Rate of Occupational Disease and Injuries: In Kyung Park, Kyung Jong Lee, Soon Young Lee, Jae Beom Park, Kyoung Bok Min; Korean Journal of Occupational and Environmental Medicine 2012;24(3):229-238. Published online September 30, 2012; DOI: https://doi.org/10.35371/kjoem.2012.24.3.229

Abstract PDF

OBJECTIVES
We investigated the associations between enterprise-scale levels, the information supplied regarding workplace safety and health, and occupational injury and disease using a nationally representative sample of Korean workers.
METHODS
We used data from the '2006 Working Condition Survey' performed by the Korean Occupational Safety & Health Agency. Demographic variables, employment characteristics, workplace hazards, enterprise-scale levels, information supplied regarding workplace safety and health, and occupational injury and disease were included for the study.
RESULTS
Subjects who had high incomes, or who were male, full-time workers, or shift workers were more likely to provide safety and health information at work, compared to other workers' groups. The larger the enterprise-scale level, the more likely they would offer information on safety and health at work. Workers who worked in small companies, especially those with less than 10 employees, were the most likely respondents to provide safety and health information. In the corresponding logistic regression, the presence of occupational injuries and disease was significantly associated with the provision of health and safety information, the enterprise-scale level had little correlation.
CONCLUSIONS
Our findings suggest that the provision of health and safety information is a critical factor regarding occupational injuries and disease. Proper safety and health education, even in small companies, may contribute to a decrease in occupational disease and injury.

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Ju-il Seo, Gab-Sik Shin, Min Gi Kim, Young-Sun Min
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Original Article

Epidemiological Characteristics and Scale for Needlestick Injury in Some University Hospital Workers: Yong Hun Yun, Yun Kyung Chung, Jae Sim Jeong, Ihn Sook Jeong, Eun Suk Park, Sung Won Yoon, Hye Young Jin, Jin Hee Park, Si Hyun Han, Jeong Hwa Choi, Hye Ran Choi, Min Kyung Han, Soon Im Choi; Korean Journal of Occupational and Environmental Medicine 2011;23(4):371-378. Published online December 31, 2011; DOI: https://doi.org/10.35371/kjoem.2011.23.4.371

Abstract PDF

OBJECTIVES
Based on multicenter research among tertiary hospitals in Korea, it was our intention to effectively contribute to the prevention of needlestick injuries by understanding the current state of the incidence rate of needlestick injuries and the related epidemiology with respect to medical institution and worker's characteristics.
METHODS
Ten hospitals were selected, with the research performed from July to September 2007. Data on cases of needlestick injuries were collected by hospital infection-controlling centers using a specifically developed website and a partially modified self-writing questionnaire based on the Exposure Prevention Information Network (EPINet).
RESULTS
During the study period, a total of 327 needlestick injury cases were reported, with an incidence of 10.56 cases per 100 patient beds per year. The existence of source of infection could not be confirmed in one third of the needlestick injuries. There were 4.07 incidences per 100 employees per year. The job with the highest incidence was medical doctor interns (18.66 cases), followed by clinical laboratory workers (7.12 cases) and registered nurses (6.66 cases).
CONCLUSIONS
There was no difference in number of incidences according to the number of beds. The highest number of cases occurred in the registered nurse-group, but the incidence rate per healthcare worker was the highest in the medical doctor intern-group. Therefore, it is important to conduct research to identify the risk of the incidence with respect to different risk-groups. As a result of this research, it is suggest that a protective policy is required relating to needlestick injuries, regardless of the number of beds and potential cause of infection.

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Review

The Status of Occupational Accidents and Injuries and the Implications: Seong Kyu Kang; Korean Journal of Occupational and Environmental Medicine 2011;23(4):351-359. Published online December 31, 2011; DOI: https://doi.org/10.35371/kjoem.2011.23.4.351

Abstract PDF

Since 1964, when the official statistics on occupational injury rates had been produced for the first time, the rates have showed a steady decline until 2000. However, the injury rate has been stagnant since 2000 although the fatal injury rate has decreased 40% in the same period. The non-fatal injury rate per 100 employees was 0.63 while the fatal injury rate per 100,000 employees was 9.74 in 2010. Traumatic injuries accounted for 86.8% of all injuries, followed by non-traumatic injuries at 8.4% and injuries by traffic accidents at 4.6%. Injuries caused by being caught in objects, hit by flying or falling objects and collisions have decreased while those caused by slip and fall on same level and fall from the height have increased. The decrease in injuries caused by being caught in objects may be the result of prevention efforts because 68.6% of them occurred in the manufacturing industry where most efforts for prevention have been invested. The increase in injuries involving slips and falls on same level may be caused by the growing number of employees in the service industry where 51% of the cases occurred. The construction industry accounted for 40.2% of all fatal injuries, and falls from the height caused 54.3% of the fatality. The non-fatal injury rate of Korea is lower than that of industrialized countries while its fatal injury rate is comparatively higher. It is probably caused by many unclaimed cases of mild non-fatal injuries whereas most fatal injuries were filed. Another problem is that the injury rate does not include injuries that occur to workers who are not eligible for the compensation scheme. This information can be obtained through a surveillance system or the national survey. Therefore, the attention of occupational physicians should focus on injuries as well as diseases occurring at work, and also on all working population whose injuries and diseases are not covered by the compensation scheme.

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Original Article

Risk Factors of Musculoskeletal Injuries among the Marine Corps Enlisted Trainees: Seong Woo Choi, Jong Seo Park, Sun Ok Jung; Korean Journal of Occupational and Environmental Medicine 2010;22(2):146-153. Published online June 30, 2010; DOI: https://doi.org/10.35371/kjoem.2010.22.2.146

Abstract PDF

OBJECTIVE: The Korean Marine Corps enlistees endure tremendous physical and mental stress during basic military training, resulting in an increased risk of musculoskeletal injuries. The aim of this study was to investigate the incidence and type of the musculoskeletal injury problems and the risk factors associated with injuries among the Marine Corps recruits and to suggest preventive measures.
METHODS
The study subjects were the Marine Corps recruits (n=8,231) who were enlisted from July, 2008 to March, 2009 for basic military training. We used a prospective cohort design and collected basic demographic information and subject musculoskeletal injury risk factors through a questionnaire on the first day basic training. The subjects were followed for the subsequent 6-week military training period.
RESULTS
The cumulative incidence of musculoskeletal injuries was 13.4% during the 6-week training period, and more than half of the injuries involved the lower limbs at or below the level of the knee. Based on multivariate logistic regression analysis, the following factors were related to an elevated risk for injuries: age, height, educational level, subjective health perception, injury history during the past year, and stress scale after entrance.
CONCLUSION
Based on our study results, the application of injury prevention measures such as stress management program and gradual fitness increasing program to the Marine Corps recruit training would contribute to the reduction of musculoskeletal injuries.

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Journal of the Korean Society of Radiology.2011; 5(6): 315. CrossRef

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Original Article

Factors Associated with Occupational Injuries of Ship-building Supply Workers in Busan: Seung Hwan Shin, Dae Hwan Kim, Jin Hong Ahn, Hwi Dong Kim, Jeong Ho Kim, Hyun Man Kang, Jong Tae Lee; Korean Journal of Occupational and Environmental Medicine 2008;20(1):15-24. Published online March 31, 2008; DOI: https://doi.org/10.35371/kjoem.2008.20.1.15

Abstract PDF

OBJECTIVE: This study was conducted to evaluate both personal and work-related factors associated with occupational injuries of ship-building supply workers in Busan, Korea.
METHODS
A self-administered, questionnaire survey, asking both personal and work-related factors associated with occupational injuries, was administered to 1,651 workers from 64 different ship-building supply companies in Busan, Korea. All occupational injuries had occurred within the previous 5 years. The workers were divided into three sub-groups: Group I, under 4 day-sick leave, Group II, 4 day-sick leave and over, and Group III, which consisted of both Groups I and II. The statistical significance of the factors associated with occupational injuries underwent cross tabulation analysis for each group. Afterwards, the relationships between the factors which had statistical significance and the occurrence of occupational injuries were analyzed through multiple logistic regression by using the SPSS 12.0 K program.
RESULTS
The prevalence of occupational injuries was 4.30% in Group II and 7.57% in Group III. The work activities which had the most frequent occupational injuries were 'Fit-up' and 'Welding', and 30.0% of injured workers were covered by workers' compensation in Group II. According to the multiple logistic regression analysis results, the factors which had statistical significance in occupational injury occurrence were education level above college (OR 2.78) and high level of fatigue (OR 2.18) in Group I, sleeping less than 5 hours per day (OR 3.47), high level of fatigue (OR 2.79) and working over 56 hours per week (OR 1.53) in Group II, and education level above college (OR 1.78), sleeping less than 5 hours per day (OR 2.98), poor sleep quality (OR 1.65) and high level of fatigue (OR 2.58) in Group III.
CONCLUSION
This study demonstrated that several factors of ship-building supply workers such as sleep hours, sleep quality, fatigue, working hours, and educational level exerted a statistical effect on the occurrence of occupational injuries. In association with occupational injuries occurrence, these factors need to be controlled by proper methods such as effective safety education, work condition modification, and life style management.

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Jin-Young Min, Sung-Hee Song, HyeJin Kim, Kyoung-Bok Min
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So Eun Choi, Sam Sun Lee, Sang Dol Kim
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Jong-Eun Kim, Young-Ki Kim, Dong-Mug Kang
Journal of the Ergonomics Society of Korea.2012; 31(1): 157. CrossRef
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Sun-Young Choi, Jeong-Eun Bin, Sung-Hee Kim
The Korean Journal of Food And Nutrition.2012; 25(4): 1047. CrossRef
Ergonomic Research Trends in the Shipbuilding Industry: Present and the Future
Yu-Chang Kim
Journal of the Ergonomics Society of Korea.2012; 31(1): 131. CrossRef

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Case Report

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

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

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