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2 "Lung-RADS"
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Original Article
Cooking oil fume exposure and Lung-RADS distribution among school cafeteria workers of South Korea
Minjun Kim, Yangho Kim, A Ram Kim, Woon Jung Kwon, Soyeoun Lim, Woojin Kim, Cheolin Yoo
Ann Occup Environ Med 2024;36:e2.   Published online January 31, 2024
DOI: https://doi.org/10.35371/aoem.2024.36.e2
AbstractAbstract AbstractAbstract in Korean PDFSupplementary MaterialPubReaderePub
Background

Cooking oil fumes (COFs) from cooking with hot oil may contribute to the pathogenesis of lung cancer. Since 2021, occupational lung cancer for individual cafeteria workers has been recognized in South Korea. In this study, we aimed to identify the distribution of lung-imaging reporting and data system (Lung-RADS) among cafeteria workers and to determine factors related to Lung-RADS distribution.

Methods

We included 203 female participants who underwent low-dose computed tomography (LDCT) screening at a university hospital and examined the following variables: age, smoking status, second-hand smoke, height, weight, and years of service, mask use, cooking time, heat source, and ventilation. We divided all participants into culinary and non-culinary workers. Binomial logistic regression was conducted to determine the risk factors on LDCT of Category ≥ 3, separately for the overall group and the culinary group.

Results

In this study, Lung-RADS-positive occurred in 17 (8.4%) individuals, all of whom were culinary workers. Binary logistic regression analyses were performed and no variables were found to have a significant impact on Lung-RADS results. In the subgroup analysis, the Lung-RADS-positive, and -negative groups differed only in ventilation. Binary logistic regression showed that the adjusted odds ratio (aOR) of the Lung-RADS-positive group for inappropriate ventilation at the workplace was 14.89 (95% confidence interval [CI]: 3.296–67.231) compared to appropriate ventilation as the reference, and the aOR for electric appliances at home was 4.59 (95% CI: 1.061–19.890) using liquid fuel as the reference.

Conclusions

The rate of Lung-RADS-positive was significantly higher among culinary workers who performed actual cooking tasks than among nonculinary workers. In addition, appropriate ventilation at the workplace made the LDCT results differ. More research is needed to identify factors that might influence LDCT findings among culinary workers, including those in other occupations.

한국 학교 급식소 종사자의 조리흄 노출과 Lung-RADS 분포
목적
2021년부터 한국에서는 개별 학교 급식 종사자의 폐암 산업재해가 인정되고 있다. 본 연구에서는 급식 종사자들의 Lung-imaging reporting and data system ( Lung-RADS ) 분포를 확인하고, Lung-RADS 분포와 관련된 요인을 탐색해보고자 한다.
방법
2020년도에 울산대학병원에서 저선량 CT를 촬영한 여성 참가자 중 203명을 대상으로 나이, 흡연 여부, 간접 흡연 여부, 키, 체중, 근무 년수, 마스크 착용 여부, 조리 시간, 열원, 환기방식 등의 변수를 조사하였다. 참가자를 조리직, 비조리직으로 분류하였다. 범주 3이상에 대한 영향을 확인하기 위해 이분형 로지스틱을 전체집단 조리직 집단에 나누어 실시하였다.
결과
Lung-RADS 양성은 17 (8.4%)명에게서 발생했고 모두 조리직에 해당했다. 이분형 로지스틱 회귀분석을 시행한 결과 전체집단에서 Lung-RADS 결과에 유의미한 영향을 주는 변수는 확인할 수 없었다. Subgroup 분석에서 Lung-RADS 양성, 음성군은 직장 내 환기방식에서만 차이가 있었다. 이분형 로지스틱 회귀분석 결과 직장에서 환기를 철저히 한 것을 참고치로 했을 때 부적절한 환기에 대한 Lung-RADS 양성의 오드비가 14.89이고 가정에서 액화연료 사용을 참고치로 했을 때 전기 요리기구 사용의 오드비는 4.59이였다.
결론
실제 조리업무를 시행하는 조리직의 경우 비조리직에 비해 Lung-RADS 양성 비율이 유의하게 높았다. 또한 조리실 환경에서 환기를 철저하게 하는 것이 Lung-RADS 소견에 영향을 주었다.
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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
AbstractAbstract AbstractAbstract in Korean PDFPubReaderePub
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
    BMC Medical Education.2024;[Epub]     CrossRef
  • 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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