Annals of Occupational and Environmental Medicine

Original Article

Association of heavy metal complex exposure and neurobehavioral function of children: Minkeun Kim, Chulyong Park, Joon Sakong, Shinhee Ye, So young Son, Kiook Baek; Ann Occup Environ Med 2023;35:e23. Published online July 6, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e23

Abstract Abstract in Korean PDF Supplementary Material PubReader ePub

Background

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

Methods

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

Results

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

Conclusions

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

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

Citations

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The impact of unfavorable and toxic environmental conditions on autonomic tone modulations while wearing N95 face masks
Valery Erkudov, Andrey Pugovkin, Kenjabek Rozumbetov, Azat Matchanov, Shanika Arachchi, Upaka Rathnayake
Case Studies in Chemical and Environmental Engineering.2024; 9: 100619. CrossRef
Association Between Multiple Heavy Metal Exposures and Cholesterol Levels in Residents Living Near a Smelter Plant in Korea
Sun-In Moon, Dong-Hyuk Yim, Kyunghi Choi, Sang-Yong Eom, Byung-Sun Choi, Jung-Duck Park, Heon Kim, Yong-Dae Kim
Journal of Korean Medical Science.2024;[Epub] CrossRef

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Original Article

Risk assessment of heavy metals in tuna from Japanese restaurants in the Republic of Korea: Seong-Jin Bae, Kyu-Sik Shin, Chulyong Park, Kiook Baek, So-Young Son, Joon Sakong; Ann Occup Environ Med 2023;35:e3. Published online February 9, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e3

Abstract Abstract in Korean PDF Supplementary Material PubReader ePub

Background

Studies on the risk of mercury (Hg) in Korean fishery products focus primarily on total Hg levels as opposed to methylmercury (MeHg) levels. None of the few studies on MeHg in tuna investigated tuna from Japanese restaurants. Few have evaluated lead (Pb), cadmium (Cd) and arsenic (As) in tuna. Thus, this study aimed to conduct a risk assessment by evaluating heavy metal concentrations in tuna from Japanese restaurants.

Methods

Thirty-one tuna samples were collected from Japanese restaurants in the Republic of Korea. They were classified according to region and species. The concentration of heavy metals in the samples was analyzed using the Ministry of Food and Drug Safety Food Code method. The rate of exceedance of maximum residue levels (MRLs) and the risk compared to the provisional tolerable weekly intake (PTWI) set by the Joint Food and Agriculture Organization/World Health Organization Expert Committee on Food Additives (%PTWI) were evaluated for risk assessment.

Results

The mean of MeHg, Pb, Cd and As concentrations were 0.56 ± 1.47 mg/kg, 33.95 ± 3.74 μg/kg, 14.25 ± 2.19 μg/kg and 1.46 ± 1.89 mg/kg, respectively. No sample exceeded the MRLs of Pb and Cd, but 9.7% of the samples exceeded the MRL of MeHg. The %PTWIs of MeHg, Pb, Cd and As were 4.2037, 0.0162, 0.0244 and 1.1627, respectively. The %PTWI of MeHg by age group and sex was highest among men aged 19–29 years (10.6494), followed by men aged 30–49 years (7.2458) and women aged 19–29 years (4.8307).

Conclusions

We found that 3 out of 31 samples exceeded the MRL of MeHg. The %PTWI of MeHg showed significant differences based on age and sex, and the value was likely to exceed a safe level depending on individuals’ eating behaviors. Therefore, improved risk management for MeHg is required.

한국의 일식집 유통 참치의 중금속(4종) 위해성평가
목적
국내 수산물의 수은에 관한 위해성 연구는 주로 메틸수은이 아닌 총 수은을 대상으로 이루어졌다. 소수의 참치의 메틸수은에 대한 연구들 중 일식점 유통 참치에 대한 연구는 없었다. 참치의 납, 카드뮴 및 비소에 대한 연구도 거의 이루어지지 않았다. 따라서 본 연구에서는 일식점 유통 참치의 중금속 농도를 평가하여 위해성평가를 실시하고자 하였다.
방법
참치는 한국의 일식집에서 총 31개의 시료가 수집되었다. 지역과 참치의 종에 따라서 분류하였다. 시료의 중금속 농도는 식품의약품안전처의 식품공전에 따라 분석했다. 위해성평가를 위해서 식품의 잔류허용기준을 초과하는 비율과 FAO/WHO합동식품첨가물 전문가위원회가 설정한 잠정주간섭취허용과 비교한 위험도(%PTWI)를 산출하였다.
결과
메틸수은, 납, 카드뮴 및 비소 농도의 기하평균은 각각 0.56 ± 1.47 mg/kg, 33.95 ± 3.74 μg/kg, 14.25 ± 2.19 μg/kg 및 1.46 ± 1.89 mg/kg이었다. 납과 카드뮴의 경우 잔류허용기준을 초과하는 시료가 없었으나 메틸수은의 경우 시료의 9.7%가 초과했다. 메틸수은, 납, 카드뮴 및 비소의 %PTWI는 4.2037, 0.0162, 0.0244 및 1.1627이었다. 메틸수은의 %PTWI는 19-29세의 남성, 30-49세의 남성, 19-29세의 여성 순으로 높았으며, 그 값은 10.6494, 7.2458, 4.8307이었다.
결론
총 31개의 시료 중 3개에서 메틸수은의 잔류허용기준을 초과하는 것으로 나타났다. 메틸수은의 %PTWI는 연령과 성별에 따라 상당한 차이를 보였고, 그리고 그 값은 섭취행태에 따라서 안전 수준을 초과할 가능성을 보였다. 따라서, 메틸수은에 대한 개선된 안전성 관리 방안이 필요할 것으로 보인다.

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Metal Load of Potentially Toxic Elements in Tuna (Thunnus albacares)—Food Safety Aspects
József Lehel, Zita Papp, András Bartha, Péter Palotás, Rita Szabó, Péter Budai, Miklós Süth
Foods.2023; 12(16): 3038. CrossRef

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Original Article

Association between exposure to particulate matter and school absences in Korean asthmatic adolescents: Seongmin Jo, Kiook Baek, Joon Sakong, Chulyong Park; Ann Occup Environ Med 2022;34:e21. Published online August 22, 2022; DOI: https://doi.org/10.35371/aoem.2022.34.e21

Abstract Abstract in Korean PDF Supplementary Material PubReader ePub: Background
Because particulate matter (PM) and asthma are closely related, the prevalence of school absence among adolescents with asthma can be affected by the concentration of PM. We aimed to investigate the relationship between school absences due to asthma and the total number of days that the PM concentration exceeded the standard.
Methods
We used the data from the 16th Korea Youth Risk Behavior Survey and the PM levels of 17 metropolitan cities and provinces gathered from the AirKorea. Information on the characteristics of asthmatic adolescents and the prevalence of school absence was obtained using a questionnaire, while the PM levels based on the total number of days with poor and very poor PM grades were collected from the AirKorea website. Both χ² test and logistic regression analysis were performed using the weights presented in the original dataset.
Results
In the case of particulate matter of 10 microns in diameter or smaller (PM₁₀), the odds ratio (OR) after adjusting for confounders (sex, school year, body mass index, smoking history, diagnosis of allergic rhinitis, diagnosis of atopic dermatitis and city size) was 1.07 (95% confidence interval [CI]: 1.01–1.13) for absents due to asthma when the total days of poor and very poor grades of PM₁₀ (81 μg/m³ or higher) increased by 1 day. In the analysis of particulate matter of 2.5 microns in diameter or smaller (PM_2.5), the OR after adjusting for confounders was 1.01 (95% CI: 1.00–1.03) for absents due to asthma when the total number of days with poor and very poor PM_2.5 grades (36 μg/m³ or higher) increased by 1 day.
Conclusions
A significant association was observed between the total number of days of poor and very poor PM₁₀ and PM_2.5 grades and school absence due to asthma; PM can cause asthma exacerbation and affect the academic life.; 한국 천식 청소년의 미세먼지 노출과 학교 결석과의 상관관계
목적
미세먼지와 천식은 밀접한 관련이 있기 때문에 천식을 앓고 있는 청소년들의 천식악화로 인한 결석률은 미세먼지 농도에 영향을 받을 수 있다. 이번 연구는 일정 기준의 미세먼지 농도를 초과하는 총 일수와 천식 악화로 인한 학교 결석의 관계를 조사했다.
방법
제16차 청소년건강행태조사의 설문결과 중 천식을 진단받은 청소년들을 대상으로 ‘천식으로 인한 학교 결석 여부’를 결과변수로, 에어코리아에서 제공하는 광역시·도의 미세먼지 측정 자료 중 연간 나쁨 및 매우나쁨 등급을 받은 날짜를 미세먼지의 노출 지표로 사용하여 분석하였다. 분석 시 복합표본설계에 따른 가중치를 적용한 카이-제곱 검정과 로지스틱 회귀 분석을 사용하였다.
결과
교란 변수를 보정 후, 1년간 대기 중 PM10 나쁨 및 매우나쁨 등급을 합산한 총 일수가 1일 증가할 때 천식 증상 악화로 인한 학교 결석에 대한 오즈비는 1.06 (95% 신뢰 구간: 1.01–1.13)이었다. PM2.5는 1년간 대기 중 나쁨 및 매우나쁨 등급을 합산한 총 일수가 1일 증가할 때, 천식 증상 악화로 인한 학교 결석에 대한 오즈비는 1.01 (95% 신뢰구간: 1.00–1.02)이었다.
결론
PM10과 PM10의 나쁨 및 매우나쁨 등급을 합산한 총 일수와 천식으로 인한 학교 결석 사이에 유의한 연관성이 관찰되었다.

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Research Article

The association between mercury concentrations and lipid profiles in the Korean National Environmental Health Survey (KoNEHS) cycle 3: Soo Ho Sohn, Han Cheol Heo, Seongmin Jo, Chulyong Park, Joon Sakong; Ann Occup Environ Med 2020;32:e19. Published online June 22, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e19

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Background

High concentrations of mercury intake from seafood are known to cause various side effects in humans, including on the nervous system. Various studies have reported the effects of mercury concentrations in humans; however, the association between dyslipidemia, a cardiovascular disease risk factor, and mercury remains controversial. Therefore, this study aimed to investigate the association between mercury accumulation and cholesterol concentrations in a Korean population.

Methods

We analyzed data of a sample of 3,228 respondents obtained from the Korean National Environmental Health Survey cycle 3, surveyed between 2015 and 2017, to determine how lipid profiles changed according to the blood mercury concentrations (BHg) and urine mercury concentrations (UHg). Multiple regression analysis was used to determine the effects of mercury concentrations among various factors affecting blood cholesterol levels.

Results

The arithmetic mean (AM) of BHg was 2.91 (2.81–3.02) μg/L, and the geometric mean (GM) was 2.71 (2.59–2.85) μg/L. The AM of UHg was 0.52 (0.48–0.56) μg/L, and the GM was 0.35 (0.33–0.38) μg/L. Lipid profiles were more related to the BHg than to the UHg. Total cholesterol (total-C), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels increased significantly as BHg increased in males, and total-C, triglyceride, and LDL-C levels increased significantly in females. Multiple regression analysis indicated that BHg were significantly associated with total-C, HDL-C, and LDL-C levels.

Conclusions

We found an association between mercury exposure and the risk of dyslipidemia; however, further studies are required to elucidate a causal association.

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Do blood metals influence lipid profiles? Findings of a cross-sectional population-based survey
Sabit Cakmak, Kimberly Mitchell, Anna Lukina, Robert Dales
Environmental Research.2023; 231: 116107. CrossRef
Association of Blood Total Mercury with Dyslipidemia in a sample of U.S. Adolescents: Results from the National Health and Nutrition Examination Survey Database, 2011–2018
Chibuzor Abasilim, Victoria Persky, Mary E. Turyk
Hygiene and Environmental Health Advances.2023; 6: 100047. CrossRef
Association of Blood Mercury Level with Liver Enzymes in Korean Adults: An Analysis of 2015–2017 Korean National Environmental Health Survey
Jin-Wook Chung, Dilaram Acharya, Jitendra Kumar Singh, Joon Sakong
International Journal of Environmental Research and Public Health.2023; 20(4): 3290. CrossRef
Heavy metal-induced lipogenic gene aberration, lipid dysregulation and obesogenic effect: a review
Yang Zhou, Frank Peprah Addai, Xinshuang Zhang, Yuelin Liu, Yinfeng Wang, Feng Lin, Alex Tuffour, Jie Gu, Guangxiang Liu, Haifeng Shi
Environmental Chemistry Letters.2022; 20(3): 1611. CrossRef
Mercury may reduce the protective effect of sea fish consumption on serum triglycerides levels in Chinese adults: Evidence from China National Human Biomonitoring
Bing Wu, Yingli Qu, Yifu Lu, Saisai Ji, Liang Ding, Zheng Li, Miao Zhang, Heng Gu, Qi Sun, Bo Ying, Feng Zhao, Xulin Zheng, Yidan Qiu, Zheng Zhang, Ying Zhu, Zhaojin Cao, Yuebin Lv, Xiaoming Shi
Environmental Pollution.2022; 311: 119904. CrossRef
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Kaviyarasi Renu, Anirban Goutam Mukherjee, Uddesh Ramesh Wanjari, Sathishkumar Vinayagam, Vishnu Priya Veeraraghavan, Balachandar Vellingiri, Alex George, Ricardo Lagoa, Kamaraj Sattu, Abhijit Dey, Abilash Valsala Gopalakrishnan
Molecules.2022; 27(17): 5657. CrossRef
The effects of chemical mixtures on lipid profiles in the Korean adult population: threshold and molecular mechanisms for dyslipidemia involved
Hai Duc Nguyen, Hojin Oh, Min-Sun Kim
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Association between Heavy Metal Exposure and Dyslipidemia among Korean Adults: From the Korean National Environmental Health Survey, 2015–2017
Do-won Kim, Jeongwon Ock, Kyong-Whan Moon, Choong-Hee Park
International Journal of Environmental Research and Public Health.2022; 19(6): 3181. CrossRef

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Research Article

Mercury concentration in shark meat from traditional markets of Gyeongsangbuk-do, South Korea: Han Cheol Heo, Yeon Hee Lim, Young Seok Byun, Joon Sakong; Ann Occup Environ Med 2020;32:e3. Published online January 2, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e3

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Background

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

Methods

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

Results

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

Conclusions

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

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Association of Blood Mercury Level with Liver Enzymes in Korean Adults: An Analysis of 2015–2017 Korean National Environmental Health Survey
Jin-Wook Chung, Dilaram Acharya, Jitendra Kumar Singh, Joon Sakong
International Journal of Environmental Research and Public Health.2023; 20(4): 3290. CrossRef
Increase of blood mercury level with shark meat consumption: A repeated-measures study before and after Chuseok, Korean holiday
Kiook Baek, Chulyong Park, Joon Sakong
Chemosphere.2023; 344: 140317. CrossRef
Mercury cycling in Australian estuaries and near shore coastal ecosystems: Triggers for management
William Maher, Frank Krikowa, Michael Ellwood, Detlev Helmig, Ruoyu Sun
Elementa: Science of the Anthropocene.2020;[Epub] CrossRef

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Research Article

Validity assessment of self-reported smoking status in firefighters using the urine cotinine test: Han Cheol Heo, Young Seok Byun, Soo Ho Sohn, Seong Min Jo, Sung Kyu Park, Joon Sakong; Ann Occup Environ Med 2020;32:e2. Published online January 2, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e2

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Background

In firefighters, smoking management is important because they are exposed to various harmful substances in their occupational environment. Accurate surveys of smoking status are essential to control tobacco use. The main disadvantage of self-report questionnaires, which are commonly used for investigating smoking status, is the possibility that the subjects' response are invalid. If the validity of firefighters' answers on smoking questionnaires is not adequate, different methods will be needed for investigating smoking status in firefighters.

Methods

This study was conducted on 445 male firefighters from 9 fire stations in Daegu (the city in South Korea) who visited a medical institution for medical checkup in 2016. The urine cotinine test strip (DCT-102; CLIAwaived Inc., cut-off value = 200 ng/mL) was used to classify the actual smoking status and to assess the validity of self-reported smoking status on questionnaires. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the smoking questionnaires were analyzed. Subjects testing positive in the urine cotinine test (assumed the actual current smokers) were selected. The frequency at which actual current smokers were misclassified as current non-smokers by the questionnaire was calculated. Subjects' characteristics were analyzed for possible association with any discrepancy between self-reported smoking status and urine cotinine test results.

Results

The smoking rates among firefighters surveyed using the smoking questionnaire and the urine cotinine test were 22.47% and 51.24%, respectively. Of the all subjects, 29.66% (n = 132) were misclassified. The sensitivity of the smoking questionnaire was 42.98%, the specificity was 99.08%, the PPV was 98.00%, and the NPV was 62.32%. In the 228 subjects classified as current actual smokers by the urine cotinine test, 57.02% (n = 130) were misclassified on the questionnaire. The misclassification rate increased with age. The degree of misclassification also increased when subjects had a history of disease.

Conclusions

In present study, the validity of the smoking questionnaire for firefighters was not suitable for investigating smoking status due to low sensitivity. To increase the validity of smoking status monitoring in firefighters, consideration of the various factors like survey environment, subjects' characteristics, and occupational factors is needed.

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Se-Won Lee, Jun-Young Heu, Ju-Yeong Kim, Jinyoung Kim, Kyungdo Han, Hyuk-Sang Kwon
Endocrinology and Metabolism.2023; 38(6): 679. CrossRef
Smoking Prevalence and Factors Associated with False Reporting in Korean Adolescents: The Korea National Health and Nutrition Examination Survey (2016-2020)
Seong Jun Park, Yoo Bin Seo, Jungun Lee, Seung Hee Kim, Chung Hwan Kim
Korean Journal of Family Practice.2022; 12(5): 375. CrossRef
Combustible cigarettes, heated tobacco products, combined product use, and periodontal disease: A cross-sectional JASTIS study
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Biomonitoring of smoke exposure in firefighters: A review
Biban Gill, Philip Britz-McKibbin
Current Opinion in Environmental Science & Health.2020; 15: 57. CrossRef

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Research Article

Emotional labor and job types of male firefighters in Daegu Metropolitan City: Sung Kyu Park, Han Cheol Heo, Joon Sakong, Man Joong Jeon; Ann Occup Environ Med 2019;31:e25. Published online September 26, 2019; DOI: https://doi.org/10.35371/aoem.2019.31.e25

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Background

Research on the emotional labor of firefighters is actively being carried out, but studies that analyze emotional labor separately by job types, working departments, and other conditions of firefighters are insufficient. The purpose of this study is to investigate the difference in emotional labor level between departments and other conditions of firefighters.

Methods

A total of 287 Korean firefighters were included for analysis. The demands of emotional labor and emotional damage were measured using the Korean Emotional Labor Scale. To analyze the conditions and factors affecting the emotional labor level of the firefighters, logistic regression analysis was performed using the emotional labor high risk group as a dependent variable.

Results

The average score of overall emotional labor level of the firefighters was 47.2 ± 17.3, and the prevalence of high risk firefighters with emotional labor was 27.1%. It was found that the emergency medical service and administration departments showed a higher prevalence of high risk emotional labor firefighters than did other departments. The result of multiple logistic regression analysis for the high risk emotional labor firefighters showed that the adjusted odds ratio of emergency medical service department compared to the reference group (the rescue department) was 2.89 (95% confidence interval [CI]: 1.02–8.24).

Conclusions

Among the firefighters, the emergency medical service department is a high risk factor for emotional labor. Therefore, education and prevention training on emotional labor should be more thorough before work shifts.

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Global prevalence and associated factors of sleep disorders and poor sleep quality among firefighters: A systematic review and meta-analysis
Amir Hossein Khoshakhlagh, Saleh Al Sulaie, Saeid Yazdanirad, Robin Marc Orr, Hossein Dehdarirad, Alireza Milajerdi
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Xiao Chen, Xiongliang Xiao, Arpit Bhardwaj
Computational Intelligence and Neuroscience.2022; 2022: 1. CrossRef

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Research Article

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; Ann Occup Environ Med 2018;30:55. Published online August 29, 2018; DOI: https://doi.org/10.1186/s40557-018-0264-6

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Background

The Korean Computerized Neurobehavioral Test (KCNT) is a psychological assessment tool used as part of Workers’ Special Health Examinations in Korea. Due to the spread of mobile technology, this study aimed to compare results of the KCNT administered on a tablet PC versus a desktop computer, and, therefore, assess the clinical applicability of mobile devices.

Methods

A total of 72 participants enrolled in this study. Their age, sex, and years of formal education were collected during an interview, as well as their typing speed. The test battery comprised five subtests: Simple Reaction Time test, Choice Reaction Time test, Digit Addition test, Symbol-Digit Substitution test, and Finger Tapping Speed test. Participants repeated the KCNT test battery in a randomly assigned order using four different testing systems: a desktop computer equipped with a conventional 106-key keyboard (System 1), a desktop computer equipped with a simplified keyboard (System 2), a tablet PC with a simplified 17-key on-screen keyboard (System 3), and a tablet PC equipped with a simplified keyboard (System 4).

Results

Results of the Digit Addition test did not differ significantly for different testing systems. In contrast, results of the Simple Reaction Time test, Choice Reaction Time test, Symbol-Digit Substitution test, and Finger Tapping test were lower for the tablet PC (Systems 3 and 4) compared to the desktop computer (Systems 1 and 2). Systems 1 and 2 did not show significantly different results. Performance on System 3 was inferior to that on System 4, only for the Choice Reaction Time test and Finger Tapping Speed test. There were also significant differences in performance by computer familiarity when adjusted for age and education; however, the performance of each group on the test systems showed similar patterns.

Conclusions

It is not recommended to use a tablet PC to administer the KCNT to evaluate neurobehavioral performance for the Simple Reaction Time test and Choice Reaction Time test; however, tablet PCs with an on-screen keyboard may be used to perform the Digit Addition test, and the Symbol-Digit Substitution test and Finger Tapping Speed test to a limited degree.

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How Do ImPACT Quick Test Scores Compare with ImPACT Online Scores in Non-Concussed Adolescent Athletes?
R J Elbin, Nathan R D’Amico, Matthew McCarthy, Melissa N Womble, Sydne O’Connor, Philip Schatz
Archives of Clinical Neuropsychology.2020; 35(3): 326. CrossRef

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Research Article

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

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Background

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

Methods

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

Results

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

Conclusions

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

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Association between Blood Mercury and Seafood Consumption in Korean Adults: KoNEHS Cycle 4 (2018~2020)
Ji-Eun Oh, Tae-Hyeong Kim, Eun-Hee Lee
Biomedical Science Letters.2024; 30(1): 24. CrossRef
Association of Blood Mercury Level with Liver Enzymes in Korean Adults: An Analysis of 2015–2017 Korean National Environmental Health Survey
Jin-Wook Chung, Dilaram Acharya, Jitendra Kumar Singh, Joon Sakong
International Journal of Environmental Research and Public Health.2023; 20(4): 3290. CrossRef
Increase of blood mercury level with shark meat consumption: A repeated-measures study before and after Chuseok, Korean holiday
Kiook Baek, Chulyong Park, Joon Sakong
Chemosphere.2023; 344: 140317. CrossRef
Mercury concentration in shark meat from traditional markets of Gyeongsangbuk-do, South Korea
Han Cheol Heo, Yeon Hee Lim, Young Seok Byun, Joon Sakong
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Mercury poisoning in a fisherman working on a pelagic fishing vessel due to excessive tuna consumption
Ji-Sung Ahn, Kyung Wook Kang, Won-Yang Kang, Hyeong-Min Lim, Seunghyeon Cho, Jai-Dong Moon, Won-Ju Park
Journal of Occupational Health.2018; 60(1): 89. CrossRef

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Research Article

Urinary arsenic species concentration in residents living near abandoned metal mines in South Korea: Jin-Yong Chung, Byoung-Gwon Kim, Byung-Kook Lee, Jai-Dong Moon, Joon Sakong, Man Joong Jeon, Jung-Duck Park, Byung-Sun Choi, Nam-Soo Kim, Seung-Do Yu, Jung-Wook Seo, Byeong-Jin Ye, Hyoun-Ju Lim, Young-Seoub Hong; Ann Occup Environ Med 2016;28:67. Published online November 22, 2016; DOI: https://doi.org/10.1186/s40557-016-0150-z

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Background

Arsenic is a carcinogenic heavy metal that has a species-dependent health effects and abandoned metal mines are a source of significant arsenic exposure. Therefore, the aims of this study were to analyze urinary arsenic species and their concentration in residents living near abandoned metal mines and to monitor the environmental health effects of abandoned metal mines in Korea.

Methods

This study was performed in 2014 to assess urinary arsenic excretion patterns of residents living near abandoned metal mines in South Korea. Demographic data such as gender, age, mine working history, period of residency, dietary patterns, smoking and alcohol use, and type of potable water consumed were obtaining using a questionnaire. Informed consent was also obtained from all study subjects (n = 119). Urinary arsenic species were quantified using high performance liquid chromatography (HPLC) and inductively coupled plasma mass spectrometry (ICP/MS).

Results

The geometric mean of urinary arsenic (sum of dimethylarsinic acid, monomethylarsonic acid, As³⁺, and As⁵⁺) concentration was determined to be 131.98 μg/L (geometric mean; 95% CI, 116.72–149.23) while urinary inorganic arsenic (As³⁺ and As⁵⁺) concentration was 0.81 μg/L (95% CI, 0.53–1.23). 66.3% (n = 79) and 21.8% (n = 26) of these samples exceeded ATSDR reference values for urinary arsenic (>100 μg/L) and inorganic arsenic (>10 μg/L), respectively. Mean urinary arsenic concentrations (geometric mean, GM) were higher in women then in men, and increased with age. Of the five regions evaluated, while four regions had inorganic arsenic concentrations less than 0.40 μg/L, one region showed a significantly higher concentration (GM 15.48 μg/L; 95% CI, 7.51–31.91) which investigates further studies to identify etiological factors.

Conclusion

We propose that the observed elevation in urinary arsenic concentration in residents living near abandoned metal mines may be due to environmental contamination from the abandoned metal mine.

Trial registration

Not Applicable (We do not have health care intervention on human participants).

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Assessing Acute and Chronic Risks of Human Exposure to Arsenic: A Cross-Sectional Study in Ethiopia Employing Body Biomarkers
Solomon Demissie, Seblework Mekonen, Tadesse Awoke, Bezatu Mengistie
Environmental Health Insights.2024;[Epub] CrossRef
Changes in arsenic accumulation and metabolic capacity after environmental management measures in mining area
Chen Zhao, Meng Du, Jun Yang, Guanghui Guo, Lingqing Wang, Yunxian Yan, Xuewen Li, Mei Lei, Tongbin Chen
Science of The Total Environment.2023; 855: 158652. CrossRef
Concentrations of blood and urinary arsenic species and their characteristics in general Korean population
Jeong Weon Choi, Yoon Chae Song, Nam-Yong Cheong, Kiyoung Lee, Sunmi Kim, Kyoung-Mu Lee, Kyunghee Ji, Mi-Yeon Shin, Sungkyoon Kim
Environmental Research.2022; 214: 113846. CrossRef
MTHFR, As3MT and GSTO1 Polymorphisms Influencing Arsenic Metabolism in Residents Near Abandoned Metal Mines in South Korea
Ulziikhishig Surenbaatar, Byoung-Gwon Kim, Hyun-Jin Son, Seong-Sik Cho, Gwon-Min Kim, Hyoun-Ju Lim, Jung-Yeon Kwon, Ki-Hwan Kim, Young-Seoub Hong
Journal of Environmental Health Sciences.2021; 47(6): 530. CrossRef

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Research Article

Effects of computer familiarity and computer type on the performance of Korean computerized neurobehavioral test: Nak Joon Baek, Gun Il Park, Young Seok Byun, Man Joong Jeon, Joon Sakong; Ann Occup Environ Med 2016;28:44. Published online September 9, 2016; DOI: https://doi.org/10.1186/s40557-016-0129-9

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Background

It is thought that computer familiarity has increased significantly since 2004 as well as the use of computers. This study aimed to evaluate the effects of computer familiarity and types of keyboard and computer on the performance of the Korean computerized neurobehavioral test (KCNT), and to identify which parameters of KCNT were affected by aforementioned factors.

Methods

A total of 85 subjects were classified into three groups of computer familiarity by Korean typing speed. Their age, gender and the level of education were also collected. The parameters of KCNT included simple reaction time, choice reaction time, addition, symbol digit, and finger tapping speed. The test was conducted using three types of computers: a laptop computer, a laptop computer with a simplified keyboard, and a desktop computer with a simplified keyboard.

Results

Parameters including the simple reaction time, choice reaction time, addition, and symbol digit, and the finger tapping speed of non-dominant hand showed no significant differences in the results among the three groups by computer familiarity after age and educational years were controlled as covariates. The mean reaction time of the simple reaction time and the choice reaction time with a simplified keyboard was significantly shorter compared to that with a typical keyboard. With regard to type of computer, the mean reaction time of the simple reaction time and the choice reaction time was significantly reduced when performed with the desktop computer with a simplified keyboard.

Conclusions

Unlike previous study results, the choice reaction time, the addition, and the finger tapping speed of dominant hand were the only parameters affected by the computer familiarity. Both the type of keyboard and the type of computer significantly influenced the simple reaction time and the choice reaction time. Therefore, it is recommended to use a desktop computer with a simplified keyboard for such parameters.

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Participation and engagement in online cognitive testing
Daniel Radosław Sokołowski, Jasmine Pani, Tor Ivar Hansen, Asta Kristine Håberg
Scientific Reports.2024;[Epub] CrossRef
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

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Research Article

The association between blood cadmium level, frequency and amount of gejang (marinated crab) intake: Chang Yul Choi, Gun Il Park, Young Seok Byun, Man Joong Jeon, Kwang Hae Choi, Joon Sakong; Ann Occup Environ Med 2016;28:23. Published online May 14, 2016; DOI: https://doi.org/10.1186/s40557-016-0109-0

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Background

Gejang (marinated crab) is a favorite traditional food and a main source of crab intake among Koreans. The present study aimed to identify the possibility of cadmium inflow to the body through gejang; accordingly, the relationship between gejang intake frequency and amount, and blood cadmium concentrations was investigated.

Methods

Using data from the first Korea National Health and Nutrition Examination Survey in the sixth period in 2013, means and standard errors of blood cadmium concentrations in relation to gejang intake frequency and amount, as well as the monthly intake of gejang, were obtained from 1381 participants for whom data regarding blood cadmium concentration measurements was available.

Results

After adjustment for confounding factors, a gejang intake frequency of four or fewer times per week and a monthly intake of 200 cm³ or less had no significant effect on blood cadmium concentrations. However, participants with gejang intake of at least five times per week had a weighted mean cadmium concentration of 2.12 μg/L (p < 0.001), and participants who had a gejang monthly intake of more than 200 cm³ had a weighted mean cadmium concentration of 1.76 μg/L (p < 0.001).

Conclusion

These results suggest that to minimize the effect of gejang consumption on blood cadmium level, gejang intake should be limited to four or less times per week and 200 cm³ or less per month. Weekly intake of at least five times and monthly intake of more than 200 cm³ may increase blood cadmium levels.

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Sung Woo Huh, Seong-yong Cho, Seongyong Yoon, Daehwan Kim, Hyun Woo Park, Jisoo Kang, Keon Woo Kim
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A Systematic Review on Metal Dynamics and Marine Toxicity Risk Assessment Using Crustaceans as Bioindicators
Paloma de Almeida Rodrigues, Rafaela Gomes Ferrari, Lilian Seiko Kato, Rachel Ann Hauser-Davis, Carlos Adam Conte-Junior
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Regular crabmeat consumers do not show increased urinary cadmium or beta-2-microglobulin levels compared to non-crabmeat consumers
Karlee N. Dyck, Shabina Bashir, Graham W. Horgan, Alan A. Sneddon
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Research Article

Association of cadmium with diabetes in middle-aged residents of abandoned metal mines: the first health effect surveillance for residents in abandoned metal mines: Hee-seung Son, Soo-geun Kim, Byung-seong Suh, Dong-uk Park, Dae-seon Kim, Seung-do Yu, Yeong-seoub Hong, Jung-duck Park, Byung-kook Lee, Jai-dong Moon, Joon Sakong; Ann Occup Environ Med 2015;27:20. Published online August 24, 2015; DOI: https://doi.org/10.1186/s40557-015-0071-2

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Objective

The aim of this study was to determine the association between urinary cadmium (U-cd) concentration and diabetes in middle-aged Korean residents of abandoned mines using the first Health Effect Surveillance for Residents in Abandoned Metal mines (HESRAM).

Methods

This study was cross-sectional study conducted on 719 residents between 40–70 years in 38 abandoned metal mines in Korea. Data was collected by HESRAM from 2008 to 2011. The correlation coefficient of U-cd and fasting blood glucose, odds ratio in urinary cadmium tertiles and diabetes prevalence was analyzed according to the sex category.

Results

The correlation coefficient U-cd concentration and fasting blood glucose was 0.182 in male. Logistic regression analysis in male revealed a third tertile odds ratio of U-cd (2 μg/g creatinine < U-cd) while diabetes prevalence was 1.81 (95 % CI 1.05-3.12) with adjusted age, BMI, smoking and alcohol consumption, region, family income. On the other hand, the odds ratio for third tertile of U-cd (3 μg/g creatinine < U-cd) between diabetes prevalence in female was 1.39 (95 % CI 0.52-3.72) in addition to adjusted menopausal status.

Conclusions

Environmental exposure to cadmium in abandoned mine residents was associated with diabetes in male. Closed monitoring and periodic evaluation of the health effects of chronic environmental exposure on abandoned mines residents will be needed.

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Research Article

The association between long working hours and the metabolic syndrome: evidences from the 5th Korean National Health and Nutrition Examination Survey of 2010 and 2012: Jae Uk Jeong, Man Joong Jeon, Joon Sakong; Ann Occup Environ Med 2014;26:53. Published online December 21, 2014; DOI: https://doi.org/10.1186/s40557-014-0053-9

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Objectives

This study was conducted in order to evaluate the association between the working hours of Korean employees and the metabolic syndrome and the effects of long working hours on metabolic syndrome based on the 5th Korean National Health and Nutrition Examination Survey (2010-2012).

Methods

Based on the 5th Korean National Health and Nutrition Examination Survey (2010-2012), 4,456 Korean employees without shift work, aged over 15, who work 30 hours or more per week were targeted in this study. The association between the general characteristics, including age, smoking, alcohol drinking, exercise, and the metabolic syndrome criteria defined by International Diabetes Federation (IDF) and weekly working hours were analyzed. In addition, the association between weekly working hours and the metabolic syndrome of the subjects stratified by gender was analyzed through multiple logistic regression analyses and generalized linear mixed model after adjusting the general characteristics.

Results

In the results of stratified analysis by gender, in male subjects, in comparison with the 30-39 weekly working hours group, there were no significant adjusted odds ratios to the other working hours groups. In female subjects, in comparison with the 30-39 weekly working hours group, there were no significant adjusted odds ratios to the other working hours groups. In addition, no trend associations were observed among weekly working hour groups in both stratified genders.

Conclusion

No significant differences in prevalence of metabolic syndrome of the subjects stratified by gender were found according to weekly increasing working hours. However, due to some limitations of this study, further prospective studies may be necessary for verification.

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Case Report

A Case of Lead Poisoning due to a Mixture of Talisman Ash: Han Hui Ye, Jae Uk Jeong, Nak Joon Baek, Chang Yul Choi, Man Joong Jeon, Joon Sakong; Ann Occup Environ Med 2013;25:37-37. Published online November 28, 2013; DOI: https://doi.org/10.1186/2052-4374-25-37

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Background

Lead is a metal that has no biological function useful for the human body. In Korea, non-occupational exposure to lead has mostly occurred through taking oriental medicine. However, in this paper we report a case of lead poisoning caused by ingesting talisman material.

Case presentation

A 16-year-old male patient complained of severe abdominal pain after taking cinnabar, a talisman material. He was diagnosed with lead poisoning accompanied by acute hepatitis. We confirmed that the cinnabar the patient took contained about 10% elemental lead. After symptom management, the patients’ symptoms, liver function test results, and blood lead concentration level improved.

Conclusion

Lead poisoning can be accompanied by hepatitis, although rarely. As we have confirmed that cinnabar as a talisman material is harmful to the human body, measures to prevent its misuse are needed.

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Collective exposure to lead from an approved natural product-derived drug in Korea
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Ravibabu Kalahasthi, Tapu Barman
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Research Article

The Association between Shift Work and the Metabolic Syndrome in Female Workers: Han Hui Ye, Jae Uk Jeong, Man Joong Jeon, Joon Sakong; Ann Occup Environ Med 2013;25:33-33. Published online November 1, 2013; DOI: https://doi.org/10.1186/2052-4374-25-33

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Objective

This study aimed to determine identify any association between shift work and the metabolic syndrome by comparing the prevalence rates of the metabolic syndrome in shift work groups and daytime work groups for female workers.

Methods

Based on data from health examinations carried out from April to December of 2012, we selected as our subjects 254 female workers from the Daegu area Dyeing Industrial Complex. We diagnosed the metabolic syndrome using the examination results, and information about age, whether or not they did shift work, job type, smoking habits, drinking habits, exercise habits, and past medical history was collected through self-administered questionnaire surveys and face-to-face interviews. The variables found in a univariate analysis to be significant in the occurrence of the metabolic syndrome - age, drinking habits, exercise habits, and shift work - were included in a logistic regression analysis of the risk of the metabolic syndrome for female workers.

Results

The prevalence rates of the metabolic syndrome for the total group of study subjects was 11.8%, for daytime workers was 2.8%, and for shift workers was 15.3%. A logistic regression analysis of the odds of the metabolic syndrome for female workers was conducted that included factors associated with the occurrence of the metabolic syndrome: age, drinking habits, exercise habits, and shift work. The results revealed that the odds ratio of the metabolic syndrome in the shift work group, 6.30 (95% CI 1.24-32.15), was significantly higher when compared with the daytime work group.

Conclusion

Shift work appears to have an association with the metabolic syndrome in female workers. Accordingly, we believe that the attention of government agencies and business owners is needed together with the individual practice of health behaviors to manage the metabolic syndrome for the prevention of cardiovascular disease in female shift workers.

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Original Article

Posttraumatic Stress Disorder and Related Factors in Male Firefighters in a Metropolitan City: Deuk Yong Shin, Man Joong Jeon, Joon Sakong; Korean Journal of Occupational and Environmental Medicine 2012;24(4):397-409. Published online December 31, 2012; DOI: https://doi.org/10.35371/kjoem.2012.24.4.397

Abstract PDF

OBJECTIVES
This study was conducted in order to evaluate the prevalence of posttraumatic stress disorder (PTSD) and related factors in male firefighters in Daegu, Korea.
METHODS
A total of 1,261 firefighters from fire stations in Daegu were the subjects of this study. Each firefighter completed a questionnaire on general and occupational matters, experience of traumatic events, and impact of event scale (IES). The IES questionnaire was administered to subjects in order to determine the high risk group for PTSD. We calculated the IES score and determined that an individual was abnormal if the IES score was over 26.
RESULTS
The average IES score of the firefighters was 11.0+/-14.3, and the prevalence of high risk firefighters with PTSD was 15.1%. It was found that 40 years of age, fire sergeant, and emergency medical service personnel showed higher prevalence of PTSD than other groups. The most experienced event among traumatic events was 'witness death of victims or patients'. The results of multiple logistic regression analysis for the high risk PTSD group showed that fire sergeant (OR=2.28, 95% CI: 1.28~4.06), fire lieutenant (OR=2.47, 95% CI: 1.14~5.37), fire captain (OR=2.88, 95% CI: 1.11~7.45), firefighting department (OR=2.04, 95% CI: 1.00~4.17), emergency medical service personnel (OR=3.68, 95% CI: 1.47~9.23), total frequency of traumatic events experienced (OR=1.01, 95% CI: 1.00~1.02), and total type of traumatic event experienced (OR=1.35, 95% CI: 1.25~1.46) were significant variables with regards to the reference group (fire fighter and administration department).
CONCLUSIONS
These findings indicate that the prevalence of PTSD in firefighters is higher than that in the general population, and fire sergeant, fire lieutenant, fire captain, emergency medical service personnel, firefighting department, total frequency of traumatic events experienced, and total type of traumatic event experienced were significant variables for the PTSD high risk group.

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John Langtry, Marcin Owczarek, Donal McAteer, Laurence Taggart, Christina Gleeson, Catherine Walshe, Mark Shevlin
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Original Article

Assessment of Acquired Color Vision Impairment in Inhalant Abusers: Myeong Hyo Kim, Yeon Cheol Kim, Kyu Hwa Lee, Man Joong Jeon, Joon Sakong; Korean Journal of Occupational and Environmental Medicine 2011;23(4):439-449. Published online December 31, 2011; DOI: https://doi.org/10.35371/kjoem.2011.23.4.439

Abstract PDF: OBJECTIVES
This study was conducted in order to evaluate the effects of inhalants on color vision impairment.
METHODS
The inhalation group consisted of 81 neurotoxic chemical substance abusers at Bugok National Hospital and Institute of Forensic Psychiatry, Ministry of Justice. The control group consisted of 41 employees of Bugok National Hospital. The Lanthony D-15 desaturated hue test was administered to both groups. For the qualitative analysis, we classified the results by the morphological characteristics of color vision impairment. For the quantitative analysis, we calculated the total color distance score (TCDS) and the color confusion index (CCI) and determined that the individual was abnormal if the TCDS was over 65.0 or the CCI was over 1.25.
RESULTS
The TCDS of the inhalation group was 75.58+/-21.07 and the CCI was 1.34+/-0.37 in the right eye, and 75.47+/-23.63 and 1.34+/-0.42, respectively in the left eye. These results are higher than those found for the control group. In regards to the TCDS, 50 (61.8%) of the abusers in the inhalation group had color vision impairment in the right eye and 48 (59.2%) had impairment in the left eye. 11 (26.8%) of the employees in the control group had color vision impairment in the right eye and 13 (31.7%) had impairment in the left eye. In regards to the CCI, 38 (46.9%) of the abusers in the inhalation group had color vision impairment in the right eye and 35 (43.2%) had impairment in the left eye. 4 (9.8%) of the employees in the control group had color vision impairment in the right eye and 7 (17.0%) had impairment in the left eye. The results of multiple logistic regression analysis for acquired color vision impairment showed that the inhalation period (OR=1.20, 95% CI: 1.03~1.40) was the significant variable.
CONCLUSIONS
These findings indicate that the inhalation of neurotoxic substances may impair the color vision, and the period inhaled with neurotoxic substances is significant variable affecting on the acquired color vision impairment.

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Original Article

The Relationship Between Amalgam Tooth Fillings and Concentration of Blood Mercury in Elementary School Students in Korea: Kyu Hwa Lee, Man Joong Jeon, Yun Chul Hong, Jong Han Leem, Mi Na Ha, Ho Jang Kwon, Joon Sakong; Korean Journal of Occupational and Environmental Medicine 2011;23(4):420-427. Published online December 31, 2011; DOI: https://doi.org/10.35371/kjoem.2011.23.4.420

Abstract PDF: OBJECTIVES
The adverse health effects of mercury in dental amalgam have not yet been clarified. This study was conducted to examine the effects of dental amalgam on the concentration of blood mercury in Korean children.
METHODS
A total of 1,275 students were enrolled in the elementary school in Seoul, Incheon, and Daegu. The number and location of dental amalgam filling of teeth were ascertained by oral examination. Dietary habits-including frequency of seafood intake-and other demographic factors were obtained from the children's parents. The concentration of blood mercury was measured by an atomic absorption spectrophotometer to which a hydride generator was installed.
RESULTS
The geometric mean of blood mercury concentration was 1.91 microg/L. It was found that elementary school students in Seoul and the 4th grade elementary school students have the lowest concentration of blood mercury among the study groups. Both linear and secondary linear increase of the concentration of blood mercury, depending on the number of dental amalgam fillings, were statistically significant (p-trend < 0.01, p-quadratic < 0.01). As a result of multiple regression analysis on the blood mercury concentration of elementary school students, the regression coefficient (beta) of a dental amalgam filling was found to be 0.027 (standard error = 0.014, p = 0.048).
CONCLUSIONS
In children, the dental amalgam fillings were significantly contribute to the concentration of blood mercury. To accurately assess the effect of dental amalgam on the concentration of body mercury, further studies using the concentration of urine mercury are needed.

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Original Article

Association Between Blood Lead Concentration and Computerized Neurobehavioral Performance in Korean Elementary School Students: Yeon Cheol Kim, Man Joong Jeon, Yun Chul Hong, Chul Gab Lee, Mi Na Ha, Ho Jang Kwon, Joon Sakong; Korean Journal of Occupational and Environmental Medicine 2011;23(2):183-191. Published online June 30, 2011; DOI: https://doi.org/10.35371/kjoem.2011.23.2.183

Abstract PDF

OBJECTIVES
This study was conducted to evaluate association between computerized neurobehavioral performance and blood lead concentration in Korean elementary school students.
METHODS
The subjects were 1,077 elementary school students of Seoul, Busan, Daegu and Gwangju. Blood lead concentration was measured and computerized neurobehavioral performance tests were performed.
RESULTS
Blood lead concentration of the subjects was in the range of 0.20 and 7.39 microg/dl. The geometric mean of the subjects' blood lead concentration was 1.41 microg/dl. As blood lead concentration increased, reaction time to the symbol digit tended to increase significantly and linearly. As a result of LOWESS(locally weighted scatterplot smoothing), increasing reaction time to the symbol digit was observed.
CONCLUSIONS
As blood lead concentration under the CDC (center for disease control and prevention) reference value increased, reaction time to the symbol digit tended to increase. But, as the number of subjects over 3 microg/dl is small, it is difficult to make a definite conclusion. If confounding variables are controlled properly in a follow-up study, we can obtain a more definite conclusion.

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Original Article

Association of Blood Mercury Level and Neurobehavioral Performance in Korean Elementary School Students: Joon Sakong, Man Joong Jeon, Sung Ho Yun, Yun Chul Hong, Chul Gab Lee, Young Ki Kim, Mina Ha, Ho Jang Kwon; Korean Journal of Occupational and Environmental Medicine 2010;22(4):324-330. Published online December 31, 2010; DOI: https://doi.org/10.35371/kjoem.2010.22.4.324

Abstract PDF

OBJECTIVES
This study was conducted to examine the effect of blood mercury on neurobehavioral performance in Korean elementary school students.
METHODS
We measured the blood mercury concentration in 1,077 elementary school students from Seoul, Busan, Daegu and Gwangju, then the students underwent computerized neurobehavioral test.
RESULTS
The mean concentration of blood mercury of study subjects was 2.10 microg/L. An increased blood mercury was associated with an increased reaction time in digit addition and symbol digit.
CONCLUSIONS
The blood mercury concentration of study subjects was very high compared to findings in a foreign country. We found several associations between blood mercury level and neurobehavioral performance.

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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
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Evaluation of reliability of computerized neurobehavioral tests in Korean children
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Original Article

The Concentration of Cadmium in Urine, and Its Role in Health-risk Assessment of Residents in the Vicinity of Abandoned Mines in Gyeongsangbuk-do, Korea: Sung Ho Yun, Chang Yoon Kim, Tae Yoon Hwang, Kyu Chang Won, Jun Young Do, Se Jin Lee, Yeong Mog Park, Kwan Soo Jun, Gae Ho Lee, Do Young Lee, Kwang Seub Park, Joon Sakong; Korean Journal of Occupational and Environmental Medicine 2010;22(3):251-261. Published online September 30, 2010; DOI: https://doi.org/10.35371/kjoem.2010.22.3.251

Abstract PDF

OBJECTIVES
This study was conducted to assess the concentration of urine cadmium and health risks of residents in the vicinity of abandoned metal mines in Gyeongsangbuk-do.
METHODS
The concentration of cadmium in the soil, water, and agricultural crops was measured in Gyeongsangbuk-do, Butdeun and Suksan, which have abandoned metal mines. We measured the concentration of cadmium in the urine of residents from the following areas: 78 from village A, 99 from village C and 147 from control areas. Other health-risk assessments were performed on each resident, such as measuring the concentration of beta2-MG and a bone density test.
RESULTS
In abandoned mine areas, the mean concentration of cadmium was higher in agricultural soil and in the crops than in that of control areas. The concentration of cadmium in the stream exceeded the guideline level. In regard to provisional tolerable daily intake (PTDI) of cadmium, the actual intake rate through crops was 33.81%, 72.74% in abandoned mine areas and 5.03%, 6.16% in control areas. Residents in abandoned mine areas, A village and C village had a geometric mean of urine Cd of 1.90 microgram/g cr and 1.45 microgram/g cr. These measurements were significantly higher than those of residents in control areas, B village and D village, 0.59 microgram/g cr and 0.65 microgram/g cr (p<0.01). Following adjustments for age, sex, smoking habit, and occupational history, the concentration of urine cadmium of residents in the Butdeun abandoned meta mine was higher by 1.62 microgram/g cr as compared with the control group (p<0.01). Residents from the Suksan abandoned metal mine also had a higher concentration by 1.07 microgram/g cr (p<0.01). A multiple linear regression analysis was performed for the factors associated with T-score, and this showed that the concentration of urine cadmium was not an influential factor.
CONCLUSIONS
Based on these measurements, areas with abandoned metal mines contaminated streams, agricultural soil, and crops of the adjacent areas, with cadmium. Because residents in the adjacent areas intake contaminated crops, their urine cadmium was increased. Despite a lack of evidence demonstrating the detrimental effect of increased urine cadmium in residents, an additional study is needed to assess the health risks of residents in the vicinity of abandoned metal mines.

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Original Article

Relationship between Blood Lead Concentration and Neurobehavioral Function of Children: Kwang Seub Park, Jae Yong Park, Joon Sakong; Korean Journal of Occupational and Environmental Medicine 2009;21(2):131-142. Published online June 30, 2009; DOI: https://doi.org/10.35371/kjoem.2009.21.2.131

Abstract PDF

OBJECTIVES
To evaluate effects of lead on the central nervous system of children by measuring blood lead concentration, computerized neurobehavioral function and intelligence of elementary school students.
METHODS
The study was conducted with 208 elementary school students living in the vicinity of Pohang Industrial Complex in October and November, 2005. Data on demographic characteristics, living environments and lifestyle habits were collected from subjects.
RESULTS
Blood lead levels of elementary school students ranged from 0.76-4.97 microg/dl, which is below the 10 microg/dl recommended level of CDC. The blood lead levels were similar with those reported in other domestic and international studies. Neurobehavioral tests revealed that most third grade students reacted slowly and their speed declined in simple reaction time (p<0.05), choice reaction time (p<0.05), symbol digit substitution (p<0.01), finger tapping speed nondominant hand (p<0.05) as blood lead levels increased. Sixth grade students demonstrated significance in test performance, and displayed blood lead levels of 2.00-4.00 microg/dl. Results of intelligence testing showed significantly low performance in IQ (p<0.05), vocabulary ability (p<0.05), reasoning ability (p<0.05), mathematical ability (p<0.05) and perception ability (p<0.05) among third grade students who displayed high levels of blood lead concentration. Sixth grade students showed significantly low performance in vocabulary ability (p<0.05) at high level of blood lead concentration. The difference in mean IQ scores between the group with blood lead level of < or =2.00 microg/dl and the group with blood lead level > or =3.00 microg/ dl was 3.21 in third grade students and 4.28 in sixth grade students. Low academic achievement was observed among third grade students (p<0.05) and six grade students (p<0.05) as the average blood lead level increased. Correlation analysis on the association of blood lead concentration with neurobehavioral tests revealed a positive correlation between blood lead levels and reaction time of choice reaction time and symbol digit substitution in third grade students. A positive correlation was observed between blood lead levels and reaction time of symbol digit substitution and finger tapping speed in sixth grade students. There was a negative correlation between blood lead levels and reasoning ability of third grade students (r=-0.247) and vocabulary ability of six grade students (r=-0.255).
CONCLUSION
There have been few studies on the effects of blood lead on the central nervous systems of children in Korea. The study supports the findings of earlier studies that blood lead has an impact on children. However, the study did not confirm significant association of blood lead concentration with each neurological and motor test conducted for this study due to a small sample size and relatively low blood lead levels of elementary school students. Further studies using a similar assessment methods would be helpful to evaluate the effects of low blood lead levels on the central nervous systems of children.

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Minkeun Kim, Chulyong Park, Joon Sakong, Shinhee Ye, So young Son, Kiook Baek
Annals of Occupational and Environmental Medicine.2023;[Epub] CrossRef
The association between lead concentration in the blood and neurobehavioral performance of children
Dae-Seon Kim, Seungchul Ahn, Seungdo Yu, Eun-Hee Lee
Toxicology and Environmental Health Sciences.2012; 4(2): 87. CrossRef
Evaluation of reliability of computerized neurobehavioral tests in Korean children
Kyeong-Soo Lee, Man-Joong Jeon, Tae-Yoon Hwang, Chang-Yoon Kim, Joon Sakong
NeuroToxicology.2012; 33(5): 1362. CrossRef

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Original Article

Assessment of Changes in Computerized Neurobehavioral Performance across Multiple Test Sessions: Sung Tae Chung, Man Joong Jeon, Joon Sakong; Korean Journal of Occupational and Environmental Medicine 2007;19(4):251-258. Published online December 31, 2007; DOI: https://doi.org/10.35371/kjoem.2007.19.4.251

Abstract PDF

OBJECTIVE: A cross-sectional study was performed to assess changes in computerized neurobehavioral performance across multiple test sessions for developing a valid performance level and reducing test time.
METHODS
The study was conducted on 118 male car painters exposed to low-dose, mixed organic solvents. The study controls were 113 unexposed reference workers matched for age and educational year from different sections of the same factory. Each worker completed a medical and occupational exam and questionnaire. Three tests of the Swedish Performance Evaluation System (5 minutes of Simple Reaction Time, 9 sessions of Symbol Digit, and 4 sessions of Finger Tapping Speed) were administered to each group.
RESULTS
The mean age, mean duration of employment, and mean years of education were 33 years, 6.7 years, and 12 years in both groups, respectively. The mean reaction times of the Simple Reaction Time increased with the lapse of time. The known group difference between the exposed and control groups was larger for the first minute than for the successive 3 minutes. Both groups showed improved performance across the first to the seventh sessions on Symbol Digit. Following the seventh session, the performance levels of Symbol Digit had worsened. The t statistic of the two groups was the largest when the two mean reaction times were calculated from the sessions of the fifth to the seventh. In the dominant and non-dominant hands, the number of taps increased and decreased, respectively, across the sessions on Finger Tapping Speed. The known group difference was the largest when comparing the performances from the first to the second sessions.
CONCLUSIONS
For valid interpretation and timesaving in computerized neurobehavioral tests, the following is recommended: one practice and one test session for Simple Reaction Time, four practice and three test sessions for Symbol Digit, and one practice and two test sessions for Finger Tapping Speed.

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Nak Joon Baek, Gun Il Park, Young Seok Byun, Man Joong Jeon, Joon Sakong
Annals of Occupational and Environmental Medicine.2016;[Epub] 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.

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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 Health Effects of Formaldehyde during an Anatomy Dissection Course: Si Young Park, Chang Yoon Kim, Joo Young Kim, Joon Sakong; Korean Journal of Occupational and Environmental Medicine 2006;18(3):171-178. Published online September 30, 2006; DOI: https://doi.org/10.35371/kjoem.2006.18.3.171

Abstract PDF

OBJECTIVES
This study evaluated the acute health effect of formaldehyde during an anatomy dissection course.
METHODS
The formaldehyde concentrations in a gross anatomy laboratory were measured and analyzed during an anatomy dissection course attended by eighty medical students. The Pulmonary Function Test and three tests of the Korean Computerized Neurobehavioral Test (digit classification, digit addition and symbol digit) were given to thirty of the eighty medical students at the pre- and post-exposure. A questionnaire survey was administered to the eighty medical students at the pre- and post-exposure.
RESULTS
The differences in the mean FVC and FEV(1) were statistically significant (p<0.01) at the preand post-exposure. In the low exposed group (<2 ppm), only the decreases in FEV(1) on post-exposure were statistically significant (p<0.05) compared with FEV(1) on pre-exposure. In the high exposed group (> or = 2 ppm), decreases in both FVC and FEV(1) on post-exposure were statistically significant (p<0.05). The overall performance on the digit classification, digit addition and symbol digit of the Korean Computerized Neurobehavioral Test on post-exposure was lower than that on pre-exposure. In the low exposed group, the performances on the digit classification and symbol digit were lower than those on pre-exposure. In the high exposed group, the performances on digit classification, digit addition and symbol digit were lower than those on pre-exposure. Complaints involving the eyes, nose and throat increased substantially on post-practice compared with pre-practice in both groups. There were statistically significant differences in the complaints involving the eyes, nose and throat between the pre-practice and post-practice in both groups (p<0.05). There were more complaints in the high exposed group than in the low exposed group.
CONCLUSIONS
Formaldehyde exposure during a dissection can decrease the pulmonary function and neurobehavioral performance, and can increase the complaints involving the eyes, nose and throat. The effect on the symptoms, pulmonary function and neurobehavioral performance is positively correlated with the formaldehyde level.

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Soon-Chan Kwon, Inah Kim, Jaechul Song, Jungsun Park
Annals of Occupational and Environmental Medicine.2018;[Epub] CrossRef
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Original Article

Blood Pb, Urine Cd and Health Assessment of Residents in the Vicinity of Abandoned Mines in Gyeongsangbuk-do: Jong Hak Chung, Pock Soo Kang, Chang Yoon Kim, Kyung Soo Lee, Tae Yoon Hwang, Gyu Tae Kim, Jong Seo Park, Si Young Park, Dae Seop Kim, Ou Taek Lim, Joon Sakong; Korean Journal of Occupational and Environmental Medicine 2005;17(3):225-237. Published online September 30, 2005; DOI: https://doi.org/10.35371/kjoem.2005.17.3.225

Abstract PDF

OBJECTIVES
The objective of this health assessment is to evaluate the health risks that may result from exposure to abandoned mine tailings in Gyeongsangbuk-do. The tailings are remnants from an earlier flotation mill and mining operation that was in business from the early 1930's until 1970.
METHODS
The soil, stream water, and drinking water in and around three abandoned mine areas, Soochul, Gumjang, Darock, and three control areas located in Gyeongsangbuk-do were analyzed for level of Cd, Pb, Cu, As, and Hg. Potential chronic health effects were evaluated by interview and medical examination.
RESULTS
Some soil and stream samples exceeded the Korean standard for soil contamination in farmland and the Korean standard of water contamination in streams respectively. Blood lead (5.37 microgram/dl) and urine cadmium (2.79 microgram/g Cr) levels of the residents in the vicinity of the abandoned mine sites were significantly higher than of the residents in the control areas (blood lead, 4.34 microgram/dl; urine cadmium, 1.62 microgram/g Cr). There were no significant differences between the mining and control areas in terms of blood pressure, Hb, BUN, creatinine, SGOT, SGPT, fasting blood sugar, and the prevalence of potential chronic diseases.
CONCLUSIONS
The results of the assessment suggested that the three abandoned mine sites do not pose an apparent health risk to nearby residents. Nevertheless, the elevated blood lead and urine cadmium levels in the residents of the abandoned mine site suggested that it might be an important source of heavy metals contamination. Therefore, a nationwide evaluation program is needed to assess the potential health risks of residents living in the vicinity of abandoned mine sites.

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Blood Cadmium Concentration of Residents Living near Abandoned Metal Mines in Korea
Young-Seoub Hong, Byung-Kook Lee, Jung-Duck Park, Joon Sakong, Jae-Wook Choi, Jai-Dong Moon, Dae-Seon Kim, Byoung-Gwon Kim
Journal of Korean Medical Science.2014; 29(5): 633. CrossRef
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International Journal of Hygiene and Environmental Health.2013; 216(3): 255. CrossRef
Relationship between Urine Cadmium and Bone Mineral Density of Residents Around Abandoned Metal Mines
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Original Article

Effect of the Type of Computer on Computerized Neurobehavioral Performance Tests: Gyu Tae Kim, Chang Yoon Kim, Joon Sakong; Korean Journal of Occupational and Environmental Medicine 2004;16(3):276-286. Published online September 30, 2004; DOI: https://doi.org/10.35371/kjoem.2004.16.3.276

Abstract PDF

OBJECTIVES
It is difficult to carry and set up a large numbers of computers when computerized neurobehavioral tests are performed to many subjects. There are difficulties in mobilizing and resetting desktop computers and so, the use of desktop computers will decrease due to the recent increasing popularity of laptop computers. However, it is essential that there is no difference between the tests performed on a laptop and on a desktop computer. This study was conducted to estimate the effect that the type of computer has on computerized neurobehavioral performance tests.
METHODS
Three types of computers were applied. Type 1 was a normal laptop computer. Type 2 was a laptop computer that was remodeled and equipped with a modified keyboard. A common desktop computer with a remodeled keyboard as type 3. The computerized tests included Simple Reaction Time, Choice Reaction Time, Symbol Digit, and Finger Tapping Speed. A total of 60 subjects were examined by the identical tester in the same testing conditions. The computers were randomly allocated, which were used in the test and let examinees take tests with the separate computers.
RESULTS
There were no significant differences among the computers for the results of the Simple Reaction Time and Finger Tapping Speed tests. The mean reaction time, error number of Choice Reaction Time and mean reaction time, correct mean reaction time, error number of Symbol Digit produced significantly different results among the three types of computers.
CONCLUSION
This study indicates that with only a laptop computer the Simple Reaction Time test using the space bar was useful. But with the laptop computer, the Choice Reaction Time test using the four-direction key and the Symbol Digit test using the upper end number key were unsuitable. The keyboard should be developed further for the Choice Reaction Time and Symbol Digit tests. Among the three computers, we recommend the use of the desktop computer with the remodeled keyboard which the examinees are familiar with and the laptop computer with the remodeled keyboard.

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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
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Effects of computer familiarity and computer type on the performance of Korean computerized neurobehavioral test
Nak Joon Baek, Gun Il Park, Young Seok Byun, Man Joong Jeon, Joon Sakong
Annals of Occupational and Environmental Medicine.2016;[Epub] CrossRef

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Original Article

Effects of Familiarity with Computer and Type of Keyboard on Computerized Neurobehavioral Performance Tests: Man Joong Jeon, Chang Yoon Kim, Jong Hak Chung, Woo Taek Lim, Joon Sakong; Korean Journal of Occupational and Environmental Medicine 2004;16(2):178-190. Published online June 30, 2004; DOI: https://doi.org/10.35371/kjoem.2004.16.2.178

Abstract PDF

OBJECTIVES
A stratified cross-over study was conducted to evaluate the effects of familiarity with computer on the performance of computerized neurobehavioral tests. Effects of keyboard type on the relationship between familiarity with computer and performance of computerized neurobehavioral tests were also examined.
METHODS
We tested 70 persons classified into three groups according to degree of familiarity with computer: Group 1 was people with no computer competency, Group 2 had slight working experience on the computer, and Group 3 were highly competent and efficient on the computer. For each group, we executed 4 tests of the Korean version of the Swedish Performance Evaluation System (Simple Reaction Time, Addition, Symbol Digit, and Finger Tapping Speed). Three types of keyboard were applied for all three groups. Type 1 keyboard was a conventional layout with 106 keys. We removed the unused keys except for the 17 which were used in the test and remodeled the normal keyboard into Type 2 keyboard with 17 keys (10 numeric keys, 4 arrow keys, space bar, and both Ctrl keys). Type 3 keyboard with 11 keys consisted of 10 numeric keys and the space bar was newly developed for the computerized neurobehavioral performance test.
RESULTS
It was found that Simple Reaction Time, Addition, and Finger Tapping Speed were not affected by familiarity with computer and type of keyboard. The mean reaction time of Symbol Digit adjusted by age and educational level with Type 1 keyboard was found to have significant difference among the three groups (F=3.347, p=0.041). The performance of Symbol Digit in Group 1 was found to be significantly lower than that in Group 2. The performances of Symbol Digit measured with Types 2 and 3 keyboards were not found to have significant differences among the three groups. In Groups 1 and 3, the performances of Symbol Digit measured with Type 1 keyboard were found to be significantly lower than those of other keyboards.
CONCLUSIONS
According to the above results, Simple Reaction Time, Addition, and Finger Tapping Speed have high priority over other neurobehavioral tests for the workers having varying degrees of computer familiarity. It is also suggested that familiarity with computer and keyboard type needs to be considered in interpretation of the performance of Symbol Digit. We recommended executing the computerized neurobehavioral test with keyboards 2 or 3 to reduce the effect of computer familiarity.

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Effects of computer familiarity and computer type on the performance of Korean computerized neurobehavioral test
Nak Joon Baek, Gun Il Park, Young Seok Byun, Man Joong Jeon, Joon Sakong
Annals of Occupational and Environmental Medicine.2016;[Epub] CrossRef
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INDUSTRIAL HEALTH.2005; 43(2): 320. CrossRef

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Original Article

Impact of Subject and Time Related Factors on Reliability of Neurobehavioral Tests: Joon Sakong, Man Joong Jeon, Nak Jung Sung, Gyu Tae Kim; Korean Journal of Occupational and Environmental Medicine 2003;15(2):188-195. Published online June 30, 2003; DOI: https://doi.org/10.35371/kjoem.2003.15.2.188

Abstract PDF: OBJECTIVES
This study was conducted to select neurobehavioral tests that are more reliable and less affected by subjects characteristics and test conditions.
METHODS
Five computerized and five traditional neurobehavioral tests and retests were administered to 85 medical school students and 35 hospital workers. The computerized tests consisted of the Simple Reaction Time, Addition, Symbol Digit, Digit Span, and Finger Tapping Speed, while the traditional tests comprised the Benton Visual Retention test, Digit Symbol, Digit Span, Pursuit Aiming, and pegboard. In addition, the effects of various factors on the reliability of the neurobehavioral tests, including age, sex, educational level, computer familiarity, test intervals, and test time of day, were also evaluated.
RESULTS
Among the computerized neurobehavioral tests, the reliability of Addition, Symbol Digit, Digit Span, and Finger Tapping Speed were not affected significantly by age, sex, test interval, or computer familiarity. It was found that Finger Tapping Speed is not affected by educational level. When the time of retest was incongruous with the time of the first test, test-retest reliability was lower in most neurobehavioral tests except computerized Addition, Digit Span, and Finger Tapping Speed, and traditional Symbol Digit.
CONCLUSIONS
These results suggest that the computerized Addition, Symbol digit, Digit Span, and Finger Tapping Speed, and the traditional Digit Symbol are more satisfactory for our purposes. These results should facilitate selection of the most appropriate tests for periodical evaluation of the central nervous system of workers exposed to neurotoxic substances in Korea.

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