Annals of Occupational and Environmental Medicine

Case Report

Two Cases of Methemoglobinemia Induced by the Exposure to Nitrobenzene and Aniline: Chang Hwan Lee, Soo Hyeon Kim, Do Hyung Kwon, Keun Ho Jang, Yong Hoon Chung, Jai Dong Moon; Ann Occup Environ Med 2013;25:31-31. Published online November 1, 2013; DOI: https://doi.org/10.1186/2052-4374-25-31

Objective

To report two cases of methemoglobinemia induced by inhaled nitrobenzene and dermally absorbed aniline.

Methods

We have evaluated a 37-year-old male worker exposed to nitrobenzene by inhalation while conducting maintenance job of mononitrobenzene pump and a 25-year-old male worker exposed dermally to aniline while unloading.

Results

The first case is a 37-year-old male exposed to nitrobenzene. His blood methemoglobin concentration level was initially 19.8%, and chest X-ray was normal. After oxygen therapy, the blood methemoglobin concentration level decreased to 2.1%, and the symptoms were alleviated. The second case is a 25-year-old male exposed dermally to aniline. His chest X-ray was normal, but blood methemoglobin concentration level reached maximally 46.8%. He was treated with methylene blue due to relatively high blood methemoglobin level. Gradually after the treatment, his methemoglobin concentration level was normalized to 0.8% and simultaneously symptoms were resolved.

Conclusions

After the thorough exposure investigations and medical evaluations, we have concluded that these cases were methemoglobinemia induced by occupational exposure to nitrobenzene and aniline. We suggest that businesses which handle methemoglobinemia-causing substances control the engineering process strictly, implement periodic screening, and establish emergency patient management system.

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Case Report

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

Abstract PDF

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

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Original Article

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

Abstract PDF

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

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Original Article

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

Abstract PDF

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

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Original Article

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

Abstract PDF

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

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The association between cadmium and lead exposure and blood pressure among workers of a smelting industry: a cross-sectional study
Hyun Chan An, Joo Hyun Sung, Jiho Lee, Chang Sun Sim, Sang Hoon Kim, Yangho Kim
Annals of Occupational and Environmental Medicine.2017;[Epub] CrossRef

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