It is widely known that carbon dioxide (CO₂) arc welding generates carbon monoxide (CO). However, to the best of our knowledge, no case reports have been published regarding CO poisoning in CO₂ arc welders. Therefore, we aimed to report a case of CO poisoning-induced encephalopathy in a CO₂ arc welder in the Republic of Korea to inform about the dangers of CO exposure among CO₂arc welders.

A 40-year-old man working as a CO₂ arc welder for 15 years visited a local hospital with a tremor, involuntary urination, and speaking gibberish, on April 9, 2019. He stated that he had intermittent headache and forgetting symptoms for the last 5 years, and had been lost on the way to work several times. On April 9, 2019, he was diagnosed with CO poisoning-induced encephalopathy through brain magnetic resonance imaging. He received hyperbaric oxygen therapy, and some of his symptoms improved. According to the exposure assessment of his work environment, he was continuously exposed to high concentrations of CO for 15 years while operating CO₂ arc welding machines.

After evaluating the patient's work environment and evaluating his medical history, we concluded that his encephalopathy was caused by CO exposure during CO₂ arc welding. Thus CO₂ arc welders must be aware of the risk of CO poisoning and strive to avoid CO exposure.

Antimony is used in catalysts, pesticides, brake systems, pharmaceuticals, and synthetic fire retardants in the plastic, paint, and rubber industries. Accumulation of trivalent antimony compounds in the body can cause cardiotoxic effects and increase the risk of electrocardiogram (ECG) abnormalities and sudden death. Antimony exposure can result in action potential prolongation, causing a cardiac repolarization delay, which appears as QTc prolongation and T-wave abnormalities on the ECG. There are no studies on antimony-associated cardiac toxicity in Korea.

Accordingly, the present study reports cases of ECG abnormalities in workers handling antimony trisulfide at a company located in the Gyeongsangbuk-do region. Nineteen workers employed at an automobile brake lining manufacturer were exposed to antimony trisulfide dust through thermoforming, grinding, and drilling processes. In 2020, the workers were reported to work 12-hour shifts, 5 days a week. The time-weighted average (TWA) of antimony trisulfide exposure measured in workers was 0.0028 mg/m³. Two workers were excluded from the analysis due to pre-existing medical conditions (cardiovascular disease). Of the remaining 17 workers, ECG abnormalities were found in 41% (seven out of 17: four with QTc prolongation and T-wave abnormalities; two with only T-wave abnormalities; and one with only QTc prolongation).

This case report outlines the first few cases in Korea in which potential cardiac toxicity caused by occupational exposure to antimony was identified. However, data regarding cardiac toxicity caused by antimony exposure are still lacking in Korea; thus, additional studies are needed to identify causal relationships.

The objective of the present study is to identify differences in the prevalence of acute occupational pesticide poisoning across Korean orchard farmers' farming characteristics and the risk factors that have an effect on acute occupational pesticide poisoning.

For 3 years (2014, 2015, and 2017), a questionnaire survey was conducted on 394 orchard farmers in some parts of south Chungcheong Province in relation to pesticide poisoning. 323 orchard farmers who responded to acute occupational pesticide poisoning were included for final analysis. With acute occupational pesticide poisoning as the dependent variable, a χ² test and a multiple logistic regression analysis were conducted.

The results of the prevalence of acute occupational pesticide poisoning across farming characteristics showed that the group wearing 4 or more pesticide personal protective equipment (PPE) had a lower prevalence of acute occupational pesticide poisoning than the group wearing 3 or less pesticide PPE (p < 0.05). Furthermore, an analysis by area of fruit farming revealed that the group with more than 12,000m² in the area of fruit farming had a higher prevalence of acute occupational pesticide poisoning (p < 0.05). Orchard farmers mainly use a speed sprayer to spray pesticides, and the speed sprayer can be categorized by presence of cabin. The analysis of the prevalence of acute occupational pesticide poisoning by speed sprayer's cabin existence found that existence of speed sprayer's cabin did not show a statistically significant difference in the prevalence of acute occupational pesticide poisoning.

The present study analyzed the prevalence of acute occupational pesticide poisoning depending on the speed sprayer's cabin existence and found no significant difference. The fact that famers using the cabinless style speed sprayer shows a higher percentage in wearing PPE than those using the cabin style speed sprayer is suggested to elucidate the result. As the first study in Korea which examined the prevalence of acute occupational pesticide poisoning by speed sprayer's cabin existence, the present study proposes the expected effect that increase of wearing pesticide PPE along with employ of speed sprayer's cabin can reduce the prevalence of acute occupational pesticide poisoning among orchard farmers.

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

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

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

In the construction industry, maintaining health and safety of workers often challenging. Among the workers at construction sites, painters are at particular risk of respiratory diseases and neurotoxicity. However, in Korea there is weak enforcement of workers' health and safety practices in the construction industry in Korea. Poisonings frequently occur at (semi)closed construction sites. In this study, we report a case of acute organic solvent poisoning during construction site painting.

A 71-year-old man was found unconscious at a construction site and immediately transferred to the emergency room. The consciousness level was 'stupor state' and the body temperature was hypothermic, at 32 degrees (Celsius). There were no acute brain or cardiac lesions that would have accounted for the faintness. In addition, blood and urine tests did not indicate a cause of loss of consciousness. He had been painting epoxy to waterproof the basement floor before fainting. According to exposure simulation, the patient was overexposed to various organic solvents, such as approximately 316–624 ppm toluene during the work before fainting. Considering the ventilation status of the workplace and the status of no protection, it is considered that exposure through the respiratory tract was considerable.

The patient in this case lost consciousness during the epoxy coating in a semi-enclosed space. It can be judged as a result of acute poisoning caused by organic solvent exposure and considered to be highly related to work environment.

In Korea, Carbon disulfide (CS₂) toxicity was an important social problem from the late 1980s to the early 1990s but there have been few large-scale studies examining the prevalence of diseases after CS₂ exposure discontinuance. So we investigated past working exposure to CS₂ characteristics from surviving ex-workers of a rayon manufacturing plant including cumulative CS₂ exposure index. Furthermore, we studied the prevalence of their chronic diseases recently after many years.

We interviewed 633 ex-workers identified as CS₂ poisoning-related occupational diseases to determine demographic and occupational characteristics and reviewed their medical records. The work environment measurement data from 1992 was used as a reference. Based on the interviews and foreign measurement documents, weights were assigned to the reference concentrations followed by calculation of individual exposure index, the sum of the portion of each time period multiplied by the concentrations of CS₂ during that period.

The cumulative exposure index was 128.2 ppm on average. Workers from the spinning, electrical equipment repair, and motor repair departments were exposed to high concentrations of ≥10 ppm. Workers from the maintenance of the ejector, manufacturing of CS_2, post-process, refining, maintenance and manufacturing of viscose departments were exposed to low concentrations below 10 ppm. The prevalence for hypertension, coronary artery disease, cerebrovascular disease, diabetes, arrhythmia, psychoneurotic disorder, disorders of the nervous system and sensory organ were 69.2%, 13.9%, 24.8%, 24.5%, 1.3%, 65.7%, 72.4% respectively.

We estimated the individual cumulative CS₂ exposure based on interviews and foreign measurement documents, and work environment measurement data. Comparing the work environment measurement data from 1992, these values were similar to them. After identified as CS₂ poisoning, there are subjects over 70 years of average age with disorders of the nervous system and sensory organs, hypertension, psychoneurotic disorder, cerebrovascular disease, diabetes, coronary artery disease, and arrhythmia. Because among ex-workers of the rayon manufacturing plant, only 633 survivors recognized as CS₂ poisoning were studied, the others not identified as CS₂ poisoning should also be investigated in the future.

Acute carbon monoxide poisoning has important clinical value because it can cause severe adverse cardiovascular effects and sudden death. Acute carbon monoxide poisoning due to charcoal is well reported worldwide, and increased use of charcoal in the restaurant industry raises concern for an increase in occupational health problems. We present a case of carbon monoxide poisoning induced cardiomyopathy in a 47-year-old restaurant worker.

A male patient was brought to the emergency department to syncope and complained of left chest pain. Cardiac angiography and electrocardiography were performed to rule out acute ischemic heart disease, and cardiac markers were checked. After relief of the symptoms and stabilization of the cardiac markers, the patient was discharged without any complications.

Electrocardiography was normal, but cardiac angiography showed up to a 40% midsegmental stenosis of the right coronary artery with thrombotic plaque. The level of cardiac markers was elevated at least 5 to 10 times higher than the normal value, and the carboxyhemoglobin concentration was 35% measured at one hour after syncope. Following the diagnosis of acute carbon monoxide poisoning induced cardiomyopathy, the patient’s medical history and work exposure history were examined. He was found to have been exposed to burning charcoal constantly during his work hours.

Severe exposure to carbon monoxide was evident in the patient because of high carboxyhemoglobin concentration and highly elevated cardiac enzymes. We concluded that this exposure led to subsequent cardiac injury. He was diagnosed with acute carbon monoxide poisoning-induced cardiomyopathy due to an unsafe working environment. According to the results, the risk of exposure to noxious chemicals such as carbon monoxide by workers in the food service industry is potentially high, and workers in this sector should be educated and monitored by the occupational health service to prevent adverse effects.

Lead is a metal that has no biological function useful for the human body. In Korea, non-occupational exposure to lead has mostly occurred through taking oriental medicine. However, in this paper we report a case of lead poisoning caused by ingesting talisman material.

A 16-year-old male patient complained of severe abdominal pain after taking cinnabar, a talisman material. He was diagnosed with lead poisoning accompanied by acute hepatitis. We confirmed that the cinnabar the patient took contained about 10% elemental lead. After symptom management, the patients’ symptoms, liver function test results, and blood lead concentration level improved.

Lead poisoning can be accompanied by hepatitis, although rarely. As we have confirmed that cinnabar as a talisman material is harmful to the human body, measures to prevent its misuse are needed.