Annals of Occupational and Environmental Medicine

Original Articles

Association between serum perfluoroalkyl substances concentrations and non-alcoholic fatty liver disease among Korean adults: a cross-sectional study using the National Environmental Health Survey cycle 4: Yong Tae Park, Eui Yup Chung, Chang Ho Chae, Young Hoon Lee; Ann Occup Environ Med 2024;36:e10. Published online April 8, 2024; DOI: https://doi.org/10.35371/aoem.2024.36.e10

Abstract Abstract in Korean PDF PubReader ePub

Background

Perfluoroalkyl substances (PFAS) are widely used in industry and daily life due to their useful properties. They have a long half-life, accumulate in the body, and there is evidence that they are associated with biomarkers of lipid metabolism and liver damage. This may suggest non-alcoholic fatty liver disease (NAFLD) caused by PFAS. However, since there has been no study analyzing the relationship between PFAS and NAFLD in the entire population in Korea. We sought to confirm the relationship between serum PFAS concentration and NAFLD prevalence in Korean adults using the Korean National Environmental Health Survey (KoNEHS) cycle 4.

Methods

The study was conducted on 2,529 subjects in 2018–2019 among KoNEHS participants. For the diagnosis of NAFLD, the hepatic steatosis index (HSI) was used, and the geometric mean and concentration distribution of serum PFAS were presented. Logistic regression was performed to confirm the increase in the risk of NAFLD due to changes in PFAS concentration, and the odds ratio and 95% confidence interval (CI) were calculated.

Results

In both adjusted and unadjusted models, an increased odds ratio was observed with increasing serum concentrations of total PFAS and perfluorooctane sulfonate (PFOS) in the non-obese group. In the adjusted model, the odds ratios for serum total PFAS and PFOS were 6.401 (95% CI: 1.883–21.758) and 7.018 (95% CI: 2.688–18.319).

Conclusions

In this study, a higher risk of NAFLD based on HSI was associated with serum total PFAS, PFOS in non-obese group. Further research based on radiological or histological evidence for NAFLD diagnosis and long-term prospective studies are necessary. Accordingly, it is necessary to find ways to reduce exposure to PFAS in industry and daily life.

대한민국 성인의 혈청 과불화화합물 농도와 비알코올성 지방간 질환의 연관성 : 제4기 국민환경보건 기초조사를 이용한 단면연구
목적
과불화 화합물(이하 PFAS)는 그 유용한 특성들로 인하여 산업 및 일상생활에 널리 사용되는 물질이다. 이들은 긴 반감기를 지녀 생체 내에 축적되며, 지질 대사 및 간 손상의 바이오마커들과 연관이 있다는 여러 증거들이 있다. 이는 PFAS와 비알코올성 지방간(이하 NAFLD)의 연관성을 시사할 수 있다. 그러나 국내 전체 인구를 대상으로 PFAS와 NAFLD간의 연관성을 분석한 연구는 없었기에 제4주기 국민환경보건 기초조사를 이용하여 대한민국 성인에서 혈청 PFAS의 농도와 NAFLD 유병률 간의 연관성을 확인하고자 하였다.
방법
제4주기 국민환경보건 기초조사 참여자 중 2018-2019년 대상자 2595명을 대상으로 연구를 진행하였다. NAFLD의 진단을 위해 Hepatic Steatosis Index(이하 HSI)를 사용하였으며, 혈청 PFAS의 기하평균 및 농도 분포를 제시하였다. PFAS의 농도 변화에 따른 NAFLD의 위험도 증가를 확인하기 위하여 로지스틱 회귀분석을 시행하였으며 이에 대한 교차비와 95% 신뢰구간을 산출하였다.
결과
조정되지 않은 모델 및 조정된 모델의 비만하지 않은 그룹에서 혈청 총 PFAS, PFOS의 농도 증가에 따른 교차비의 증가를 확인할 수 있었다. 조정된 모델에서 혈청 총 PFAS 및 PFOS의 교차비는 각각 6.401 (95% CI 1.883–21.758) and 7.018 (95% CI 2.688-18.319)으로 나타났다.
결론
본 연구에서 HSI에 기초한 NAFLD의 더 높은 위험은 비만하지 않은 군에서 혈청 총 PFAS 및 PFOS와 유의한 연관성을 보였다. PFAS에 의한 NAFLD 발생의 위험에 대한 영상 또는 조직 병리에 기반한 추가 연구가 필요하며, 일상 생활 및 산업 전반에 있어 PFAS에의 노출을 줄이기 위한 방법의 모색이 필요하다.

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Diabetes and male fertility disorders
Andrea Graziani, Raffaele Scafa, Giuseppe Grande, Alberto Ferlin
Molecular Aspects of Medicine.2024; 99: 101303. CrossRef

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Association between exposure to violence, job stress and depressive symptoms among gig economy workers in Korea: Min-Seok Kim, Juyeon Oh, Juho Sim, Byung-Yoon Yun, Jin-Ha Yoon; Ann Occup Environ Med 2023;35:e43. Published online October 30, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e43

Abstract Abstract in Korean PDF PubReader ePub

Background

Gig workers, also known as platform workers, are independent workers who are not employed by any particular company. The number of gig economy workers has rapidly increased worldwide in the past decade. There is a dearth of occupational health studies among gig economy workers. We aimed to investigate the association between exposure to violence and job stress in gig economy workers and depressive symptoms.

Methods

A total of 955 individuals (521 gig workers and 434 general workers) participated in this study and variables were measured through self-report questionnaires. Depressive symptoms were evaluated by the Patient Health Questionnaire-9 when the score was greater than or equal to 10 points. The odds ratio with 95% confidence interval was calculated using multivariable logistic regression adjusted for age, sex, working hours, education level, exposure to violence and job stress.

Results

19% of gig economy workers reported depressive symptoms, while only 11% of general workers reported the depressive symptoms. In association to depressive symptoms among gig economy workers, the mainly result of odds ratios for depressive symptoms were as follows: 1.81 for workers type, 3.53 for humiliating treatment, 2.65 for sexual harassment, 3.55 for less than three meals per day, 3.69 for feeling too tired to do housework after leaving work.

Conclusions

Gig economic workers are exposed to violence and job stress in the workplace more than general workers, and the proportion of workers reporting depressive symptoms is also high. These factors are associated to depressive symptoms. Furthermore, the gig workers associated between depressive symptoms and exposure to violence, job stress.

한국 긱경제 근로자에서 폭력 및 직무 스트레스 노출과 우울 증상관의 연관성
목적
긱경제 근로자 또는 플랫폼 근로자는 특정 회사에 고용되지 않은 독립적인 근로자들을 말한다. 긱경제는 그 규모가 커지고 있고, 종사하는 근로자들도 많아지고 있으나, 긱경제 노동자들의 산업 보건 연구가 부족한 실정이다. 우리는 긱경제 근로자에서 폭력 노출과 직무 스트레스에 노출되는 것이 우울 증상과 연관성이 있는지 조사하는 것을 목표로 했다.
방법
총 955명(긱 근로자 521명, 일반 근로자 434명)이 본 연구에 참여하였으며, 우울 증상은 PHQ-9(Patient Health Questionnaire-9) 점수가 10점 이상일 때로 평가하였다. 폭력 노출과 직무 스트레스는 자기보고식 설문지를 이용하여 측정하였다. 연령, 성별, 근무시간, 교육수준을 보정한 다변량 로지스틱 회귀분석을 이용하여 Odds Ratio, 95% Confidence Interval를 산출했다.
결과
긱 근로자의 19%가 우울 증상을 보고한 반면, 일반 근로자의 11%만이 우울 증상을 보고했습니다. 긱경제 근로자의 우울상과 관련하여 우울상 Odds ratio의 주요 결과는표3에서 ‘긱경제 근로자’ 1.89, ‘굴욕적 처우 경험’ 3.53, ‘성희롱 경험’ 2.65, ‘하루 세 끼 미만의 식사’ 3.55, ‘퇴근 후 집안일을 하기엔 너무 피곤함’ 3.69로 나타났다.
결론
긱경제 근로자는 일반 근로자에 비해 직장 내 폭력과 직무스트레스에 더 많이 노출되고, 우울 증상을 호소하는 근로자의 비율도 높다. 이러한 요인은 우울 증상과 관련이 있다. 더욱이, 긱경제 근로자들은 우울 증상과 폭력 노출, 직업 스트레스와 관련이 있다.

Citations

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Higher anxiety level and associated work-related factors of delivery workers in South Korea: from the 6th Korean working conditions survey
Sungjin Park, June-Hee Lee
International Archives of Occupational and Environmental Health.2024;[Epub] CrossRef
Association between precarious employment and the onset of depressive symptoms in men and women: a 13-year longitudinal analysis in Korea (2009–2022)
Seong-Uk Baek, Jong-Uk Won, Yu-Min Lee, Jin-Ha Yoon
Epidemiology and Psychiatric Sciences.2024;[Epub] CrossRef

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Environment-wide association study of elevated liver enzymes: results from the Korean National Environmental Health Survey 2018–2022: Youngchan Chi, Jong-Tae Park, Sewhan Na, Kyeongmin Kwak; Ann Occup Environ Med 2023;35:e27. Published online July 31, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e27

Abstract PDF Supplementary Material PubReader ePub: Background
Environmental exposure is characterized by low concentration, chronic, and complex exposure. Traditional epidemiological studies show limitations in reflecting these characteristics since they usually focus on a single or very limited number of exposure factors at a time. In this study, we adopted the methodology of environment-wide association study (EWAS) to figure out the association of human liver function with various environmentally hazardous substances.
Methods
We analyzed 2,961 participants from the Korean National Environmental Health Survey Cycle 4 (2018–2020). Using generalized linear model (GLM) analysis, we analyzed the association of 72 variables with 3 liver function indices (aspartate aminotransferase [AST], alanine aminotransferase [ALT], and gamma glutamyl transferase [GGT]). Finally, we visualized our results with Manhattan plot.
Results
In GLM analysis, perfluorooctanesulfonate were positively associated with ALT (odds ratio [OR]: 2.2; 95% confidence interval [CI]: 1.39–3.46; p _adjusted = 0.0147) and perfluorodecanoic acid showed positive association with GGT (OR: 2.73; 95% CI: 1.36–5.5; p _adjusted = 0.0256). Plasma mercury showed positive association with GGT (OR: 1.45; 95% CI: 1.14–1.84; p _adjusted = 0.0315). Using a plastic container while keeping food in the refrigerator was associated with elevated GGT compared to using a glass container (OR: 1.51; 95% CI: 1.16–1.95; p _adjusted = 0.0153). 2-ethyl-5-oxohexyl phthalate, showed a negative trend with all 3 indices, with AST (OR: 0.54; 95% CI: 0.39–0.73; p _adjusted = 0.00357), ALT (OR: 0.5; 95% CI: 0.34–0.75; p _adjusted = 0.036), GGT (OR: 0.55; 95% CI: 0.4–0.76; p _adjusted = 0.00697). Bisphenol S and frequent use of sunblock cream showed negative association with ALT (OR: 0.77; 95% CI: 0.66–0.89), and GGT (OR: 0.25; 95% CI: 0.11–0.55), respectively.
Conclusions
We conducted an exploratory study on environmental exposure and human liver function. By using EWAS methodology, we identified 7 factors that could have potential association with liver function.

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Special Article

Problems and suggested improvement plans for occupational health service in Korea: Dongmug Kang; Ann Occup Environ Med 2023;35:e10. Published online May 11, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e10

Abstract Abstract in Korean PDF Supplementary Material PubReader ePub

The purpose of this paper was to review the problems relating to Korea’s occupational health services and suggest ways to improve them. Korea can be classified as a welfare state type of conservative corporatism partially interwoven with liberalism. While experiencing compressed economic growth, the economic sectors of developed (excess areas) and developing (deficient areas) countries are interwoven. Therefore, it is necessary to perfect conservative corporatism along with a complementary reinforcement of liberal contents and to apply a multilayered approach focusing on complementing the deficient areas. It is essential to form a national representative indicator related to occupational health, and a strategy for selection and concentration is needed. The proposed central indicator is the occupational health coverage rate (OHCR), which is the number of workers who have applied for mandatory occupational health services under the Occupational Safety and Health Act in the numerator with the total working population in the denominator. This paper proposes ways to raise the OHCR, which is currently at the level of 25%–40%, to 70%–80%, which is the level of Japan, Germany, and France. To achieve this target, it is necessary to focus on small businesses and vulnerable workers. This is an area of market failure and requires the active input of community-oriented public resources. For access to larger workplaces, the marketability of services should be strengthened and personal intervention using digital health resources should be actively attempted. Taking a national perspective, work environment improvement committees with tripartite (labor, management, and government) participation for improvement of the working environment need to be established at the center and in the regions. Through this, prevention funds linked to industrial accident compensation and prevention could be used efficiently. A national chemical substance management system must be established to monitor the health of workers and the general public.

한국의 직업보건서비스의 문제점과 개선 방안
한국의 직업보건서비스의 문제점을 살펴보고 개선 방안을 제시하고자 하였다. 발간된 논문과 보고서 및 2022년의 산업보건환경 변화에 따른 대응방안 연구(정책포럼)1의 결과를 중심으로 조사하였다. 한국은 보수적조합주의를 근간으로 한 자유주의가 가미된 형태의 복지국가유형으로 분류할 수 있고, 압축적 경제성장을 경험하면서 선진국과 개발도상국의 영역이 섞여 있어 과잉과 결핍이 혼재되어 있다. 따라서 한국의 직업보건서비스의 발전을 위해서는 보수조합주의적 완성도를 높이면서 부수적으로 자유주의적 내용을 보완하여야 하며, 동일한 발전단계에 대한 단일한 접근법 보다는 결핍영역에 대한 보완을 중심으로 한 중층적 접근법이 필요하다. 직업보건관련 중심적 지표를 형성하고 이에 대한 선택과 집중전략이 필요하며, 중심지표로는 현재 25~40% 수준에 머물러 있는 직업보건 적용율을 독일, 프랑스, 일본 수준인 70~80% 수준으로 제고하는 것을 목표로 삼기를 제안한다. 이렇게 하기 위해서는 소규모 사업장과 취약한 노동자에 대해 집중하여야 하며, 이 영역은 시장실패영역으로서 지역중심의 공공자원의 적극적 투입이 필요한데, 전국 보건소 숫자인 256개 정도의 지역에 지역 직업보건 지원센터를 건립할 것을 제안한다. 중규모 이상의 사업장에 대한 접근으로는 서비스의 수요에 기반한 시장성을 강화하고 디지털헬스를 이용한 개인영역의 중재를 적극 시도하여야 한다. 전국적차원에서 사업장 작업환경개선과 중재를 위한 노사정이 참여하는 작업환경개선위원회를 중앙과 지역에 설치하고, 이를 통해 산재보상과 예방을 연계한 예방기금을 효율적으로 사용하도록 한다. 국가 차원의 화학물질 관리체계를 구축하고, 근로자와 일반국민의 건강을 모니터링할 수 있어야 한다

Citations

Citations to this article as recorded by

Precarious employment and the onset of depressive symptoms and problematic alcohol use in middle-aged or older workers: A Korean longitudinal study (2006–2022)
Seong-Uk Baek, Yu-Min Lee, Jong-Uk Won, Jin-Ha Yoon
Social Science & Medicine.2024; 357: 117170. CrossRef
Association of precarious employment with depressive symptoms and suicidal ideation among female workers: Findings from a nationwide longitudinal study in Korea
Seong-Uk Baek, Yu-Min Lee, Jin-Ha Yoon
Journal of Affective Disorders.2024; 351: 931. CrossRef
Association between precarious employment and the onset of depressive symptoms in men and women: a 13-year longitudinal analysis in Korea (2009–2022)
Seong-Uk Baek, Jong-Uk Won, Yu-Min Lee, Jin-Ha Yoon
Epidemiology and Psychiatric Sciences.2024;[Epub] CrossRef
Multidimensional typologies of precarious employment and their relationships with mental well-being in Korean wageworkers: A latent class analysis based on the Korean Working Conditions Survey (2020–2021)
Seong-Uk Baek, Jong-Uk Won, Jin-Ha Yoon
Preventive Medicine.2023; 177: 107787. CrossRef

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Original Articles

Correlation between shift work and non-alcoholic fatty liver disease among male workers in the steel manufacturing company of Korea: a cross-sectional study: Kiseok Kim, Yong-Jin Lee, Soon-Chan Kwon, Young-Sun Min, Hyun Kyo Lee, Gwangin Baek, Sang Hyeon Kim, Eun-Chul Jang; Ann Occup Environ Med 2022;34:e33. Published online November 2, 2022; DOI: https://doi.org/10.35371/aoem.2022.34.e33

Abstract Abstract in Korean PDF PubReader ePub

Background

Circadian rhythm disturbance caused by shift work has adverse effects on the metabolic homeostasis of the liver. Disruption of the metabolic homeostasis of the liver causes fat accumulation in the liver. The aim of this study was to investigate the correlation between shift work and non-alcoholic fatty liver disease (NAFLD) among male workers in the steel manufacturing industry of Korea.

Methods

Based on medical examination data collected in June 2020, 2,511 male subjects from one steel manufacturing company in Korea were selected in total. NAFLD was evaluated using abdominal ultrasound, which was performed by two experienced radiologists. The multinomial logistic regression analysis was performed by adjusting for age, physical activity, smoking history, alcohol consumption, body mass index, waist circumference, blood pressure, blood glucose, lipidemia, liver function test, employment duration, and hepatotoxic materials exposure status.

Results

Compared to daytime workers, the odds ratio (OR) of moderate-severe NAFLD in shift workers was 1.449 (95% confidence interval [CI], 1.028–2.043). Compared to daytime workers, the ORs of moderate-severe NAFLD were significantly higher for the group that engaged in total shift work for more than 20 years (OR, 2.285; 95% CI, 1.051–4.970), the group that was not allowed to sleep during night shift work (OR, 1.463; 95% CI, 1.030–2.078), and the group that consumed food during night shift work (OR, 1.580; 95% CI, 1.093–2.284).

Conclusions

There was a correlation between shift work and moderate-severe NAFLD in male steel manufacturing workers. There will be a need for more research related to the correlation of shift work with steatohepatitis and cirrhosis in the future.

한국 철강 제조업 남성 근로자의 교대근무와 비알코올성 지방간 질환의 상관관계 연구 : 단면연구.
목적
교대근무로 인한 일주기 리듬 교란은 간의 신진대사 항상성에 부정적인 영향을 미친다. 간의 신진대사 항상성 교란은 간에 지방 축적을 일으킨다. 본 연구의 목적은 한국 철강 제조업 남성 근로자의 교대근무와 비알코올성 지방간 질환의 상관관계를 조사하는 것이다.
방법
2020년 6월 수집한 건강검진 자료를 바탕으로 국내 1개 철강 제조업 사업장에서 총 2,511명의 대상자를 선정하였다. 비알코올성 지방간은 두 명의 숙련된 방사선사가 수행한 복부 초음파를 기준으로 평가되었다. 연령, 신체활동, 흡연력, 알코올 소비량, 체질량 지수, 허리둘레, 혈압, 혈당, 지질혈증, 간 기능 검사, 근무 기간 및 간 독성 물질 노출 상태에 대한 보정을 시행한 다항 로지스틱 회귀분석을 실시하였다.
결과
주간 근로자 대비 교대 근무자의 중등도-고도 비알코올성 지방간의 오즈 비는 1.499 (95% 신뢰구간: 1.028-2.043)이었다. 총 교대근무 종사 기간 20년 이상인 군, 야간교대근무 중 수면이 불가능한 군, 그리고 야간교대근무 중 음식 섭취를 하는 군에서 주간 근로자 대비 통계적으로 유의미하게 큰 중등도-고도 비알코올성 지방간의 오즈 비를 보였다.
결론
교대근무는 한국 철강 제조업에 종사하는 남성 근로자의 중등도-고도 비알코올성 지방간과 상관관계가 있다. 앞으로 교대근무와 지방간염, 간경변과의 상관관계와 관련된 추가 연구가 필요할 것이다.

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Dipali K Chatur, Saroj K Pati, Jayshri R Ghate, Rachita Nanda, Meenakshi Sinha, Kalpana Kodapi
Cureus.2024;[Epub] CrossRef
Shift work promotes adipogenesis via cortisol-dependent downregulation of EGR3-HDAC6 pathway
Xinxing Wan, Linghao Wang, Md Asaduzzaman Khan, Lin Peng, Keke Zhang, Xiaoying Sun, Xuan Yi, Zhouqi Wang, Ke Chen
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Inter-individual variations in circadian misalignment-induced NAFLD pathophysiology in mice
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Effects of Oat β-Glucan and Inulin on Alleviation of Nonalcoholic Steatohepatitis Aggravated by Circadian Disruption in C57BL/6J Mice
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Association between long working hours and liver enzymes: evidence from the Korea National Health and Nutrition Examination Survey, 2007–2017: Ji-Hun Song, Hyoung-Ryoul Kim, Dong-Wook Lee, Jeehee Min, Yu Min Lee, Mo-Yeol Kang; Ann Occup Environ Med 2022;34:e9. Published online May 13, 2022; DOI: https://doi.org/10.35371/aoem.2022.34.e9

Abstract Abstract in Korean PDF Supplementary Material PubReader ePub

Background

Long working hours causes several health risks, but little is known about its effects on the liver. This study aimed to examine the correlation between working hours and abnormal liver enzyme levels.

Methods

We used data from the Korea National Health and Nutrition Examination Survey IV–VII. For the final 15,316 study participant, the information on working hours was obtained through questionnaires, and liver enzyme levels, consisting of serum levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT), through blood tests. The relationship between weekly working hours and abnormal levels of liver enzymes was analyzed using multiple logistic regression, and a trend test was also conducted.

Results

In male, working ≥ 61 hours per week was significantly associated with elevated AST and ALT levels compared with working 35–52 hours per week. Even after adjusting for covariates, the odds ratios (ORs) of abnormal AST and ALT increased by 1.51 (95% confidence interval: 1.20–2.05) and 1.25 (1.03–1.52), respectively, and a dose-response relationship was observed. This association was more prominent among the high-risk group, such as those aged > 40 years, obese individuals, worker on non-standard work schedule, pink-collar workers, or temporary worker. No correlation was observed in female.

Conclusions

Long working hours are associated with abnormal liver function test results in male. Strict adherence to statutory working hours is necessary to protect workers’ liver health.

장시간 노동과 간기능 이상의 상관성: 2007-2017 국민건강영양조사 자료를 이용하여
목적
장시간 노동은 여러 가지 건강상의 위험을 초래하지만 간에 미치는 영향에 대해서는 아직까지 알려진 바가 거의 없다. 본 연구는 근로시간과 간기능 이상과의 상관관계를 알아보는 것을 목적으로 하였다.
방법
본 연구를 위해 4-7차 국민건강영양조사 자료를 사용하였다. 최종 연구참여자 15,316명을 대상으로 설문지를 통해 근무시간 정보를 얻었고 혈액검사를 통해 혈청 아스파르테이트아미노트랜스퍼라제(AST)와 알라닌아미노트랜스퍼라제(ALT)로 구성된 간효소치 정보를 얻었다. 다중 로지스틱 회귀 분석을 통해 주당 근무 시간과 간효소 이상 수치와의 관계를 분석하고 추세 검정도 함께 진행하였다.
결과
남성의 경우 주당 35-52시간 일하는 것에 비해, 법정 최대 근로시간을 초과한 주당 53-60시간을 근무하여도 AST 및 ALT 수치의 유의한 상승이 관찰되진 않았으나, 주당 60시간을 초과하여 일하는 경우 유의하게 상승하였다. 공변량을 보정한 후에도 AST와 ALT이상수치의 교차비(ORs)가 각각 1.51 (95% 신뢰 구간: 1.20-2.05) 및 1.25 (1.03-1.52) 증가하여 용량-반응 관계가 관찰되었다. 이 연관성은 40세 이상, 비만인, 비정규시간 근로자, 핑크 칼라 노동자, 임시직 노동자와 같은 고위험군에서 더 두드러졌다. 여성에서는 상관관계가 관찰되지 않았다.
결론
남성의 경우 장시간 노동은 간기능 검사 결과 이상과 관련이 있다. 근로자의 간 건강을 보호하기 위해서는 법정 근로시간을 철저히 준수하는 것이 필요하다.

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S.-U. Baek, J.-U. Won, Y.-M. Lee, J.-H. Yoon
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Research Article

Relationship between shift work and liver enzymes: a cross-sectional study based on the Korea National Health and Examination Survey (2007–2015): Hyeongyeong Choi, Hyun-Jeong Oh, Ji-Su Shin, MyeongSeob Lim, Sung-Kyung Kim, Hee-Tae Kang, Sung-Soo Oh, Sang-Baek Koh; Ann Occup Environ Med 2019;31:e15. Published online July 31, 2019; DOI: https://doi.org/10.35371/aoem.2019.31.e15

Abstract PDF PubReader ePub

Background

Shift work has well-known adverse effects on health. However, few studies have investigated the relationship between shift work and hepatic disorders. This study aimed to evaluate the association between shift work and abnormal level of liver enzymes.

Methods

The aggregated data from the 2007–2009, 2010–2012, and 2013–2015 cycles of the Korea National Health and Nutrition Examination Survey was used for this study. The χ² test and multiple logistic regression analysis were used to assess relationship between shift work and abnormal level of liver enzymes stratified by gender.

Results

The odds ratio (OR) of abnormal serum level of alanine aminotransferase (abnormal ALT) in female shift workers was higher with 1.31 (95% confidence interval: 1.00–1.71) compared with day workers after adjusting for covariates. After dividing into subgroups of the shift work pattern, the ORs of abnormal liver enzymes for each pattern compared with day work were not significantly higher.

Conclusions

This study provides limited support for the hypothesis that shift work is related to liver enzyme abnormalities, but offers some evidence in favor of the idea that shift work affects female workers more than males on abnormal ALT. Further studies are needed to define the relationship between shift work and abnormal liver enzymes to be carried out as well as the gender difference in the association.

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Ahmad Soltanzadeh, Meysam Eyvazlou, Mostafa Mohammad-ghasemi, Mansoureh Sadeghi-Yarandi, Monireh Rahimkhani, Neda Ghasemi, Mojdeh Bonyadi, Mohsen Sadeghi-Yarandi
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Consequences of Shift Work and Night Work: A Literature Review
Isabel Silva, Daniela Costa
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Shift work and nonalcoholic fatty liver disease incidence among Chinese rail workers: a 4-year longitudinal cohort study
Jiahui Xu, Shu Ni, Yuming Wang, Mengfan Yan, Xueli Yang, Han Ge, Zizhuo Jia, Ze Yang, Anqi Shan, Huanyu Liu, Nai-jun Tang
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Kiseok Kim, Yong-Jin Lee, Soon-Chan Kwon, Young-Sun Min, Hyun Kyo Lee, Gwangin Baek, Sang Hyeon Kim, Eun-Chul Jang
Annals of Occupational and Environmental Medicine.2022;[Epub] CrossRef
Association between long working hours and liver enzymes: evidence from the Korea National Health and Nutrition Examination Survey, 2007–2017
Ji-Hun Song, Hyoung-Ryoul Kim, Dong-Wook Lee, Jeehee Min, Yu Min Lee, Mo-Yeol Kang
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Factors associated with elevated alanine aminotransferase in employees of a German chemical company: results of a large cross-sectional study
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Kibeom Kim, Seongyong Yoon, Jinseok Kim, Kuck-Hyun Woo, Seong-yong Cho, Ha-ram Jo
Annals of Occupational and Environmental Medicine.2021;[Epub] CrossRef

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Case Reports

HCFC-123-induced toxic hepatitis and death at a Korean fire extinguisher manufacturing facility: a case series: Mu Young Shin, Jong Soo Park, Hae Dong Park, Jihye Lee; Ann Occup Environ Med 2018;30:20. Published online March 28, 2018; DOI: https://doi.org/10.1186/s40557-018-0231-2

Abstract PDF PubReader ePub

Background

Exposure to sustained high concentrations of HCFC-123 is known to be hepatotoxic. We report two simultaneous cases of toxic hepatitis related to exposure to 2,2-dichloro-1,1,1-trifluoroethane (HCFC-123), a common refrigerant, at a Korean fire extinguisher manufacturing facility.

Case presentation

Patients A and B were men aged 21 and 22 years, respectively, with no notable medical histories. They had recently started working for a manufacturer of fire extinguishers. During the third week of their employment, they visited the emergency center of a general hospital due to fever, lack of appetite, and general weakness. At the time of their visit, they were suspected as having hepatitis due to elevated aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), and total bilirubin levels and were hospitalized. However, as their condition did not improve, they were moved to a tertiary general hospital. After conservative treatment, one patient improved but the other died from acute hepatic failure. Assessments of the work environment showed that the short-term exposure levels of HCFC-123 for valve assembly processes were as high as 193.4 ppm. A transjugular liver biopsy was performed in patient A; the results indicated drug/toxin-induced liver injury (DILI). Given the lack of a medical history and the occupational exposure to high levels of HCFC-123, a hepatotoxic agent, the toxic hepatitis of the workers was likely related to HCFC-123 exposure.

Conclusions

Work environment assessments have not included this agent. To the best of our knowledge, we are the first to report a case of death related to HCFC-123-induced liver damage. Our findings suggest that exposure standards and limits for HCFC-123 must be developed in Korea; work environments will have to be improved based on such standards.

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A case report of toxic hepatitis caused by chloroform in automotive parts manufacturer coating process
Jong Hyun Hwang, Jung Il Kim
Annals of Occupational and Environmental Medicine.2022;[Epub] CrossRef

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Acute liver injury in two workers exposed to chloroform in cleanrooms: a case report: Young Joong Kang, Jungho Ahn, Yang-In Hwang; Ann Occup Environ Med 2014;26:49. Published online November 4, 2014; DOI: https://doi.org/10.1186/s40557-014-0049-5

Abstract PDF PubReader ePub

We report 2 cases of hepatotoxicity in cleanroom workers due to high retained chloroform air concentrations. The women, aged 34 and 41 years, who had been working in a medical endoscopic device manufacturer as cleanroom workers for approximately 40–45 days suffered severe liver damage. Two measured time-weighted averages of the chloroform concentration in the air in the cleanroom were 82.74 and 64.24 ppm, which are more than 6 times the legal occupational exposure limit in Korea. Only 7% of the cleanroom air was newly introduced from outside. The clinical courses of these cases and workplace inspection, led us to conclude that both cases of hepatotoxicity were caused by chloroform exposure.

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Yosuke Suehiro, Takuro Uchida, Masataka Tsuge, Eisuke Murakami, Daiki Miki, Tomokazu Kawaoka, Michio Imamura, Hiroshi Aikata, Koji Arihiro, Shiro Oka
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Original Articles

An Assessment of the Needs and the Affecting Factors for Small Scale Enterprise Worker's Health Centers: Ki Chul Nam, Ji Su Park, Jae Woo Koh, Jong Seo Kim, Jong Tae Park, Hae Joon Kim, Jin Joo Chung, Jeong Youn Kim, Dae Sung Kim, Jung Sun Park; Korean Journal of Occupational and Environmental Medicine 2011;23(4):407-419. Published online December 31, 2011; DOI: https://doi.org/10.35371/kjoem.2011.23.4.407

Abstract PDF

OBJECTIVES
The aim of this paper is to assess the needs and roles of the Worker's Health Centers employed by small scale enterprises by investigating the requested services made to this type of Worker's Health Center.
METHODS
The population of this research was taken from 1,145 business owners or managers of manufacturing companies employing less than fifty people in six industrial estates. Stratified sampling was used. Individual interviews were performed to assess the conditions and needs of these enterprises using a structured questionnaire and professional interviewers.
RESULTS
According to the questionnaire survey, 941(82.2%) of the enterprises wish to use a Worker's Health Center. 946(83.3%) of the enterprises preferred an 'Expert visit to the enterprise or mixed' for the Delivery type. 486(42.4%) of the enterprises preferred the 'in the center of industrial complex' for the location of the Worker's Health Center. 789(69.1%) of the enterprises preferred 6-10 PM for the available open hours. A multiple regression analysis revealed a significantly positive association regarding the intention of using a Worker's Health Center and the Gyeonggi-Banwol (OR 2.49) or Gwangju-Hanam(OR 4.24) for the region. Compared to enterprises employing 1-4 worker, 30-49 worker enterprises show a 3.33 fold preference (95% CI 1.80~6.12) for the use of a Worker's Health Center.
CONCLUSIONS
Generally, the intention regarding the use of a Worker's Health Center was high, Considering the time and spatial limits inherentin small scale enterprises, the 'expert visit to the enterprise' paradigm is important. It should be noted that when providing the service, a customized approach is necessary, determined by size, region, industry, and scale of the business, through the assessment of the small scale enterprises and the nature of the work environment when designing a Worker's Health Center operation.

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Hyun Sang Park, Sungmoon Jeong, Ho-young Chung, Jae Young Soh, Young Ho Hyun, Seong Hwan Bang, Hwa Sun Kim
International Journal of Medical Informatics.2022; 166: 104844. CrossRef
Factors Influencing Acceptance of Personal Health Record Apps for Workplace Health Promotion: Cross-Sectional Questionnaire Study
Hyun Sang Park, Kwang Il Kim, Jae Young Soh, Young Ho Hyun, Sae Kyun Jang, Sol Lee, Ga Young Hwang, Hwa Sun Kim
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Effects of health and safety problem recognition on small business facility investment
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The Relationship between Job Stress and Liver Dysfunction among Male White-Collar Workers: Jung Yeon Hong, Hyoung Ryoul Kim, Bo Ram Lee, Yong Kyu Kim, Jung Wan Koo, Chung Yill Park; Korean Journal of Occupational and Environmental Medicine 2009;21(2):165-173. Published online June 30, 2009; DOI: https://doi.org/10.35371/kjoem.2009.21.2.165

Abstract PDF

OBJECTIVES
We wanted to investigate the relationship between job stress and liver dysfunction in Korean male white collar workers.
METHODS
A total of 700 male white collar workers who worked at one electronic institute and who participated in an annual surveillance program were recruited: 664(94.9%) workers were initially recruited and the data for 36 workers was excluded due to poor responses and a past history of liver disease. The questionnaire survey included the participants' general characteristics, the job-related factors, the health-related behaviors and job stress. Job stress was assessed using the Korean Occupational Stress Scale-Short Form (KOSS-SF). We merged the job stress data with the individual liver function results by conducting annual surveillance. Multiple logistic regression analysis with adjusting it for the confounding variables, including alcohol drinking and the body mass index (BMI), was used to evaluate the relationship between job stress and liver dysfunction.
RESULTS
After adjustment for the confounding variables, the proportion of liver dysfunction cases was significantly higher in the groups with a high level of job stress, as assessed by the 'job demands and total score'. After conducting a stratified analysis with considering alcohol drinking and the BMI, the prevalence odds ratio of liver dysfunction was higher in the groups with a high level of job stress, as assessed by the 'job demands and total score'.
CONCLUSIONS
The results of this study suggest that the level of job stress (and especially that assessed by the job demands and total score) is related to liver dysfunction. Thus, further preventive efforts and studies are needed to reduce job stress and address liver dysfunction.

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Yoo-Mi Chae, Jeong-bae Rhie, Sook Lee
Journal of the Korea Academia-Industrial cooperation Society.2016; 17(7): 389. CrossRef

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Incidence of Dimethylacetamide Induced Toxic Liver Injury among Workers in a Synthetic Fiber Manufacturing Company: Yong Seok Jang, Seong Yong Yoon, Seong Yong Jo, Tae Sung Choi, Jay Young Yoo, Kuck Hyun Woo, Bong Goo Ha, Sang Jae Jung, Byung Yeol Chun, Jin Seok Kim; Korean Journal of Occupational and Environmental Medicine 2006;18(3):246-254. Published online September 30, 2006; DOI: https://doi.org/10.35371/kjoem.2006.18.3.246

Abstract PDF

OBJECTIVES
The main goal of this study was to find the incidence of the dimethylacetamide (DMAc) induced toxic liver injury among workers who were exposed to DMAc for about 5 years in a synthetic fiber factory.
METHODS
In our investigation, total 1,021 workers had been exposed to DMAc from 1st February, 2000 to 30th June, 2004. Among them, 24 workers who had initial abnormal hepatic enzyme level or was viral hepatitis B carrier were excluded. Finally, 997 DMAc exposed workers were followed up for their incidence of toxic liver injury. To find out DMAc induced toxic liver injury case, we carried out regular examinations including liver enzyme tests such as AST and ALT.
RESULTS
We followed up 997 workers and among them 72 cases coincided with our case definition. Incidence density method was 6.05 per 100 person-year. and, a cumulative incidence by life table method was 0.0965 within a year. The incidence of the DMAc-induced toxic liver injury peaked at 4 to 5 in weeks after employment. There was no toxic liver injury case within second week after exposure to DMAc. Five new cases developed in 2th to 3th week, 25 cases in 4th to 5th week, 14 cases in 6th to 7th week, 12 cases in 8th to 9th week, 5 cases in 10th to 11th week, 4 cases in 12th to 13th week, 4 cases in 14th to 15th week, 1 case in 16th to 17th week, 1 case in 30th to 31th week, and there was one case in 48th to 49th week.
CONCLUSIONS
The incidence rate of toxic liver injury was considerably high during the 1st year after a worker is placed. So it is needed to take careful monitoring of hepatic enzyme level for newly exposed worker.

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A review of life table applications and an introduction of its application method
Kyoungjin Shin, Boseung Choi
Journal of the Korean Data and Information Science Society.2013; 24(6): 1159. CrossRef
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Hyoung Ryoul Kim, Tae Woo Kim
Journal of Korean Medical Science.2010; 25(Suppl): S36. CrossRef
Current status of liver diseases in Korea: Toxic and alcoholic liver diseases
Kyung-Ah Kim
The Korean Journal of Hepatology.2009; 15(Suppl 6): S29. CrossRef

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Relationship of Biological Indices of Manganese with Pallidal Index on MRI in Liver Cirrhotics: Younghee Choi, Neung Hwa Park, Jung Woo Shin, Hyo Kyung Kim, Sung Ryul Kim, Tae Heum Jeong, Ji Kang Park, Hun Lee, Cheol In Yoo, Choong Ryeol Lee, Ji Ho Lee, Yangho Kim; Korean Journal of Occupational and Environmental Medicine 2004;16(2):129-138. Published online June 30, 2004; DOI: https://doi.org/10.35371/kjoem.2004.16.2.129

Abstract PDF: OBJECTIVES
The objectives of this study were to clarify which biological manganese exposure indices reflect the pallidal signal intensities in magnetic resonance imaging (MRI) in liver cirrhotics.
METHODS
We examined whole blood, plasma, RBC and urinary manganese concentrations, as well as, brain MRI in 22 cirrhotic patients and 10 healthy controls. From MRI scans we calculated the signal intensity of the globus pallidus using the pallidal index (PI), the ratio of the globus pallidus to subcortical frontal white-matter signal intensity in axial T1-weighted MRI planes multiplied by 100. In addition, we studied the relationships between PI and other measurements.
RESULTS
The high signal intensity in the globus pallidus on T1-weighted MRI was observed in 18 (81.8%) patients. There was a significant correlation between whole blood and RBC manganese concentration, and PI on MRI. According to multiple linear regression, whole blood and RBC manganese concentration reflected PI on MRI better the other indices did.
CONCLUSIONS
Whole blood and RBC manganese concentrations could be useful as biological manganese exposure indices that reflect PI on MRI.

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Incidence and related factors of fatty liver among male workers: Jin Seok Kim, Jong Young Lee, Kuck Hyun Woo, Jay Young Ryu; Korean Journal of Occupational and Environmental Medicine 2003;15(3):310-322. Published online September 30, 2003; DOI: https://doi.org/10.35371/kjoem.2003.15.3.310

Abstract PDF

OBJECTIVE: This study was conducted to investigate the incidence rate of fatty liver and it's related factors based on a three year follow up of multiphasic health screening participants.
METHODS
671 male workers who had participated in both initial and second multiphasic health screening were selected. Initial screening was performed during the year of 1996 to 1997 and second screening was performed during the year of 1999 to 2000. Among them, four hundred and thirty workers who didn't initially have a fatty liver were selected as the final study subjects. They were classified into 2 categories according to the initial and second hepatic ultrasonographic findings; stationary normal(307, 71.4%), and fatty liver incident(123, 28.6%). The incidence rate was calculated using the incidence density method.
RESULTS
The incidence rate of fatty liver among the male workers was 9.73 per 100 person-years. The white collar workers had a higher incidence rate(10.66) than the blue collar workers(8.14). The incidence density ratio of alcohol drinking to fatty liver incidence was 1.41, and the incidence density ratio of low vegetable diet was 1.63. The incidence density ratio of obesity was 1.78 for the 100-109% obesity index group, 2.83 for the 110-119% obesity index group, 4.25 for the >or=120% obesity index group over <100%. Smoking, regular exercise, salty food preference, and taking food supplement had no significant effect on the incidence of fatty liver. The fatty liver incident group had higher initial blood pressure, GPT, gamma GTP, fasting blood sugar, HbA1c, uric acid, total cholesterol and triglyceride levels than the stationary normal group. However, there were no differences in the GOT, HDL-cholesterol or LDL-cholesterol levels. In the multiple logistic regression analysis, obesity index and serum triglyceride were found to be major factors in the incidence of fatty liver after controlling age, alcohol drinking, vegetable diet, daily coffee intake, blood pressure, HbA1c, total cholesterol, and uric acid levels.
CONCLUSION
The incidence rate of fatty liver among the male workers was 9.73 per 100 person-years. The lifestyles which gave rise to an increasing incidence of fatty liver were those involving excessive alcohol drinking, obesity, and low vegetable diet. Moreover, many cardiovascular disorder related health indices such as blood pressure, and the blood sugar, blood lipid and uric acid levels, were related to the incidence of fatty liver.

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Assessment of the Health Complaints among White-Collar and Blue-Collar Workers Using the Electronic Health Records
Veysel ALCAN, Caner DOĞRU
Karaelmas İş Sağlığı ve Güvenliği Dergisi.2023; 7(1): 1. CrossRef
Effects of Providing Health Education to Workers for the Management of Liver Disease Screened by Periodic Health Surveys
Mee-Ra Lee, Jin-Seok Kim
Korean Journal of Occupational Health Nursing.2013; 22(4): 324. CrossRef

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A study on the relationship between Alcohol Use Disorders Identification Test and liver function test in blue-collar workers: Jin Guhn Sohn, Hae Rhan Song, Kwang Young Lee, Jin Ha Kim, Ho Chan Kim; Korean Journal of Occupational and Environmental Medicine 2003;15(3):281-289. Published online September 30, 2003; DOI: https://doi.org/10.35371/kjoem.2003.15.3.281

Abstract PDF

OBJECTIVES
The purpose of this study was to investigate the usefulness of the Alcohol Use Disorders Identification Test (AUDIT) and the relationship between AUDIT score and liver function test.
METHODS
AUDIT questionnaires were distributed to 440 blue-collar workers. We compared liver function test with firstly, normal and hazardous drinking as defined by WHO, and secondly, with normal, hazardous and harmful drinking as measured by Kim et al.(1999). We also compared influencing factors on abnormal liver function.
RESULTS
By simple analysis in the normal BMI group, abnormal liver function was significantly affected by hazardous drinking (odds ratio 2.81) based on the guideline of WHO. By chi-square test for linear trend in the normal BMI group, abnormal liver function was significantly affected by hazardous drinking (odds ratio 1.23) and harmful drinking (odds ratio 2.14) based on the guideline of Kim et al.By multiple logistic regression analysis, abnormal liver function was significantly affected by AUDIT questionnaires No. 1-3 (odds ratio- high risk 2.39), age (odds ratio- thirties 1.95, forties 2.40, fifties 3.85), BMI (odds ratio- overweight 1.66, obesity 4.53), guideline by WHO (odds ratio- hazardous drinking 2.10), and guideline by Kim et al (odds ratio- harmful drinking 2.20) CONCLUSIONS: We found that the problem of alcohol drinking as measured by AUDIT was significantly associated with abnormal liver function. Therefore we suggest that AUDIT will be useful for the predictive test of abnormal liver function and screening test of hazardous and harmful drinking.

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Effects of nutrition education on nutrition-related knowledge, dietary habits, and nutrient intakes of alcoholic patients
An Na Kim, Hyeon-Sook Lim
Journal of Nutrition and Health.2014; 47(4): 277. CrossRef
Nutrient Intake Status of Korean Drinkers: Analysis of Data from Korea National Health and Nutrition Examination Survey (KNHANES), 2011
Hyung-Tae Kim, Sung-Soo Chun, Sun-Hee Joung, Mi-Eun Yun
Journal of the Korean Dietetic Association.2013; 19(4): 343. CrossRef
Psychometric Properties of the Alcohol Use Disorders Identification Test: A Korean Version
Sun S. Kim, Elsie E. Gulick, Kyoung A. Nam, Seong-Ho Kim
Archives of Psychiatric Nursing.2008; 22(4): 190. CrossRef

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A Study on Liver Function Indices in Male Lead Workers: Young Hwangbo, Yong Bae Kim, Gap Soo Lee, Sung Soo Lee, Kyu Dong Ahn, Byung Kook Lee; Korean Journal of Occupational and Environmental Medicine 2002;14(3):270-279. Published online September 30, 2002; DOI: https://doi.org/10.35371/kjoem.2002.14.3.270

Abstract PDF

OBJECTIVES
To evaluate the effects of lead on the liver function indices in male lead workers.
METHODS
The study comprised of 274 lead workers and 113 non-lead workers who were confirmed not to have HBsAg (Hepatitis B surface Antigen). Blood lead (PbB), blood zinc protoporphyrin (ZPP) and urinary delta-aminolevulinic acid (ALAU) were selected as parameters for monitoring exposure to lead while aspartate aminotransferase (SGOT), alanine aminotransferase (SGPT) and gamma-glutamyltransferase (gamma-GTP) were chosen as parameters for monitoring liver function. Demographic information, such as age, smoking and drinking histories were collected. The duration of work for the lead workers, and their BMI(body mass index), were also obtained.
RESULTS
After adjusting for possible confounders {age, BMI, work duration, smoking (pack-year) and drinking (bottles of Soju consumed per week)}, blood lead was observed to be a significant variable from the logistic regression analysis of the abnormalities of SGOT( >35 IU/L), with an odds ratio of 1.04 (95 % CI, 1.008-1.066). The amount of alcohol drunk (odds ratio 1.28: 95 % CI, 1.054-1.549) and BMI (odds ratio 1.24: 95 % CI, 1.075-1.421) were also significant variables. From the multiple linear regression analyses, blood lead was significantly, and positively, associated with SGOT (p<0.05).
CONCLUSIONS
These findings suggest that exposure to lead may have an effect on SGOT in male lead workers.

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Effect of Pork Consumption on Renal and Hematochemical Indices in Workers Occupationally Exposed to Unclean Environments
Chan-Kyu Han, Jeong-Hae Rho, Bog-Hieu Lee
Korean Journal for Food Science of Animal Resources.2008; 28(1): 91. CrossRef

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The Association of Exposure to Organic Solvents with Liver Function: Chi Young Ann, Kyung Jong Lee, Jae Bum Park, Jae Yeon Jang, Moon Jong Kim; Korean Journal of Occupational and Environmental Medicine 2001;13(1):64-74. Published online March 31, 2001; DOI: https://doi.org/10.35371/kjoem.2001.13.1.64

Abstract PDF

OBJECTIVES
This study was conducted to evaluate the association of cumulative exposure to organic solvent with liver function.
METHODS
We conducted a cross sectional study. 461 male workers who perform painting job at a shipyard and use organic solvents routinely and 125 workers of the same shipyard who never have been exposed to organic solvents were studied. All subjects who were confirmed not having HBsAg surveyed their age, BMI(body mass index), alcohol drinking and smoking history, and examined liver function test (SGOT, SGPT, gamma-GTP, Total protein, albumin, total bilirubin, direct bilirubin). The amount of cumulative exposure (CE) to mixed organic solvents were measured by biological monitoring method using their metabolites in urine.
RESULTS
The CE was observed as a significant variable with logistic regression analysis on abnormality of SGOT(>35IU/L), SGPT(>40IU/L) and gamma-GTP(>63IU/L), their odds ratio were 1.10 (95 %CI, 1.02-1.20), 1.10 (95 %CI, 1.01-1.19), and 1.10 (95 %CI, 1.01-1.19) each.
CONCLUSIONS
Therefore we suggest that the cumulative exposure to mixed organic solvents might be a significant variable on abnormal liver function indices (SGOT, SGPT,gamma-GTP) in male shipyard workers

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Liver function alterations among workers in the shoe industry due to combined low-level exposure to organic solvents
Nina Umicevic, Jelena Kotur-Stevuljevic, Vesna Paleksic, Danijela Djukic-Cosic, Evica Antonijevic Miljakovic, Aleksandra Buha Djordjevic, Marijana Curcic, Zorica Bulat, Biljana Antonijevic
Drug and Chemical Toxicology.2022; 45(4): 1907. CrossRef
Estimating Benzene Exposure Level over Time and by Industry Type through a Review of Literature on Korea
Donguk Park, Sangjun Choi, Kwonchul Ha, Hyejung Jung, Chungsik Yoon, Dong-Hee Koh, Seunghun Ryu, Soogeun Kim, Dongmug Kang, Kyemook Yoo
Safety and Health at Work.2015; 6(3): 174. CrossRef
The effect of exposure to a mixture of organic solvents on liver enzymes in an auto manufacturing plant
Saber Mohammadi, Amirhoushang Mehrparvar, Yasser Labbafinejad, Mir Saeed Attarchi
Journal of Public Health.2010; 18(6): 553. CrossRef

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Reference Values of Cadmium in Kidney and Liver in Korean: Jung Duck Park, Byung Sun Choi, Il Hoon Kweon, Yeon Pyo Hong, Im Won Chang; Korean Journal of Occupational and Environmental Medicine 2000;12(3):346-355. Published online September 30, 2000; DOI: https://doi.org/10.35371/kjoem.2000.12.3.346

Abstract PDF

OBJECTIVES
Cadmium (Cd), a toxic and non-essential metal, is recognized as a human carcinogen, which has a tendency to accumulate in the human body. The levels of Cd in renal cortex and liver are good indicators as an index of Cd exposure in the general population. In this study, we present an estimation of reference Cd levels in tissue (renal cortex and liver) and total body burden in the general population of Korea. MEDTHODS: Cd and zinc (Zn) were analyzed in renal cortex and liver from 254 autopsies (male : 188 cases, female : 66 cases) aged 0 to 87 years.
RESULTS
Geometric mean concentration of Cd was 27.4 and 3.1 ua/g wet weight in renal cortex and liver, respectively. The level of Zn in renal cortex and liver was 35.4 and 42. 6 v/g wet weight, respectively. The result suggests that kidney is the target organ for Cd accumulation. The accumulation of Cd in renal cortex was age-dependent with a biphasic pattern. The level of Cd in renal cortex increased with age up to the fifties, and then leveled off thereafter. Based on the data, the regression model for Cd accumulation in renal cortex by age is predicted by : Log KCd = 0. 2325 + 0. 0553 Age 0. 0005 Age. The highest Cd accumulation in renal cortex of Koreans was estimated at 43. 3 ua/g wet weight at 50. 8 years old. In addition, the total Cd body burden by age was estimated by the following equation: Total Cd Body Burden = -4. 5948 + l. 2278 Age - 0. 0121 Age. The highest body burden of Cd was estimated at 26. 5 mg at age 50. 7 years in the Korean general population. The positive correlation between Zn and Cd was observed in renal cortex and liver.
CONCLUSIONS
The level of Cd exposure in Korean was found to be lower than in Japanese, but same as or higher than in American and Europeans.

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Effects of Environmental Cadmium Exposure on the Liver in Korean Adults: Cross-Sectional and Longitudinal Studies
Mi-Na Seo, Sang-Yong Eom, Ji-Ae Lim, Jung-Eum Lee, Byung-Sun Choi, Ho-Jang Kwon, Young-Seoub Hong, Heon Kim, Jung-Duck Park
Archives of Environmental Contamination and Toxicology.2023; 84(2): 237. CrossRef
Association of Blood Heavy Metal Levels and Renal Function in Korean Adults
Yoonjin Park, Su-Jung Lee
International Journal of Environmental Research and Public Health.2022; 19(11): 6646. CrossRef

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Incidence of Abnormal Liver Function and Risk Factors in Male Employees: Young Ae Ha, Kyeong Dong Chung, Byung Yeol Chun; Korean Journal of Occupational and Environmental Medicine 2000;12(1):59-69. Published online March 31, 2000; DOI: https://doi.org/10.35371/kjoem.2000.12.1.59

Abstract PDF: OBJECTIVES
This study was conducted to estimate the incidence of abnormal liver function and risk factors in male employees of an industry in Ulsan City.
METHODS
Five hundreds and seventy nine male employees were selected as the study cohort and 533(92.1%) of them were followed after one year. The blood sample was collected to test for AST, ALT, gamma-GTP, total-cholesterol, fasting blood sugar and a self-administered questionnaire on life style was done. General characteristics(age, marital status, educational level), job department, exposure status for organic solvents, life style(alcohol, smoking, exercise, diet), past history of liver disease, family history of liver disease, drug intake, HBsAg, blood glucose, total-cholesterol were considered as risk factors. The result of liver function test after 1 year follow-up was treated as dependent variable. The operational definition of abnormal liver function was as follows; those who had abnormal liver functions in the two repeated tests with one month interval.
RESULTS
The annual incidence of abnormal liver function was 9.6 per 100 and age-standardized incidence was 9.5. BMI, alcohol, past history of liver disease, and meat intake were significantly related to the incidence(p<0.05). In multiple logistic regression analysis, BMI(RR=2.70, 95% CI=1.41-5.16) and alcohol(RR=1.98, 95% CI=1.08-3.60) were proved as the significant variables. By stratified analysis considering changing pattern of alcohol and BMI, the relative risk of the BMI normal-normal and alcohol intake high-high group was 2.24(95% CI=1.09-4.62) and that of the BMI obese-obese and alcohol intake high-high group was 5.66(95% CI=2.69-11.88) compared with that of BMI normal-normal and alcohol intake low-low group.
CONCLUSIONS
The age-standardized annual incidence of abnormal liver function was 9.5 per 100 in male employees. Thus, an active effort for reducing alcohol intake and controlling BMI should be done to reduce the incidence.

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Structural Modeling of Stress, Life Style and Health Status in Industrial Employees: Jang Kyun Oh; Korean Journal of Occupational and Environmental Medicine 2000;12(1):26-40. Published online March 31, 2000; DOI: https://doi.org/10.35371/kjoem.2000.12.1.26

Abstract PDF

OBJECTIVES
The purpose of this study was to examine stress affecting the life style(such as alcohol consumption, smoking, exercise, sleep disturbance, obesity), and to determine the relationships among the stress, life style and health status of in industrial employees.
METHODS
This study utilized the data from health survey and laboratory test(such as liver enzymes and lipid profiles) in 463 Industrial Employees. Psychosocial wellbeing index was used in stress scales. The data were analyzed using SAS version 6. 11, LISREL version 8. 12i and PRELIS 2, 12i. The analytic methods for study were chi-square analysis, anova and covariance structural analysis.
RESULTS
There was no significant relationship between socio-demographic characteristics and stress. The older person, married, higher education level, higher economic status and researcher group included the good life style. The higher streas groups included the more alcohol consumption, more smoking, less exercise and more sleep disturbance. There was no significant relationship between stress and health status(liver enzymes and lipid profiles) Alcohol consumption, less exercise and obesity had a significant relationship with abnormal liver enzymes. Alcohol consumption, smoking, less exercise, sleep disturbance and obesity had a significant relationship with abnormal lipid profiles. Based on the findings, the structural model of stress, life style and health status was established and then consider to socio-demographic characteristics the covariance structural analysis was used. The higher stress scores included the bad life style. The bad life style included the lower health status. Regardless stress, obesity was significant relationship with health status.
CONCLUSIONS
Control of stress was initiative clues in health-promotive behaviors. Less alcohol consumption, no smoking, regular exercise, no sleep disturbance and not obese were health-promotive behaviors. Stress influenced the life style, and then life style influenced the health status.

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Seo Young Yu, Donghyun Kim
Journal of Korea Planning Association.2023; 58(7): 39. CrossRef
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Ji-Eun Jung, Sung-Eun Kim
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Se-Yune Kim, Yeon-Ja Seo, Mi-Hyun Kim, Mi-Kyeong Choi
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The Relationship between Health Behavior and General Health Status: Based on 2011 Korea National Health and Nutrition Examination Survey
Chunhoo Cheon, So-Mi Oh, Soobin Jang, Jeong-Su Park, Sunju Park, Bo-Hyoung Jang, Yong-Cheol Shin, Seong-Gyu Ko
Osong Public Health and Research Perspectives.2014; 5(1): 28. CrossRef
Relationship Between the Psychosocial Factors and Job Stress Among Clerical Public Officers
Ho-Jin Park, Sung-Kyeong Park, Young-Chae Cho
Journal of the Korea Academia-Industrial cooperation Society.2014; 15(9): 5610. CrossRef
Factors Influencing Health Promoting Behaviour according to the Type A/B Personality of White Collar Workers
Jin Yi Choi, Young Mi Park
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Relationships Between Job Stress and Psychosocial Stress Among Nurses in a University Hospital
Sung-Kyeong Park, Jong-Oh Kim, Young-Chae Cho
Journal of the Korea Academia-Industrial cooperation Society.2011; 12(9): 3887. CrossRef
Relationship Between Job Stress and Psychosocial Stress Among Clerical Public Officers
Yoon-Jeong Jo, Young-Chae Cho
Journal of the Korea Academia-Industrial cooperation Society.2011; 12(6): 2598. CrossRef
The Relationship of Work Stress and Family Stress to the Self‐Rated Health of Women Employed in the Industrial Sector in Korea
Gwang Suk Kim, Won Jung Cho, Chung Yul Lee, Lucy N. Marion, Mi Ja Kim
Public Health Nursing.2005; 22(5): 389. CrossRef

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The Metabolism and Liver Toxicity of N, N-dimethylformamide in the Isolated Perfused Liver: Sang Baek Koh, Bong Suk Cha, Myung Guen Kang, Sang Yeol Koh, Jung Woo Lee, Sang Ok Kwon; Korean Journal of Occupational and Environmental Medicine 1997;9(2):217-229. Published online June 30, 1997; DOI: https://doi.org/10.35371/kjoem.1997.9.2.217

Abstract PDF

N, N-dimethylformamide (DMF) is a solvent which is widely used in the industrial workplace. It causes the liver damages to the chronically exposed workers and is also well known as the harzadous material to generate occupational malignancies. DMF is mainly metabolized into N-hydroxymethyl-N-methylformamide (HMMF) by the microsomal cytochrome p-450. HMMF breaks down to NMF. However, the detailed mechanism of its toxicity are unknown. In this experiment, the metabolism and the toxicity of DMF was investigated using an isolated perfumed liver model. DMF (0, 10, 25mM) were added into recirculating perfusate of the isolated perfused rat liver. Samples were collected at 0, 30, 45, 60, 75, 90 minutes from inferior vena cava. The gas-chromatography was used to analyze the metabolite of DMF, The changes in the oxygen consumption rate by DMF were monitored during perfusion. The enzyme activity (AST, ALT, LDH) in the perfusate were treasured to find out whether DMF causers hepatotoxicity. As perfusion continued, DMF concentration in the perfusate decreased, and NMF 1.16mM was detected. The oxygen consumption rate increased both at 10mM and 25mM DMF concentration. However, when SKF 525A, a known inhibitor of cytochrome p-450, had been pretreated (300uM before DMF addition, the oxygen consumption rate was significantly inhibited, indicating that cytochrome p-450 system is responsible for the conversion to NMF. With DMF addition, the activity of AST, ALT, and LDH significantly increased time dependently and dose dependently. However, the pretreatment of perfused liver with SKF 525A shoved that the release of AST, ALT and LDH was inhibited. In summary, it is found that DMF is metabolized to NMF in liver, and that cytochrome p-450 mono-oxygenase is suggested to play a role in the biotransformation of NMF. The time course of BMF toxicity in relation to NMF formation is compatible with hypothesis that the hepatotoxicity of DMF is mediated via NMF. Further study combined with in vivo experiment through the toxicological approaches is expected.

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Clinical Outcomes of Occupational Exposure to N,N-Dimethylformamide: Perspectives from Experimental Toxicology
Tae Hyun Kim, Sang Geon Kim
Safety and Health at Work.2011; 2(2): 97. CrossRef

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The Metabolism of Benzidine-based Dye Direct Black 38 in the Isolated Perfused Rat Liver: Jong Uk Won, Jaehoon Roh, Chunsung Kim, Younjung Park, Chi Nyun Kim; Korean Journal of Occupational and Environmental Medicine 1996;8(1):59-65. Published online February 29, 1996; DOI: https://doi.org/10.35371/kjoem.1996.8.1.59

Abstract PDF

Direct Black 38, a kind of benzidine-based azo dye, is widely used as a dye for fabric, leather, cotton, cellulosic material, paper, wool, silk, and so on. Benzidine-based azo dyes are proven as a mutagen and linked to bladder cancer. In 1978, Natonal Institute for Occupational Safety and Health recommended that three widely used benzidine-based dyes (Direct Black 38, Direct Blue 6, and Direct Brown 95) should be treated as carcinogens. In this experiment, metabolism of the benzidine-based dye. Direct Black 38 was examined by using an isolated liver perfusion system. To measure the metbolites of Direct Black 38,/ 8.0 micrometer, 30.5 micrometer and 63,3 micrometer of Direct Black 38 was added into the recirculating perfusate of the isolated perfused rat liver. Samples were collected at 0, 10, 20, 30, 60, 90. 120 minute. They were treated with sep-pak and methanol, and the metabohtes were detected and quantified with high performance liquid chromatography (HPLC). Residual non-reactive dye in the perfusate and liver was reduced to benzidine and then analyzed by HPLC. Detected metabolites of ?Direct^-Black 38 were benzidine, N-acetylbenzidine, and N,N'-diacetylbenzidine. The average conentration of benzidine was 0.1 micrometer and this concentration was maintained throughout the experimental period. The average concentration of N-acetylbenzidine was 0.22 micrometer and took the same pattern of benzidine. When 30.5 micrometer of Direct BIact 38 was added to the perfusate, only. N,N'-diacetylbenzidin.e increased slightly with time. From the above results we suggest that only small amount of Dirst Black 38 might be metabolized to benzidine regardless of the s, amount of the Direct Black 38. There are some possible explanations. The liver was damaged during the perparation. And the function of the perfused liver decreased rapidly because adsorbing of dye. The benzidine, acetylbenzidine and diacetylbenzidine metabolized to other metabolites were not detected in this experiment.

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Occupational Cancers with Chemical Exposure and their Prevention in Korea: A Literature Review
Kyung-Taek Rim
Asian Pacific Journal of Cancer Prevention.2013; 14(6): 3379. CrossRef

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Studies on Activities of Xenobiotic Metabolic Enzymes in Rats treated with Trichloroethylene: Ki Woong Kim, Seong Kyu Kang, Byung Soon Choi, Jong Seong Lee, Jong Sung Kim, Young Hahn Moon; Korean Journal of Occupational and Environmental Medicine 1994;6(2):323-331. Published online September 30, 1994; DOI: https://doi.org/10.35371/kjoem.1994.6.2.323

Abstract PDF: Trichloroethylene (TRI) is one of the most widely used organic solvent in many industries. It is used a degreasing agent, extract and dillution solvents. TRI is metabolized by liver microsomal cytochrome P4SO to reactive intermediates, which are considered responsible for its hepatotoxicity. Cytochrome P450 is a key enzyme in the first step of TRI metabolism resulting in chloral hydrate (CH) formation, which is a rate-limiting step in TRI metabolism. This study was perfomed to find out the change of hepatic cytochrome P450 levels and of electron transport system for P-450 dependent reaction. Intraperitoneal injections of TRI were done to the male Sprague Dawley rats(mean body wights,170+/-10g) in corn oil at the dosage of 150,300,600 mg/kg for 2 days. The results of experiments are following : 1. The contents of microsomal protein, cytochrome P450 and b(5) are tended to be decreased with increasing amount of TRI, but not significantly (p>0.05) . 2. The activity of NADPH-cytochrome P450 reductase is slowly decreased by increasing amount of TRI, but not slgnificantly (p>0.05) . On the other hand, the activity of NADH-b(5) reductase is increased with increasing amount of TRI (p<0.05) 3. The activity of 7-ethoxyresolufin 0-deethylase did not show any critical changes (P>0.05) . This result suggests that the inductive pattern of TRI may not be related to P 450IAl and P450IIB.

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Effect of Maternal Job Activity on Preterm Delivery, Low Birth Weight and Spontaneous Abortion: Yong Deok Shin, Tae Yong Lee, Young Soo Lee, Dong Bae Lee; Korean Journal of Occupational and Environmental Medicine 1994;6(1):69-84. Published online February 28, 1994; DOI: https://doi.org/10.35371/kjoem.1994.6.1.69

Abstract PDF: To investigate the effect of maternal job activity on the preterm delivery, low birth weight infant and spontaneous abortion, 1646 delivery data were analyzed from Jan. 1991 to Dec. 1992 in Chungnam University Hospital. The results obtained were as follows; 1. The percentage of subjects who had job during pregnancy was 20.3% and the variables of maternal age, education level, prepregnancy weight, maternal height, number of abortion showed significant difference in the distribution of subjects whether they had job or not. 2. There were no significant difference between the group who had job during pregnancy and those who had no job in the mean gestational period, number of spontaneous abortion, rate of preterm delivery and spontaneous abortion. However mean birth weight and rate of low birth weight showed significant difference between the groups. 3. The rate of preterm delivery of the group who had job were higher than those who had no job activity in the subgroup of 35 years or more age, prematurity history presence, 2 or more abortion history, obstetric complication presence, but there were no significant difference. The rate of low birth weight also higher in the group who had job than those who had no job activity in the same subgroup except obstetric complication presence. 4. The rate of spontaneous abortion of the group who had job were higher than those who had no job activity in the subgroup of 35 years or more age, below high school, height of 163cm or above, but there were no significant difference. 5. Rate of preterm delivery still showed better results in the group who had job than the group who had no job when adjusted for variables related, but there was no statistical significance. 6. Rate of low birth weight still showed better results with statistical significance in the group who had job than the group who had no job when adjusted for variables related. 7. Spontaneous abortion had occured less frequently in the group who had job than the group who had no job when adjusted for variables related. 8. Rate of preterm delivery and low birth weight were lower in the group of teacher, bank clerk, medical personnel, citizen servant than the group who had no job, but higher in the job of company employee, commerce. Spontaneous abortion was most frequent in group of commerce, and the group of teacher, company employee showed higher rate of abortion than the group who had no job.

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Changes in Cadmium Deposit and Histopathologic Finding of Testis, Liver and Kidney in Cadmium Exposed Rats: Young Goo Lee, Jung Duck Park, Byung Sun Choi, Yeon Pyo Hong, Im Won Chang; Korean Journal of Occupational and Environmental Medicine 1994;6(1):56-68. Published online February 28, 1994; DOI: https://doi.org/10.35371/kjoem.1994.6.1.56

Abstract PDF: To assess the changes of cadmium deposit and histopathologic finding of testis, liver and kidney, different dose of cadmium (Cd) was administered into male Sprague-Dawley rat(purchased from KIST, Korea Institute of Science and Technology) by single intravenous injection. At 12, 24, 48, 168 and 672 hours after Cd injection, tissue cadmium concentration and histopathological change were examined. Cd exposed group showed lesser weight gain than the control. Renal Cd content tended to increase in time-dependent pattern, while hepatic and testicular Cd content tended to decrease. Mean of renal Cd content to hepatic Cd content (Cd K/Cd L) also progressively increased. These results suggest that Cd might be gradually transported to kidney fro other organs. In testis and liver, degenerative changes appeared relatively in acute phase. These changes became more pronounced in testis, while less prominent in liver. In kidney, swelling of proximal tubluar cells and thickening of glomerular basement membrane appeared relatively later and these changes were progressively aggravated.

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