Annals of Occupational and Environmental Medicine

Original Articles

Incidence rates of injury, musculoskeletal, skin, pulmonary and chronic diseases among construction workers by classification of occupations in South Korea: a 1,027 subject-based cohort of the Korean Construction Worker’s Cohort (KCWC): Seungho Lee, Yoon-Ji Kim, Youngki Kim, Dongmug Kang, Seung Chan Kim, Se-Yeong Kim; Ann Occup Environ Med 2023;35:e26. Published online July 24, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e26

Abstract Abstract in Korean PDF Supplementary Material PubReader ePub

Background

The objective of this study is to investigate the differences in incidence rates of targeted diseases by classification of occupations among construction workers in Korea.

Methods

In a subject-based cohort of the Korean Construction Worker’s Cohort, we surveyed a total of 1,027 construction workers. As occupational exposure, the classification of occupations was developed using two axes: construction business and job type. To analyze disease incidence, we linked survey data with National Health Insurance Service data. Eleven target disease categories with high prevalence or estimated work-relatedness among construction workers were evaluated in our study. The average incidence rates were calculated as cases per 1,000 person-years (PY).

Results

Injury, poisoning, and certain other consequences of external causes had the highest incidence rate of 344.08 per 1,000 PY, followed by disease of the musculoskeletal system and connective tissue for 208.64 and diseases of the skin and subcutaneous tissue for 197.87 in our cohort. We especially found that chronic obstructive pulmonary disease was more common in construction painters, civil engineering welders, and civil engineering frame mold carpenters, asthma in construction painters, landscape, and construction water proofers, interstitial lung diseases in construction water proofers.

Conclusions

This is the first study to systematically classify complex construction occupations in order to analyze occupational diseases in Korean construction workers. There were differences in disease incidences among construction workers based on the classification of occupations. It is necessary to develop customized occupational safety and health policies for high-risk occupations for each disease in the construction industry.

한국 건설업 종사자의 손상, 근골격계 질환, 피부, 호흡기 및 만성질환의 건설 직종에 따른 발생률: 한국 건설업 종사자 코호트(KCWC) 의 1027명 대상자 기반 세부 코호트 분석
목적
본 연구의 목적은 한국 건설업 종사자에 있어 주요 질환의 건설 직종별 발생률 차이를 알아보는 것이다.
방법
한국 건설업 종사자 코호트(KCWC)의 대상자 기반 세부 코호트로 총 1,027명의 건설업 종사자가 1:1면접설문조사를 통해 입적되었다. 직업적 노출요인으로 직종은 크게 건설산업환경과 직무 두 가지 축으로 분류되었다: 직업적 노출(설문조사) 자료와 국민건강보험공단 청구 맞춤형 자료를 연계하여 질환의 평균 발생률을 분석하였다. 주요 질환은 건설업 종사자에서 유병률이 높거나 업무 관련성이 있을 것으로 추정되는 11개의 대상 질환을 평가하였다. 질환별 평균 발생률은 1,000인년당 발병 사례수(명)으로 계산하였다.
결과
손상, 중독 및 외인에 의한 특정 기타 결과가 1,000인년당 344.08명으로 가장 높은 발생률을 보였고, 그 다음으로 근골격계 및 결체조직의 질환이 1,000인년당 208.64명, 피부 및 피하조직 질환이 1,000인녕당 197.87명 순으로 높았다. 특히, 만성 폐쇄성 폐질환이 건축 도장공, 토목 용접공, 토목 형틀목공에서 타 직종에 비해 상대적으로 높은 발생률을 보였고, 천식은 건축 도장공, 조경, 건축 방수공에서, 간질성 폐질환은 건축 방수공에서 상대적으로 높은 발생률을 보였다.
결론
본 연구는 한국 건설업 종사자의 주요 직업성 질환 및 호발 질환 등을 복잡한 건설산업의 직종을 체계적으로 분류하여 분석한 최초의 연구로 연구진들은 건설업 종사자의 질환별 발생률에 있어 직종별 차이를 확인하였다. 건설 산업에서 각 질환별 고위험 직종별로 맞춤형 산업안전보건정책 개발이 필요하다.

Citations

Citations to this article as recorded by

Work Performance Among Workers without Disabilities after Industrial Accidents: A Longitudinal Study
Chong Min Hong
The Open Public Health Journal.2024;[Epub] CrossRef

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Development of algorithm for work intensity evaluation using excess overwork index of construction workers with real-time heart rate measurement device: Jae-young Park, Jung Hwan Lee, Mo-Yeol Kang, Tae-Won Jang, Hyoung-Ryoul Kim, Se-Yeong Kim, Jongin Lee; Ann Occup Environ Med 2023;35:e24. Published online July 19, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e24

Abstract Abstract in Korean PDF Supplementary Material PubReader ePub

Background

The construction workers are vulnerable to fatigue due to high physical workload. This study aimed to investigate the relationship between overwork and heart rate in construction workers and propose a scheme to prevent overwork in advance.

Methods

We measured the heart rates of construction workers at a construction site of a residential and commercial complex in Seoul from August to October 2021 and develop an index that monitors overwork in real-time. A total of 66 Korean workers participated in the study, wearing real-time heart rate monitoring equipment. The relative heart rate (RHR) was calculated using the minimum and maximum heart rates, and the maximum acceptable working time (MAWT) was estimated using RHR to calculate the workload. The overwork index (OI) was defined as the cumulative workload evaluated with the MAWT. An appropriate scenario line (PSL) was set as an index that can be compared to the OI to evaluate the degree of overwork in real-time. The excess overwork index (EOI) was evaluated in real-time during work performance using the difference between the OI and the PSL. The EOI value was used to perform receiver operating characteristic (ROC) curve analysis to find the optimal cut-off value for classification of overwork state.

Results

Of the 60 participants analyzed, 28 (46.7%) were classified as the overwork group based on their RHR. ROC curve analysis showed that the EOI was a good predictor of overwork, with an area under the curve of 0.824. The optimal cut-off values ranged from 21.8% to 24.0% depending on the method used to determine the cut-off point.

Conclusion

The EOI showed promising results as a predictive tool to assess overwork in real-time using heart rate monitoring and calculation through MAWT. Further research is needed to assess physical workload accurately and determine cut-off values across industries.

실시간 심박수 측정 장치를 이용한 건설업 근로자 과로 예측 알고리즘
목적
건설업 근로자는 육체적 업무강도가 높아 이에 따른 피로와 그에 따른 사고 및 건강 악영향 우려가 높다. 이 연구에서는 일개 사업장 건설업 근로자를 대상으로 과로와 심박수 사이의 관계를 탐색하고 실시간 심박수 모니터링을 이용하여 과로를 방지하는 방법을 제안하였다.
방법
서울의 일개 건설업 현장에서 근무하는 근로자를 대상으로 2021.08.-2021.10.까지 근무 중 심박수를 측정하였다. 총 66명의 한국인 근로자가 손목시계 형 장치를 이용하여 심박수 측정에 참여하였다. 안정시 심박수와 최대 심박수 추정치를 바탕으로 상대심박수(RHR)를 산출하였고, 이를 바탕으로 피로 없이 근무할 수 있는 최대시간(MAWT)를 계산하여 이를 바탕으로 업무 부담(workload)를 추정하였다. 이를 통해 산출한 누적 업무량으로 과로 지수(Overwork index)를 산출한 후 적정 업무 부담(PSL)과의 차이인 초과 과로 지수(Excess overwork index)를 정의하였다. EOI 값을 이용해 일평균 상대심박수 30%값을 기준으로 정의한 과로군-비과로군을 예측할 수 있는 최적 절단값을 ROC 분석을 통해 산출하였다.
결과
근로자 60명의 심박수 측정값을 분석한 결과 28(46.7%)가 일평균 상대심박수를 기준으로 과로군으로 분류되었다. ROC 분석 결과 EOI값이 과로를 예측하는데 유용함을 확인하였고 AUC값은 0.824였다. 최적 절단 값은 최적화 방법에 따라 21.8%에서 24.0%로 나타났다.
결론
실시간 심박수 모니터링과 MAWT를 이용해 산출한 EOI값은 과로를 예측하는데 유용한 지표임을 확인하였다. 단, 건설업을 비롯하여 다른 육체적 부담이 큰 업종에서 최적 절단값을 찾기 위해서는 추가 연구가 필요하다.

Citations

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Development of productivity model of continuous miner operators working in hazardous underground mine environmental conditions
Siddhartha Roy, Devi Prasad Mishra, Hemant Agrawal, Ram Madhab Bhattacharjee
Measurement.2025; 239: 115516. CrossRef

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Case Report

Occupational asthma related to indoor air pollution in a worker at an indoor air gun shooting range: a case report: Kwang Min Lee, Seungho Lee, Yoon-Ji Kim, Seung-eun Lee, Youngki Kim, Dongmug Kang, Se-Yeong Kim; Ann Occup Environ Med 2023;35:e13. Published online June 19, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e13

Abstract Abstract in Korean PDF Supplementary Material PubReader ePub

Background

Indoor air pollution can cause and exacerbate asthma. We report a previously undescribed case of occupational asthma related to indoor air pollution in a worker at an indoor air gun shooting range and highlight the potential risk of developing occupational asthma in this environment.

Case presentation

A 31-year-old man presented with dyspnea, cough, and sputum and was diagnosed with asthma complicated by pneumonia. Objective evidence of asthma was obtained by performing a methacholine bronchial provocation test. It was suspected that the patient had occupational asthma, which began one month after changing jobs to work within the indoor air gun shooting range. The highest peak expiratory flow (PEF) diurnal variability on working days was 15%, but the highest variation was 24%, with 4 days out of 4 weeks having a variation of over 20% related to workplace exposure. Conversely, the diurnal variability on the rest days was 7%, and no day showed a variation exceeding 20%. The difference in the average PEF between working and rest days was 52 L/min. PEF deterioration during working days and improvement on rest days were noted.

Conclusions

The results obtained from the in-depth analysis of the PEF were adequate to diagnose the patient with occupational asthma. Exposure to indoor air pollution and lead and the patient’s atopy and allergic rhinitis may have contributed to the development of occupational asthma.

실내 공기총 사격장 근로자의 실내공기오염관련 직업성 천식 증례보고
a배경: 실내공기오염은 천식을 유발하고 악화시킬 수 있다. 본 연구는 실내 공기총 사격장에서 일하는 근로자의 실내 공기 오염과 관련된 이전에 기술되지 않은 직업성 천식 사례를 보고하고, 이러한 환경에서 직업성 천식 발병의 잠재적 위험을 강조한다.
증례
31세 남자가 호흡곤란, 기침, 가래 증상이 나타나 내원하였고, 폐렴이 동반된 천식으로 진단되었다. 천식의 객관적인 증거는 메타콜린 기관지유발검사를 시행하여 획득하였다. 환자는 실내공기총 사격장에서 근무하기 위해 이직한지 한달만에 직업성 천식을 앓고 있는 것으로 의심되었다. 근무일의 최고호기유량(PEF) 주간 변동성은 15%였지만, 가장 높은 변동성은 24%였으며, 4주 중 4일은 작업장 노출과 관련하여 20% 이상의 변동성을 보였다. 반대로 쉬는 날의 일교차는 7%로 20%를 넘는 날은 없었다. 근무일과 휴식일 사이의 평균 최고호기유량(PEF) 차이는 52 L/min이었다. 근무일 동안 PEF 악화 및 휴식일의 개선이 주목되었다.
결론
최고호기유량(PEF)의 심층분석결과는 직업성 천식 환자를 진단하기에 적합하였다. 실내공기오염과 납 노출, 환자의 아토피와 알레르기성 비염이 직업성 천식 발병에 기여했을 가능성이 있다.

Citations

Citations to this article as recorded by

Recent developments in occupational asthma
Claudia Blouin, Catherine Lemière
Current Opinion in Pulmonary Medicine.2024; 30(3): 281. CrossRef
Occupational agents-mediated asthma: From the perspective of autophagy
Xiu He, Dengxiang Yao, Xiaoli Yuan, Jiaqi Ban, Yuxuan Gou, Mingdan You
Science of The Total Environment.2024; 952: 175880. CrossRef

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Original Article

Relationship between of working hours, weekend work, and shift work and work-family conflicts among Korean manufacturers: Yohan Lee, SooYoung Lee, Yoon-Ji Kim, Youngki Kim, Se-Yeong Kim, Dongmug Kang; Ann Occup Environ Med 2022;34:e20. Published online August 8, 2022; DOI: https://doi.org/10.35371/aoem.2022.34.e20

Abstract Abstract in Korean PDF Supplementary Material PubReader ePub

Background

In the manufacturing industry, work-family conflict (WFC) is related to working hour characteristics. Earlier studies on the relationship between working hour characteristics and WFC in the manufacturing industry have been limited to some regions in Korea. No study has addressed the data on a national scale. Thus, this study investigated the impact of weekly working hours, weekend work, and shift work on WFC using national-scale data.

Methods

This study was based on the fifth Korean Working Conditions Survey of 5,432 manufacturers. WFC consists of 5 variables; WFC1 “kept worrying about work”; WFC2 “felt too tired after work”; WFC3 “work prevented time for family”; WFC4 “difficult to concentrate on work”; WFC5 “family responsibilities prevented time for work”. As WFC refers to the inter-role conflict between the need for paid work and family work, WFC has been measured in two directions, work to family conflict (WTFC: WFC1, 2, 3) and family to work conflict (FTWC: WFC4, 5). With these WFC variables, we conducted multiple logistic analyses to study how working hours, weekend work, and shift work impact WFC.

Results

Korean manufacturers’ prolonged working hours increased all aspects of WFCs. Odds ratios (ORs) of WFCs based on working hours (reference of under 40 hours) of 41–52, 53–60, over 61 were 1.247, 1.611, 2.279 (WFC1); 1.111, 2.561, 6.442 (WFC2); 1.219, 3.495, 8.327 (WFC3); 1.076, 2.019, 2.656 (WFC4); and 1.166, 1.592, 1.946 (WFC5), respectively. Shift-work in the WFC2 model showed a significantly higher OR of 1.390. Weekend work ‘only on Saturday’ had significant ORs with WFC2 (1.323) and WFC3 (1.552).

Conclusions

An increase in working hours leads to the spending of less time attending to problems between work and family, causing both WTFC and FTWC to increase. As weekends, evenings, and nighttime are considered to be family-friendly to people, working on weekends and shift-work were highly correlated to WTFC.

한국 제조업 노동자에서 근무시간, 주말근무 및 교대근무와 일-가정 양립의 관계
목적
현대 사회에서는 야간 근무를 포함하여 다양한 업무를 수행하는 교대 근무자가 증가하고 있다. 교대 근무는 장기적으로 근로자의 건강에 악영향을 미칠 수 있지만 교대 근무와 우울증의 관계에 대한 연구 결과는 일관성이 없는 것으로 나타났다. 본 연구는 PHQ-9로 예측한 우울증에 걸릴 위험이 높은 국내 야간 및 교대 근무 근로자 수가 주간 근로자보다 많은지 여부를 확인하고자 한다.
방법
본 연구는 제 6 차 및 제 7 차 국민 건강 영양 조사 자료 중 2014, 2016년 및 2018년의 자료를 바탕으로 진행되었다. 근무 일정은 주간 근무와 야간 및 교대근무로 구분 하였다. 이 연구는 우울증에 걸릴 위험이 있는 근로자를 결정하기 위해 자가 보고 우울증 선별 검사 인 PHQ-9를 사용하였다. SPSS 23.0을 이용하여 통계 분석을 수행하였고 통계적 방법으로는 기술 통계, 카이 제곱 분석, 로지스틱 회귀 분석을 사용 하였다.
결과
연령, 교육 수준, 주당 근무 시간 및 수입으로 보정 후 분석하였을 때, 야간 및 교대 근무 근로자에서 우울증 위험군에 해당하는 경우가 유의하게 더 높았으며(odds ratio [OR] = 1.407 (95% confidence interval [CI]: 0.937–2.113)), 이는 여성에서도 마찬가지로 나타났다(odds ratio [OR] = 1.564 (95% confidence interval [CI]: 1.176–2.081)).
결론
본 연구를 통해 야간 및 교대근무 근로자에서 PHQ-9 점수가 10점 이상인 우울증 위험군에 해당하는 경우가 유의하게 높음을 확인할 수 있었다. 현재 한국의 정신 병력과 증상의 유병률을 고려할 때 야간 근로자에게 현실적인 도움을 제공 할 수 있는 방법에 대한 추가 논의와 함께 추가 연구가 필요하다.

Citations

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Association between long working hours and the development of suicidal ideation among female workers: An 8-year population-based study using the Korean Longitudinal Survey of Women & Family (2012–2020)
Seong-Uk Baek, Yu-Min Lee, Jin-Ha Yoon
Psychiatry Research.2024; 333: 115731. CrossRef
Food Manufacturing Workers and Structural Causality among Work Environment, Work–Family Conflict, Musculoskeletal Pain, Sleep-Related Problems, and Burnout
Jun Won Kim, Byung Yong Jeong
Applied Sciences.2024; 14(17): 7489. CrossRef
Association between long working hours and engagement in preventive healthcare services in Korean workers: Findings from the Korean National Health and Nutrition Examination Survey
Seong-Uk Baek, Yu-Min Lee, Jin-Ha Yoon
Preventive Medicine.2024; 180: 107849. CrossRef
Association between long working hours and physical inactivity in middle-aged and older adults: a Korean longitudinal study (2006–2020)
Seong-Uk Baek, Won-Tae Lee, Min-Seok Kim, Myeong-Hun Lim, Jin-Ha Yoon, Jong-Uk Won
Journal of Epidemiology and Community Health.2023; 77(6): 355. CrossRef
Working hours and the onset of suicidal ideation and depressive symptoms: A 10-year nationwide longitudinal study in South Korea (2012–2022)
Seong-Uk Baek, Min-Seok Kim, Myeong-Hun Lim, Taeyeon Kim, Jong-Uk Won, Jin-Ha Yoon
Psychiatry Research.2023; 326: 115344. CrossRef
The role of work–family conflict in the association between long working hours and workers’ sleep disturbance and burnout: results from the sixth Korean Working Conditions Survey
Seong-Uk Baek, Jong-Uk Won, Jin-Ha Yoon
BJPsych Open.2023;[Epub] CrossRef
Association between unpredictable work schedule and work-family conflict in Korea
Sang Moon Choi, Chan Woo Kim, Hyoung Ouk Park, Yong Tae Park
Annals of Occupational and Environmental Medicine.2023;[Epub] CrossRef
Mediating Effect of Work–Family Conflict on the Relationship Between Long Commuting Time and Workers' Anxiety and Insomnia
Seong-Uk Baek, Jin-Ha Yoon, Jong-Uk Won
Safety and Health at Work.2023; 14(1): 100. CrossRef
Association Between Commuting Time and Subjective Well-Being in Relation to Regional Differences in Korea
Jaehyuk Jung, Kwon Ko, Jae Bum Park, Kyung-Jong Lee, Yong Hyuk Cho, Inchul Jeong
Journal of Korean Medical Science.2023;[Epub] CrossRef

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Research Articles

Distribution of age, gender, and occupation among individuals with carpal tunnel syndrome based on the National Health Insurance data and National Employment Insurance data: Il-Ho Lee, Young-Ki Kim, Dong-Mug Kang, Se-Yeong Kim, In-Ah Kim, Eun-Mi Kim; Ann Occup Environ Med 2019;31:e31. Published online November 7, 2019; DOI: https://doi.org/10.35371/aoem.2019.31.e31

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Background

The present study aimed to investigate the basic characteristics of carpal tunnel syndrome (CTS) and its differences between occupations using Korea's National Health Insurance (NHI) and National Employment Insurance (NEI).

Methods

The study participants were obtained from the NEI and NHI data from 2008 to 2015, with a diagnosis code of G560 (CTS) as the main or sub-diagnosis. Data about gender, age, diabetes mellitus, smoking, drinking, and length of employment, information about type of occupation, and number of employees according to age and occupation were obtained from NHI and NEI data. In total, 240 occupations were classified into blue-collar (BC) and white-collar (WC) work. In addition, each occupation was classified as high-risk and low-risk groups depending on the degree of wrist usage.

Results

The number of patients with CTS per 100,000 individuals increased with advancing age, and it was higher in women (4,572.2) than in men (1,798.5). Furthermore, the number was higher in BC workers (3,247.5) than in WC workers (1,824.1) as well as in the high-risk group than in the low-risk group in both BC workers (3,527.8 vs. 1,908.2) and WC workers (1,829.9 vs. 1,754.4). The number of patients with CTS was higher in the high-risk group than in the low-risk group among male and female BC workers and female WC workers. However, the number was higher in the low-risk group among male WC workers. In the BC category, the number of patients with CTS was highest among food processing-related workers (19,984.5). In the WC category, the number of patients with CTS was highest among social workers and counselors (7,444.1).

Conclusions

The results of this study are expected to help identify occupational differences in patterns of CTS. High number of patients with CTS was seen in new jobs, as well as in previous studies.

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Effects of shift work on abdominal obesity among 20–39-year-old female nurses: a 5-year retrospective longitudinal study: Gyeong-Jin Lee, Kunhyung Kim, Se-yeong Kim, Jeong-Ho Kim, Chunhui Suh, Byung-Chul Son, Chae-Kwan Lee, Junghye Choi; Ann Occup Environ Med 2016;28:69. Published online December 5, 2016; DOI: https://doi.org/10.1186/s40557-016-0148-6

Abstract PDF PubReader ePub

Background

This study aimed to investigate the effects of shift work on abdominal obesity among young and middle-aged female nurses during a 5-year retrospective study.

Methods

This retrospective study included female nurses (20–39 years old) who worked at a university hospital in Korea and had available health screening results from 2010–2015. Among 2,611 employees, 934 healthy 20–39-year-old female nurses were identified, and data regarding their demographic information (age and date of employment), waist circumferences (WC), and lifestyle factors (alcohol and exercise) were obtained. Abdominal obesity was defined as a WC of ≥80 cm, based on the World Health Organization’s Asia-West Pacific standard in 2000. The mean WC change from baseline was analyzed using the paired t test, and the association between shift work and abdominal obesity was analyzed using the generalized estimating equation.

Results

Compared to all day workers (both age groups), the 20–29-year-old nurses did not exhibit significant changes in WC at each follow-up. However, among the 30–39-year-old nurses, shift workers exhibited a significant change in WC (vs. baseline) during years 4 and 5, compared to day workers. After adjusting for effective confounders and stratifying the participants according to age, the 20–29-year-old nurses exhibited an odds ratio of 3.21 (95 % confidence interval: 1.29–7.98) for shift work-associated obesity, although the odds ratio for the 30–39-year-old nurses was not statistically significant.

Conclusion

In the study population, shift work was associated with a significant change in mean WC among 30–39-year-old nurses, and the shift work-associated risk of abdominal obesity was significant among 20–29-year-old nurses. These results indicate that shift work may influence abdominal obesity differently in 20–29-year-old and 30–39-year-old female nurses.

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Reviews

Evaluation of mercury exposure level, clinical diagnosis and treatment for mercury intoxication: Byeong-Jin Ye, Byoung-Gwon Kim, Man-Joong Jeon, Se-Yeong Kim, Hawn-Cheol Kim, Tae-Won Jang, Hong-Jae Chae, Won-Jun Choi, Mi-Na Ha, Young-Seoub Hong; Ann Occup Environ Med 2016;28:5. Published online January 22, 2016; DOI: https://doi.org/10.1186/s40557-015-0086-8

Abstract PDF PubReader ePub

Mercury occurs in various chemical forms, and it is different to health effects according to chemical forms. In consideration of the point, the evaluation of the mercury exposure to human distinguished from occupational and environmental exposure.

With strict to manage occupational exposure in factory, it is declined mercury intoxication cases by metallic and inorganic mercury inhalation to occupational exposure. It is increasing to importance in environmental exposure and public health.

The focus on the health impact of exposure to mercury is more on chronic, low or moderate grade exposure—albeit a topic of great controversy—, not high concentration exposure by methylmercury, which caused Minamata disease.

Recently, the issue of mercury toxicity according to the mercury exposure level, health effects as well as the determination of what mercury levels affect health are in the spotlight and under active discussion. Evaluating the health effects and Biomarker of mercury exposure and establishing diagnosis and treatment standards are very difficult.

It can implement that evaluating mercury exposure level for diagnosis by a provocation test uses chelating agent and conducting to appropriate therapy according to the result. but, indications for the therapy of chelating agents with mercury exposure have not yet been fully established.

The therapy to symptomatic patients with mercury poisoning is chelating agents, combination therapy with chelating agents, plasma exchange, hemodialysis, plasmapheresis. But the further evaluations are necessary for the effects and side effects with each therapy.

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Evaluation and management of lead exposure: Hwan-Cheol Kim, Tae-Won Jang, Hong-Jae Chae, Won-Jun Choi, Mi-Na Ha, Byeong-Jin Ye, Byoung-Gwon Kim, Man-Joong Jeon, Se-Yeong Kim, Young-Seoub Hong; Ann Occup Environ Med 2015;27:30. Published online December 15, 2015; DOI: https://doi.org/10.1186/s40557-015-0085-9

Abstract PDF PubReader ePub

Lead, which is widely used in industry, is a common element found in low concentrations in the Earth’s crust. Implementations to reduce environmental lead concentrations have resulted in a considerable reduction of lead levels in the environment (air) and a sustained reduction in the blood lead levels of the average citizen. However, people are still being exposed to lead through a variety of routes in everyday commodities.

Lead causes health problems such as toxicity of the liver, kidneys, hematopoietic system, and nervous system. Having a carcinogenic risk as well, the IARC classifies inorganic lead compounds as probably carcinogenic to humans (Group 2A). Occupational lead poisonings have decreased due to the efforts to reduce the lead concentrations in the working environment. In contrast, health hazards associated with long-term environmental exposure to low concentrations of lead have been reported steadily. In particular, chronic exposure to low concentrations of lead has been reported to induce cognitive behavioral disturbances in children.

It is almost impossible to remove lead completely from the human body, and it is not easy to treat health hazards due to lead exposure. Therefore, reduction and prevention of lead exposure are very important. We reviewed the toxicity and health hazards, monitoring and evaluation, and management of lead exposure.

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Research Articles

Decline in non-smoking workers’ urine cotinine levels after increased smoking regulation in Korea: Ju-Hyoung Park, Chae-Kwan Lee, Se-Yeong Kim, Chunhui Suh, Kun-Hyung Kim, Jeong-Ho Kim, Byung-Chul Son, Jong-Tae Lee, Seung-Do Yu, Wookhee Choi, Hosub Im; Ann Occup Environ Med 2015;27:17. Published online June 10, 2015; DOI: https://doi.org/10.1186/s40557-015-0066-z

Abstract PDF PubReader ePub

Objectives

To identify any association between implementing smoking regulation policies and workers’ urine cotinine concentration levels in Korea.

Methods

From the first stage of the Korean National Environmental Health Survey conducted by the National Institute of Environmental Research from 2009 to 2011, 2,475 non-smoking workers selected. We analyzed the trend in the changes of cotinine concentration in urine using the general linear model and linear regression, in various jobs as categorized by the National Center for Health Statistics (NCHS) and Korea Standard Classification of Occupations (KSCO).

Results

The urine cotinine concentration tended to decrease every year (2.91 ng/ml in 2009, 2.12 ng/ml in 2010, and 1.31 ng/ml in 2011), showing a decreasing trend (P < 0.001). The total subjects’ decreased cotinine concentration in urine between 2009 and 2011 was 2.72 ng/ml (54.1 % relative decrease). The changes in each subgroup’s urine cotinine concentration ranged from 1.59 to 6.03 ng/ml (33.2 to 77.5 %). All groups except for the managerial group (n = 49), which had a small sample size, had statistically significant negative regression coefficients (p < 0.05). The ranges of the decrease in urine cotinine were 2.75 ng/ml (53.6 %) for males and 2.72 ng/ml (54.9 %) for females. The negative slope in urine cotinine level was statistically significantly greater in men than women. The changes in urine cotinine by occupation as classified by the NCHS occupational categories ranged from 2.43 to 3.36 ng/ml (46.6 to 61.5 % relative decrease). The negative slopes in urine cotinine levels of the white-collar and farm workers were statistically significantly greater than those of the service workers and blue-collar workers. The change by occupation as classified by the KSCO ranged from 1.59 to 6.03 ng/ml (a 33.2 to 77.5 % relative decrease). The negative slopes in urine cotinine levels of the professionals and related workers and clerks were statistically significantly greater than those of the service workers and plant and machine operators and assemblers.

Conclusions

The cotinine concentration in urine among non-smoking worker groups tended to decline from 2009 to 2011. Such a result may be an indirect indicator of the effectiveness of smoking regulation policies including the revision of the National Health Promotion Act.

Citations

Citations to this article as recorded by

Time trend of exposure to secondhand tobacco smoke and polycyclic aromatic hydrocarbons between 1995 and 2019 in Germany – Showcases for successful European legislation
Therese Burkhardt, Max Scherer, Gerhard Scherer, Nikola Pluym, Till Weber, Marike Kolossa-Gehring
Environmental Research.2023; 216: 114638. CrossRef
Effects of municipal smoke-free ordinances on secondhand smoke exposure in the Republic of Korea
Siwoo Kim, Yuri Lee, Changwoo Han, Min Kyung Kim, Ichiro Kawachi, Juhwan Oh
Frontiers in Public Health.2023;[Epub] CrossRef
Association between Pb, Cd, and Hg Exposure and Liver Injury among Korean Adults
Do-Won Kim, Jeongwon Ock, Kyong-Whan Moon, Choong-Hee Park
International Journal of Environmental Research and Public Health.2021; 18(13): 6783. CrossRef
Public support for health taxes and media regulation of harmful products in South Korea
Kyae Hyung Kim, EunKyo Kang, Young Ho Yun
BMC Public Health.2019;[Epub] CrossRef
Female non-smokers’ environmental tobacco smoking exposure by public transportation mode
Seyoung Kim, Jin-Soo Park, Minkyu Park, Yeji Kim, Sinye Lim, Hye-Eun Lee
Annals of Occupational and Environmental Medicine.2018;[Epub] CrossRef
Exposure to environmental chemicals among Korean adults-updates from the second Korean National Environmental Health Survey (2012–2014)
Wookhee Choi, Suejin Kim, Yong-Wook Baek, Kyungho Choi, Keejae Lee, Sungkyoon Kim, Seung Do Yu, Kyunghee Choi
International Journal of Hygiene and Environmental Health.2017; 220(2): 29. CrossRef

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The effect of applying ethnicity-specific spirometric reference equations to Asian migrant workers in Korea: Nami Kim, Se-Yeong Kim, Yoojun Song, Chunhui Suh, Kun-Hyung Kim, Jeong-Ho Kim, Byung-Chul Son, Chae-Kwan Lee, Jong-Tae Lee; Ann Occup Environ Med 2015;27:14. Published online May 18, 2015; DOI: https://doi.org/10.1186/s40557-015-0065-0

Abstract PDF PubReader ePub

Objectives

Asian migrant workers in Korea have various ethnicities. The purpose of this study was to evaluate the difference in spirometric interpretation made using the set of third National Health and Nutrition Examination Survey (NHANES III) reference equations and the relevant ethnicity-specific reference sets.

Methods

Spirometry was performed on 166 migrant and 498 Korean male workers between March and November 2012. We analyzed the spirometric data of healthy never-smokers. Spirometric patterns were evaluated using the NHANES III reference set and some relevant ethnicity-specific equations (Eom’s equation for Koreans, Ip’s equation for East Asians, Crapo’s equation for Central Asians, Memon’s equation for South Asians, and Gnanou’s equation for Southeast Asian people).

Results

In all migrant groups except the Central Asian group, the forced expiratory volume in 1 second percentage (FEV₁%) and forced vital capacity percentage (FVC%) calculated using each of the ethnicity-specific reference equations considered were significantly higher than those calculated using the NHANES III reference set. This study showed that in the evaluation of the spirometric result of subjects from Southeast Asia or South Asia, the percentage of cases with an abnormal FEV₁ or FVC increased when the NHANES III set of equations was used as compared to when the ethnicity-specific equations were used.

Conclusions

We found that the spirometric results of all ethnic groups were higher and the composition of the abnormal spirometric result was lower when the ethnicity-specific reference equations were used instead of the NHANES III reference set.

Citations

Citations to this article as recorded by

Spirometry Reference Equations for Asian Migrant Workers in Korea: A Proposal
Hwa-Yeon LEE, Yonglim WON
Korean Journal of Clinical Laboratory Science.2023; 55(1): 29. CrossRef
Effect of Race and Ethnicity on Pulmonary Function Testing Interpretation
Darcy D. Marciniuk, Ellen A. Becker, David A. Kaminsky, Meredith C. McCormack, Sanja Stanojevic, Nirav R. Bhakta, Christian Bime, Vikram Comondore, Clayton T. Cowl, Sharon Dell, Jeffrey Haynes, Fred Jaffe, Carl Mottram, Nneka Sederstrom, Mary Townsend, Jo
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Wei Yee Leong, Ananya Gupta, Mehedi Hasan, Sara Mahmood, Samreen Siddiqui, Sajjad Ahmed, Ian Y. Goon, Marie Loh, Theresia H. Mina, Benjamin Lam, Yik Weng Yew, Joanne Ngeow, Jimmy Lee, Eng Sing Lee, Elio Riboli, Paul Elliott, Geak Poh Tan, Sanjay H. Chotir
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Denis Vinnikov, Paul D. Blanc, Nurlan Brimkulov
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Case Report

High lead exposure in two leaded bronze ingot foundry workers: Yoojun Song, Chunhui Suh, Shin-Ae Kim, Nami Kim, Sung-Min Kim, Seong-Wook Jeong, Se-Yeong Kim, Kun-Hyung Kim, Jeong-Ho Kim, Byung-Chul Son, Chae-Kwan Lee, Jong-Tae Lee; Ann Occup Environ Med 2014;26:38. Published online December 1, 2014; DOI: https://doi.org/10.1186/s40557-014-0038-8

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Background

Awareness about lead poisoning in South Korea has increased; however, occupational exposures occurring in small-scale businesses have not been thoroughly investigated. We report two cases of high lead exposure in a leaded bronze ingot foundry.

Case presentation

Two employees, a 54-year-old primary operator and a 46-year-old assistant, at a small-scale metalworking company who had been employed for 18 years and 1 month, respectively, showed elevated blood lead levels (61.1 μg/dL and 51.7 μg/dL, respectively) at an occupational health checkup. Neither worker complained of abnormal symptoms nor signs related to lead poisoning. Health assessment follow-ups were conducted and biological exposure indices of lead were calculated every four weeks. After the initial follow-up assessment, both workers were relocated from the foundry process to the metalworking process. In addition, a localized exhaust system was installed after the second follow-up.

Conclusions

Foundry workers in a small-scale businesses might be at high risk of lead exposure because these businesses might be vulnerable to poor industrial hygiene. Therefore, regular occupational health checkups are required.

Citations

Citations to this article as recorded by

Comparison of Blood Lead Levels in Children and Adolescents with and Without Functional Abdominal Pain
Fatemeh Famouri, Maryam Yazdi, Awat Feizii, Hossein Saneian, Peiman Nasri, Roya Kelishadi
Advanced Biomedical Research.2023;[Epub] CrossRef
Association Between Blood Lead Level With High Blood Pressure in US (NHANES 1999–2018)
Ziyao Huang
Frontiers in Public Health.2022;[Epub] CrossRef
A systematic review of clinical and laboratory findings of lead poisoning: lessons from case reports
Saeed Samarghandian, Farshad M. Shirazi, Farhad Saeedi, Babak Roshanravan, Ali Mohammad Pourbagher-Shahri, Emad Yeganeh Khorasani, Tahereh Farkhondeh, Jan Olav Aaseth, Mohammad Abdollahi, Omid Mehrpour
Toxicology and Applied Pharmacology.2021; 429: 115681. CrossRef
Exposure to lead and other toxic metals from informal foundries producing cookware from scrap metal
Renee Anne Street, Walter Goessler, Saloshni Naidoo, Busisiwe Shezi, Nokulunga Cele, Jaqueline Rieger, Karl Ettinger, Tarylee Reddy, Angela Mathee
Environmental Research.2020; 191: 109860. CrossRef
Bayesian network model to diagnose WMSDs with working characteristics
Gilseung Ahn, Sun Hur, Myung-Chul Jung
International Journal of Occupational Safety and Ergonomics.2020; 26(2): 336. CrossRef
Challenges in diagnosing lead poisoning: A review of occupationally and nonoccupationally exposed cases reported in India
Monica Shirley Mani, Divyani Gurudas Nayak, Herman Sunil Dsouza
Toxicology and Industrial Health.2020; 36(5): 346. CrossRef
Lead Poisoning at an Indoor Firing Range
Kyung Wook Kang, Won-Ju Park
Journal of Korean Medical Science.2017; 32(10): 1713. CrossRef
Occupational Lead Exposure from Indoor Firing Ranges in Korea
Won-Ju Park, Suk-Ho Lee, Se-Ho Lee, Hye-Sik Yoon, Jai-Dong Moon
Journal of Korean Medical Science.2016; 31(4): 497. CrossRef

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Research Article

Discordance in Spirometric Interpretations Based on Korean and Non-Korean Reference Equations: Nami Kim, Mi-Hee Park, Se-yeong Kim, Chunhui Suh, Sangyoon Lee, Kun-Hyung Kim, Chae-Kwan Lee, Dae-Hwan Kim, Jong-Tae Lee; Ann Occup Environ Med 2013;25:42-42. Published online December 27, 2013; DOI: https://doi.org/10.1186/2052-4374-25-42

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Objectives

Korean regression models for spirometric reference values are different from those of other ethnic groups. The purpose of this study was to evaluate discordance in spirometric interpretations based on using Korean reference equations versus non-Korean reference equations.

Methods

Spirometry was performed on 825 Korean male workers from April 2009 to November 2011. The spirometric patterns and disease severity were evaluated using two Korean equations (Choi's and Lee's) and three equations for Caucasians (NHANES III, Morris's, and Knudson's), and the results of Choi's equation were compared with the non-Korean equations. The spirometric patterns were defined as normal, restrictive, and mild and moderate obstructive.

Results

The mean differences in the FEV₁% and FVC% between the two Korean equations were 2.0 ± 1.3% and 3.5 ± 2.2%, respectively. Morris's equation had the greatest difference in the FEV₁% from Choi's equation: 32.9 ± 8.5%. Knudson's equation had the greatest difference in the FVC% from Choi's equation: 10.5 ± 6.5%.

Conclusions

The two Korean equations shared similar characteristics of spirometric interpretation. The spirometric interpretations of Choi's equation were significantly different from those of Morris's equation and Knudson's equation.

Citations

Citations to this article as recorded by

Advances in spirometry testing for lung function analysis
Agnaldo José Lopes
Expert Review of Respiratory Medicine.2019; 13(6): 559. CrossRef

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Case Report

Malignant Fibrous Histiocytoma of the Maxillary Sinus in a Spray Painter from an Automobile Repair Shop: Seok-Hwan Choi, Se-Yeong Kim, Man-Ki Son, Hui-Seok Yang, Sun-Woo Lee, Jung-Il Kim, Kap-Yeol Jung; Ann Occup Environ Med 2013;25:30-30. Published online November 1, 2013; DOI: https://doi.org/10.1186/2052-4374-25-30

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Background

We report a case of a spray painter who developed malignant fibrous histiocytoma (MFH) of the maxillary sinus following long-term exposure to chromium, nickel, and formaldehyde, implying that these agents are probable causal agents of MFH.

Case report

The patient developed right-sided prosopalgia that began twenty months ago. The symptom persisted despite medical treatment. After two months, he was diagnosed with MFH through imaging studies, surgery, and pathological microscopic findings at a university hospital in Seoul. His social, medical, and family history was unremarkable.

The patient had worked for about 18 years at an automobile repair shop as a spray painter. During this period, he had been exposed to various occupational agents, such as hexavalent chromium, nickel, and formaldehyde, without appropriate personal protective equipment. He painted 6 days a week and worked for about 8 hours a day.

Investigation of the patient’s work environment detected hexavalent chromium, chromate, nickel, and formaldehyde.

Conclusions

The study revealed that the patient had been exposed to hexavalent chromium, formaldehyde, and nickel compounds through sanding and spray painting. The association between paranasal cancer and exposure to the aforementioned occupational human carcinogens has been established. We suggest, in this case, the possibility that the paint spraying acted as a causal agent for paranasal cancer.

Citations

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Assessment of heavy metals among auto workers in metropolitan city: a case study
Kaleem Khan, Shahzada Amani Room, Aziz-Ur-Rahim Bacha, Iqra Nabi, Shabir Ahmad, Muhammad Younas, Zahid Ullah, Akhtar Iqbal, Abdulwahed Fahad Alrefaei, Mikhlid H. Almutairi, Jung-Wei Chang, Kai Hsien Chi
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