Annals of Occupational and Environmental Medicine

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

Abstract Abstract in Korean PDF PubReader ePub: 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

Exposure to polycyclic aromatic hydrocarbons and serum total IgE in the Korean adults: the Third Korean National Environmental Health Survey (2015–2017): Jeong Hun Jo, Dae Hwan Kim, Ji Young Ryu; Ann Occup Environ Med 2022;34:e43. Published online December 14, 2022; DOI: https://doi.org/10.35371/aoem.2022.34.e43

Abstract Abstract in Korean PDF PubReader ePub

Background

Polycyclic aromatic hydrocarbons (PAHs) have become common pollutants with industrial development. Although the effect of exposure to PAHs on allergic disease in humans has been evaluated, evidence of an association is sparse. The association between PAH exposure and serum total immunoglobulin E (IgE) levels was evaluated in Korean adults.

Methods

In total, this study included 3,269 participants in the Third Korean National Environmental Health Survey (2015–2017). Four urinary PAH metabolites were used to assessed exposure to PAHs: 1-hydroxypyrene, 1-hydroxyphenanthrene, 2-naphthol, and 2-hydroxyfluorene. The analyses were performed on 3 cutoff levels (100 IU/mL, 114 IU/mL, and 150 IU/mL) set as the total IgE elevation. Prevalence of total IgE elevation by PAH exposure group and general characteristics (age, sex, BMI, smoking, alcohol drinking, and occupation) were analyzed using the Rao–Scott χ² test. Multiple logistic regression analyses were conducted to calculate adjusted odds ratios (ORs) for total IgE elevation by PAH exposure groups.

Results

Total IgE elevation differed significantly by age, sex, smoking status, alcohol drinking status, and occupation. For 2-hydroxyfluorene, the fourth quartile showed a significant association with IgE elevation compared to the first quartile in the analyses of cutoff-level 100 IU/mL (OR: 1.372, 95% confidence interval [CI]: 1.007–1.869) and 114 IU/mL (OR: 1.643, 95% CI: 1.167–2.312). In the analysis of cutoff-level 150 IU/mL, the adjusted ORs of the third and fourth quartile of 2-hydroxyfluorene were significantly higher than the first quartile (3rd quartile: OR: 1.478, 95% CI: 1.034–2.113; 4th quartile: OR: 1.715, 95% CI: 1.161–2.534). However, there were no significant positive associations for the other metabolites.

Conclusions

This study implied that PAHs exposure is associated with total IgE elevation in Korean adults. More research is needed to confirm the effect of exposure to PAHs on serum IgE and allergic diseases.

다환 방향족 탄화수소 노출과 혈중 총 면역글로불린 E (제3기 국민환경보건 기초조사 2015-2017)
목적
다환 방향족 탄화수소(Polycyclic Aromatic Hydrocarbons, PAHs)는 화석 연료, 폐기물, 목재 등의 여러 유기물의 불완전 연소에 의해서 발생하는 환경 및 직업상 오염물질로서, 산업 발전으로 인해 생활 곳곳에서 노출이 가능한 오염물질이 되었다. PAHs노출과 알레르기 질환과의 관련성을 보여주는 연구 결과들이 있으나 부족한 실정이다. 본 연구에서는 제3기 국민환경보건기초조사(2015-2017) 자료를 이용하여 국내 성인에서 PAHs 노출과 알레르기 지표 중 하나인 혈중 총 면역글로불린 E(IgE)의 관련성을 평가하였다.
방법
국민환경보건 기초조사(2015 - 2017) 제3기에 참여한 성인 3269명을 대상으로 가중치를 적용하여 분석하였다. PAHs에 대한 노출에 대한 지표로 요중 1-hydroxypyrene, 2-naphthol, 1-hydroxyphenanthrene, 2-hydroxyfluorene 농도를 이용하였고, 혈중 total IgE의 증가 여부는 100 IU/mL, 114 IU/mL, 150 IU/mL를 기준으로 설정하여 분석하였다. 요중 PAHs 대사체 농도는 사분위수 기준 네 그룹으로 나누어 분석에 이용하였다.
나이, 성별, BMI, 흡연 여부, 알코올 섭취 여부, 직업군 등 인구학적 요인에 따른 혈중 total IgE 증가 여부 및 각 대사체의 사분위수 그룹에 따른 혈중 total IgE 증가 여부를 카이제곱 검정을 이용하여 분석하였다. 로지스틱 회귀분석을 이용하여 요중 PAHs 대사체 농도 사분위수 그룹과 혈중 total IgE 농도 증가와의 관련성을 파악하고자 하였다.
결과
총 IgE 상승은 연령, 성별, 흡연 여부, 음주 여부, 직업에 따라 유의한 차이를 보였다.
나이, 성별, 흡연 여부, 알코올 섭취 여부, 직업군 등 요인들을 보정한 로지스틱 회귀분석에서는 2-hydroxyfluoren의 경우 IgE 증가를 100IU/mL 및 114IU/mL로 설정한 분석에서 4사분위수 그룹이 1사분위수 그룹과 비교하여 혈중 total IgE 증가에 대해 유의하게 높은 교차비를 보였다(100 IU/mL을 IgE 증가 기준으로 분석 시: OR 1.372, 95% CI 1.007-1.869; 114 IU/mL을 IgE 증가 기준으로 분석 시: OR 1.643, 95% CI 1.167-2.312). 혈중 total IgE의 증가를 150IU/mL로 설정한 분석에서는 2-hydroxyfluoren의 3사분위 그룹과 4분위수 그룹의 total IgE 증가에 대한 교차비가 1사분위수 그룹과 비교하여 유의하게 더 높았다(3사분위수 그룹: OR 1.478, 95% CI 1.034-2.113; 4사분위수그룹: OR 1.715, 95% CI 1.161-2.534). 그러나 다른 대사 산물들에 대한 분석에서는 유의한 연관성이 없었다.
결론
본 연구의 결과는 한국 성인의 PAHs 노출과 총 IgE 수준 사이에 연관성이 있음을 제시한다. PAHs 노출이 혈청 IgE와 알레르기 질환에 미치는 영향을 평가하기 위해서는 추가적인 연구가 더 필요할 것으로 보인다.

Citations

Citations to this article as recorded by

Association of mixed polycyclic aromatic hydrocarbons exposure with oxidative stress in Korean adults
Ji Young Ryu, Dong Hyun Hong
Scientific Reports.2024;[Epub] CrossRef

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Research Article

The relationship between working hours and the intention to quit smoking in male office workers: data from the 7th Korean National Health and Nutrition Examination Survey (2016–2017): Eui Hyek Choi, Dae Hwan Kim, Ji Young Ryu; Ann Occup Environ Med 2021;33:e13. Published online May 4, 2021; DOI: https://doi.org/10.35371/aoem.2021.33.e13

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Background

The intention to quit smoking is one of the most important factors in smoking cessation. Long working hours is also a constant issue, and many studies have shown an association between the working hours and diseases, including cardiovascular and gastrointestinal diseases. This study evaluated the relationship between working hours and the intention to quit smoking among Korean male office workers, and blue collar workers for comparison.

Methods

This study was based on the Seventh Korea National Health and Nutrition Examination Survey (2016–2017). A total of 1,389 male workers were smokers, and then office workers and blue collar workers were selected. Logistic regression was used to calculate the odds ratio (OR) for the intention to quit smoking according to smoking-related characteristics and working hours after adjusting for age group, body mass index (kg/m²), marital status, household income (quartile), educational level, drinking, exercise, smoking-related characteristics (smoking initiation age, smoking amount, and attempt to quit smoking more than 1day in the past year) and working hours.

Results

The percentage of workers who had the intention to quit smoking in 6 months was higher in office workers (38.9% for office workers and 29.4% for blue collars, p = 0.017). Blue collar workers had higher percentages of workers who worked more than 52 hours per week (19.8% for office workers and 38.9% for blue collar workers, p < 0.001). Logistic regression analysis showed that working > 52 hours per week was significantly associated with a lower intention to quit smoking within 6 months among male office workers (OR = 0.30, 95% confidence interval = 0.14–0.66).

Conclusions

Working more than 52 hours per week was positively related with a lower intention to quit smoking among currently smoking male office workers. Further studies are needed considering more work-related variables such as job stress and physical load.

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Research Article

Relationship between triclosan exposure and thyroid hormones: the Second Korean National Environmental Health Survey (2012–2014): Na-Young Ha, Dae Hwan Kim, Ji Young Ryu; Ann Occup Environ Med 2019;31:e22. Published online September 5, 2019; DOI: https://doi.org/10.35371/aoem.2019.31.e22

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Background

5-chloro-2-(2,4-dichlorophenoxy)phenol (triclosan) is used as an antiseptic and is a potential endocrine-disrupting chemical that can affect thyroid hormone levels. This study evaluated the relationship between triclosan exposure and thyroid hormones.

Methods

Data from the second Korean National Environmental Health Survey (2012–2014) were analyzed. Triclosan exposure was evaluated using urinary triclosan concentrations and classified into 2 groups: ‘below detection (< limit of detection [LOD])’ vs. ‘detected (≥ LOD).’ Multiple linear regression analysis was conducted to determine the relationship between triclosan exposure and the serum thyroid hormone concentrations, adjusting for age, body mass index, urinary creatinine, and smoking status.

Results

When grouped by sex, triclosan exposure was positively associated with the serum thyroid-stimulating hormone (TSH) concentrations in females with marginal significance (β = 0.066, p = 0.058). However, no significant association was identified between triclosan exposure and serum total triiodothyronine and thyroxine in both males and females, and TSH in males.

Conclusions

This study is the first human study to evaluate the relationship between triclosan exposure and serum thyroid hormone concentrations in the Korean population. There was suggestive positive association between triclosan exposure and the serum TSH in females. Further studies need to evaluate the relationship between long-term exposure to low-dose triclosan and thyroid hormones.

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Ana C. Marques, Melissa Mariana, Elisa Cairrao
International Journal of Molecular Sciences.2022; 23(19): 11427. CrossRef
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Elham Attarian, Karim Ebrahimpour, Mohammadreza Maracy, Seyede Shahrbanoo Daniali, Bahareh Shoshtari-Yeganeh, Malihe Moazeni, Afshin Ebrahimi, Roya Kelishadi, Gabriella Galluccio
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Evaluation of triclosan exposures on secretion of pro-inflammatory cytokines from human immune cells
Wendy J. Wilburn, Sara Jamal, Farah Ismail, Dylan Brooks, Margaret Whalen
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Research Article

The effects of exposure to lead, cadmium and mercury on follicle-stimulating hormone levels in men and postmenopausal women: data from the Second Korean National Environmental Health Survey (2012–2014): Tae-Woo Lee, Dae Hwan Kim, Ji Young Ryu; Ann Occup Environ Med 2019;31:e21. Published online August 28, 2019; DOI: https://doi.org/10.35371/aoem.2019.31.e21

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Background

Follicle-stimulating hormone (FSH), a gonadotropin secreted by the pituitary gland, is a representative secondary sex hormone and an important indicator of reproductive function. The effects of heavy metals such as lead, cadmium, and mercury on humans have been studied, but reports on their effects on sex hormone levels are lacking. Therefore, we investigated the relationship between heavy metal exposure and FSH levels in Korean men and postmenopausal women.

Methods

A total of 4,689 adults (2,763 men and 1,926 postmenopausal women aged 50 years or over) who participated in the Second Korean National Environmental Health Survey (2012–2014) were included. We compared differences in serum FSH levels by demographic characteristics using the t-test and analysis of variance. Multiple linear regression analysis was used to determine the relationship between the blood levels of lead and mercury and the urine cadmium level, and serum FSH levels.

Results

On multiple linear regression analysis, lead exposure was positively associated with serum FSH concentrations in postmenopausal women (β = 2.929, p = 0.019). However, we found no significant association between serum FSH concentration and blood lead and mercury levels, or urine cadmium level, in men.

Conclusions

This study suggests that lead exposure can affect the FSH level in postmenopausal women. Further studies are needed to evaluate the effects of low-dose long-term exposure to heavy metals on sex hormones.

Citations

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Research Article

Relationship between residence characteristics and polycyclic aromatic hydrocarbon exposure in housewives: second Korean National Environmental Health Survey (2012–2014): Hyung-Gue Park, Na-Young Ha, Dae Hwan Kim, Jeong-Ho Kim, Chae-Kwan Lee, Kunhyung Kim, Ji Young Ryu; Ann Occup Environ Med 2018;30:23. Published online April 18, 2018; DOI: https://doi.org/10.1186/s40557-018-0236-x

Abstract PDF PubReader ePub

Background

Polycyclic aromatic hydrocarbons (PAHs) produced by incomplete combustion have negative effects on human health due to their carcinogenicity and teratogenicity. Indoor sources of PAHs include tobacco smoke, heating sources, and cooking. This study evaluated the relationship between human PAH exposure and residence characteristics.

Method

This study was based on the second Korean National Environmental Health Survey (2012–2014). Non-smoking housewives were included in the analyses (n = 1269). The concentrations of urinary PAH metabolites (2-naphthol, 2-hydroxyfluorene, 1-hydroxyphenanthrene, and 1-hydroxypyrene) were adjusted by urine creatinine level. The geometric mean concentrations of urinary PAH metabolites by residential factors were examined. Logistic regression models were used to evaluate associations between residential variables and PAH exposures.

Results

The adjusted geometric mean concentrations of urinary 2-hydroxyfluorene and 1-hydroxyphenanthrene were significantly higher in the group residing within 100 m of a major road (p < 0.05) than in those residing > 100 m from a major road. In logistic regression analyses, the odds ratio (OR) for exceeding the third quartile of urinary 1-hydroxypyrene concentration was significantly higher in the group using coal or wood fuel for residential heating than in the group using gas (OR = 2.745, 95% confidence interval [CI] = 1.295–5.819). The detached house group had a significantly higher OR for 1-hydroxyphenanthrene compared with the apartment group (OR = 1.515, 95% CI = 1.023–2.243).

Conclusion

Our study shows the evidence of associations between some urinary PAH metabolite levels (1-hydroxyphenanthrene and 1-hydroxypyrene) and residence characteristics. Additional studies are needed to clarify these associations.

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Association of mixed polycyclic aromatic hydrocarbons exposure with oxidative stress in Korean adults
Ji Young Ryu, Dong Hyun Hong
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Characterization of the internal working-life exposome using minimally and non-invasive sampling methods - a narrative review
Eline Verscheure, Rob Stierum, Vivi Schlünssen, Anne Mette Lund Würtz, Dorian Vanneste, Manolis Kogevinas, Barbara N. Harding, Karin Broberg, Shan Zienolddiny-Narui, Johanna Samulin Erdem, Mrinal K. Das, Konstantinos C. Makris, Corina Konstantinou, Xanthi
Environmental Research.2023; 238: 117001. CrossRef
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Yifeng Dai, Xijin Xu, Xia Huo, Marijke M. Faas
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Relationship between urinary metabolites of polycyclic aromatic hydrocarbons and risk of papillary thyroid carcinoma and nodular goiter: A case-control study in non-occupational populations
Boying Liu, Yanyan Chen, Siyao Li, Yuanyuan Xu, Yi Wang
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Li-Min Cao, Ge Mu, Wei-Hong Chen
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Mengchen Shen, Guijian Liu, Hao Yin, Li Zhou
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Association between urinary polycyclic aromatic hydrocarbons and hypertension in the Korean population: data from the Second Korean National Environmental Health Survey (2012–2014)
Tae-Woo Lee, Dae Hwan Kim, Ji Young Ryu
Scientific Reports.2020;[Epub] CrossRef
Comparison of Polycyclic Aromatic Hydrocarbons Exposure Across Occupations Using Urinary Metabolite 1-Hydroxypyrene
Dong-Hee Koh, Ju-Hyun Park, Sang-Gil Lee, Hwan-Cheol Kim, Sangjun Choi, Hyejung Jung, Donguk Park
Annals of Work Exposures and Health.2020; 64(4): 445. CrossRef

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Research Article

Perception of and attitude toward ethical issues among Korean occupational physicians: Junghye Choi, Chunhui Suh, Jong-Tae Lee, Segyeong Lee, Chae-Kwan Lee, Gyeong-Jin Lee, Taekjoong Kim, Byung-Chul Son, Jeong-Ho Kim, Kunhyung Kim, Dae Hwan Kim, Ji Young Ryu; Ann Occup Environ Med 2017;29:23. Published online June 24, 2017; DOI: https://doi.org/10.1186/s40557-017-0182-z

Abstract PDF PubReader ePub: Background
Occupational physicians (OPs) have complex relationships with employees, employers, and the general public. OPs may have simultaneous obligations towards third parties, which can lead to variable conflicts of interests. Among the various studies of ethical issues related to OPs, few have focused on the Korean OPs. The aim of the present survey was to investigate the ethical contexts, the practical resolutions, and the ethical principles for the Korean OPs.
Methods
An email with a self-administered questionnaire was sent to members of the Korean Society of Occupational and Environmental Medicine, comprising 150 specialists and 130 residents. The questionnaire was also distributed to 52 specialists and 46 residents who attended the annual meeting of the Korean Association of Occupational and Environmental Clinics in October 2015, and to 240 specialists by uploading the questionnaire to the online community ‘oem-doctors’ in February 2016. The responses to each question (perception of general ethical conflicts, recognition of various ethical codes for OPs, core professional values in ethics of occupational medicine, and a mock case study) were compared between specialists and residents by the chi-squared test and Fisher’s exact test.
Results
Responses were received from 80 specialists and 71 residents. Most participants had experienced ethical conflicts at work and felt the need for systematic education and training. OPs suffered the most ethical conflicts in decisions regarding occupational health examination and evaluation for work relatedness. Over 60% of total participants were unaware of the ethical codes of other countries. Participants thought ‘consideration of worker’s health and safety’ (26.0%) and ‘neutrality’ (24.7%) as the prominent ethical values in professionality ofoccupational medicine. In mock cases, participants chose beneficence and justice for fitness for work and confidential information acquired while on duty, and beneficence and respect for autonomy in pre-placement examinations.
Conclusions
This study evaluated the current perception of and attitude toward ethical issues among the Korean OPs. These findings will facilitate the development of a code of ethics and the ethical decision-making program forthe Korean OPs.
Electronic supplementary material
The online version of this article (doi:10.1186/s40557-017-0182-z) contains supplementary material, which is available to authorized users.

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Research Article

Relationship between housing characteristics, lifestyle factors and phthalates exposure: the first Korean National Environmental Health Survey (2009–2011): Kyungyong Jung, Hyounho Oh, Ji Young Ryu, Dae Hwan Kim, Sangyoon Lee, Byung-Chul Son, Chae-Kwan Lee; Ann Occup Environ Med 2015;27:33. Published online December 23, 2015; DOI: https://doi.org/10.1186/s40557-015-0078-8

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International Journal of Environmental Health Research.2024; : 1. CrossRef
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Chenxi Liao, Wei Liu, Jialing Zhang, Wenming Shi, Xueying Wang, Jiao Cai, Zhijun Zou, Rongchun Lu, Chanjuan Sun, Heng Wang, Chen Huang, Zhuohui Zhao
Science of The Total Environment.2018; 616-617: 1288. CrossRef
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Won Dong Lee, Jonathan J. Fong, John A. Eimes, Young Woon Lim
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Case Report

A case of fitness to work in a worker with COPD using the exercise stress test: Yewon Kim, Kyungyong Jung, Ji Young Ryu, Dae Hwan Kim, Sangyoon Lee; Ann Occup Environ Med 2015;27:26. Published online December 11, 2015; DOI: https://doi.org/10.1186/s40557-015-0074-z

Abstract PDF PubReader ePub: Background
Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease characterized by persistent airflow limitation. Therefore, both work ability and workday length may be affected in individuals with this disease. We studied a worker with suspected COPD and assessed fitness to work using post-bronchodilator spirometry, symptom assessment scales, and the exercise stress test.
Case report
The patient was a 58-year-old man due to work as a field supervisor in the ship construction sector. He had a 40 pack-year smoking history and experienced occasional dyspnea when climbing stairs. He visited this hospital to receive cardiopulmonary function tests and to determine his ability to work. Post-bronchodilator spirometry revealed severe irreversible airway obstruction corresponding to a modified Medical Research Council grade of 2 on the dyspnea scale. His COPD Assessment Test score was 12, placing him in patient group D (high risk, more symptoms) based on the Global Initiative for Chronic Obstructive Lung Disease classification system. His maximum oxygen uptake (VO_2max) was determined to be 19.16 ml/kg/min, as measured by the exercise stress test, and his acceptable workload for 8 h of physical work was calculated to be 6.51 ml/kg/min. His work tasks required an oxygen demand of 6.89 ml/kg/min, which exceeded the acceptable workload calculated. Accordingly, he was advised to adjust the work tasks that were deemed inappropriate for his exercise capacity.
Conclusion
As COPD incidence is expected to rise, early COPD diagnosis and determination of fitness to work is becoming increasingly important. Performing the exercise stress test, to evaluate the functional capacity of workers with COPD, is considered an acceptable solution.

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Research Article

Prevalence of the Metabolic Syndrome among Korean Workers by Occupational Group: Fifth Korean National Health and Nutrition Examination Survey (KNHANES) 2010: Ji Young Ryu, Sukwoo Hong, Chang-Hyo Kim, Sangyoon Lee, Jeong-Ho Kim, Jong-Tae Lee, Dae Hwan Kim; Ann Occup Environ Med 2013;25:13-13. Published online August 5, 2013; DOI: https://doi.org/10.1186/2052-4374-25-13

Abstract PDF PubReader ePub

Objectives

The prevalence of the metabolic syndrome has increased rapidly in South Korea over the past 10 years. However, the occurrence of the metabolic syndrome in workers grouped according to the specific type of work is not well understood in Korea. In this study, we assessed the differences in the prevalence of the metabolic syndrome by occupational group and evaluated the risk of the metabolic syndrome among occupational groups.

Methods

From the Fifth Korean National Health and Nutrition Examination Survey (2010), 3,303 employed participants were included in this study. The unadjusted and age-adjusted prevalences of the metabolic syndrome were estimated and multiple logistic regression analysis was conducted using the presence of the metabolic syndrome as a dependent variable, and adjusting for age, education level, household income, drinking behavior, smoking status, physical activity, work hours, and work scheduling pattern.

Results

Among male workers, non-manual workers had the greatest age-adjusted prevalence (26.4%, 95% CI: 22.3-30.5%) among the occupational groups. In a logistic regression analysis, male manual workers had a significantly lower odds ratio for the metabolic syndrome relative to non-manual workers (0.59, 95% CI: 0.41-0.85).

Conclusion

Our study demonstrated differences in the prevalence of the metabolic syndrome by occupational group and identified the greatest risk for the metabolic syndrome in male non-manual workers.

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