Annals of Occupational and Environmental Medicine

Research Article

The association between cadmium and lead exposure and blood pressure among workers of a smelting industry: a cross-sectional study: Hyun Chan An, Joo Hyun Sung, Jiho Lee, Chang Sun Sim, Sang Hoon Kim, Yangho Kim; Ann Occup Environ Med 2017;29:47. Published online October 4, 2017; DOI: https://doi.org/10.1186/s40557-017-0202-z

Background

Lead and cadmium are harmful heavy metals that are used for a variety of occupational purposes. Considering their potentially hazardous effects on health, studies on the association between exposure to these two heavy metals and health disorders have been actively conducted. This study aimed to determine the association between blood lead and cadmium levels and blood pressure in workers exposed to lead and cadmium in a smelter.

Methods

Nine hundred and sixty-three male workers who worked in a smelter, and underwent medical examinations at the Ulsan University Hospital between January 1 and December 31, 2014, were selected as participants. Among them, 310 subjects whose data on height, weight, blood pressure, fasting blood glucose, lipid profile, and blood lead and cadmium levels were available and who answered the questionnaire were selected as the final participants. We investigated the drinking habit, smoking status, exercise adequacy, and family history of hypertension of these workers using formal questionnaires. A statistical analysis was conducted using Student’s t-test, analysis of variance, and linear or logistic regression.

Results

The association between blood lead and cadmium levels and blood pressure was analyzed through statistical adjustment of the risk factors of hypertension. Results showed an association between blood cadmium level and blood pressure elevation. However, blood lead level was found to be not correlated with blood pressure elevation.

Conclusions

This study shows the association between blood cadmium level and systolic blood pressure (SBP) and diastolic blood pressure (DBP) elevation.

Trial registration

IRB No. 2017–03-037. Retrospectively Registered 30 March 2017.

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Research Article

Levels of blood lead and urinary cadmium in industrial complex residents in Ulsan: Sang Hoon Kim, Yang Ho Kim, Hyun Chan An, Joo Hyun Sung, Chang Sun Sim; Ann Occup Environ Med 2017;29:26. Published online June 26, 2017; DOI: https://doi.org/10.1186/s40557-017-0179-7

Abstract PDF PubReader ePub

Background

Populations neighboring industrial complexes are at an increased health risk, due to constant exposure to various potentially hazardous compounds released during industrial production activity. Although there are many previous studies that focus on occupational exposure to heavy metals, studies that focused on environmental exposure to lead and cadmium are relatively rare. The purpose of this study is to evaluate the extent of the environmental exposure of heavy metals in residents of industrial area.

Methods

Four areas in close proximity to the Ulsan petrochemical industrial complex and the Onsan national industrial complex were selected to be included in the exposure group, and an area remotely located from these industrial complexes was selected as the non-exposure group. Among the residents of our study areas, a total of 1573 subjects aged 20 years and older were selected and all study subjects completed a written questionnaire. Blood and urine samples were obtained from about one third of the subjects (465 subjects) who provided informed consent for biological sample collection. Total 429 subjects (320 subjects from exposure area, 109 subjects from non-exposure area) were included in final analysis.

Results

The geometric mean blood lead level among the subjects in the exposed group was 2.449 μg/dL, which was significantly higher than the non-exposure group’s level of 2.172 μg/dL. Similarly, the geometric mean urine cadmium levels between the two groups differed significantly, at 1.077 μg/g Cr. for the exposed group, and 0.709 μg/g Cr. for the non-exposure group.

In a multiple linear regression analysis to determine the relationship between blood lead level and related factors, the results showed that blood lead level had a significant positive correlation with age, the male, exposure area, and non-drinkers. In the same way, urine cadmium level was positively correlated with age, the female, exposure area, and smokers.

Conclusions

This study found that blood lead levels and urine cadmium levels were significantly higher among the residents of industrial areas than among the non-exposure area residents, which is thought to be due to the difference in environmental exposure of lead and cadmium. Furthermore, it was clear that at a low level of exposure, differences in blood lead or urine cadmium levels based on age, gender, and smoking status were greater than the differences based on area of residence. Therefore, when evaluating heavy metal levels in the body at a low level of exposure, age, gender, and smoking status must be adjusted, as they are significant confounding factors.

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Original Article

Area-Based Occupational Disease Surveillance in Incheon, Korea: Results of an 11-year Data Survey: Jeong Hoon Kim, Shin Goo Park, Jong Han Leem, Jong Uk Won, Sang Hwan Han, Soo Young Chung, Sang Hoon Kim, Hwan Cheol Kim, Yun Chul Hong, Cheol Woo Kim, Chang Hwan Kim, Dong Hyun Kim, Dong Hoon Lee, Seung Jun Lee, Young Joong Kang, Woo Seok Kwak, Jeongbae Rhie; Korean Journal of Occupational and Environmental Medicine 2010;22(3):183-199. Published online September 30, 2010; DOI: https://doi.org/10.35371/kjoem.2010.22.3.183

Abstract PDF

OBJECTIVES
Between Jan 1998 and Dec 2008, area-based occupational disease surveillance in Incheon was used to collect data on occupational diseases. The long-term data was used to estimate the scale of disease, to analyze disease characteristics, and to achieve surveillance in order to determine development tasks.
METHODS
For a period of 11 years, occupation-related disease surveillance was performed on an annual basis for employees of Incheon industries. All cases of occupational disease were reported by means of the Incheon Occupational Disease Information Network (IODIN) web site, downloaded, and analyzed, subsequently.
RESULTS
Between Jan 1998 and Dec 2008, 1577 cases of occupational disease were reported. Of these, there were 1043(66.1%) cases of occupational musculoskeletal disorders, 172(10.9%) cases of occupational asthma, 162(10.3%) cases of occupational dermatoses, 135(8.6%) cases of occupationally-related cancers, 30(1.9%) cases of pneumoconiosis, 27(1.7%) cases of toxic hepatitis, and 8(0.5%) cases of occupational neuronal disease.
CONCLUSION
In the Incheon area, small and medium industries comprise 99% of business. The composition of the industry by category, in Incheon, is similar to the country on the whole. In actually, the data on occupational diseases in Korea are almost workers' compensation data. Thus, the survey of occupational disease based in Incheon, Korea, can serve as an estimate of the trends and size of the occupational disease throughout the entire country.

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Work-Related Asthma in Korea - Findings from the Korea Work-Related Asthma Surveillance (KOWAS) program, 2004-2009
Soon-Chan Kwon, Jaechul Song, Yong-kyu Kim, Geoffrey M. Calvert
Allergy, Asthma & Immunology Research.2015; 7(1): 51. CrossRef

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Original Article

Usefulness of High Resolution Computed Tomography (HRCT) in the Diagnosis of Asbestos-Related Lung Diseases: Hyun Jae Lee, Ji Eun Son, Young Seoub Hong, Young Ill Lee, Byung Jin Yeah, Chang Hun You, Kap Yeol Jung, Sang Hoon Kim, Hyoung June Im, Eun Chul Jang, Jung Man Kim, Joon Youn Kim; Korean Journal of Occupational and Environmental Medicine 2006;18(2):112-122. Published online June 30, 2006; DOI: https://doi.org/10.35371/kjoem.2006.18.2.112

Abstract PDF

OBJECTIVES
This study was carried out to improve the medical surveillance program of workers exposed to asbestos by examining the usefulness of High Resolution Computed Tomography (HRCT) in the diagnosis of asbestos-related lung disease.
METHODS
The study subjects comprised 162 workers in a ship-repairing yard, 68 of whom had been directly exposed to asbestos and 94 indirectly exposed. The 'Occupational Safety & Health Administration (OSHA) asbestos standard, medical surveillance program' and HRCT were conducted to analyze the aspects of the asbestos-related lung disease. The OSHA asbestos standard, medical surveillance program consists of simple chest x-ray, spirometry and medical questionnaire.
RESULTS
Seventeen (10.5%) of the 162 subjects, 10 (14.7%) directly exposed and 7 (7.4%) indirectly exposed, revealed asbestos-related lung disease on HRCT. The sensitivity and specificity of simple chest x-ray for asbestos-related lung disease were 70.6% and 98.6%, and the positive and negative predictive values were 85.7% and 96.6% respectively, as compared with HRCT. HRCT was an effective diagnostic tool especially to detect early asbestos-related lung disease. The study results indicated a relative significant association between the results of spirometry and HRCT. The variables significantly associated with asbestos-related lung disease on HRCT were work duration, smoking history (pack-years), past history of respiratory disease, cough and dyspnea.
CONCLUSIONS
In the diagnosis of asbestos-related lung disease, HRCT should be considered not only for workers with positive findings on simple chest x-ray, but also workers with specific findings on spirometry, occupational history, smoking history, and past history of respiratory disease, or with respiratory symptoms such as cough and dyspnea.

Citations

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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

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Original Article

The Analysis of Disease Distribution and Referral Routes of Patients in an Occupational and Environmental Medicine Clinic of a University Hospital: Sang Hoon Kim, Jee Na Lee, Jong han Leem, Yun Chul Hong; Korean Journal of Occupational and Environmental Medicine 2002;14(4):448-458. Published online December 31, 2002; DOI: https://doi.org/10.35371/kjoem.2002.14.4.448

Abstract PDF: OBJECTIVES
The occupational & environmental medicine clinic plays an important role in the growth and advance of occupational & environmental medicine.This study analyzes the disease distribution and referral routes of patients in an occupational & environmental medicine clinic of a university hospital.
METHODS
843 Agent Orange cases and 839 other cases were treated in the clinic over a period of 4 years. The Agent Orange cases were excluded from this study.Distributions of age, sex, disease and referral route were examined according to the medical records of the hospital.
RESULTS
654 of the patients in the study population were male (77.9 %)and 185 were female (22.1 %).The most common age group consisted of patients in their forties.The number of cases has been increasing annually(1998,146 cases;1999,174 cases; 2000, 247 cases; 2001, 272 cases). The source of the cases were as follows: health examination, 548(65.4 %); health management service, 132(15.7 %);self-referral,125(14.9 %); physicians in other hospitals, clinics, 18 (2.1 %); and physicians in other clinic in the hospital, 16(1.9 %). The most commonly occurring disease was liver disease(28.6 %),followed by respiratory disease(12.8 %), gastroenteric disease (10.3 %)and musculoskeletal disease (8.7%).When the clinic was first opened, most cases came through 'health examination'. Subsequently the number of cases arising from 'self-refferal' and 'health management services' were increased.The disease distribution has also changed as the referral route distribution evolved.
CONCLUSIONS
In order to expand the work of the clinic, primary cares for patients who came from 'health examination' will be needed to settle down the clinic at the beginning. Thereafter,specialized services need to be developed for cases originating from 'self-refer-ral' and from referral by other organizations.Increasing the number of cases needs to go hand in hand with the development of good management skills.

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Original Article

Effect of Commuting Time on Male Worker's Serum Gamma-glutamyltransferase Level: Sang hoon Kim, Jee Na Lee, Yun Chul Hong; Korean Journal of Occupational and Environmental Medicine 2002;14(4):418-425. Published online December 31, 2002; DOI: https://doi.org/10.35371/kjoem.2002.14.4.418

Abstract PDF: OBJECTIVES
Alcohol drinking, obesity, and reduced physical activity are commonly related to oxidative stress, which induces plasma membrane-bound protein damage in hepatic cells and elevates serum gamma-GTP. We have a hypothesis that a long commuting time may induce oxidative stress. This study was undertaken to investigate the relationship between commuting time and serum gamma-GTP level.
METHODS
Questionnaires were administered to 717 male workers who had worked at Kimpo airport until the year 2000,and had then moved to Incheon airport and were working there in 2002. The questionnaire included items concerning commuting time, sleeping time and alcohol consumption. Physical examination and laboratory data were also collected.
RESULTS
Serum gamma-GTP level was significantly and positively correlated with commuting time, body mass index, systolic blood pressure,diastolic blood pressure, hemoglobin, glucose, total cholesterol, AST, ALT and alcohol consumption. Multivariate regression analysis demonstrated that serum gamma-GTP level is significantly associated with commuting time, after considering the other covariates.
CONCLUSIONS
Commuting time is one of the factors that affects serum gamma-GTP level in male workers.

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