Annals of Occupational and Environmental Medicine

Original Article

Organic solvent exposure for the chronic kidney disease: updated systematic review with meta-analysis: Chaeseong Lim, Hyeoncheol Oh; Ann Occup Environ Med 2023;35:e11. Published online May 17, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e11

Abstract Abstract in Korean PDF PubReader ePub: Background
Studies on the relationship between organic solvent exposure and chronic kidney disease (CKD) have presented inconsistent results. Definition of CKD has changed in 2012, and other cohort studies have been newly published. Therefore, this study aimed to newly confirm the relationship between organic solvent exposure and CKD through an updated meta-analysis including additional studies.
Methods
This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The search was conducted on January 2, 2023 using Embase and MEDLINE databases. Case-control and cohort studies on the relationship between organic solvent exposure and CKD were included. Two authors independently reviewed full-text.
Results
Of 5,109 studies identified, a total of 19 studies (control studies: 14 and cohort studies: 5) were finally included in our meta-analysis. The pooled risk of CKD in the organic solvent exposed group was 2.44 (1.72–3.47). The risk of a low-level exposure group was 1.07 (0.77–1.49). The total risk of a high-level exposure group was 2.44 (1.19–5.00). The risk of glomerulonephritis was 2.69 (1.18–6.11). The risk was 1.46 (1.29–1.64) for worsening of renal function. The pooled risk was 2.41 (1.57–3.70) in case-control studies and 2.51 (1.34–4.70) in cohort studies. The risk of subgroup classified as ‘good’ by the Newcastle Ottawa scale score was 1.93 (1.43–2.61).
Conclusions
This study confirmed that the risk of CKD was significantly increased in workers exposed to mixed organic solvents. Further research is needed to determine the exact mechanisms and thresholds. Surveillance for kidney damage in the group exposed to high levels of organic solvents should be conducted.
Trial Registration
PROSPERO Identifier: CRD42022306521; 유기용제와 만성 콩팥병 ; 갱신된 메타-분석
목적
유기용제는 많은 산업현장에서 널리 사용되고 있는 물질로, 산업현장 근로자들의 건강에 나쁜 영향을 초래하고 있다. U.Ravnskov et al, 2000 에서는 유기용제 노출과 만성 신부전에 대해 조사했던 환자-대조군 연구들을 모아 메타분석을 시행하였다. 해당 메타 분석이 발표된 이후 만성 신부전의 정의가 변경되었으며 새로운 코호트 연구들도 새로 발표되었다. 따라서 본 연구에서는 기존 메타 분석에서 포함되지 못한 연구들을 추가로 포함하여 업데이트된 메타 분석을 시행하였다.
방법
본 체계적 검토는 Preferred Reporting Items For Systematic Reviews and Meta-Analysis(PRISMA) guideline 에 의거하여 진행되었다. 검색은 Embase 와 MEDLINE 데이터베이스를 활용하여 2021년 11월 9일날 시행되었다. 유기용제 노출에 의한 만성 신부전에 대한 총 위험도와 더불어, 저도 노출, 중등도 노출, 고도 노출로 구분된 논문들을 모아 노출강도에 따른 하위그룹의 위험도 또한 분석하였다.
결과
유기용제 노출군은 비노출군에 비해 만성 신부전에 대한 총 위험도 (pooled risk) 는 2.44(1.72-3.47) 로 나왔다. 저도 노출의 경우 위험도 1.07(0.77-1.49) 로 나타났고 고도 노출군의 경우 총 위험도 2.44(1.19-5.00) 로 나타났다. 사구체 신염 발생의 경우 위험도가 2.69(1.18-6.11), 신기능 악화의 경우 1.46(1.29-1.64) 로 나타났다. 환자-대조군 연구들의 경우 2.41(1.57-3.70), 코호트 연구들의 경우 2.51(1.34-4.70) 으로 나타났다. Newcastle Ottawa scale 점수가 ‘좋음’으로 분류된 연구들의 경우 1.93(1.43-2.61)로 나타났다.
결론
선행 연구와 마찬가지로 혼합 유기용제 노출 근로자에서 만성 신부전의 위험성이 유의하게 증가한 것을 확인하였다. 이는 현재 석유 관련 제품 취급자, 도장공, 금속가공, 실험실 근로자 등 혼합 유기용제 고용량 노출군에 대한 특수건강진단 시 신기능 검사나 단백뇨 검사의 범위를 넓혀야 함을 시사할 수 있다.

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Review

Estimations of the lethal and exposure doses for representative methanol symptoms in humans: Chan-Seok Moon; Ann Occup Environ Med 2017;29:44. Published online October 2, 2017; DOI: https://doi.org/10.1186/s40557-017-0197-5

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Background

The aim of this review was to estimate the lethal and exposure doses of a representative symptom (blindness) of methanol exposure in humans by reviewing data from previous articles.

Methods

Available articles published from 1970 to 2016 that investigated the dose-response relationship for methanol exposure (i.e., the exposure concentration and the biological markers/clinical symptoms) were evaluated; the MEDLINE and RISS (Korean search engine) databases were searched. The available data from these articles were carefully selected to estimate the range and median of a lethal human dose. The regression equation and correlation coefficient (between the exposure level and urinary methanol concentration as a biological exposure marker) were assumed from the previous data.

Results

The lethal human dose of pure methanol was estimated at 15.8–474 g/person as a range and as 56.2 g/person as the median. The dose-response relationship between methanol vapor in ambient air and urinary methanol concentrations was thought to be correlated. An oral intake of 3.16–11.85 g/person of pure methanol could cause blindness. The lethal dose from respiratory intake was reported to be 4000–13,000 mg/l. The initial concentration of optic neuritis and blindness were shown to be 228.5 and 1103 mg/l, respectively, for a 12-h exposure.

Conclusion

The concentration of biological exposure indices and clinical symptoms for methanol exposure might have a dose-response relationship according to previous articles. Even a low dose of pure methanol through oral or respiratory exposure might be lethal or result in blindness as a clinical symptom.

Citations

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Research Article

Work-related Musculoskeletal Disorders in Korea and Japan: A Comparative Description: Eun-A Kim, Minori Nakata; Ann Occup Environ Med 2014;26:17-17. Published online June 24, 2014; DOI: https://doi.org/10.1186/2052-4374-26-17

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Objectives

Work related Musculoskeletal disorders (WMSD) is one of the most important problem in occupational health system of Korea and Japan, where the OHS system developed in similar socio-cultural environment. This study compared WMSD in Korea and Japan to review similarities and differences in their historical background, and development of prevention policies.

Methods

Scientific articles, government reports, and related official and non-official statistics on WMSD since the 1960s in Japan and Korea were reviewed.

Results

The historical background and basic structure of the compensation system in Korea and Japan largely overlapped. The issuing of WMSD in both countries appeared as upper limb disorder (ULD), named occupational cervicobrachial diseases (OCD) in Japan, and neck-shoulder-arm syndrome (NSA) 30 years later in Korea, following the change from an industrial structure to automated office work. Both countries developed manuals for diagnosis, guidelines for workplace management, and prevention policies. At present, compensation cases per covered insurers for WMSD are higher in Korea than in Japan, due to the social welfare system and cultural environment. Prevention policies in Korea are enforced more strongly with punitive measures than in Japan. In contrast, the Japanese system requires autonomous effort toward risk control and management, focusing on specific risky processes.

Conclusions

WMSD in Korea and Japan have a similar history of identification and compensation structure, yet different compensation proportions per covered insurer and prevention policies. Follow-up study with international cooperation is necessary to improve both systems.

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Review

Systematic Review of the Effects of Asbestos Exposure on the Risk of Cancer between Children and Adults: Dongmug Kang, Min-Seung Myung, Young-Ki Kim, Jong-Eun Kim; Ann Occup Environ Med 2013;25:10-10. Published online July 8, 2013; DOI: https://doi.org/10.1186/2052-4374-25-10

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Children are considerably more susceptible to enviro006Emental hazards than adults. This study was conducted to investigate whether the first asbestos exposure in childhood increases the risk of asbestos-related cancer including mesothelioma and lung cancer. MEDLINE (PubMed), Embase, and Google Scholar were searched to find relevant studies published up to July 2012. Six studies reported the relationship between age, including age during childhood, at the first asbestos exposure and mesothelioma. Among them, 4 indicated that people exposed to asbestos in childhood have a higher risk of mesothelioma than those exposed in adulthood. Meanwhile, the other 2 studies showed that asbestos exposure later in life increases the risk of mesothelioma. The results of the 2 studies including non-occupational early childhood exposure report conflicting results. There were 3 studies regarding the relationship between age at first asbestos exposure and lung cancer. However, none of them reported an association between age at first asbestos exposure and the risk of lung cancer. All studies have limitations including small numbers of subjects, the validity of the standardized mortality ratio, and different age categories at first asbestos exposure. There are only a few studies on the harmful effects of asbestos in children in the literature. Therefore, the effect of asbestos exposure during childhood remains unclear and requires further study.

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Original Article

Are Cerebrovascular and Cardiovascular Diseases among Employees Work-related?: Jungsun Park; Korean Journal of Occupational and Environmental Medicine 2005;17(4):288-296. Published online December 31, 2005; DOI: https://doi.org/10.35371/kjoem.2005.17.4.288

Abstract PDF

Cerebrovascular and cardiovascular diseases (CVDs) are a major cause of deaths among workers as well as in general population in Korea. The term "Karoshi" in Japan represents work-related cerebrovascular and cardiovascular diseases (WR-CVD) due to excessive overwork. According to the Karasek's Demand-Control Model many prospective studies reported a significant association between working in jobs with high strain and increased likelihood of subsequent development of cardiovascular diseases. However, further understanding of the etiopathology of each different work-relatedness is needed to prevent WR-CVDs effectively. This review was planned to help the readers with knowledge on the etiopathology of the WR-CVDs. Based on the causal or triggering factors, work-relatedness in the literature can be classified into four types: 'accidental type (e.g. sudden cardiac deaths)', 'typical Karoshi type due to extreme overwork', 'maladaptation type due to dramatic change in job characteristics', and 'job stress type due to inherent characteristics'. Even though the outcome of each type is apparently similar, their causes and pathophysiologic mechanisms are quite different. In conclusion, the work-relatedness of CVDs among employees is very limited and usually works as a trigger rather than as the causal factors. A thorough understanding of the etiopathology of WR-CVDs can be very helpful in developing a prevention strategy.

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Original Article

Biomarkers of Susceptibility in Bladder Carcinogenesis: Sue Kyung Park, Hae Won Jung, Dae Hee Kang, Keun Young Yoo, Soo Hun Cho; Korean Journal of Occupational and Environmental Medicine 1997;9(2):341-356. Published online June 30, 1997; DOI: https://doi.org/10.35371/kjoem.1997.9.2.341

Abstract PDF: Owing to the development of molecular biological techniques to identify new biomarkers of bladder cancer, the information obtained from the studios in which newly developed biomarkers are applied potentially useful in screening of general population, diagnosis of patients, predicting biological behavior and prognosis, and exposure assessments. Despite of rapid development there are a few review about the biomarkers in bladder cancer from which grogs summary of results as well as their optimal function can be considered. This study was carried out in biomarkers of bladder cancer by reviewing the literature to assess the usefulness and stapes of researches for biomarkers of bladder cancer on high risk groups, general population and patients. The biomarkers of bladder cancer were classified by Weinstein's model of carcinogenesis, simple classification of exposure-discase in classical epidemiology, classification by conception of exposure-disease continuum on molecular epidemiology, and application of biomarkers. Two biomarkers, N-acetylation enzyme and Glutathion S-transferase, which had been studied extensively in molecular epidemiology were selected and reviewed. Although the generalization, prediction and diagnosis of bladder cancer based on a single biomarker give rise to trouble due to intravariation of bladder tumor and heterogeneity of biomarkers variation, searching for more specific tumor markers may accurately lead better prediction of prognosis and better estimation of treatment response. The usefulness of both N-acetylation enzyme and glutathion 5-transferase in high-risk groups who have exposes to carcinogen may be more valuable. However more informations are neede in order to apply these biomarkers in clinical practices in further studies.

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