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

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

Case presentation

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

Conclusions

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

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

Citations

Citations to this article as recorded by  
  • Recent developments in occupational asthma
    Claudia Blouin, Catherine Lemière
    Current Opinion in Pulmonary Medicine.2024; 30(3): 281.     CrossRef
  • Occupational agents-mediated asthma: From the perspective of autophagy
    Xiu He, Dengxiang Yao, Xiaoli Yuan, Jiaqi Ban, Yuxuan Gou, Mingdan You
    Science of The Total Environment.2024; 952: 175880.     CrossRef
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Original Article
The health effects of low blood lead level in oxidative stress as a marker, serum gamma-glutamyl transpeptidase level, in male steelworkers
Su-Yeon Lee, Yong-Jin Lee, Young-Sun Min, Eun-Chul Jang, Soon-Chan Kwon, Inho Lee
Ann Occup Environ Med 2022;34:e34.   Published online November 2, 2022
DOI: https://doi.org/10.35371/aoem.2022.34.e34
AbstractAbstract AbstractAbstract in Korean PDFPubReaderePub
Background

This study aimed to investigate the association between lead exposure and serum gamma-glutamyl transpeptidase (γGT) levels as an oxidative stress marker in male steelworkers.

Methods

Data were collected during the annual health examination of workers in 2020. A total of 1,654 steelworkers were selected, and the variables for adjustment included the workers’ general characteristics, lifestyle, and occupational characteristics. The association between the blood lead level (BLL) and serum γGT level was investigated by multiple linear and logistic regression analyses. The BLL and serum γGT values that were transformed into natural logarithms were used in multiple linear regression analysis, and the tertile of BLL was used in logistic regression analysis.

Results

The geometric mean of the participants’ BLLs and serum γGT level was 1.36 μg/dL and 27.72 IU/L, respectively. Their BLLs differed depending on age, body mass index (BMI), smoking status, drinking status, shift work, and working period, while their serum γGT levels differed depending on age, BMI, smoking status, drinking status, physical activity, and working period. In multiple linear regression analysis, the difference in models 1, 2, and 3 was significant, obtaining 0.326, 0.176, and 0.172 (all: p < 0.001), respectively. In the multiple linear regression analysis stratified according to drinking status, BMI, and age, BLLs were positively associated with serum γGT levels. Regarding the logistic regression analysis, the odds ratio of the third BLL tertile in models 1, 2, and 3 (for having an elevated serum γGT level within the first tertile reference) was 2.74, 1.83, and 1.81, respectively.

Conclusions

BLL was positively associated with serum γGT levels in male steelworkers even at low lead concentrations (< 5 μg/dL).

제철소 남성근로자들의 저농도 납노출이 산화스트레스 지표인 혈청 감마지티에 미치는 건강영향
목적
본 연구의 목적은 일개 제철소에 근무하는 남성 근로자들의 납 노출 수준과 산화스트레스 지표로서의 혈청 감마지티와의 연관성을 확인하는 것이다.
방법
본 연구는 2020년 시행된 근로자 건강검진 자료를 이용하였으며, 총 1,654명의 남성 근로자가 최종 연구대상으로 선정되었다. 일반적 특성, 생활양식 및 직업적 특성을 나타내는 변수를 설정하여 보정하였으며, 혈중납수준과 혈청 감마지티의 연관성을 알아보기 위해 다중선형회귀분석 및 로지스틱회귀분석을 실시하였다. 다중선형회귀분석에서는 자연로그로 변환된 혈중납 및 혈청 감마지티값을, 로지스틱회귀분석에서는 혈중납 3분위수를 이용하였다.
결과
연구대상자의 혈중납 및 혈청 감마지티의 기하평균은 각각 1.36 μg/dL, 27.72 IU/L 이었으며, 혈중납수준은 연령, 체질량지수, 흡연, 음주, 교대근무, 근무기간에 따라 차이가 있었고, 혈청 감마지티는 연령, 체질량지수, 흡연, 음주, 신체활동, 근무기간에 따라 차이를 보였다. 다중선형회귀분석에서는 모형 1,2,3 에서 혈중납수준과 혈청감마티지의 유의미한 연관성을 보여주었으며 (Model 1, β : 0.326, p < 0.001 ;Model 2, β: 0.176, p< 0.001;Model 3, β: 0.172 p< 0.001), 음주상태, 연령, 체질량지수, 음주 및 흡연 통합변수로 층화하여 분석하였을 때에도 혈중납수준과 혈청감마지티의 연관성은 유의하였다. 로지스틱회귀분석은 혈중납 3분위수와 혈청 감마지티 상승위험의 연관성을 보여주었다. (Model 1, OR: 2.74, 95% CI: 1.764.28 ;Model 2, OR: 1.83, 95%CI:1.132.95 ; Model 3, OR 1.81, 95%CI:1.122.92)
결론
일개 제철소 남성근로자를 대상으로 실시된 본 연구는 혈중납 5μg/dL 이하의 저농도 노출수준에서도 혈중납 수준과 혈청 감마지티 수치가 연관성이 있음을 보여준다.

Citations

Citations to this article as recorded by  
  • The Association Between Blood Lead Levels and Coronary Artery Calcium Score Determined by Using Coronary Computed Tomography Angiography
    Eunyoung Park, Suwhan Kim, Seunghyeon Cho, Hyeonjun Kim, Inho Jung, Jai-Dong Moon, Won-Ju Park
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
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Research Article
The effects of exposure to lead, cadmium and mercury on follicle-stimulating hormone levels in men and postmenopausal women: data from the Second Korean National Environmental Health Survey (2012–2014)
Tae-Woo Lee, Dae Hwan Kim, Ji Young Ryu
Ann Occup Environ Med 2019;31:e21.   Published online August 28, 2019
DOI: https://doi.org/10.35371/aoem.2019.31.e21
AbstractAbstract PDFPubReaderePub
Background

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

Methods

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

Results

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

Conclusions

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


Citations

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  • ADAPTIVE REARRANGEMENTS OF STRUCTURAL COMPONENTS IN THE ADULT RATS’ ADENOHYPOPHYSIS AFTER LONG-TERM EXPOSURE TO HEAVY METAL SALTS
    N. B. Hryntsova, A. M. Romaniuk, V. I. Bumeister, K. O. Sikora
    World of Medicine and Biology.2024; 20(87): 192.     CrossRef
  • Hormonal profile changes under the influence of environmental factors in children residing in the Aral environmental disaster region
    Valerii O. Erkudov, Kenzhabek Umar ugli Rozumbetov, Azat T. Matchanov, Andrey P. Pugovkin, Symbat N. Nisanova, Madina A. Kalmuratova, Andrey V. Kochubeev, Sergey S. Rogozin
    Pediatrician (St. Petersburg).2024; 14(5): 51.     CrossRef
  • Exposure to heavy metals and hormone levels in midlife women: The Study of Women's Health Across the Nation (SWAN)
    Xin Wang, Ning Ding, Siobán D. Harlow, John F. Randolph, Bhramar Mukherjee, Ellen B. Gold, Sung Kyun Park
    Environmental Pollution.2023; 317: 120740.     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
  • Exposure to endocrine-disrupting metals and serum estrogen levels among US women
    Anna Corry Gerald, Srividya Ganapathy, Jianmin Zhu, Yudan Wei
    Reproductive Toxicology.2023; 118: 108392.     CrossRef
  • A cross-sectional study of the association between heavy metals and pan-cancers associated with sex hormones in NHANES 1999–2018
    Hai-ming Cao, Ya-zhu Yang, Bao-yi Huang, Yunzhe Zhang, Yu Wu, Zi Wan, Lin Ma
    Environmental Science and Pollution Research.2023; 30(21): 61005.     CrossRef
  • Exposure to mixed chemicals elevated triiodothyronine (T3) and follicle-stimulating hormone (FSH) levels: epidemiology and in silico toxicogenomic involvement
    Hai Duc Nguyen
    Environmental Science and Pollution Research.2023; 30(38): 88803.     CrossRef
  • The Association Between Heavy Metals Exposure and Sex Hormones: a Systematic Review on Current Evidence
    Yasaman Rami, Karim Ebrahimpour, Mahboobeh Maghami, Bahareh Shoshtari-Yeganeh, Roya Kelishadi
    Biological Trace Element Research.2022; 200(8): 3491.     CrossRef
  • Follicle-stimulating hormone and blood lead levels with bone mineral density and the risk of fractures in pre- and postmenopausal women
    Huixin Tong, Bo Su, Zhize Liu, Yongjie Chen
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
  • Adaptive morphofunctional rearrangements in the adult rats adenohypophysis after long-term exposure of heavy metal salts
    Hryntsova Nataliia, Hodorova Ingrid, Romanyuk Anatoly, Kravets Alexander, Rybarova Silvia, Lovasova Kvetuse, Mihalik Josef, Pavliuk-Karachevtseva Andriana, Vecanova Janka, Kolesar Dalibor, Bolekova Andriana, Flesarova Slavka
    Acta Medica Martiniana.2022; 22(2): 70.     CrossRef
  • Association between blood cadmium and vitamin D levels in the Yangtze Plain of China in the context of rapid urbanization
    Chi Chen, Hao-Jie Zhang, Hua-Ling Zhai, Yi Chen, Bing Han, Qin Li, Fang-Zhen Xia, Ning-Jian Wang, Ying-Li Lu
    Chinese Medical Journal.2021; 134(1): 53.     CrossRef
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    Dong-Wook Lee, Jongmin Oh, Shinhee Ye, Youngrin Kwag, Wonho Yang, Yangho Kim, Eunhee Ha
    Environmental Research.2021; 197: 111013.     CrossRef
  • Prenatal blood levels of some toxic metals and the risk of spontaneous abortion
    Mohsen Vigeh, Masud Yunesian, Takehise Matsukawa, Mansour Shamsipour, Maryam Zare Jeddi, Noushin Rastkari, Mohammad Sadegh Hassanvand, Mamak Shariat, Homa Kashani, Reihaneh Pirjani, Mohammad Effatpanah, Mahboobeh Shirazi, Ghazal Shariatpanahi, Katsumi Oht
    Journal of Environmental Health Science and Engineering.2021; 19(1): 357.     CrossRef
  • Independent and combined associations of urinary heavy metals exposure and serum sex hormones among adults in NHANES 2013–2016
    Chengzhe Tao, Zhi Li, Yun Fan, Xiuzhu Li, Hong Qian, Hao Yu, Qiaoqiao Xu, Chuncheng Lu
    Environmental Pollution.2021; 281: 117097.     CrossRef
  • Effects of Cadmium, Lead, and Mercury on the Structure and Function of Reproductive Organs
    Peter Massányi, Martin Massányi, Roberto Madeddu, Robert Stawarz, Norbert Lukáč
    Toxics.2020; 8(4): 94.     CrossRef
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Case Report
Collective exposure to lead from an approved natural product-derived drug in Korea
Dae-Young Lim, Won-Yang Kang, Ji-Sung Ahn, Seunghyeon Cho, Suwhan Kim, Jai-Dong Moon, Byung-Chan Lee, Won-Ju Park
Ann Occup Environ Med 2019;31:e20.   Published online August 26, 2019
DOI: https://doi.org/10.35371/aoem.2019.31.e20
AbstractAbstract PDFPubReaderePub
Background

In Asian countries, including Korea, lead poisoning caused by traditional herbal medicines is often observed in the clinic. However, there have been no reports thus far of lead poisoning caused by drugs that were approved by the Korea Food and Drug Administration (KFDA). Here, we describe seven patients who ingested a problematic natural product-derived drug (NPD).

Case presentation

In July 2018, seven patients visited a university hospital after ingesting an NPD, S. capsules. These patients complained of various symptoms, and their blood lead levels (BLLs) were elevated relative to those of the general population (arithmetic mean: 19.5 ± 11.6 µg/dL, range: 6.28–35.25 µg/dL). The total doses and BLLs were directly proportional to each other among the patients (r = 0.943, p = 0.001). After the patients discontinued drug intake, their BLLs decreased gradually. The capsule was confirmed to contain lead above the standard value (arithmetic mean: 2,547 ± 1,821.9 ppm).

Conclusion

This incident highlights the need to strengthen standards for the management of NPD ingredients in Korea. NPDs are more likely to be contaminated than other drugs. Thorough management by the KFDA is essential to prevent a recurrence. Moreover, systematic health care is needed for many patients who have taken problematic NPDs.


Citations

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  • Lead and arsenic intoxications by traditional and alternative medicine: men are more sensitive than women
    Lucia Gerke, Roland Seifert
    Naunyn-Schmiedeberg's Archives of Pharmacology.2024;[Epub]     CrossRef
  • A Case of Severe Lead Poisoning with Basophilic Stippling Teardrop Cell
    Wonyang Kang, Seunghyeon Cho, Dae-Young Lim, Suwhan Kim, Won-Ju Park
    Journal of Korean Medical Science.2019;[Epub]     CrossRef
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Research Article
Environmental exposure of heavy metal (lead and cadmium) and hearing loss: data from the Korea National Health and Nutrition Examination Survey (KNHANES 2010–2013)
Gu Hyeok Kang, Jun Young Uhm, Young Gon Choi, Eun Kye Kang, Soo Young Kim, Won Oh Choo, Seong Sil Chang
Ann Occup Environ Med 2018;30:22.   Published online April 17, 2018
DOI: https://doi.org/10.1186/s40557-018-0237-9
AbstractAbstract PDFPubReaderePub
Background

Lead and cadmium have been identified as risk factors for hearing loss in animal studies, but large-scale studies targeting the general human population are rare. This study was conducted to investigate the link between heavy metal concentrations in blood and hearing impairment, using a national population-based survey.

Methods

The study participants comprised 6409 Koreans aged 20 or older, who were included in the Fifth and Sixth Korea National Health and Nutrition Examination Surveys (KNHANES 2010–2013). Hearing impairment was categorized into two types, low- and high-frequency hearing impairment, using pure tone audiometry. Low-frequency hearing impairment was defined as having a binaural average of hearing thresholds for 0.5, 1, and 2 kHz exceeding 25 dB, and high-frequency hearing impairment was defined as having a binaural average of hearing thresholds for 3, 4, and 6 kHz exceeding 25 dB. The blood levels of heavy metals (lead and cadmium) were classified into quartiles. Cross-sectional association between hearing impairment and the level of heavy metals (lead and cadmium) was examined in both sexes. Multivariate logistic regression was used to obtain adjusted odds ratios (ORs) and 95% confidence intervals (CIs).

Results

Among men, the prevalence of low- and high- frequency hearing impairment was 13.9% and 46.7%, respectively, which was higher than the prevalence among women (11.8% and 27.0%, respectively). Regarding lead, the adjusted OR of high-frequency hearing impairment for the highest blood level group versus the lowest group was significant in both men (OR = 1.629, 95% CI = 1.161–2.287) and women (OR = 1.502, 95% CI = 1.027–2.196), after adjusting for age, body mass index, education, smoking, alcohol consumption, exercise, diagnosis of diabetes mellitus, hypertension, and noise exposure (occupational, loud, firearm noises). No links were found between blood lead levels and low-frequency hearing impairment, or between blood cadmium levels and low- or high-frequency hearing impairment in either sex.

Conclusions

The present study findings suggest that even exposure to low-level lead is a risk factor for high-frequency hearing loss. A prospective epidemiologic study should be conducted to identify the causal relationship between human health and exposure to heavy metals, and efforts to reduce heavy metal exposure in the general population should continue.


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  • Higher exposure to 1,3-butadiene is associated with more severe hearing loss
    Sang-Yoon Han, Sang-Yeon Lee, Myung-Whan Suh, Jun Ho Lee, Moo Kyun Park
    Scientific Reports.2024;[Epub]     CrossRef
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    Soledad Solis-Angeles, Luz María Del Razo, Guadalupe Aguilar-Madrid, Carmina Jiménez-Ramírez, Laura Coco, Alejandro Cabello-López, Cuauhtémoc Arturo Juárez-Pérez
    Ear & Hearing.2023;[Epub]     CrossRef
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    Sue Sherratt
    American Journal of Audiology.2023; 32(4): 793.     CrossRef
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    Jennifer Galdieri, Chloe Adams, María Padilla, Tamara M. Stawicki
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    Mingming Liang, Xianwei Guo, Xiuxiu Ding, Qiuxia Song, Hao Wang, Ning Li, Wanying Su, Qiwei Liang, Yehuan Sun
    Ecotoxicology and Environmental Safety.2022; 247: 114279.     CrossRef
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    Qian Li, Liuqian Wang, Di Ji, Wei Yu, Yan Zhang, Yanghong Xiang, Chao Zhou, Liting Wang, Ping Deng, Huifeng Pi, Yonghui Lu, Qinlong Ma, Mindi He, Lei Zhang, Zhengping Yu, Anchun Deng
    Journal of Inorganic Biochemistry.2022; 234: 111901.     CrossRef
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    Bin Zhou, Adrienne Gentry, Qian Xu, Jamie L. Young, Xiaofang Yan, Kelly Pagidas, Yu Yang, Walter H. Watson, Maiying Kong, Lu Cai, Jonathan H. Freedman
    Toxicology Reports.2021; 8: 718.     CrossRef
  • Metal Exposures, Noise Exposures, and Audiometry from E-Waste Workers in Agbogbloshie, Ghana
    Krystin Carlson, Niladri Basu, Julius N. Fobil, Richard L. Neitzel
    International Journal of Environmental Research and Public Health.2021; 18(18): 9639.     CrossRef
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    Caleigh Schmid, Isabella Alampi, Jay Briggs, Kelly Tarcza, Tamara M. Stawicki
    Frontiers in Cellular Neuroscience.2020;[Epub]     CrossRef
  • Disruption of essential metal homeostasis in the brain by cadmium and high-fat diet
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    Toxicology Reports.2020; 7: 1164.     CrossRef
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    Ehsan Hemmativaghef
    Journal of Occupational and Environmental Hygiene.2020; 17(11-12): 574.     CrossRef
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    Jihyun Jeong, Sang-moon Yun, Minkyeong Kim, Young Ho Koh
    International Journal of Environmental Research and Public Health.2020; 17(17): 6288.     CrossRef
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    Da Jung Jung
    Yeungnam University Journal of Medicine.2019; 36(2): 141.     CrossRef
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Research Article
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
Ann Occup Environ Med 2017;29:47.   Published online October 4, 2017
DOI: https://doi.org/10.1186/s40557-017-0202-z
AbstractAbstract PDFPubReaderePub
Background

Lead and cadmium are harmful heavy metals that are used for a variety of occupational purposes. Considering their potentially hazardous effects on health, studies on the association between exposure to these two heavy metals and health disorders have been actively conducted. This study aimed to determine the association between blood lead and cadmium levels and blood pressure in workers exposed to lead and cadmium in a smelter.

Methods

Nine hundred and sixty-three male workers who worked in a smelter, and underwent medical examinations at the Ulsan University Hospital between January 1 and December 31, 2014, were selected as participants. Among them, 310 subjects whose data on height, weight, blood pressure, fasting blood glucose, lipid profile, and blood lead and cadmium levels were available and who answered the questionnaire were selected as the final participants. We investigated the drinking habit, smoking status, exercise adequacy, and family history of hypertension of these workers using formal questionnaires. A statistical analysis was conducted using Student’s t-test, analysis of variance, and linear or logistic regression.

Results

The association between blood lead and cadmium levels and blood pressure was analyzed through statistical adjustment of the risk factors of hypertension. Results showed an association between blood cadmium level and blood pressure elevation. However, blood lead level was found to be not correlated with blood pressure elevation.

Conclusions

This study shows the association between blood cadmium level and systolic blood pressure (SBP) and diastolic blood pressure (DBP) elevation.

Trial registration

IRB No. 2017–03-037. Retrospectively Registered 30 March 2017.


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Research Article
Levels of blood lead and urinary cadmium in industrial complex residents in Ulsan
Sang Hoon Kim, Yang Ho Kim, Hyun Chan An, Joo Hyun Sung, Chang Sun Sim
Ann Occup Environ Med 2017;29:26.   Published online June 26, 2017
DOI: https://doi.org/10.1186/s40557-017-0179-7
AbstractAbstract PDFPubReaderePub
Background

Populations neighboring industrial complexes are at an increased health risk, due to constant exposure to various potentially hazardous compounds released during industrial production activity. Although there are many previous studies that focus on occupational exposure to heavy metals, studies that focused on environmental exposure to lead and cadmium are relatively rare. The purpose of this study is to evaluate the extent of the environmental exposure of heavy metals in residents of industrial area.

Methods

Four areas in close proximity to the Ulsan petrochemical industrial complex and the Onsan national industrial complex were selected to be included in the exposure group, and an area remotely located from these industrial complexes was selected as the non-exposure group. Among the residents of our study areas, a total of 1573 subjects aged 20 years and older were selected and all study subjects completed a written questionnaire. Blood and urine samples were obtained from about one third of the subjects (465 subjects) who provided informed consent for biological sample collection. Total 429 subjects (320 subjects from exposure area, 109 subjects from non-exposure area) were included in final analysis.

Results

The geometric mean blood lead level among the subjects in the exposed group was 2.449 μg/dL, which was significantly higher than the non-exposure group’s level of 2.172 μg/dL. Similarly, the geometric mean urine cadmium levels between the two groups differed significantly, at 1.077 μg/g Cr. for the exposed group, and 0.709 μg/g Cr. for the non-exposure group.

In a multiple linear regression analysis to determine the relationship between blood lead level and related factors, the results showed that blood lead level had a significant positive correlation with age, the male, exposure area, and non-drinkers. In the same way, urine cadmium level was positively correlated with age, the female, exposure area, and smokers.

Conclusions

This study found that blood lead levels and urine cadmium levels were significantly higher among the residents of industrial areas than among the non-exposure area residents, which is thought to be due to the difference in environmental exposure of lead and cadmium. Furthermore, it was clear that at a low level of exposure, differences in blood lead or urine cadmium levels based on age, gender, and smoking status were greater than the differences based on area of residence. Therefore, when evaluating heavy metal levels in the body at a low level of exposure, age, gender, and smoking status must be adjusted, as they are significant confounding factors.


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Review
Evaluation and management of lead exposure
Hwan-Cheol Kim, Tae-Won Jang, Hong-Jae Chae, Won-Jun Choi, Mi-Na Ha, Byeong-Jin Ye, Byoung-Gwon Kim, Man-Joong Jeon, Se-Yeong Kim, Young-Seoub Hong
Ann Occup Environ Med 2015;27:30.   Published online December 15, 2015
DOI: https://doi.org/10.1186/s40557-015-0085-9
AbstractAbstract PDFPubReaderePub

Lead, which is widely used in industry, is a common element found in low concentrations in the Earth’s crust. Implementations to reduce environmental lead concentrations have resulted in a considerable reduction of lead levels in the environment (air) and a sustained reduction in the blood lead levels of the average citizen. However, people are still being exposed to lead through a variety of routes in everyday commodities.

Lead causes health problems such as toxicity of the liver, kidneys, hematopoietic system, and nervous system. Having a carcinogenic risk as well, the IARC classifies inorganic lead compounds as probably carcinogenic to humans (Group 2A). Occupational lead poisonings have decreased due to the efforts to reduce the lead concentrations in the working environment. In contrast, health hazards associated with long-term environmental exposure to low concentrations of lead have been reported steadily. In particular, chronic exposure to low concentrations of lead has been reported to induce cognitive behavioral disturbances in children.

It is almost impossible to remove lead completely from the human body, and it is not easy to treat health hazards due to lead exposure. Therefore, reduction and prevention of lead exposure are very important. We reviewed the toxicity and health hazards, monitoring and evaluation, and management of lead exposure.


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Case Report
High lead exposure in two leaded bronze ingot foundry workers
Yoojun Song, Chunhui Suh, Shin-Ae Kim, Nami Kim, Sung-Min Kim, Seong-Wook Jeong, Se-Yeong Kim, Kun-Hyung Kim, Jeong-Ho Kim, Byung-Chul Son, Chae-Kwan Lee, Jong-Tae Lee
Ann Occup Environ Med 2014;26:38.   Published online December 1, 2014
DOI: https://doi.org/10.1186/s40557-014-0038-8
AbstractAbstract PDFPubReaderePub
Background

Awareness about lead poisoning in South Korea has increased; however, occupational exposures occurring in small-scale businesses have not been thoroughly investigated. We report two cases of high lead exposure in a leaded bronze ingot foundry.

Case presentation

Two employees, a 54-year-old primary operator and a 46-year-old assistant, at a small-scale metalworking company who had been employed for 18 years and 1 month, respectively, showed elevated blood lead levels (61.1 μg/dL and 51.7 μg/dL, respectively) at an occupational health checkup. Neither worker complained of abnormal symptoms nor signs related to lead poisoning. Health assessment follow-ups were conducted and biological exposure indices of lead were calculated every four weeks. After the initial follow-up assessment, both workers were relocated from the foundry process to the metalworking process. In addition, a localized exhaust system was installed after the second follow-up.

Conclusions

Foundry workers in a small-scale businesses might be at high risk of lead exposure because these businesses might be vulnerable to poor industrial hygiene. Therefore, regular occupational health checkups are required.


Citations

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  • Comparison of Blood Lead Levels in Children and Adolescents with and Without Functional Abdominal Pain
    Fatemeh Famouri, Maryam Yazdi, Awat Feizii, Hossein Saneian, Peiman Nasri, Roya Kelishadi
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    Ziyao Huang
    Frontiers in Public Health.2022;[Epub]     CrossRef
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    Saeed Samarghandian, Farshad M. Shirazi, Farhad Saeedi, Babak Roshanravan, Ali Mohammad Pourbagher-Shahri, Emad Yeganeh Khorasani, Tahereh Farkhondeh, Jan Olav Aaseth, Mohammad Abdollahi, Omid Mehrpour
    Toxicology and Applied Pharmacology.2021; 429: 115681.     CrossRef
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    Renee Anne Street, Walter Goessler, Saloshni Naidoo, Busisiwe Shezi, Nokulunga Cele, Jaqueline Rieger, Karl Ettinger, Tarylee Reddy, Angela Mathee
    Environmental Research.2020; 191: 109860.     CrossRef
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    Gilseung Ahn, Sun Hur, Myung-Chul Jung
    International Journal of Occupational Safety and Ergonomics.2020; 26(2): 336.     CrossRef
  • Challenges in diagnosing lead poisoning: A review of occupationally and nonoccupationally exposed cases reported in India
    Monica Shirley Mani, Divyani Gurudas Nayak, Herman Sunil Dsouza
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  • Lead Poisoning at an Indoor Firing Range
    Kyung Wook Kang, Won-Ju Park
    Journal of Korean Medical Science.2017; 32(10): 1713.     CrossRef
  • Occupational Lead Exposure from Indoor Firing Ranges in Korea
    Won-Ju Park, Suk-Ho Lee, Se-Ho Lee, Hye-Sik Yoon, Jai-Dong Moon
    Journal of Korean Medical Science.2016; 31(4): 497.     CrossRef
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Research Article
Blood lead levels of Korean lead workers in 2003–2011
Ji-Hye Kim, Eun-A Kim, Dong-Hee Koh, Kiwhan Byun, Hyang-Woo Ryu, Sang-Gil Lee
Ann Occup Environ Med 2014;26:30-30.   Published online October 1, 2014
DOI: https://doi.org/10.1186/s40557-014-0030-3
AbstractAbstract PDFPubReaderePub
Objectives

This study aimed to document the trend in blood lead levels in Korean lead workers from 2003 until 2011 and blood lead levels within each of the main industries.

Methods

Nine years (2003–2011) of blood lead level data measured during a special health examination of Korean lead workers and collected by the Korea Occupational Safety and Health Agency were analyzed. Blood lead levels were determined by year, and a geometric mean (GM) was calculated for each industry division.

Results

The overall GM blood lead level for all years combined (n = 365,331) was 4.35 μg/dL. The GM blood lead level decreased from 5.89 μg/dL in 2003 to 3.53 μg/dL in 2011. The proportion of the results ≥30 μg/dL decreased from 4.3% in 2003 to 0.8% in 2011. In the “Manufacture of Electrical Equipment” division, the GM blood lead level was 7.80 μg/dL, which was the highest among the industry divisions. The GM blood lead levels were 7.35 μg/dL and 6.77 μg/dL in the “Manufacturers of Rubber and Plastic Products” and the “Manufacture of Basic Metal Products” division, respectively.

Conclusions

The blood lead levels in Korean lead workers decreased from 2003 to 2011 and were similar to those in the US and UK. Moreover, workers in industries conventionally considered to have a high risk of lead exposure also tended to have relatively high blood lead levels compared to those in other industries.


Citations

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  • Evaluation of Temporal Trends of Lead Exposure in Korean Workers Using Workplace Monitoring Data
    Dong-Hee Koh, Sangjun Choi, Ju-Hyun Park, Sang-Gil Lee, Hwan-Cheol Kim, Inah Kim, Jong-Uk Won, Dae Sung Lim, Hoekyeong Seo, Dong-Uk Park
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
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    Jiabin Liang, Jieyan Cai, Jiaming Guo, Jianping Mai, Liping Zhou, Jinwei Zhang, Yimin Liu, Zhi Wang
    Archives of Environmental & Occupational Health.2022; 77(5): 403.     CrossRef
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    Min-Gi Kim, Young-Sun Min, Yeon-Soon Ahn
    International Journal of Environmental Research and Public Health.2021; 18(17): 9077.     CrossRef
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    Emmanuel Obeng-Gyasi, Barnabas Obeng-Gyasi
    Diseases.2020; 8(1): 7.     CrossRef
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    Yafei Wang, Yuqing Tang, Zhou Li, Qihang Hua, Li Wang, Xin Song, Baobo Zou, Min Ding, Jinshun Zhao, Chunlan Tang
    International Journal of Environmental Research and Public Health.2020; 17(4): 1451.     CrossRef
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    Dae-Young Lim, Won-Yang Kang, Ji-Sung Ahn, Seunghyeon Cho, Suwhan Kim, Jai-Dong Moon, Byung-Chan Lee, Won-Ju Park
    Annals of Occupational and Environmental Medicine.2019;[Epub]     CrossRef
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    Dong-Hee Koh, Ju-Hyun Park, Sang-Gil Lee, Hwan-Cheol Kim, Sangjun Choi, Hyejung Jung, Jae-Oh Park, Dong-Uk Park
    Annals of Work Exposures and Health.2018; 62(2): 210.     CrossRef
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    Milad Azami, Zainab Tardeh, Akram Mansouri, Ali Soleymani, Kourosh Sayehmiri
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    Kyung Wook Kang, Won-Ju Park
    Journal of Korean Medical Science.2017; 32(10): 1713.     CrossRef
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    Won-Ju Park, Suk-Ho Lee, Se-Ho Lee, Hye-Sik Yoon, Jai-Dong Moon
    Journal of Korean Medical Science.2016; 31(4): 497.     CrossRef
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    Min-Gi Kim, Jae-Hong Ryoo, Se-Jin Chang, Chun-Bae Kim, Jong-Ku Park, Sang-Baek Koh, Yeon-Soon Ahn, Max Costa
    PLOS ONE.2015; 10(10): e0140360.     CrossRef
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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
AbstractAbstract PDFPubReaderePub
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.


Citations

Citations to this article as recorded by  
  • A systematic review of clinical and laboratory findings of lead poisoning: lessons from case reports
    Saeed Samarghandian, Farshad M. Shirazi, Farhad Saeedi, Babak Roshanravan, Ali Mohammad Pourbagher-Shahri, Emad Yeganeh Khorasani, Tahereh Farkhondeh, Jan Olav Aaseth, Mohammad Abdollahi, Omid Mehrpour
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    Kyung Wook Kang, Won-Ju Park
    Journal of Korean Medical Science.2017; 32(10): 1713.     CrossRef
  • Effect of Lead Exposure on the Status of Reticulocyte Count Indices among Workers from Lead Battery Manufacturing Plant
    Ravibabu Kalahasthi, Tapu Barman
    Toxicological Research.2016; 32(4): 281.     CrossRef
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Research Article
The Relevance of Hyperuricemia and Metabolic Syndrome and the Effect of Blood Lead Level on Uric Acid Concentration in Steelmaking Workers
Deul Lee, Won-Jun Choi, Jae-Seok Oh, Min-Kee Yi, Sung-Woo Han, Jong-Wan Yun, Sang-Hwan Han
Ann Occup Environ Med 2013;25:27-27.   Published online October 25, 2013
DOI: https://doi.org/10.1186/2052-4374-25-27
AbstractAbstract PDFPubReaderePub
Objectives

Uric acid concentration is known to increase the prevalence of metabolic syndrome by affecting its components, resulting in increased risk of cerebrovascular and cardiovascular diseases, and long-term lead exposure is known to affect this serum uric acid level. In this study, we aimed to examine the association between the causes of hyperuricemia and metabolic syndrome, and to determine whether an increased blood lead level affects hyperuricemia.

Method

Anthropometric measurements, surveys, and blood tests were conducted between May and June 2012 in 759 men working in the steelmaking process at a domestic steel company. Workers were divided into 2 groups according to the presence or absence of hyperuricemia, and an analysis was performed to examine its association with metabolic syndrome. In addition, the workers were divided into 3 groups according to the blood lead level to analyze the association between blood lead and hyperuricemia.

Results

The geometric mean (standard deviation) of the blood lead levels in the hyperuricemia group was significantly higher than that of the healthy group (3.8 [1.8] vs. 3.3 [1.8] μg/dL). The adjusted odds ratio for metabolic syndrome of the hyperuricemia group increased significantly to 1.787 (1.125–2.839) compared with the healthy group. In addition, the adjusted odds ratios for the occurrence of hyperuricemia in the tertile 2 (2.61–4.50 μg/dL) and tertile 3 groups (>4.50 μg/dL) according to blood lead level significantly increased to 1.763 (1.116–2.784) and 1.982 (1.254–3.132), respectively, compared with the tertile 1 group (< 2.61 μg/dL).

Conclusion

Hyperuricemia is believed to function as an independent risk factor for metabolic syndrome, while lead seems to increase the serum uric acid level even at a considerably low blood level. Therefore, attention should be given to patients with hyperuricemia and metabolic syndrome who are prone to lead exposure, and a prospective study should be conducted to identify their causal relationship.


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    Tingting Gu, Guorong Cao, Miao Luo, Nannan Zhang, Ting Xue, Rongchun Hou, Min Leng
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    Science of The Total Environment.2017; 601-602: 741.     CrossRef
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Research Article
The Relationship of Liver Function Tests to Mixed Exposure to Lead and Organic Solvents
Won-Joon Chang, Kyu-Tak Joe, Hye-Young Park, Jong-Do Jeong, Duk-Hee Lee
Ann Occup Environ Med 2013;25:5-5.   Published online May 21, 2013
DOI: https://doi.org/10.1186/2052-4374-25-5
AbstractAbstract PDFPubReaderePub
Objective

This study aims to compare liver function indices (aspartate aminotransferase [AST], alanine aminotransferase [ALT], and gamma glutamyl transferase [GGT]) among males who work with lead, organic solvents, or both lead and organic solvents, under the permissible exposure limit (PEL).

Methods

A total of 593 (out of 2,218) male workers who agreed to share their personal health information for medical research were selected for this study. Those excluded were hepatitis B carriers, individuals exposed to occupational risk factors other than lead and organic solvents, and individuals without liver function results. The 593 were divided into five groups: a lead-exposed group, an organic solvent-exposed group exposed to trichloroethylene (TCE co-exposed solvent group), an organic solvent-exposed group not exposed to trichloroethylene (TCE non-exposed solvent group), a lead and organic solvent-exposed group (mixed exposure group), and a non-exposed group (control group).

We performed a one way-analysis of variance (one way-ANOVA) test to compare the geometric means of liver function indices among the groups, using a general linear model (GLM) to adjust for age, work duration, body mass index (BMI), smoking, and alcohol intake. In addition, we performed a binary logistic regression analysis to compare the odds ratios among groups with an abnormal liver function index, according to a cut-off value.

Results

The ALT and AST of the mixed exposure group were higher than those of the other groups. The GGT of the mixed exposure group was higher than the TCE co-exposed solvent group, but there was no difference among the control group, TCE non-exposed solvent group, lead-exposed group, and mixed exposure group. The same result was evident after adjusting by GLM for age, work duration, BMI, smoking, and alcohol intake, except that ALT from the mixed exposure group showed no difference from the TCE co-exposed solvent group.

When the cut-off values of the AST, ALT, and GGT were 40 IU/L, 42 IU/L, and 63 IU/L, respectively, a logistic regression analysis showed no differences in the odds ratios of those who had an abnormal liver function index among the groups. However, if the cut-off values of the AST, ALT, and GGT were 30 IU/L, 30 IU/L, and 40 IU/L, respectively, the odds ratio of the AST in the mixed exposure group was 4.39 (95% CI 1.86-10.40) times higher than the control.

Conclusion

This study indicates that a mixed exposure to lead and organic solvents is dangerous, even if each single exposure is safe under the permissible exposure limit. Therefore, to ensure occupational health and safety in industry, a continuous efforts to study the effects from exposure to mixed chemicals is needed.


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Case Report
Detection of Cases and a Cause of Lead Exposure in Korean Steel Company
Bon Hak Koo, Young Ki Kim, Sang Gil Lee, Dong Mug Kang, Jong Eun Kim
Korean Journal of Occupational and Environmental Medicine 2012;24(4):441-448.   Published online December 31, 2012
DOI: https://doi.org/10.35371/kjoem.2012.24.4.441
AbstractAbstract PDF
BACKGROUND
We report cases of high lead exposure in a Korean steel manufacturing company and a likely cause for these cases.
CASE
REPORT: Neurological examinations, neurobehavioral tests, blood tests, and urine tests were performed to detect an association between high lead exposure and physical symptoms for workers in a steel manufacturing company. In order to determine the cause of high lead exposure, the work process and environment was assessed. The highest lead exposure was during the work process. We found that the interior of an oil storage tank was coated with lead-containing paint, leading to severe exposure during the cutting process. In two observations, 4 of 12 workers diagnosed with occupational disease were found to have high exposure to lead from the storage tank and three had increased beta-2 microglobulin levels in the blood (indicative of urinary tract damage).
CONCLUSIONS
Lead management, including routine measurements of the working environment and examinations of lead concentrations in workers, are needed in the korean scrap metal industry. In addition, rules requiring workers to wear personal protective equipment and receive education about lead exposure should be strictly enforced.

Citations

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  • Evaluation of Temporal Trends of Lead Exposure in Korean Workers Using Workplace Monitoring Data
    Dong-Hee Koh, Sangjun Choi, Ju-Hyun Park, Sang-Gil Lee, Hwan-Cheol Kim, Inah Kim, Jong-Uk Won, Dae Sung Lim, Hoekyeong Seo, Dong-Uk Park
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
  • Occupational Lead Exposure from Indoor Firing Ranges in Korea
    Won-Ju Park, Suk-Ho Lee, Se-Ho Lee, Hye-Sik Yoon, Jai-Dong Moon
    Journal of Korean Medical Science.2016; 31(4): 497.     CrossRef
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Case Report
A Case of Amyotrophic Lateral Sclerosis in an Equipment Maintenance Worker Exposed to Lead
In Ki Yoon, Hyoung Jun Lim, Young Su Ju, Se Jin An, Young Jun Kwon
Korean Journal of Occupational and Environmental Medicine 2012;24(2):195-205.   Published online June 30, 2012
DOI: https://doi.org/10.35371/kjoem.2012.24.2.195
AbstractAbstract PDF
OBJECTIVES
Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease involving the upper and lower motor neuron of the brain and spinal cord, leading ultimately to death due to respiratory failure in most cases. The etiology of ALS is currently unknown, but several studies show that lead exposure might be one of the potential environmental causes of ALS. In this perspective, we introduce a case involving an ALS patient exposed to lead while maintaining mechanical equipment in a waste treatment plant.
METHODS
The patient was interviewed and his medical records were investigated to confirm the final diagnosis of ALS. The results of his health examination and working environment measurement were reviewed in order to evaluate the relation of his work with ALS. We also performed an analysis of lead concentration from samples taken from his workplace when we visited the plant to survey the work environment.
RESULTS
Based on the patient's clinical information, work environment, relatively high level of blood lead concentration, and several studies proposing the occupational relationship between lead and ALS, his ALS may possibly have been caused by lead exposure at his workplace.
CONCLUSIONS
Given the recent situation where the causal association between lead exposure and ALS is still unclear, this case report could be used as a basis to support the relevance of lead exposure with ALS, and to help improve the health and work environment of other workers who are likely to be exposed to lead.

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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
AbstractAbstract 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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  • Association of heavy metal complex exposure and neurobehavioral function of children
    Minkeun Kim, Chulyong Park, Joon Sakong, Shinhee Ye, So young Son, Kiook Baek
    Annals of Occupational and Environmental Medicine.2023;[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
  • 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
The Effects of Smoking and Drinking on Blood Lead and Cadmium Levels: Data from the Fourth Korea National Health and Nutrition Examination Survey
Boram Lee, Jaehyeok Ha
Korean Journal of Occupational and Environmental Medicine 2011;23(1):31-41.   Published online March 31, 2011
DOI: https://doi.org/10.35371/kjoem.2011.23.1.31
AbstractAbstract PDF
OBJECTIVES
The purpose of this study is to assess the effects of smoking and drinking on blood lead and cadmium levels based on a dose-response relationship in the general Korean adult population.
METHODS
The study population consisted of 1,901 Koreans, who took part in the 2008 Korean National Health and Nutrition Examination Survey, in which blood lead and cadmium levels were measured. Geometric mean concentrations and their 95% confidence intervals of metals in blood were estimated by analysis of covariance (ANCOVA) adjusting for demographic and lifestyle factors.
RESULTS
We observed a statistically significant dose-response relationship with daily smoking amount/alcohol intake and blood lead/cadmium levels. While daily smoking amount was more consistent with blood cadmium level (0.1-0.2 microg/L per 5 cigarettes), blood lead concentrations were higher as daily alcohol intake increased (0.1-0.2 microg/dL per 10 gram of alcohol).
CONCLUSIONS
Our findings clearly support a relationship between daily smoking amount/alcohol intake and blood lead/cadmium levels, suggesting an additional reason towards efforts to reduce smoking and drinking habits.

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    Sunmi Kim
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    Sunmi Kim
    Korean Journal of Health Promotion.2023; 23(4): 198.     CrossRef
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    Sunmi Kim
    Korean Journal of Clinical Geriatrics.2023; 24(3): 104.     CrossRef
  • Exposure Assessment of Heavy Metals using Exposure Biomarkers among Residents Living Near a Chungcheongnam-do Province Industrial Complex Area
    Yosub Joo, Sangchul Roh
    Korean Journal of Environmental Health Sciences.2016; 42(3): 213.     CrossRef
  • Health Effect and Blood Lead Concentration among Residents in Gwangyang and Yeosu
    Heejin Park, Myung-Kyu Park, Tack-Shin Kang, Geun-Bae Kim, Jong-Wha Lee, Bong-Ki Jang, Bu-Soon Son
    Korean Journal of Environmental Health Sciences.2016; 42(3): 205.     CrossRef
  • Association of among alcohol consumption and blood vitamin D and lead concentrations: Based on 2010-2012 Korea national health and nutrition examination survey
    Ho-Ki An, Jae-Yong Park, Hee-Jung Yoon
    Journal of the Korea Academia-Industrial cooperation Society.2015; 16(1): 498.     CrossRef
  • Association between secondhand smoke exposure and blood lead and cadmium concentration in community dwelling women: the fifth Korea National Health and Nutrition Examination Survey (2010–2012)
    Se Young Jung, Suyeon Kim, Kiheon Lee, Ju Young Kim, Woo Kyung Bae, Keehyuck Lee, Jong-Soo Han, Sarah Kim
    BMJ Open.2015; 5(7): e008218.     CrossRef
  • Simultaneous Exposure to Heavy Metals among Residents in the Industrial Complex: Korean National Cohort Study
    Heejin Park, Kyoungho Lee, Chan-Seok Moon, Kyungsook Woo, Tack-Shin Kang, Eun-Kyung Chung, Bu-Soon Son
    International Journal of Environmental Research and Public Health.2015; 12(6): 5905.     CrossRef
  • A Study on Concentrations of Heavy Metal in Blood and Urine of Local Area in Korea
    Ji-Young Im, Eun-Kyung Chung, Hee-Jin Park, Seungdo Yu, Bong-Ki Jang, Bu-Soon Son
    Journal of Environmental Science International.2013; 22(1): 59.     CrossRef
  • Smoking Prevalence and the Association between Smoking and Sociodemographic Factors Using the Korea National Health and Nutrition Examination Survey Data, 2008 to 2010
    Sungroul Kim
    Tobacco Use Insights.2012; 5: TUI.S9841.     CrossRef
  • The association of heavy metals in blood, fish consumption frequency, and risk of cardiovascular diseases among Korean adults: The Korean National Health and Nutrition Examination Survey (2008-2010)
    Ji-Ye Shin, Ji-Myung Kim, Yuri Kim
    Korean Journal of Nutrition.2012; 45(4): 347.     CrossRef
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Case Report
A Case of Lead Poisoning by Ingesting Herbal Pills Tainted by Lead during the Manufacturing Process
Young Hoo Shin, Jun Seok Son, Young Wook Kim, Chang Ho Chae, Ja Hyeon Kim, Chan Woo Kim, Jun Ho Lee
Korean Journal of Occupational and Environmental Medicine 2010;22(3):271-277.   Published online September 30, 2010
DOI: https://doi.org/10.35371/kjoem.2010.22.3.271
AbstractAbstract PDF
BACKGROUND
This is a case report of lead poisoning after herbal pill ingestion. We report this case here as a reminder that contamination during the manufacturing process is an important issue regarding herbal pills. Case Report: A 37-year-old male was admitted to the hospital with abdominal pain caused by cholecystitis. He was transferred to the Department of Occupational and Environmental Medicine on 26 December 2008, because of anemia. On follow-up examination post cholecystectomy, the patient had increasing blood lead levels. There was no specific finding in his medical history, but he had been taking herbal pills for 3 months to treat dyspepsia. We performed an analysis on the herbal pills, and determined a lead concentration of 1485 mg/kg. When he was admitted to the hospital, the patient had a blood lead level of 84.13 microgram/dL and a zinc protoporphyrin level was 230 microgram/dL. The patient was treated with 250 mg of Penicillamine, 4 times per day. During follow-up 3 weeks later, the patient's blood lead level had been reduced to 36.52 microgram/dL which allowed us to take him off of Penicillamine. By 7 months follow-up, the patient's blood lead concentration had fallen from 36.52 microgram/dL to 20.93 microgram/dL.
CONCLUSION
Lead poisoning was confirmed by analyzing blood lead levels and the cause was herbal pills. Upon analysis of the herbal pills, we have discovered that the herbal pills contained an amount of lead acquired during the manufacturing process, based on the high levels of this heavy metal in comparison to other metals. Private herbal pill manufacturing plants need systematic management and oversight.

Citations

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  • Collective exposure to lead from an approved natural product-derived drug in Korea
    Dae-Young Lim, Won-Yang Kang, Ji-Sung Ahn, Seunghyeon Cho, Suwhan Kim, Jai-Dong Moon, Byung-Chan Lee, Won-Ju Park
    Annals of Occupational and Environmental Medicine.2019;[Epub]     CrossRef
  • Monitoring of Heavy Metal Contents in Commercial Herbal Medicines in Korea: Cultivated Herbal Medicines in the Seoul and Daegu Areas
    Seol Jang, Ah-Reum Lee, A-Eong Lee, Go-Ya Choi, Ho-Kyoung Kim
    Korean Journal of Environmental Health Sciences.2015; 41(1): 30.     CrossRef
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Case Report
A Case Study on the Effect of Chelation Therapy with Dimercaptosuccinic Acid (DMSA) for Lead Poisoning in an Adult
Yong Jin Lee
Korean Journal of Occupational and Environmental Medicine 2010;22(1):69-76.   Published online March 31, 2010
DOI: https://doi.org/10.35371/kjoem.2010.22.1.69
AbstractAbstract PDF
OBJECTIVES
We wanted to investigate the efficacy of dimercaptosuccinic acid (DMSA) for the treatment of lead poisoning in an adult.
METHODS
The chelation therapy was applied using oral DMSA after measuring the blood lead and performing, renal function tests, liver tests and a physical examination. This therapy with oral DMSA 30 mg/kg/day was administered three times a day for 5 days to an adult patient with a pre-chelation blood lead concentration of 75 microgram/dL. Testing was performed by assessing the daily blood lead level, the blood ZPP, the urine ALA, the symptoms and side effects were assessed by conducting a physical examination.
RESULTS
DMSA therapy given for the duration of 5 days reduced the blood lead concentration from 75 microgram/dL to 21.8 microgram/dL. The blood ZPP concentration fell from 366 microgram/dL to 300 microgram/dL. The urine ALA concentration fell from 9.71 mg/L to 0.38 mg/L. In addition, the symptoms of headache, dizziness and abdominal pain that were induced by lead were improved after 2 days of chelation therapy. The vomiting did not improve after 5 days of chelation therapy, but this resolved 14 days following cessation of therapy. No adverse effects of DMSA therapy were seen.
CONCLUSIONS
Oral chelation therapy with DMSA 30 mg/kg/day is possible without being admitted to a hospital and it is generally effective, safe, and relatively inexpensive. DMSA provides a positive effect on adult patients who have lead poisoning.

Citations

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  • Probit analysis of comparative assays on toxicities of lead chloride and lead acetate to in vitro cultured human umbilical cord blood lymphocytes
    Rajashree Patnaik, Rabindra N. Padhy
    Interdisciplinary Toxicology.2015; 8(1): 35.     CrossRef
  • A Case of Lead Poisoning with Drug-induced Liver Injury after Ingestion of Herbal Medicine
    Gi Jung Jeon, Jongha Park, Min Sung Kim, Jong Won Yu, Jae Hyun Park, Min Sik Kim
    The Korean Journal of Gastroenterology.2015; 65(6): 375.     CrossRef
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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
AbstractAbstract 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.

Citations

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  • Association of heavy metal complex exposure and neurobehavioral function of children
    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
Blood Lead Level as a Predictor of Coronary Artery Disease
Ryoung Jin Park, Seung Hyun Kim, Ji Ung Park, Yang Hyun Kim, Myoung Bo Kim, Won Ju Park, Jai Dong Moon
Korean Journal of Occupational and Environmental Medicine 2009;21(1):38-45.   Published online March 31, 2009
DOI: https://doi.org/10.35371/kjoem.2009.21.1.38
AbstractAbstract PDF
OBJECTIVES
Lead exposure is known to be associated with high blood pressure, hypertension, coronary artery disease, peripheral arterial disease, left ventricular hypertropy, and electrocardiographic abnormalities. We investigated the association between blood lead and coronary artery calcification and stenosis.
METHODS
Between April 2006 and July 2007, 502 adults (345 males and 157 females), who had no history of cardiovascular disease or occupational exposure to lead, were recruited as study subjects. All subjects underwent coronary CT angiography and blood lead measurement.
RESULTS
Blood lead levels were distributed from 0.43 to 11.30 (microgram/dL with a geometric mean blood lead level of 2.98+/-1.5 (microgram/dL. The geometric mean blood lead levels were higher in men than women (3.31+/-1.5 (microgram/dL vs. 2.36+/-1.5 (microgram/dL, P < 0.01). Based on a multivariate analysis, a 1 unit ((microgram/dL) increase in blood lead level was associated with a 1.09 (95% confidence interval, 0.92~1.29) and a 1.01 fold (95% confidence interval, 0.63~1.63) greater risk for coronary artery calcification in men and women, respectively. Similarly, a 1 unit (microgram/dL) increase in blood lead level was associated with a 1.25 (95% confidence interval, 1.03~1.51) and a 1.42 fold (95% confidence interval, 0.73~2.75) greater risk for coronary artery stenosis in men and women, respectively.
CONCLUSIONS
The results suggest that increased blood lead levels are associated with an increased risk of coronary artery stenosis.

Citations

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  • Blood Lead Levels and Cardiovascular Disease Risk: Results from the Korean National Health and Nutrition Examination Survey
    Yoonjin Park, Jungjin Han
    International Journal of Environmental Research and Public Health.2021; 18(19): 10315.     CrossRef
  • Blood lead concentration and related factors in Korea from the 2008 National Survey for Environmental Pollutants in the Human Body
    Seong Wook Jeong, Chae Kwan Lee, Chun Hui Suh, Kun Hyung Kim, Byung Chul Son, Jeong Ho Kim, Jong Tae Lee, Soo Woong Lee, Yeong Beom Park, Jong Wha Lee, Seung-Do Yu, Chan Seok Moon, Dae Hwan Kim, Sang Yoon Lee
    International Journal of Hygiene and Environmental Health.2014; 217(8): 871.     CrossRef
  • The Effects of Blood Lead on Blood Pressure Among Non-smokers
    Yun-Suk Pak, Sang-Sin Park, Tae-Hun Kim, Sang-Yoon Lee, Young-Lim Kho, Eun-Hee Lee
    Korean Journal of Environmental Health Sciences.2012; 38(4): 311.     CrossRef
  • National estimates of blood lead, cadmium, and mercury levels in the Korean general adult population
    Nam-Soo Kim, Byung-Kook Lee
    International Archives of Occupational and Environmental Health.2011; 84(1): 53.     CrossRef
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Case Report
A Case of Chronic Renal Failure and Renal Cancer in a Worker Exposed to Lead
Somin Park, Jongeun Kim, Jungwon Kim, Daegyun Hong, Sangbum Ye, Dongmug Kang, Euna Kim
Korean Journal of Occupational and Environmental Medicine 2008;20(3):272-281.   Published online September 30, 2008
DOI: https://doi.org/10.35371/kjoem.2008.20.3.272
AbstractAbstract PDF
INTRODUCTION: Studies evaluating rats and mice have provided convincing evidence that renal adenoma and carcinoma are induced by oral doses of lead acetate and lead subacetate, as well as by parenteral doses of lead phosphate. In addition, at least 2 cases of kidney cancer associated with heavy exposure to lead have been reported. However, there is still not enough information to confirm or rule out an association between kidney cancer and exposure to lead.
CASE
REPORT: In this study, we describe a case of kidney cancer in 54-year-old male worker that was exposed to lead-stearate while employed in the polyvinyl chloride processing industry for 17 years. The patient presented with gout and hypertension. Further examination revealed proteinuria, glucose in the urine and elevated blood urea nitrogen/creatinine levels. Renal ultrasonography, renal computed tomography and renal biopsy revealed chronic renal failure and renal cell cancer.
CONCLUSION
We concluded that the gout and chronic renal failure in this case was caused by chronic lead exposure. However, further study is required to determine if the renal cancer was induced by lead exposure.

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Original Article
A Study on the Association between Blood Lead Levels and Habitual Tobacco and Alcohol Use in Koreans with No Occupational Lead Exposure
Ji Ung Park, Se Won Oh, Seung Hyun Kim, Yang Hyun Kim, Ryoung Jin Park, Jai Dong Moon
Korean Journal of Occupational and Environmental Medicine 2008;20(3):165-173.   Published online September 30, 2008
DOI: https://doi.org/10.35371/kjoem.2008.20.3.165
AbstractAbstract PDF
OBJECTIVES
The purpose of this study was to estimate the normal blood lead (PbB) levels in a group of Korean subjects and to evaluate the association between PbB levels and habitual tobacco and alcohol use.
METHODS
We recruited 532 adults (320 males and 212 females) with no history of occupational exposure to lead, as study subjects.
RESULTS
PbB levels ranged between 0.43 microgram/dl and 9.45 microgram/dl. The adjusted geometric mean PbB in men was 3.19 microgram/dl, which was significantly higher than that seen in women: 2.66 microgram/dl (P=0.017). Geometric mean PbBs were not significantly different between urban and rural patients. The adjusted geometric mean PbB in smokers was 3.31 microgram/dl, which was significantly higher than that seen in nonsmokers: 2.64 microgram/dl (P=0.035). The adjusted geometric mean PbB in drinkers was 3.10 microgram/dl, which was significantly higher than that seen in non-drinkers: 2.75 microgram/dl (P=0.049).
CONCLUSIONS
The PbB levels of some Korean adults seem to be comparable to those seen in foreign countries. Our results suggest that tobacco and alcohol cessation will be helpful in decreasing the harmful effect of lead.

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  • Prenatal Exposure to Lead and Chromium is Associated with IL-13 Levels in Umbilical Cord Blood and Severity of Atopic Dermatitis: COCOA Study
    Jihyun Kim, Seonwoo Kim, Sook-young Woo, Jin-Yong Chung, Young-Seoub Hong, Se-Young Oh, Suk-Joo Choi, Soo-Young Oh, Kyung Won Kim, Youn Ho Shin, Hye-Sung Won, Kyung-Ju Lee, Soo Hyun Kim, Ja Young Kwon, Si Hyeon Lee, Soo-Jong Hong, Kangmo Ahn
    Immune Network.2019;[Epub]     CrossRef
  • Level of Blood Lead and Urine Cotinine of Residents by Area
    Yu-Jin Oh, Hyoung-Wook Kim, Yun-Jae Kim, Yoon-Deok Han, Sung-Hyeon Jung, Jong-Dae Lee, Bong-Ki Jang, Jin-Heon Lee, Bu-Soon Son
    Journal of Environmental Science International.2019; 28(3): 329.     CrossRef
  • Association of Blood Pressure with Blood Lead and Cadmium Levels in Korean Adolescents: Analysis of Data from the 2010–2016 Korean National Health and Nutrition Examination Survey
    Jaeouk Ahn, Nam-Soo Kim, Byung-Kook Lee, Jungsun Park, Yangho Kim
    Journal of Korean Medical Science.2018;[Epub]     CrossRef
  • 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
  • Health Effect and Blood Lead Concentration among Residents in Gwangyang and Yeosu
    Heejin Park, Myung-Kyu Park, Tack-Shin Kang, Geun-Bae Kim, Jong-Wha Lee, Bong-Ki Jang, Bu-Soon Son
    Korean Journal of Environmental Health Sciences.2016; 42(3): 205.     CrossRef
  • Association of Blood Pressure with Exposure to Lead and Cadmium: Analysis of Data from the 2008–2013 Korean National Health and Nutrition Examination Survey
    Byung-Kook Lee, Jaeouk Ahn, Nam-Soo Kim, Chan Boo Lee, Jungsun Park, Yangho Kim
    Biological Trace Element Research.2016; 174(1): 40.     CrossRef
  • A Case of Lead Poisoning with Drug-induced Liver Injury after Ingestion of Herbal Medicine
    Gi Jung Jeon, Jongha Park, Min Sung Kim, Jong Won Yu, Jae Hyun Park, Min Sik Kim
    The Korean Journal of Gastroenterology.2015; 65(6): 375.     CrossRef
  • Probit analysis of comparative assays on toxicities of lead chloride and lead acetate to in vitro cultured human umbilical cord blood lymphocytes
    Rajashree Patnaik, Rabindra N. Padhy
    Interdisciplinary Toxicology.2015; 8(1): 35.     CrossRef
  • Association of among alcohol consumption and blood vitamin D and lead concentrations: Based on 2010-2012 Korea national health and nutrition examination survey
    Ho-Ki An, Jae-Yong Park, Hee-Jung Yoon
    Journal of the Korea Academia-Industrial cooperation Society.2015; 16(1): 498.     CrossRef
  • Blood lead concentration and related factors in Korea from the 2008 National Survey for Environmental Pollutants in the Human Body
    Seong Wook Jeong, Chae Kwan Lee, Chun Hui Suh, Kun Hyung Kim, Byung Chul Son, Jeong Ho Kim, Jong Tae Lee, Soo Woong Lee, Yeong Beom Park, Jong Wha Lee, Seung-Do Yu, Chan Seok Moon, Dae Hwan Kim, Sang Yoon Lee
    International Journal of Hygiene and Environmental Health.2014; 217(8): 871.     CrossRef
  • Environmental Exposure to Lead (Pb) and Variations in Its Susceptibility
    Jina Kim, Youngeun Lee, Mihi Yang
    Journal of Environmental Science and Health, Part C.2014; 32(2): 159.     CrossRef
  • Blood cadmium, mercury, and lead and metabolic syndrome in South Korea: 2005–2010 Korean National Health and Nutrition Examination Survey
    Byung‐Kook Lee, Yangho Kim
    American Journal of Industrial Medicine.2013; 56(6): 682.     CrossRef
  • Monitoring Study on Exposure Levels of Environmental Pollutants in Residents of a Non-Industrial Area, Korea
    Dae-Seon Kim, Seung Chul Ahn, Jung Min Ryu, Seung Do Yu
    Korean Journal of Environmental Health Sciences.2012; 38(6): 482.     CrossRef
  • Associations of blood lead, cadmium, and mercury with estimated glomerular filtration rate in the Korean general population: Analysis of 2008–2010 Korean National Health and Nutrition Examination Survey data
    Yangho Kim, Byung-Kook Lee
    Environmental Research.2012; 118: 124.     CrossRef
  • National estimates of blood lead, cadmium, and mercury levels in the Korean general adult population
    Nam-Soo Kim, Byung-Kook Lee
    International Archives of Occupational and Environmental Health.2011; 84(1): 53.     CrossRef
  • Blood Lead Concentration and Hypertension in Korean Adults Aged 40 and Over According to KNHANES IV (2008)
    Sun-Young Kim, Duk-Hee Lee
    Korean Journal of Environmental Health Sciences.2011; 37(6): 418.     CrossRef
  • A Study of Working Environment for Automotive Painting in Auto Repair Shops and Workers' Exposure to Hazardous Chemicals
    Sang-Hyo Sim, Chun-Hwa Jeoung, Jin-Suk Lim, Hyung-Gu Lee, Yoon-Shin Kim
    Korean Journal of Environmental Health Sciences.2009; 35(3): 153.     CrossRef
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Original Article
Bone and Blood Lead Levels of Middle Aged Koreans not Occupationally Exposed to Lead
Nam Soo Kim, Sung Woo Choi, Jin Ho Kim, Jung O Ham, Hae Yoon Park, Kyu Dong Ahn, Byung Kook Lee
Korean Journal of Occupational and Environmental Medicine 2007;19(4):285-292.   Published online December 31, 2007
DOI: https://doi.org/10.35371/kjoem.2007.19.4.285
AbstractAbstract PDF
OBJECTIVES
In order to investigate the level and the association between bone lead and blood lead levels of non-occupationally, lead-exposed Koreans, the authors studied the lead biomarkers of 137 middle aged Koreans (86 males and 51 females) older than whose age were above 40 years.
METHODS
The tibia lead level was selected as the bone lead indicator of cortical bone, and the blood lead level was also measured. The tibia lead level was measured by K-shell XRF with 30-minute measurement of each subjects. The blood lead level was analyzed by AAS method.
RESULTS
The mean (SD) of the tibia lead level of the 137 study subjects was 3.49 (4.99) microgram/g, and tended to be higher. The mean (SD) of tibia lead level in male subjects (was 3.90 (4.88) microgram/g) and larger than in that of female subjects (2.80 (5.14) microgram/g), but without no statistical significance was observed. The mean (SD) of blood lead level of all total subjects was 3.70 (1.35)microgram/dl, and tended to be higher. The mean (SD) of blood lead level in male subjects (was 3.93 (1.25) microgram/dl) and larger than in that of female subjects (3.30 (1.42) microgram/dl), but without no statistical significance was observed. In multiple regression analysis of blood lead levels after adjusting for covariates, age was a significant independent variable. A weak association of age with tibia lead in female subjects was also observed in multiple regression analysis.
CONCLUSION
The mean (SD) of tibia and blood lead levels of middle aged Koreans whose ages were over 40 years old were 3.49 (4.99) microgram/g and 3.70 (1.35) microgram/dl, respectively. Age and sex were positive predictors of blood lead level in multiple regression analysis after controlling for the covariates. However, in multiple regression analysis whereas age was weakly association with tibia lead level only in female subjects in multiple regression analysis.

Citations

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  • Blood lead concentration and related factors in Korea from the 2008 National Survey for Environmental Pollutants in the Human Body
    Seong Wook Jeong, Chae Kwan Lee, Chun Hui Suh, Kun Hyung Kim, Byung Chul Son, Jeong Ho Kim, Jong Tae Lee, Soo Woong Lee, Yeong Beom Park, Jong Wha Lee, Seung-Do Yu, Chan Seok Moon, Dae Hwan Kim, Sang Yoon Lee
    International Journal of Hygiene and Environmental Health.2014; 217(8): 871.     CrossRef
  • National estimates of blood lead, cadmium, and mercury levels in the Korean general adult population
    Nam-Soo Kim, Byung-Kook Lee
    International Archives of Occupational and Environmental Health.2011; 84(1): 53.     CrossRef
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  • 2 Crossref
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Case Report
A Case of Lead Poisoning After Ingestion of Herb Pills
Se Won Oh, Hyung Jai Lee, Hong Jae Chae, Sung Kwan Lee, Jai Dong Moon, Deok Cho
Korean Journal of Occupational and Environmental Medicine 2007;19(3):231-237.   Published online September 30, 2007
DOI: https://doi.org/10.35371/kjoem.2007.19.3.231
AbstractAbstract PDF
BACKGROUND
Lead is a common environmental metal and has been used for various purposes for a long time, leading to frequent reports of lead poisoning. The concern about lead poisoning starts has been mostly focused on occupational exposure and is linked to the prevention and management of lead exposure in refining and manufacturing processes. Nowadays, however, there is growing concern about nonoccupational lead exposure by many pollutants. Especially, lead poisoning by herb medicine has commonly been observed in clinics in Southeast Asia and South Korea. This case report contains diagnosis of inpatients who suffered from lead poisoning from a herb medicine, arthritis remedy and who complained of abdominal symptoms and dizziness. The study purpose was to awaken our healthful interest in lead poisoning.
CASE
REPORT: A 53-year-old female patient complaining of abdominal pain, dizziness, and numbness of hand and foot came to our hospital due to the continuation of her anemic finding symptoms while undergoing treatment at a secondary hospital. Her past medical history was unremarkable except she had taken herb pills for about a year which were administered by herb medicine to treat arthritis. Physical examination was unremarkable except for oral ulcer finding. Hemoglobin was 8.5 g/dl, reticulocyte count was 4.10%, bilirubin was 1.3 mg/dl (direct 0.3 mg/dl), and Zinc protoporphyrin 169.12 ug/dl. In urinalysis results, WBC increased to 30~39 /HPF, While AST/ALT, BUN/Cr, PT/aPTT, and nerve conduction velocity were normal. Basophilic stippling was observed through peripheral blood smear. The blood lead level was 80.4 microgram/dl and the urine lead level continued to increase to 541 microgram/l. Analysis of the pills that the patient had been taking showed that they contained 30 mg/g lead. By oral chelation therapy with D-penicillamine four times per day for five days, the patient's hemoglobin increased to 11.8 g/dl, while blood lead level decreased to 39.2 microgram/dl, and urine level to 196 microgram/l. Although the soles of her feet remained cold, but other symptoms and anemia finding were improved considerably. However, after discontinuing D-penicillamine medication, the blood lead level increased to 41.4 microgram/dl again. The further administration of D-penicillamine for five days reduced the blood lead level to 31.5 microgram/dl. At two years after the discontinuance of D-penicillamine, the followup findings were normal; hemoglobin was 13.1 g/dl, hematocrit 39.6%, reticulocyte count 1.22%, blood lead level 13.3 microgram/dl, and urine lead level 9.17 microgram/l.
CONCLUSION
After taking herb medicine pills for one year, the patient was admitted to hospital chiefly complaining of abdominal pain, dizziness, and numbness of the hand and foot. The high blood and urine and lead levels and lead chemical analysis of the herb pills confirmed lead poisoning which was treated with D-penicillamine for five days. The follow-up result after two years indicated normal blood and urine lead levels.

Citations

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  • Sources, distribution, bioavailability, toxicity, and risk assessment of heavy metal(loid)s in complementary medicines
    Shiv Bolan, Anitha Kunhikrishnan, Balaji Seshadri, Girish Choppala, Ravi Naidu, Nanthi S. Bolan, Yong Sik Ok, Ming Zhang, Chun-Guang Li, Feng Li, Barry Noller, Mary Beth Kirkham
    Environment International.2017; 108: 103.     CrossRef
  • A Case of Lead Poisoning with Drug-induced Liver Injury after Ingestion of Herbal Medicine
    Gi Jung Jeon, Jongha Park, Min Sung Kim, Jong Won Yu, Jae Hyun Park, Min Sik Kim
    The Korean Journal of Gastroenterology.2015; 65(6): 375.     CrossRef
  • Adverse Events Associated with Metal Contamination of Traditional Chinese Medicines in Korea: A Clinical Review
    Hyunah Kim, Peter J. Hughes, Emily M. Hawes
    Yonsei Medical Journal.2014; 55(5): 1177.     CrossRef
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Original Article
The Change of Non-smoking Knowledge and Attitude of Intensive Course of Anti-smoking Leadership Training
Seon Young Lee, Kang Sook Lee, Hyun Woo Yim, Jeong Ho Chae, Dae Jin Kim, Jong Hoo Lee, Jae Hee Yu, Sook Kyoung Choi
Korean Journal of Occupational and Environmental Medicine 2007;19(3):171-178.   Published online September 30, 2007
DOI: https://doi.org/10.35371/kjoem.2007.19.3.171
AbstractAbstract PDF
OBJECTIVES
To evaluate the effectiveness of an anti-smoking readership training program on the knowledge, attitude and practice in health managers and supervisors in the workplace.
METHODS
We surveyed 482 health managers and supervisors in the workplace from April 2005 to September 2005. The questionnaire included whether or not a smoking cessation program was conducted in their workplace. We assessed before and after educations program about knowledge, attitude and practice for smoking cessation. The 10-hour education program included the benefit of quit smoking, the law for smoking restriction, cognitive therapy, stress management, nicotine addiction, replacement therapy, case study about workplace for anti-smoking policy and program.
RESULTS
For the change in the mean scores of all items in knowledge, attitude and practice were significantly increased after the intervention.
CONCLUSION
Even a short, 10-hour intervention course of anti-smoking leadership training program was effective for improving the knowledge, attitude, practice to quit smoking activity in workplace. Nevertheless, the program effectiveness would be increased by including a re-training course and website support.

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  • Research Trend Analysis of Dental Scaling Using Topic Modeling
    Kyung Hui Moon
    International Journal of Clinical Preventive Dentistry.2022; 18(1): 8.     CrossRef
  • Effect of Standardized Smoking Cessation Training Program for Healthcare Professionals on Their Knowledge
    Cheol-Min Lee, Jong-Hyuck Park, Young-Ju Kim
    Journal of the Korean Society for Research on Nicotine and Tobacco.2016; 7(1): 1.     CrossRef
  • Risk factors of musculoskeletal symptoms in university hospital nurses
    Eunkwang Ryu, Byeongjin Ye, Youngil Yi, Jungwon Kim
    Annals of Occupational and Environmental Medicine.2014;[Epub]     CrossRef
  • Work-related Musculoskeletal Diseases and Occupational Injuries in Health Care Workers
    Jung-Yeon Hong, Jung-Wan Koo
    Journal of the Korean Medical Association.2010; 53(6): 446.     CrossRef
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Original Article
Effect of Cumulative Blood Lead and Cumulative Blood ZPP as Lead Body Burden on Renal Lead Biomarkers
Gang Ho Yoon, Nam Soo Kim, Jin Ho Kim, Hwa Sung Kim, Byung Kook Lee
Korean Journal of Occupational and Environmental Medicine 2006;18(4):298-306.   Published online December 31, 2006
DOI: https://doi.org/10.35371/kjoem.2006.18.4.298
AbstractAbstract PDF
OBJECTIVE: To evaluate the possibility of cumulative blood lead and blood ZPP as surrogates of lead body burden and to investigate their association with renal function as an index of lead body burden.
METHODS
The study subjects comprised 678 lead workers with past blood lead and blood ZPP data from their employment. Cumulative blood and ZPP were calculated by accumulating the every year mean value of both indices from the new employment since 1983. To assess the cumulative data of lead workers who started their lead work before 1983, the years before 1983 were simulated with the first available data from 1983. Study variables for lead body burden were tibia bone lead and DMSA chelatable lead, whereas those for current lead biomarkers were blood lead and blood ZPP. BUN and serum creatinine were selected as clinical renal biomarkers, while NAG (N-acetyl-D-glucosamine) and RBP (Retinol binding protein) were selected as early renal biomarkers.
RESULTS
The association between cumulative blood lead and blood ZPP with tibia bone lead was statistically significant with determinant coefficients (r(2)) of 0.72 and 0.567, respectively, and their relationships were better explained by the curvilinear regression model. In multiple regression analysis of current lead biomarkers on the renal biomarkers after controlling for possible confounders (age, sex, job duration, smoking and drinking status), blood lead was associated only with log-transformed NAG, whereas blood ZPP was associated with 3 other renal biomarkers. On the other hand, in multiple regression analysis of biomarkers of lead body burden on renal biomarkers after controlling for possible confounders (age, sex, job duration, smoking and drinking status), cumulative blood ZPP and tibia bone lead were associated with all 4 renal function biomarkers, whereas cumulative blood lead and DMSA chelatable lead were associated with 3 renal biomarkers except BUN.
CONCLUSION
Cumulative blood and ZPP were demonstrated to be good surrogates of lead burden. Furthermore, the cumulative blood ZPP was confirmed to have a better association than the cumulative blood lead.

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Original Article
The Effect of ALAD and VDR Polymorphism on the Hematopoietic Biomarkers in Lead Exposed Workers
Sung Soo Lee, Nam Soo Kim, Jin Ho Kim, Yong Bae Kim, Young Hwangbo, Hwa Sung Kim, Kyu Dong Ahn, Byung Kook Lee
Korean Journal of Occupational and Environmental Medicine 2005;17(4):343-351.   Published online December 31, 2005
DOI: https://doi.org/10.35371/kjoem.2005.17.4.343
AbstractAbstract PDF
OBJECTIVES
This study was conducted with new workers who entered lead industries from 1992 to 2001 to evaluate the genetic susceptibility of ALAD (delta-aminolevulinic acid dehydratase) and VDR (vitamin D receptor) gene on health effect of lead exposure.
METHODS
Among the subjects of the database of lead industries at the Soonchunhyang University Institute of Industrial Medicine, only new workers were selected for this study. The total of eligible workers for this category was 3,540 workers, including non lead exposed workers of same lead industries. From stored blood in specimen bank of Soonchunhyang University, genotype of ALAD and VDR were measured using PCR method. Variables for this study were blood lead as an index of lead exposure, ZPP (zinc protoporphyrin in blood), urine ALA (delta-aminolevulinic acid), and hemoglobin as an index of hematopoietic effect of lead. Information on sex, job duration, and weight were collected for personal information. The data were analyzed using SAS (version 8.2) with descriptive analysis of t-test and multiple regression analysis.
RESULTS
Among 3,540 new employed study subjects during period of 1992-2001, 3,204 workers (90.5%) had ALAD genotype 1-1, while 336 workers (9.5%) had variant type of ALAD (1-2 or 2-2). For VDR genotype, 2,903 workers (89.7%) out of total tested 3,238 workers were belonged to type bb and 335 workers (10.5%) were type bB or BB. The distribution of genotype of ALAD and VDR were not different according to the job duration in male workers, but were different in female workers. The effect of ALAD and VDR genotype on blood lead were positively significant in the analysis of all cumulative data of new employed workers for 10 years. The effect of VDR genotype on blood lead were stronger than that of ALAD. While the variant ALAD gene made decrease of mean ZPP and ALA in urine after controlling for blood lead and other covariate, the variant VDR gene made increased the mean ZPP and ALA in urine in all cumulative data analysis and cross sectional analysis by job duration. For hemoglobin, ALAD and VDR genotype did not affect the mean value.
CONCLUSIONS
From the above our results, we found that ALAD and VDR genotype exerted significant effect in various way. We confirmed that the finding of a cross sectional study of protective effect of variant ALAD on the effect of blood lead on blood ZPP in our retrospective study design. It was found that VDR did not exert protective effect for lead exposure as the variant ALAD did.

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Original Article
Effect of Developmental Lead Exposure on the Expression of Hippocampal NMDA Receptor Subunit mRNA
Tae Wan Kim, In Sung Chung, Jae Hoon Bae, Dong Hoon Shin, Mi Young Lee, Joon Sik Kim
Korean Journal of Occupational and Environmental Medicine 2005;17(4):278-287.   Published online December 31, 2005
DOI: https://doi.org/10.35371/kjoem.2005.17.4.278
AbstractAbstract PDF
OBJECTIVES
The purpose of the present study was to examine the differential effects of lead (Pb) exposure on the expression of specific NMDA receptor subunit mRNAs on the hippocampal cells depending on the neuronal developmental stage.
METHODS
Expression of the NR2A and NR2B subunits of the NMDA receptors mRNA on the hippocampal neurons was measured by in situ hybridization in the control and Pb treated groups. Pb-treated and NMDA cytotoxicity was assessed by morphological examination and LDH measurements.
RESULTS
Hippocampal NR2A subunit mRNA expression was gradually increased with increasing age, and was significantly decreased after Pb exposure. The expression of NR2B subunit mRNA was not changed during development in the rat hippocampus and the developmental effect of Pb exposure on NR2B expression was minimal. These results indicate that chronic Pb exposure may decrease the levels of NR2A-containing NMDA receptors and may thereby alter normal synaptic signal transmission. Pb or NMDA-induced cytotoxicity in vitro differed significantly between the immature and the mature hippocampal cells.
CONCLUSIONS
This study demonstrates that chronic Pb exposure during brain development alters the levels of specific NMDA receptor subunit mRNA in the rat hippocampus. These results suggest that chronic Pb exposure may attenuate the precise neuronal synaptic transmission through the differential alteration of the composition of the NMDA receptor subunit on the hippocampus depending on neuronal developmental stage.

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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
AbstractAbstract 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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