Annals of Occupational and Environmental Medicine

Original Article

Distribution of Lung-RADS categories according to job type in a single shipyard workers: Eui Yup Chung, Young Hoo Shin, Young Wook Kim, Jun Seok Son, Chan Woo Kim, Hyoung Ouk Park, Jun Ho Lee, Seung Hyun Park, Sung Joon Woo, Chang Ho Chae; Ann Occup Environ Med 2021;33:e22. Published online June 23, 2021; DOI: https://doi.org/10.35371/aoem.2021.33.e22

Abstract Abstract in Korean PDF PubReader ePub

Background

Recently, lung cancer screenings based on age and smoking history using low-dose computed tomography (LDCT) have begun in Korea. This study aimed to evaluate the distribution of lung imaging reporting and data system (Lung-RADS) categories in shipyard workers exposed to lung carcinogens such as nickel, chromium, and welding fumes according to job type, to provide basic data regarding indications for LDCT in shipyard workers.

Methods

This study included 6,326 workers from a single shipyard, who underwent health examinations with LDCT between January 2010 and December 2018. Data on age, smoking status and history, medical history, and job type were investigated. The participants were categorized into high-exposure, low-exposure, and non-exposure job groups based on the estimated exposure level of nickel, chromium, and welding fumes according to job type. Cox proportional hazard regression analysis was used to determine the difference between exposure groups in Lung-RADS category ≥ 3 (3, 4A, and 4B).

Results

Out of all participants, 97 (1.5%) participants were classified into Lung-RADS category ≥ 3 and 7 (0.1%) participants were confirmed as lung cancer. The positive predictive value (ratio of diagnosed lung cancer cases to Lung-RADS category ≥ 3) was 7.2%. The hazard ratio (HR) of Lung-RADS category ≥ 3 was 1.451 (95% confidence interval [CI]: 0.911–2.309) in low-exposure and 1.692 (95% CI: 1.007–2.843) in high-exposure job group. Adjusting for age and pack-years, the HR was statistically significant only in the high-exposure job group (HR: 1.689; 95% CI: 1.004–2.841).

Conclusions

Based on LDCT and Lung-RADS, among male shipyard workers, Lung-RADS category ≥ 3 were significantly higher in the high-exposure job group. Their HR tended to be > 1.0 and was statistically significant in the high-exposure job group. Additional studies should be conducted to establish more elaborate LDCT indications for occupational health examination.

일개 조선소 근로자의 직종간 Lung-RADS 비교
목적
최근 폐암의 조기 발견을 위해 저선량 흉부CT (LDCT)를 이용하기 시작했으며, 국내에서도 연령과 흡연력을 기준으로 한 국가폐암검진이 시작되었다. 니켈, 크롬, 용접흄은 조선소 근로자에서 흔히 노출될 수 있는 폐암 발암물질로 알려져 있으나, 이러한 위험 요인은 아직 폐암 검진의 기준이 되지 못하였다. 이 연구는 LDCT를 이용하여 니켈, 크롬, 용접흄에 노출되는 일개 조선소 근로자들에서 직종과 폐 CT 선별 판독 시스템 (Lung-RADS) 양상을 비교하여, 조선소 근로자의 LDCT 적응증에 대한 기초 자료를 생성하고자 하였다.
방법
2010년 1월부터 2018년 12월까지 건강검진에 참여한 경남지역 조선소 근로자 6,326명이 연구에 참여했다. 문진과 자기기입식 설문지를 이용하여 연령, 흡연력, 과거력, 직종 등을 확인하여, 직군에 따른 크롬, 니켈, 용접흄의 노출 추정 정도에 따라 고노출 직군, 저노출 직군, 비노출군으로 분류하였다. 그룹 간 Lung-RADS 3 이상인 군에 차이가 있는지 cox 비례위험 회귀분석을 시행하였다. 또한 연령과 갑년을 보정하여 그룹간 hazard ratio (HR)를 비교하였다.
결과
전체 대상자 6,326명 중 Lung-RADS 3 이상인 군은 97명, 폐암으로 확진된 대상자는 7명으로, 양성예측도 (PPV)는 7.2%이였다. Lung-RADS 3 이상에 대하여 직군에 따른 HR은 저노출 직군 1.451 (95% confidence interval [CI]: 0.911-2.309), 고노출 직군 1.692 (95% CI: 1.007-2.843)으로 나타났다. 연령과 갑년을 보정했을 시 HR은 고노출 직군에서만 유의하게 1.689 (95% CI: 1.004-2.841)로 나타났다.
결론
현행의 폐암검진 방법인 LDCT와 진단기준인 Lung-RADS를 이용하였을 때, 일개 조선소 남성 근로자 중 니켈, 크롬, 용접흄 노출 직군에서 Lung-RADS 3 이상군이 유의하게 많으며, HR이 1.0보다 높은 경향을 보이고, 고노출 직군에서는 유의한 결과를 보였다. 향후 추가적인 연구를 통해 보다 정밀한 근로자 건강검진 상 LDCT 적응증을 만들어야 한다.

Citations

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Xiaohong Lyu, Liang Dong, Zhongkai Fan, Yu Sun, Xianglin Zhang, Ning Liu, Dongdong Wang
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The effect of occupational exposure to welding fumes on trachea, bronchus and lung cancer: A systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury
Dana Loomis, Angel M. Dzhambov, Natalie C. Momen, Nicholas Chartres, Alexis Descatha, Neela Guha, Seong-Kyu Kang, Alberto Modenese, Rebecca L. Morgan, Seoyeon Ahn, Martha S. Martínez-Silveira, Siyu Zhang, Frank Pega
Environment International.2022; 170: 107565. CrossRef

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Research Article

The characteristics of asbestos-related disease claims made to the Korea Workers’ Compensation and Welfare Service (KCOMWEL) from 2011 to 2015: Yon Soo An, Hyung Doo Kim, Hyeoung Cheol Kim, Kyoung Sook Jeong, Yeon Soon Ahn; Ann Occup Environ Med 2018;30:45. Published online July 11, 2018; DOI: https://doi.org/10.1186/s40557-018-0256-6

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Background

This study aimed to enhance understanding of the epidemiologic characteristics of asbestos-related diseases, and to provide information that could inform policy-making aimed at prevention and compensation for occupational asbestos exposure, through analyzing asbestos-related occupational disease claims to Korea Workers’ Compensation and Welfare Service from 2011 to 2015.

Methods

We analyzed 113 workers who filed medical care claims or survivor benefits for asbestos exposure and occupational-related disease from 2011 to 2015. Among these claims, we selected approved workers’ compensation claims relating to malignant mesothelioma and lung cancer, and analyzed the general characteristics, exposure characteristics, pathological characteristics, and occupation and industry distribution.

Results

Malignant mesothelioma and lung cancer occurred predominantly in males at 89.7 and 94%, respectively. The mean age at the time of diagnosis for malignant mesothelioma and lung cancer was 59.5 and 59.7 years, respectively, while the latency period for malignant mesothelioma and lung cancer was 34.1 and 33.1 years, respectively. The companies involving exposed workers were most commonly situated within the Busan-Ulsan-Gyeongnam region. Histology results for lung cancer indicated adenocarcinoma as the most common form, accounting for approximately one half of all claims, followed by squamous cell carcinoma, and small cell lung cancer. The most common occupation type was construction in respect of malignant mesothelioma, and shipbuilding in respect of lung cancer.

Conclusions

Considering the long latency period of asbestos and that the peak period of asbestos use in Korea was throughout the mid-1990s, damage due to asbestos-related diseases is expected to show a continued long-term increase. Few studies providing an epidemiologic analysis of asbestos-related diseases are available; therefore, this study may provide baseline data to assist in predicting and preparing for future harm due to asbestos exposure.

Trial registration

DUIH 2018–02–004-001. Registered 28 Februrary 2018.

Citations

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Review

Silica exposure and work-relatedness evaluation for occupational cancer in Korea: Hyoung-Ryoul Kim, Boowook Kim, Bum Seak Jo, Ji-Won Lee; Ann Occup Environ Med 2018;30:4. Published online January 31, 2018; DOI: https://doi.org/10.1186/s40557-018-0216-1

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Crystalline silica has been classified as a definite carcinogen (Group 1) causing lung cancer by the International Agency for Research on Cancer (IARC). In Korea, crystalline silica has been the most common causal agent for workers to apply to the Korea Workers’ Compensation and Welfare Service (KWCWS). We used KWCWS data to evaluate workers’ crystalline silica exposure levels according to their occupations and industries, and reviewed research papers describing the dose-response relationship between cumulative exposure levels and lung cancer incidence. In addition, we reviewed lung cancer cases accepted by the KWCWS, and suggest new criteria for defining occupational cancer caused by crystalline silica in Korea. Rather than confining to miners, we propose recognizing occupational lung cancer whenever workers with pneumoconiosis develop lung cancer, regardless of their industry. Simultaneous exposure and lag time should also be considered in evaluations of work-relatedness.

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Short Communication

Environmental health centers for asbestos and their health impact surveys and activities: Dong-Mug Kang, Jong-Eun Kim, Yong-Jin Lee, Hyun-Hee Lee, Chang-yeol Lee, Seong-Jae Moon, Min-Sung Kang; Ann Occup Environ Med 2016;28:68. Published online December 1, 2016; DOI: https://doi.org/10.1186/s40557-016-0154-8

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In 2009, Korea banned the import, transport, and use of asbestos, and the Asbestos Injury Relief Act (AIRA) was promulgated in 2011. Two environmental health centers for asbestos (EHCA), including Pusan National University Yangsan Hospital (PNUYH) and SoonChunHyang University Cheonan Hospital (SCHUCH), were adapted to find environmental asbestos-related diseases (ARDs) and to support the purposes of AIRA. EHCA conducted a health impact survey (HIS) on persons who resided or reside near asbestos factories or mines. A total of 13,433 persons have taken screening examinations in PNUYH EHCA, and 623 persons (4.6%) have had secondary examinations. Of the 21,014 persons who had screening examinations in SCHUCH EHCA, 2490 persons (11.8%) had secondary examinations. Some of those who tested positive for ARDs through HISs filed applications for the asbestos victims’ medical pocketbook (AVMP). Approximately 116 and 612 persons received AVMPs as a result of PNUYH and SCHUCH examinees, respectively. EHCAs have conducted HISs, public relations, and education for asbestos victims, ordinary citizens, and physicians. As HISs are based on voluntary participation, they does not monitor high-risk groups. Active surveillance focusing on high-risk groups has been blocked by the personal information protection act. Although important work has been performed in finding environmental asbestos victims and increasing public awareness on asbestos, it is necessary to improve the current system and registration.

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Review

Indoor radon exposure and lung cancer: a review of ecological studies: Ji Young Yoon, Jung-Dong Lee, So Won Joo, Dae Ryong Kang; Ann Occup Environ Med 2016;28:15. Published online March 25, 2016; DOI: https://doi.org/10.1186/s40557-016-0098-z

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Lung cancer has high mortality and incidence rates. The leading causes of lung cancer are smoking and radon exposure. Indeed, the World Health Organization (WHO) has categorized radon as a carcinogenic substance causing lung cancer. Radon is a natural, radioactive substance; it is an inert gas that mainly exists in soil or rock. The gas decays into radioactive particles called radon progeny that can enter the human body through breathing. Upon entering the body, these radioactive elements release α-rays that affect lung tissue, causing lung cancer upon long-term exposure thereto. Epidemiological studies first outlined a high correlation between the incidence rate of lung cancer and exposure to radon progeny among miners in Europe. Thereafter, data and research on radon exposure and lung cancer incidence in homes have continued to accumulate. Many international studies have reported increases in the risk ratio of lung cancer when indoor radon concentrations inside the home are high.

Although research into indoor radon concentrations and lung cancer incidence is actively conducted throughout North America and Europe, similar research is lacking in Korea. Recently, however, studies have begun to accumulate and report important data on indoor radon concentrations across the nation. In this study, we aimed to review domestic and foreign research into indoor radon concentrations and to outline correlations between indoor radon concentrations in homes and lung cancer incidence, as reported in ecological studies thereof.

Herein, we noted large differences in radon concentrations between and within individual countries. For Korea, we observed tremendous differences in indoor radon concentrations according to region and year of study, even within the same region. In correlation analysis, lung cancer incidence was not found to be higher in areas with high indoor radon concentrations in Korea.

Through our review, we identified a need to implement a greater variety of statistical analyses in research on indoor radon concentrations and lung cancer incidence. Also, we suggest that cohort research or patient-control group research into radon exposure and lung cancer incidence that considers smoking and other factors is warranted.

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Review

Gene mutation discovery research of non-smoking lung cancer patients due to indoor radon exposure: Jung Ran Choi, Seong Yong Park, O Kyu Noh, Young Wha Koh, Dae Ryong Kang; Ann Occup Environ Med 2016;28:13. Published online March 16, 2016; DOI: https://doi.org/10.1186/s40557-016-0095-2

Abstract PDF PubReader ePub

Although the incidence and mortality for most cancers such as lung and colon are decreasing in several countries, they are increasing in several developed countries because of an unhealthy western lifestyles including smoking, physical inactivity and consumption of calorie-dense food. The incidences for lung and colon cancers in a few of these countries have already exceeded those in the United States and other western countries. Among them, lung cancer is the main cause of cancer death in worldwide. The cumulative survival rate at five years differs between 13 and 21 % in several countries. Although the most important risk factors are smoking for lung cancer, however, the increased incidence of lung cancer in never smokers(LCINS) is necessary to improve knowledge concerning other risk factors. Environmental factors and genetic susceptibility are also thought to contribute to lung cancer risk. Patients with lung adenocarcinoma who have never smoking frequently contain mutation within tyrosine kinase domain of the epidermal growth factor receptor(EGFR) gene. Also, K-ras mutations are more common in individuals with a history of smoking use and are related with resistance to EFGR-tyrosine kinase inhibitors. Recently, radon(Rn), natural and noble gas, has been recognized as second common reason of lung cancer. In this review, we aim to know whether residential radon is associated with an increased risk for developing lung cancer and regulated by several genetic polymorphisms.

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Residential radon and environmental burden of disease among Non-smokers: Juhwan Noh, Jungwoo Sohn, Jaelim Cho, Dae Ryong Kang, Sowon Joo, Changsoo Kim, Dong Chun Shin; Ann Occup Environ Med 2016;28:12. Published online March 15, 2016; DOI: https://doi.org/10.1186/s40557-016-0092-5

Abstract PDF PubReader ePub

Background

Lung cancer was the second highest absolute cancer incidence globally and the first cause of cancer mortality in 2014. Indoor radon is the second leading risk factor of lung cancer after cigarette smoking among ever smokers and the first among non-smokers. Environmental burden of disease (EBD) attributable to residential radon among non-smokers is critical for identifying threats to population health and planning health policy.

Methods

To identify and retrieve literatures describing environmental burden of lung cancer attributable to residential radon, we searched databases including Ovid-MEDLINE, -EMBASE from 1980 to 2016. Search terms included patient keywords using ‘lung’, ‘neoplasm’, exposure keywords using ‘residential’, ‘radon’, and outcomes keywords using ‘years of life lost’, ‘years of life lost due to disability’, ‘burden’. Searching through literatures identified 261 documents; further 9 documents were identified using manual searching. Two researchers independently assessed 271 abstracts eligible for inclusion at the abstract level. Full text reviews were conducted for selected publications after the first assessment. Ten studies were included in the final evaluation.

Review

Global disability‐adjusted life years (DALYs)(95 % uncertainty interval) for lung cancer were increased by 35.9 % from 23,850,000(18,835,000-29,845,000) in 1900 to 32,405,000(24,400,000-38,334,000) in 2000. DALYs attributable to residential radon were 2,114,000(273,000-4,660,000) DALYs in 2010. Lung cancer caused 34,732,900(33,042,600 ~ 36,328,100) DALYs in 2013. DALYs attributable to residential radon were 1,979,000(1,331,000-2,768,000) DALYs for in 2013. The number of attributable lung cancer cases was 70-900 and EBD for radon was 1,000-14,000 DALYs in Netherland. The years of life lost were 0.066 years among never-smokers and 0.198 years among ever-smoker population in Canada.

Conclusion

In summary, estimated global EBD attributable to residential radon was 1,979,000 DALYs for both sexes in 2013. In Netherlands, EBD for radon was 1,000–14,000 DALYs. Smoking population lost three times more years than never-smokers in Canada. There was no study estimating EBD of residential radon among never smokers in Korea and Asian country. In addition, there were a few studies reflecting the age of building, though residential radon exposure level depends on the age of building. Further EBD study reflecting Korean disability weight and the age of building is required to estimate EBD precisely.

Electronic supplementary material

The online version of this article (doi:10.1186/s40557-016-0092-5) contains supplementary material, which is available to authorized users.

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An updated review of case–control studies of lung cancer and indoor radon-Is indoor radon the risk factor for lung cancer?: Seungsoo Sheen, Keu Sung Lee, Wou Young Chung, Saeil Nam, Dae Ryong Kang; Ann Occup Environ Med 2016;28:9. Published online March 3, 2016; DOI: https://doi.org/10.1186/s40557-016-0094-3

Abstract PDF PubReader ePub

Lung cancer is a leading cause of cancer-related death in the world. Smoking is definitely the most important risk factor for lung cancer. Radon (²²²Rn) is a natural gas produced from radium (²²⁶Ra) in the decay series of uranium (²³⁸U). Radon exposure is the second most common cause of lung cancer and the first risk factor for lung cancer in never-smokers.

Case–control studies have provided epidemiological evidence of the causative relationship between indoor radon exposure and lung cancer. Twenty-four case–control study papers were found by our search strategy from the PubMed database. Among them, seven studies showed that indoor radon has a statistically significant association with lung cancer. The studies performed in radon-prone areas showed a more positive association between radon and lung cancer. Reviewed papers had inconsistent results on the dose–response relationship between indoor radon and lung cancer risk.

Further refined case–control studies will be required to evaluate the relationship between radon and lung cancer. Sufficient study sample size, proper interview methods, valid and precise indoor radon measurement, wide range of indoor radon, and appropriate control of confounders such as smoking status should be considered in further case–control studies.

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Attributable risk of lung cancer deaths due to indoor radon exposure: Si-Heon Kim, Won Ju Hwang, Jeong-Sook Cho, Dae Ryong Kang; Ann Occup Environ Med 2016;28:8. Published online February 26, 2016; DOI: https://doi.org/10.1186/s40557-016-0093-4

Abstract PDF PubReader ePub

Exposure to radon gas is the second most common cause of lung cancer after smoking. A large number of studies have reported that exposure to indoor radon, even at low concentrations, is associated with lung cancer in the general population. This paper reviewed studies from several countries to assess the attributable risk (AR) of lung cancer death due to indoor radon exposure and the effect of radon mitigation thereon. Worldwide, 3–20 % of all lung cancer deaths are likely caused by indoor radon exposure. These values tend to be higher in countries reporting high radon concentrations, which can depend on the estimation method. The estimated number of lung cancer deaths due to radon exposure in several countries varied from 150 to 40,477 annually. In general, the percent ARs were higher among never-smokers than among ever-smokers, whereas much more lung cancer deaths attributable to radon occurred among ever-smokers because of the higher rate of lung cancers among smokers. Regardless of smoking status, the proportion of lung cancer deaths induced by radon was slightly higher among females than males. However, after stratifying populations according to smoking status, the percent ARs were similar between genders. If all homes with radon above 100 Bq/m³ were effectively remediated, studies in Germany and Canada found that 302 and 1704 lung cancer deaths could be prevented each year, respectively. These estimates, however, are subject to varying degrees of uncertainty related to the weakness of the models used and a number of factors influencing indoor radon concentrations.

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Review

Review of carcinogenicity of asbestos and proposal of approval standards of an occupational cancer caused by asbestos in Korea: Sanghyuk Im, Kan-woo Youn, Donghee Shin, Myeoung-jun Lee, Sang-Jun Choi; Ann Occup Environ Med 2015;27:34. Published online December 30, 2015; DOI: https://doi.org/10.1186/s40557-015-0080-1

Abstract PDF PubReader ePub

Carcinogenicity of asbestos has been well established for decades and it has similar approval standards in most advanced countries based on a number of studies and international meetings. However, Korea has been lagging behind such international standards. In this study, we proposed the approval standards of an occupational cancer due to asbestos through intensive review on the Helsinki Criteria, post-Helsinki studies, job exposure matrix (JEM) based on the analysis of domestic reports and recognized occupational lung cancer cases in Korea. The main contents of proposed approval standards are as follows; ① In recognizing an asbestos-induced lung cancer, diagnosis of asbestosis should be based on CT. In addition, initial findings of asbestosis on CT should be considered. ② High Exposure industries and occupations to asbestos should be also taken into account in Korea ③ An expert’s determination is warranted in case of a worker who has been concurrently exposed to other carcinogens, even if the asbestos exposure duration is less than 10 years. ④ Determination of a larynx cancer due to asbestos exposure has the same approval standards with an asbestos-induced lung cancer. However, for an ovarian cancer, an expert’s judgment is necessary even if asbestosis, pleural plaque or pleural thickening and high concentration asbestos exposure are confirmed. ⑤ Cigarette smoking status or the extent should not affect determination of an occupational cancer caused by asbestos as smoking and asbestos have a synergistic effect in causing a lung cancer and they are involved in carcinogenesis in a complicated manner.

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Assessing trends and burden of occupational exposure to asbestos in the United States: a comprehensive analysis from 1990 to 2019
Xujun Li, Xin Su, Li Wei, Junhang Zhang, Donglei Shi, Zhaojun Wang
BMC Public Health.2024;[Epub] CrossRef
A case of laryngeal cancer induced by exposure to asbestos in a construction site supervisor
Sooyong Roh, Soyong Park, Gyeong Tae, Jaechul Song
Annals of Occupational and Environmental Medicine.2016;[Epub] CrossRef

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Research Article

Work-relatedness of lung cancer by smoking and histologic type in Korea: Young-Il Lee, Sang-Gil Lee, Dong-Mug Kang, Jong-Eun Kim, Young-Ki Kim, Jong-Han Leem, Hwan-Cheol Kim; Ann Occup Environ Med 2014;26:43. Published online December 1, 2014; DOI: https://doi.org/10.1186/s40557-014-0043-y

Abstract PDF PubReader ePub

Objectives

This study investigated the distribution of causative agents related to occupational lung cancer, their relationships with work, and associations between work-relatedness and the histologic type of lung cancer.

Methods

We used data from the occupational surveillance system in Korea in 2013. In addition, data from 1,404 participants diagnosed with lung cancer were collected through interviews. We included the patients’ longest-held job in the analysis. Work-relatedness was categorized as “definite,” “probable,” “possible,” “suspicious,” “none,” or “undetermined.”

Results

Among the subjects, 69.3% were men and 30.7% were women. Regarding smoking status, current smokers were the most prevalent (35.5%), followed by non-smokers (32.3%), ex-smokers (32.2%). Regarding the causative agents of lung cancer, asbestos (1.0%) and crystalline silica (0.9%) were the most common in definite work-related cases, while non-arsenical insecticide (2.8%) was the most common in probable cases followed by diesel engine exhaust (1.9%) and asbestos (1.0%). Regarding histologic type, adenocarcinoma was the most common (41.7%), followed by squamous cell carcinoma (21.2%). Among current smokers, squamous cell carcinoma was the most common among definite and probable cases (13.4%), while non-small cell lung cancer was the least common (7.1%). Among non-smokers, squamous cell carcinoma was the most common (21.4%), while the least common was adenocarcinoma (1.6%).

Conclusions

Approximately, 9.5% of all lung cancer cases in Korea are occupational-related lung cancer. Well-known substances associated with lung cancer, such as crystalline silica, asbestos, and diesel engine exhaust, are of particular concern. However, the histologic types of lung cancer related to smoking were inconsistent with previous studies when work-relatedness was taken into account. Future studies are required to clarify the incidence of occupational lung cancer in agricultural workers exposed to non-arsenical insecticides and the associations between work-relatedness and the histologic type of lung cancer.

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KL-6 in Obstructive Sleep Apnea: A Potential Biomarker of Subclinical Lung Injury
Sei Won Kim, Hwan Hee Kim, Heayon Lee, In Kyoung Kim, Sang Haak Lee, Hyeon Hui Kang
Chronobiology in Medicine.2021; 3(2): 64. CrossRef
Development of a Protein Biomarker Panel to Detect Non–Small-Cell Lung Cancer in Korea
Young Ju Jung, Evaldas Katilius, Rachel M. Ostroff, Youndong Kim, Minkyoung Seok, Sujin Lee, Seongsoo Jang, Woo Sung Kim, Chang-Min Choi
Clinical Lung Cancer.2017; 18(2): e99. CrossRef
Smoking habits and nicotine dependence of North Korean male defectors
Sei Won Kim, Jong Min Lee, Woo Ho Ban, Chan Kwon Park, Hyoung Kyu Yoon, Sang Haak Lee
The Korean Journal of Internal Medicine.2016; 31(4): 685. CrossRef

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Case Report

Two Cases of Lung Cancer in Foundry Workers: Inchul Jeong, Innshil Ryu, Boowook Kim, Inhyo Park, Jong-Uk Won, Eun-A Kim, Inah Kim, Jaehoon Roh; Ann Occup Environ Med 2013;25:16-16. Published online September 16, 2013; DOI: https://doi.org/10.1186/2052-4374-25-16

Abstract PDF PubReader ePub: Background
Iron and steel foundry workers are exposed to various toxic and carcinogenic substances including crystalline silica, polycyclic aromatic hydrocarbons, and arsenic. Studies have been conducted on lung cancer in iron and steel founding workers and the concentration of crystalline silica in foundries; however, the concentration of crystalline silica and cases of lung cancer in a single foundry has never been reported in Korea. Therefore, the authors report two cases of lung cancer and concentration of crystalline silica by the X-ray diffraction method.
Case presentation
A 55-year-old blasting and grinding worker who worked in a foundry for 33 years was diagnosed with lung cancer. Another 64-year-old forklift driver who worked in foundries for 39 years was also diagnosed with lung cancer. Shot blast operatives were exposed to the highest level of respirable quartz (0.412 mg/m³), and a forklift driver was exposed to 0.223 mg/m³.
Conclusions
The lung cancer of the two workers is very likely due to occupationally related exposure given their occupational history, the level of exposure to crystalline silica, and epidemiologic evidence. Further studies on the concentration of crystalline silica in foundries and techniques to reduce the crystalline silica concentration are required.

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Original Article

Characteristics of Occupational Lung Cancer from 1999 to 2005: Jung Wook Lim, So Young Park, Byung Soon Choi; Korean Journal of Occupational and Environmental Medicine 2010;22(3):230-239. Published online September 30, 2010; DOI: https://doi.org/10.35371/kjoem.2010.22.3.230

Abstract PDF

OBJECTIVES
The aim of this study was to investigate the characteristics of occupational lung cancer.
METHODS
We analyzed the characteristics of 53 occupational lung cancer cases among 128 lung cancer cases applied for industrial accident compensation insurance benefits and referred for the decision of work-relatedness between 1999 and 2005. Statistical analysis was conducted using the Chi-square test on 128 lung cancer cases.
RESULTS
The age of diagnosis, smoking history, and cell type of lung cancer cases were not significantly different between 53 cases of occupational lung cancer and 75 cases of non-occupational lung cancer (p>.05). Here is a list of occupational lung cancer case numbers associated with certain carcinogens were: 33(62.3%) cases with asbestos, 23(43.4%) cases with polycyclic aromatic hydro carbon (PAH), 17 cases(32.1%) with chromium VI (Oxidation state), 14 cases(26.4%) with crystalline silica, 12 cases (22.6%) with nickel compounds, 2 cases(3.8%) with radon daughters, and 1 case(1.9%) with arsenic. Eighteen cases(34.0%) of occupational lung cancer had exposures to a single carcinogen, and 35 cases (66.0%) had exposures to more than 2 carcinogens. Job types associated with occupational lung cancer cases were: 16 cases(30.2%) with maintenance, 13 cases(24.5%) with welding; 6 cases(11.3%) with grinding; 4 cases(7.5%) with foundry; 3 cases(5.7%) with driving, casting, and painting' and 14 cases (26.4%) with 'other'.
CONCLUSIONS
This study identified the characteristics of occupational lung cancer through the analysis of the age of diagnosis, smoking history, cell type, job, and carcinogen. There is no difference between occupational lung cancer and non-occupational lung cancer except exposure to the carcinogens. these results indicate that past exposure to occupational carcinogens remains an important determinant of occupational lung cancer occurrence.

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A Basic Study for Removal of Heavy Metal Elements from Wastewater using Spent Lithium-Aluminum-Silicate(LAS) Glass Ceramics
Min-Seok Go, Jei-Pil Wang
Resources Recycling.2022; 31(4): 49. CrossRef
Overview of occupational cancer in painters in Korea
Jun-Pyo Myong, Younmo Cho, Min Choi, Hyoung-Ryoul Kim
Annals of Occupational and Environmental Medicine.2018;[Epub] CrossRef
Radiologic Diagnosis of Asbestos-Related Lung Cancer
Yoon Kyung Kim, Jeung Sook Kim, Yookyung Kim
Journal of the Korean Society of Radiology.2015; 73(6): 347. CrossRef
Compensation for Occupational Cancer
Inah Kim, Eun-A Kim, Jae Young Kim
Journal of Korean Medical Science.2014; 29(Suppl): S40. CrossRef
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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Case Report

A Case-study of a Plastering and Waterproof Worker Suffering from Silicosis and Lung Cancer: Kyoo Sang Kim, Min Heui Jo, Byung kyu Kim; Korean Journal of Occupational and Environmental Medicine 2008;20(2):153-159. Published online June 30, 2008; DOI: https://doi.org/10.35371/kjoem.2008.20.2.153

Abstract PDF

OBJECTIVES
We report on a case-study of a silicosis sufferer with lung cancer, who was exposed to cement dust through plastering and waterproof work in the construction industry.
METHODS
We reviewed his personal history including employment, medical record and estimated level of carcinogenic materials in the work place in order to evaluate the possible source of his lung cancer.
RESULTS
The patient was a non-smoker and there was no family history of lung cancer. His medical record did not reveal anything of concern. He was exposed to cement dust while he had worked for 20 years as a plasterer and waterproof worker. After complaining of chest pain, he was examined and subsequently diagnosed with lung cancer (RUL, adenocarcinoma; cT4N2M1). He was treated in a hospital for 3 months before passing away. Radiological evaluation by high resolution computed tomography (HRCT) revealed micronodules with a profusion category 1 (p/p, 1/1) in the perilymphatic distribution, which indicated silicosis. Small amounts of cement dust which included silica was identified by environmental evaluation of his work place. He never worked with asbestos related material, which was confirmed by HRCT examination.
CONCLUSIONS
We concluded that the patient's silicosis with lung cancer was an occupational-caused disease due to exposure to cement dust.

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Analysis of Cost Benefit Related to Appointing a Health Care Manager in the Construction Industry
Hye-Sun Jung, Jee-Seon Yi, In-Jae Shin, Eun-Hi Choi
Korean Journal of Occupational Health Nursing.2016; 25(2): 130. CrossRef
Assessment for the Physiological Workload of Warterproof Workers
Tae-Kyung Lim, Sang-Min Park, Dong-Eun Lee
Journal of the Architectural Institute of Korea Structure & Construction.2015; 31(6): 33. CrossRef
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
Occupational Respiratory Cancer in Korea
Hye-Eun Lee, Hyoung Ryoul Kim
Journal of Korean Medical Science.2010; 25(Suppl): S94. CrossRef

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Original Article

Epidemiologic Characteristics of Occupational Lung Cancer in the Busan area: Jung Il Kim, Jin Ha Kim, Dongmug Kang, Jung Won Kim, Jong Eun Kim, Jin Hong Ahn, Chang Hoon Lee, Hyun Jae Lee, Jin Uk Kang, Jin Kun Son, Jin Kon Sul, Young Ki Kim, Kap Yeol Jung, Joon Youn Kim; Korean Journal of Occupational and Environmental Medicine 2006;18(1):53-58. Published online March 31, 2006; DOI: https://doi.org/10.35371/kjoem.2006.18.1.53

Abstract PDF

OBJECTIVES
The objectives of this study were to estimate the proportion of occupational lung cancer in the Busan area.
METHODS
Occupational physicians of four university hospitals operating an occupational disease surveillance system in the Busan area actively interviewed all of the newly diagnosed, lung cancer cases about their characteristics and occupational histories through a survey questionnaire and chart review. To evaluate and agree on the work-relativity, the cases were presented in periodic meetings.
RESULTS
A total of 301 lung cancer cases were interviewed, of which 50 (16.6%, all male, 27 probable and 23 possible) were related to occupational exposure. The exposure materials were asbestos, Cr, PAH etc. Pathologic findings included squamous cell carcinoma, adenocarcinoma and small cell carcinoma.
CONCLUSIONS
The proportion of occupational lung cancer cases above the probable level was 9% and above the possible level was 17%. To develop the public health policy and to prevent further cancer death, the meaningful data from occupational cancer surveillance systems should be collected continuously for ongoing monitoring.

Citations

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Overview of occupational cancer in painters in Korea
Jun-Pyo Myong, Younmo Cho, Min Choi, Hyoung-Ryoul Kim
Annals of Occupational and Environmental Medicine.2018;[Epub] CrossRef
Decision Tree of Occupational Lung Cancer Using Classification and Regression Analysis
Tae-Woo Kim, Dong-Hee Koh, Chung-Yill Park
Safety and Health at Work.2010; 1(2): 140. CrossRef

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Case Report

A Case of Lung Cancer Caused by Long-Term Asbestos Exposure: Dong Young Yoon, Jin Wook Kang, Hyun Jae Lee, Jung Il Kim, Ji Eun Son, Kap Yeol Jung, Joon Youn Kim, Mee Sook Roh; Korean Journal of Occupational and Environmental Medicine 2004;16(4):499-507. Published online December 31, 2004; DOI: https://doi.org/10.35371/kjoem.2004.16.4.499

Abstract PDF

OBJECTIVES
To report a case of lung cancer caused by long-term asbestos exposure in a shipyard.
METHODS
We evaluated chest X-ray, pulmonary function test, and chest CT and analyzed asbestos concentration in the lung tissue and bulk sample from the workplace. We also performed a workplace survey.
RESULTS
The patient had worked at the shipyard for 31 years. The biopsy samples were processed to determine the asbestos content in the lung tissue and bulk sample using a transmission electron microscope (TEM) equipped with an energy dispersive X-ray analyzer (EDX). The TEM-EDX analysis revealed many asbestos fibers, the majority of which were amosite. In addition, the concentration asbestos fibers in the workplace exceeded the occupational exposure limits of asbestos.
CONCLUSIONS
Our findings strongly suggest that this patient's lung cancer was related to the long-term asbestos exposure.

Citations

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Gastric and rectal cancers in workers exposed to asbestos: a case series
Byeong Ju Choi, Saerom Lee, Iu Jin Lee, Soon Woo Park, Sanggil Lee
Annals of Occupational and Environmental Medicine.2020;[Epub] CrossRef
Radiologic Diagnosis of Asbestos-Related Lung Cancer
Yoon Kyung Kim, Jeung Sook Kim, Yookyung Kim
Journal of the Korean Society of Radiology.2015; 73(6): 347. CrossRef
Comparison of cancer incidence between production and office workers at a shipyard in Korea: A retrospective cohort study from 1992 to 2005
Kyoung‐Sook Jeong, Yangho Kim, Moon‐Chan Kim, Cheol‐In Yoo
American Journal of Industrial Medicine.2011; 54(9): 719. CrossRef
Occupational Respiratory Cancer in Korea
Hye-Eun Lee, Hyoung Ryoul Kim
Journal of Korean Medical Science.2010; 25(Suppl): S94. CrossRef

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Original Article

Activity of Telomerase in Coal Worker's Autopsied Lung: Jin Suk Chung, Hae Yun Nam, Byoung Yong Ahn, Kyoung Ah Kim, Young Lim; Korean Journal of Occupational and Environmental Medicine 2002;14(4):347-352. Published online December 31, 2002; DOI: https://doi.org/10.35371/kjoem.2002.14.4.347

Abstract PDF: OBJECT: We measured the activity of telomerase in coal workers lung tissue and found a significant increase in telomerase activity compared to the control group. Pneumoconiosis has the characteristics of fibroblast proliferation and the accumulation of collagen,thus finally causing the pathologic changes,which lead to the irreversible and progressive fibrosis of the lungs. We hypothesized that this cellular proliferation causing irreversible fibrosis may induce some elongation of the life cycle in the chromosomes and lead to further cellular immortalization.
METHOD
8 postmortem(within 24 hours)pneumo-coniotic cases were examined and their telomerase activity was compared with that of the autopsied lungs of lung cancer patients and of accident victims without any respiratory diseases. Using the extracted ribo-nucleoprotein from pneumoconiotic nodules, telomeric repeat amplification assay (TRAP)was done.
RESULT
The pneumoconiotic lungs showed strong telomerase activity, similar to that of the lung cancer patients, while the control group showed no such activity.
CONCLUSION
Based on the results of this study, we found that coal dust-induced cellular proliferation affects telomerase-activity clinically.

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Original Article

Trace of Occupational History on Lung Cancer Patients: Doo Hie Kim, Ji Yeon Son, Wan Seoup Park, Sung Chul Hong, Jong Young Lee; Korean Journal of Occupational and Environmental Medicine 1995;7(2):219-229. Published online October 31, 1995; DOI: https://doi.org/10.35371/kjoem.1995.7.2.219

Abstract PDF

The relationship between occupation and risk of lung cancer was analyzed in hospital based case-control study conducted in Taegu on 168 patients with histologicatly confirmed lung cancer and age group (30-39, 40-49, etc) and sex frequency-matched 168 controls admitted into hospitals for other internal medicine problems. A self administered questionnaire was used to obtain occupation, resident environment, smoking histories and specific agent exposure histoy. The conditional logistic regression was used to estimate odds ratio for age group and sex frequency matched, after controlling for smoking status (non smoker, exsmoker, current smoker) Significant association was observed for farmer[odds ratio(OR), 1.84 , 95% confidence interval(CI), 1.16-2.94], briquette stove users(OR, 3.0 , 95% CI, 1.06-8.25), agricultural chemicals users[0R, 2.14 , 95% CI, 1.35-3.37], and welding/fume exposures[0R, 10.56 ;95% CI, 1.07~103.90]. Although there were elevated risks associated with production, home industry, transportation/storage/communication, lodgement/food worker and construction, none were statistically significant.The effect of smoking was showed significantly increased risk for exsmoker [0R, 4.50 ,95% CI, 1.99-10.16] and current smoker [OR, 3.98 , 95% Cl, 1.88-8.45] As results, although smoking is important risk of lung cancer, occupation and resident environment are showing association of lung cancer. So further evaluation is necessary for occupation risk and take preventive measures.

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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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