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Original Article
Relationship between the use of hair products and urine benzophenone-3: the Korean National Environmental Health Survey (KoNEHS) cycle 4
Siyoung Kim, Seong-yong Cho, Seongyong Yoon, Daehwan Kim, Hyun Woo Park, Jisoo Kang, Sung Woo Huh
Ann Occup Environ Med 2024;36:e20.   Published online August 6, 2024
DOI: https://doi.org/10.35371/aoem.2024.36.e20
AbstractAbstract AbstractAbstract in Korean PDFSupplementary MaterialPubReaderePub
Background

Benzophenone-3 is a type of ketone with 2 benzene rings attached to a carbonyl group (C=O) and one benzene ring attached to a hydroxyl group (-OH). As an endocrine-disrupting chemical, benzophenone-3 is known to be associated with reproductive, developmental, thyroid, and endocrine toxicities. Benzophenone-3 is commonly used in hair products, cosmetics, and ultraviolet (UV) filters because of its characteristic property to absorb UV light. This study aims to investigate the association between the use of hair products and urine benzophenone-3 using the data from the Korean National Environmental Health Survey (KoNEHS) cycle 4 (2018–2020), which represents the Korean population.

Methods

Using the KoNEHS cycle 4 survey, the data of 3,796 adults aged ≥ 19 years were analyzed. Based on the 75th percentile concentration of urine benzophenone-3, the participants were divided into the low- and high-concentration groups. Chi-square test was conducted to analyze the association of urine benzophenone-3 with distribution of general characteristics, use of personal care products, consumption of marine foods, and use of plastic products as the variable. Logistic regression analysis was conducted to calculate odds ratios (ORs) for the high-concentration group of urine benzophenone-3 based on the use of hair products.

Results

Women with < 6 times or ≥ 6 times of hair product usage had significantly higher adjusted ORs compared to those who did not use hair products. The calculated ORs were 1.24 (95% confidence interval [CI]: 1.12–1.38) for women with < 6 times of usage and 1.54 (95% CI: 1.33–1.79) for women with ≥ 6 times of usage.

Conclusions

This study revealed the association between the use of hair products and the concentration of urine benzophenone-3 in the general Korean population.

제4기 (2018-2020) 국민환경보건 기초조사를 이용한 헤어제품사용과 요중 벤조페논-3(benzophenone-3)과의 관계
목적
벤조페논-3은 2개의 벤젠고리가 카르보닐기(C=O)에 결합된 케톤 형태로 이루어져 있으며, 한개의 벤젠고리에 히드록시기(-OH)가 결합된 형태를 가지고 있다. 벤조페논-3은 내분비계교란화합물(Endocrine disrupting chemical)로서 생식독성, 발달독성, 갑상선 및 내분비계 독성 등을 가지고 있는 것으로 알려져 있다. 벤조페논-3은 자외선을 흡수하는 특성이 있어, 헤어제품(hair product), 화장품, 자외선차단제 등에 사용된다. 본 연구에서는 대한민국 인구집단를 대표하는 국민환경보건기초조사(KoNEHS) 4주기(2018-2020)의 데이터를 이용하여 헤어제품 사용과 요중 벤조페논-3과의 연관성을 확인하고자 한다.
방법
KoNEHS 4주기의 데이터에서 19세 이상 성인 3,796명의 참가자를 분석하였다. 요중 벤조페논-의 75번째 백분위 수 농도를 기준으로 저농도군과 고농도군으로 나누었다. 연구대상의 요중 벤조페논- 3농도와 일반적 특성, 개인 및 위생용품사용, 해양생물 섭취, 플라스틱용품사용 간의 분포 및 평균을 비교하기 위하여 독립 t-검정과 χ2 테스트를 실시하였다. 헤어제품에 대한 요중 벤조페논-3 대한 승산비(ORs)는 일반적 특성, 개인 및 위생용품사용, 해양생물 섭취, 그리고 플라스틱용품 사용을 보정한 후 로지스틱 회귀분석을 사용하여 계산하였다.
결과
본 연구에서는 여성에서 헤어제품 ‘주 6회 미만 사용군’과 ‘주 6회 이상 사용군’은 ‘사용안함군’에 비해 요중 벤조페논-3 고농도군에 속할 OR 값이 증가하였다. 계산된 OR값은 ‘주 6회 미만 사용군’ 1.24(95% CI: 1.12-1.38), ‘주 6회 이상 사용군’ 1.54 (95% CI: 1.33-1.79)이었다.
결론
본 연구를 통해서 헤어제품 사용과 요중 벤죠페논-3과의 연관성을 확인할 수 있었다.
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Original Article
Relationship between crustacean consumption and serum perfluoroalkyl substances (PFAS): the Korean National Environmental Health Survey (KoNEHS) cycle 4
Sung Woo Huh, Seong-yong Cho, Seongyong Yoon, Daehwan Kim, Hyun Woo Park, Jisoo Kang, Keon Woo Kim
Ann Occup Environ Med 2024;36:e12.   Published online April 19, 2024
DOI: https://doi.org/10.35371/aoem.2024.36.e12
AbstractAbstract AbstractAbstract in Korean PDFPubReaderePub
Background

Perfluoroalkyl substances (PFASs) are non-aromatic organic compounds, whose hydrogen atoms in the carbon chain substituted by fluorine atoms. PFASs exhibit developmental toxicity, carcinogenicity, hepatotoxicity, reproductive toxicity, immunotoxicity, and hormone toxicity. PFASs are used in the production of disposable food packages, aircraft and automobile devices, cooking utensils, outdoor gear, furniture and carpets, aqueous film forming foam (AFFF), cables and wires, electronics, and semiconductors. This study aimed to determine the association between crustacean consumption and serum PFASs.

Methods

Adult participants (2,993) aged ≥ 19 years were extracted from the 4th cycle data of the Korean National Environmental Health Survey (KoNEHS). Based on the 50th percentile concentrations of serum PFASs, participants were divided into the low-concentration group (LC) and the high-concentration group (HC). General characteristics, dietary factors, coated product usage, and personal care product usage, an independent t-test and χ2 test were analyzed. The odds ratio (OR) of serum PFAS concentration against crustacean consumption was estimated via logistic regression analysis adjusting for general characteristics, dietary factors, coated product usage, and personal care product usage.

Results

The OR for the HC of serum PFASs was higher in individuals with ≥once a week crustacean consumption than in those with < once a week crustacean consumption. Estimated ORs were perfluorohexanesulfonic acid 2.15 (95% confidence interval [CI]: 1.53–3.02), perfluorononanoic acid (PFNA) 1.23 (95% CI: 1.07–1.41), and perfluorodecanoic acid (PFDeA) 1.42 (95% CI: 1.17–1.74) in males, and perfluorooctanoic acid 1.48 (95% CI: 1.19–1.84), perfluorooctanesulfonic acid 1.39 (95% CI: 1.27–1.52), PFNA 1.70 (95% CI: 1.29–2.26) and PFDeA 1.43 (95% CI: 1.32–1.54) in females.

Conclusions

This study revealed the association between the crustacean consumption and concentrations of serum PFASs in general Korean population.

제4기(2018-2020) 국민환경보건 기초조사 자료를 이용한 갑각률 섭취와 혈청 괍불화화합물(PFAS)과의 관계.
목적
과불화화합물은 탄소 사슬에 결합 되어 있는 수소 원자가 불소 원자로 대체된 비방향족 유기 화합물이다. PFAS 는 발달 독성, 발암성, 간 독성, 생식 독성, 면역 독성, 신경 독성 및 호르몬 독성 등을 가진다. PFAS는 일회용 식품 포장, 항공, 자동차, 조리기구, 아웃도어 용품, 가구 및 카펫, 수성막포, 케이블 및 배선, 전자 및 반도체 생산에 사용된다. 본 연구에서는 국가를 대표하는 조사인 한국 국민환경보건 기초조사(KoNEHS) 4주기의 데이터를 사용하여 갑각류 섭취와 혈청 PFAS노출과의 연관성을 확인하려고 한다.
방법
KoNEHS 4주기의 데이터에서 19세 이상 성인 2,993명의 참가자를 분석하였다. 혈청 PFAS 의 50번째 백분위 수 농도를 기준으로 저농도군과 고농도군으로 나누었다. 연구대상의 혈청 PFAS 농도와 일반적 특성, 식이요인, 코팅용품 사용, 미용제품 사용간의 분포 및 평균을 비교하기 위하여 독립 t-검정과 χ2 테스트를 실시하였다. 갑각류 섭취에 대한 혈청 PFAS의 승산비는 일반적 특성, 식이요인, 코팅용품 사용, 미용제품 사용을 보정한 후 로지스틱 회귀분석을 사용하여 계산하였다.
결과
본 연구에서는 갑각류 주1회이상 섭취군은 주1회미만 섭취군에 비해 혈청 PFAS 고농도군에 속할 OR 값이 증가하였다. 남성에서는 PFHxS 2.15(95% confidence interval [CI]; 1.53-3.02), PFNA 1.23(95% CI; 1.07-1.41), PFDeA 1.42(95% CI; 1.17-1.74), 여성에서는 PFOA 1.48(95% CI; 1.19-1.84), PFOS 1.39(95% CI; 1.27-1.52), PFNA 1.70(95% CI; 1.29-2.26), PFDeA 1.43(95% CI; 1.32-1.54) 이었다.
결론
갑각류 섭취 횟수가 많을수록 혈청 PFAS (PFOA, PFOS, PFHxS, PFNA, PFDeA) 농도가 증가하였다.
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Original Article
Relationship between the use of plastics in refrigerator food storage and urine phthalate metabolites: the Korean National Environmental Health Survey (KoNEHS) cycle 3
Jisoo Kang, Seong-yong Cho, Seongyong Yoon
Ann Occup Environ Med 2023;35:e53.   Published online December 27, 2023
DOI: https://doi.org/10.35371/aoem.2023.35.e53
AbstractAbstract AbstractAbstract in Korean PDFPubReaderePub
Background

Plastics are high-molecular-weight materials composed of long carbon chains. They are prevalent in daily life, present in various items such as food containers and microwavable packaging. Phthalates, an additive used to enhance their flexibility, are endocrine-disrupting chemicals. We utilized the data from the Korean National Environmental Health Survey (KoNEHS) cycle 3, representing the general South Korean population, to investigate the relationship between the use of plastics in refrigerator food storage and phthalate exposure.

Methods

We assessed 3,333 adult participants (aged ≥ 19 years) including 1,526 men and 1,807 women, using data from KoNEHS cycle 3. Using the 75th percentile concentration, urine phthalate metabolites were categorized into high and low-concentration groups. χ2 test was conducted to analyze variations in the distribution of each variable, considering sociodemographic factors, health-related factors, food intake, the use of plastics, and the concentration of urine phthalate metabolites as the variables. To calculate odds ratios (ORs) for the high-concentration group of urine phthalate metabolites based on the use of plastics in refrigerator food storage, logistic regression analysis was conducted.

Results

In men, the use of plastics in refrigerator food storage had significantly higher adjusted ORs compared to those using the others. The adjusted ORs were calculated as follows: mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) had an OR of 1.35 (95% confidence interval [CI]: 1.05–1.72), mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP) had an OR of 1.48 (95% CI: 1.16–1.88), mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP) had an OR of 1.32 (95% CI: 1.04–1.66), ∑di(2-ethylhexyl) phthalate (∑DEHP) had an OR of 1.37 (95% CI: 1.08–1.74) and mono-n-butyl phthalate (MnBP) had an OR of 1.44 (95% CI: 1.13–1.84).

Conclusion

The concentrations of urine phthalate metabolites (MEHHP, MEOHP, MECPP, ∑DEHP, and MnBP) were significantly higher in men who used plastics in refrigerator food storage compared to those using the others.

제3기(2015-2017) 국민환경보건 기초조사 자료를 이용한 냉장고 식품보관 시 플라스틱을 사용하는 경우와 요중 프탈레이트 대사체간의 관계
목적
플라스틱은 긴 탄소 사슬로 구성된 고분자 물질로 일상생활에서 식품용기, 전자레인지용 포장용기 등 다양한 곳에서 사용되고 있다. 프탈레이트는 플라스틱의 유연성을 증가시키는 가소제로 사용되는데, 이는 내분비계 장애물질로 알려져있다. 본 연구에서는 우리나라 인구를 대표하는 자료인 국민환경보건 기초조사 3기를 이용하여 가정내 냉장고 식품보관 시 플라스틱을 사용하는 경우와 요중 프탈레이트 대사체와의 연관성을 조사하였다.
방법
본 연구는 국민환경보건 기초조사 3기에서 3,333명의 19세 이상 성인을 연구 대상자로 선정하였다. (남자: 1,526명 여자: 1,807명) 요중 프탈레이트 대사체는 75th percentile값을 기준으로 요중 프탈레이트 대사체 고농도군과 저농도군으로 정의하였다. 사회인구학적 요인, 건강행태 요인, 식이요인과 플라스틱 사용, 요중 프탈레이트 대사체 농도간의 분포를 분석하기위해 χ2-test를 사용하였다. 또한 로지스틱 회귀분석을 사용하여 가정내 냉장고 식품보관 시 플라스틱을 사용하는 경우와 요중 프탈레이트 대사체 고농도군에 속할 OR값을 계산하였다.
결과
남성에서 가정내 냉장고 식품보관시 플라스틱을 사용하는 경우 플라스틱을 사용하지 않는 경우보다 요중 프탈레이트 대사체 농도가 높았다. 플라스틱을 사용하는 경우 MEHHP의 고농도군에 해당될 adjusted ORs은 1.35(95%CI: 1.05-1.72), MEOHP 1.48(95%CI: 1.16-1.88), MECPP 1.32(95%CI: 1.04-1.66), ∑DEHP 1.37(95%CI: 1.08-1.74), MnBP 1.44(95%CI: 1.13-1.84)으로 조사되었다.
결론
남성에서 가정내 냉장고 식품 보관 시 플라스틱을 사용하는 경우는 플라스틱을 사용하지 않는 경우보다 요중 프탈레이트 대사체(MEHHP, MEOHP, MECPP, ∑DEHP, MnBP) 농도가 높았다.
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Original Article
Relationship between visual display terminal working hours and headache/eyestrain in Korean wage workers during the COVID-19 pandemic: the sixth Korean Working Conditions Survey
Gayoung Kim, Seong-yong Cho, Jinseok Kim, Seongyong Yoon, Jisoo Kang, Si young Kim
Ann Occup Environ Med 2023;35:e8.   Published online May 9, 2023
DOI: https://doi.org/10.35371/aoem.2023.35.e8
AbstractAbstract AbstractAbstract in Korean PDFPubReaderePub
Background

Prolonged use of visual display terminal (VDT) can cause eyestrain, dry eyes, blurred vision, double vision, headache and musculoskeletal symptoms (neck, shoulder, and wrist pain). VDT working hours among workers have greatly increased during the coronavirus disease 2019 (COVID-19) pandemic. Therefore, this study aimed to investigate the relationship between VDT working hours and headache/eyestrain in wage workers using data from the sixth Korean Working Conditions Survey (KWCS) (2020–2021) conducted during the COVID-19 pandemic.

Methods

We analyzed the sixth KWCS data of 28,442 wage workers aged 15 years or older. The headache/eyestrain that occurred in the last year was assessed. The VDT work group included workers who use VDT always, almost always, and three-fourth of the working hours, while the non-VDT work group included workers who use VDT half of the working hours, one-fourth of the working hours, almost never, and never. To analyze the relationship between VDT working hours and headache/eyestrain, the odds ratios (ORs) and 95% confidence interval (CI) were calculated using logistic regression analysis.

Results

Among the non-VDT work group, 14.4% workers experienced headache/eyestrain, whereas 27.5% workers of the VDT work group experienced these symptoms. For headache/eyestrain, the VDT work group showed adjusted OR of 1.94 (95% CI: 1.80–2.09), compared with the non-VDT work group, and the group that always used VDT showed adjusted OR of 2.54 (95% CI: 2.26–2.86), compared with the group that never used VDT.

Conclusions

This study suggests that during the COVID-19 pandemic, as VDT working hours increased, the risk of headache/eyestrain increased for Korean wage workers.

코로나 19 유행 시기의 임금근로자에서 영상표시단말기(VDT) 작업시간과 두통/눈피로의 연관성: 제 6차 근로환경조사(KWCS)
목적
영상표시단말기(VDT)를 장시간 사용하면 눈의 피로, 안구 건조, 시야 흐림, 복시, 두통 및 근골격계 증상(목, 어깨 및 손목 통증)을 유발할 수 있다. 코로나19의 유행 동안 근로자들의 VDT 근로시간이 크게 증가했다. 본 연구는 코로나19 유행 시기에 실시된 제6차 KWCS(2020-2021) 자료를 활용하여 임금근로자의 VDT 근로시간과 두통/눈피로의 연관성을 조사하고자 하였다.
방법
본 연구는 15세 이상 임금근로자 28,442명을 대상으로 제6차 KWCS 자료를 분석하였다. 두통/눈피로는 지난 1년 동안 발생 여부로 확인하였다. 근무시간 내내, 거의 모든 근무시간, 근무시간 3/4 동안 VDT를 사용할 경우 VDT 작업군으로 분류하였고, 근무시간 절반, 근무시간 1/4, 거의 없음, 전혀 사용하지 않는 경우 VDT 비작업군으로 분류하였다. VDT 근무시간과 두통/눈피로의 관계를 분석하기 위해 로지스틱 회귀분석을 이용하여 승산비(OR)와 95% 신뢰구간(CI)을 계산하였다.
결과
본 연구는 15세 이상 임금근로자 28,442명을 대상으로 제6차 KWCS 자료를 분석하였다. 두통/눈피로는 지난 1년 동안 발생 여부로 확인하였다. 근무시간 내내, 거의 모든 근무시간, 근무시간 3/4 동안 VDT를 사용할 경우 VDT 작업군으로 분류하였고, 근무시간 절반, 근무시간 1/4, 거의 없음, 전혀 사용하지 않는 경우 VDT 비작업군으로 분류하였다. VDT 근무시간과 두통/눈피로의 관계를 분석하기 위해 로지스틱 회귀분석을 이용하여 승산비(OR)와 95% 신뢰구간(CI)을 계산하였다.
결론
본 연구는 코로나19 세계적 유행 기간 동안 VDT 근로시간이 증가함에 따라 한국 임금근로자의 두통/눈피로 위험이 증가함을 시사한다.
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Original Article
Relationship between shellfish consumption and urinary phthalate metabolites: Korean National Environmental Health Survey (KoNEHS) cycle 3 (2015-2017)
Jisoo Kang, Seong-yong Cho, Jinseok Kim, Seongyong Yoon, Jong-min An, Gayoung Kim, Si young Kim
Ann Occup Environ Med 2023;35:e2.   Published online February 6, 2023
DOI: https://doi.org/10.35371/aoem.2023.35.e2
AbstractAbstract AbstractAbstract in Korean PDFPubReaderePub
Background

Phthalates are endocrine disrupting chemicals that are widely used in the production of items of daily life such as in polyvinylchloride plastics, insecticides, and medical devices. This study aimed to determine the association between phthalate exposure and shellfish consumption using data from the Korean National Environmental Health Survey (KoNEHS) cycle 3 (2015–2017), which is a nationally representative survey.

Methods

In this study, we analyzed the KoNEHS cycle 3 data of 3,333 (1,526 men and 1,807 women) adults aged more than 19 years. Data related to the variables of sociodemographic factors, health-related behaviors, dietary factors, seafood consumption frequency, and urinary phthalate metabolites concentrations were collected. The concentrations of urinary phthalate metabolites of all the participants were divided into quartiles to define high and low concentration groups based on the 75th percentile concentration. A χ2 test was conducted to analyze the distribution of independent variables. To analyze the relationship between shellfish consumption and phthalate exposure, the odds ratios (ORs) were calculated using logistic regression analysis.

Results

Total adults with shellfish consumption frequency of over once a week showed the following adjusted ORs for high concentrations of the following metabolites compared with the group that consumed shellfish once a week or less: 1.43 (95% confidence interval [CI]: 1.01–2.06) for mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP), 1.43 (95% CI: 1.01–2.03) for mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP), 1.57 (95% CI: 1.10–2.24) for ∑di-2-ethylhexyl phthalate (∑DEHP), 2.01 (95% CI: 1.46–2.77) for mono-carboxyoctyl phthalate (MCOP), 1.56 (95% CI: 1.11–2.18) for mono-carboxy-isononly phthalate (MCNP), and 2.57 (95% CI: 1.85–3.56) for mono (3-carboxypropyl) phthalate (MCPP).

Conclusions

The concentrations of urinary phthalate metabolites (MEOHP, MECPP, ∑DEHP, MCOP, MCNP, and MCPP) were higher in adults with a higher frequency of shellfish consumption.

국민환경보건 기초조사 제3기(2015-2017) 자료를 이용한 조개류 섭취와 요중 프탈레이트 대사체간의 관계
목적
프탈레이트(phthalate)는 내분비계 장애물질(endocrine disrupting chemicals, EDCs)로서, 일상생활에서 가소제, 살충제, 의료기기 등으로 광범위하게 사용되고 있다. 프탈레이트는 해양 생태계에서 널리 발견되며, 조개류는 해양생태계오염의 대표적인 지표로 사용된다. 현재까지 해양 생태계의 프탈레이트의 오염에 대한 다양한 연구가 수행되고 있으나 국내에서 프탈레이트 노출과 조개류 섭취와 관련된 연구는 아직 이루어진 바가 없다. 따라서 본 연구에서는 우리나라 인구를 대표하는 자료인 국민환경보건 기초조사 제3기(2015-2017) 자료를 이용하여 요중 프탈레이트 대사체와 조개류 섭취와의 연관성을 분석하고자 했다.
방법
본 연구는 국민환경보건 기초조사 제3기(2015-2017) 자료를 이용하여 만 19세 이상 성인 3,333명(남자1,526명과 여자1,807명)을 대상으로 진행하였다. 사회인구학적 변수 및 건강행태 관련 변수 및 식이 요인과 해산물의 섭취 빈도, 요중 프탈레이트 대사체 농도를 변수로 두어 각 변수 간의 분포 차이를 분석하였다. 로지스틱 회귀분석을 사용하여 조개류 섭취빈도에 따라 요중 프탈레이트 대사체 고농도군에 속할 OR값을 계산하였다.
결과
조개류 섭취의 경우 주 1회 초과군에서 MEOHP의 고농도군에 해당될 adjusted ORs은 1.43(95%CI: 1.01-2.06), MECPP 1.43(95%CI: 1.01-2.03), ∑DEHP 1.57(95%CI: 1.10-2.24), MCOP 2.01(95%CI: 1.46-2.77), MCNP 1.56(95%CI: 1.11-2.18), MCPP 2.57(95%CI: 1.85-3.56)으로 조사되었다.
결론
성인에서 조개류 섭취 빈도가 많을수록 요중 프탈레이트 대사체(MEOHP, MECPP, ∑DEHP, MCOP, MCNP, MCPP) 농도가 높았다.

Citations

Citations to this article as recorded by  
  • Urinary phthalate metabolites and heart rate variability: A panel study
    Ziqian Zhang, Miao Liu, Lei Zhao, Linlin Liu, Wenting Guo, Jie Yu, Huihua Yang, Xuefeng Lai, Xiaomin Zhang, Liangle Yang
    Environmental Pollution.2023; 330: 121760.     CrossRef
  • Microplastics induced inflammation and apoptosis via ferroptosis and the NF-κB pathway in carp
    Tianchao Xu, Jie Cui, Ran Xu, Jingwen Cao, Meng-yao Guo
    Aquatic Toxicology.2023; 262: 106659.     CrossRef
  • Relationship between the use of plastics in refrigerator food storage and urine phthalate metabolites: the Korean National Environmental Health Survey (KoNEHS) cycle 3
    Jisoo Kang, Seong-yong Cho, Seongyong Yoon
    Annals of Occupational and Environmental Medicine.2023;[Epub]     CrossRef
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Case Report
Electrocardiogram abnormalities in antimony exposed workers in the automotive brake lining manufacturing industry: a case report
Ha-ram Jo, Seongyong Yoon, Jinseok Kim, Seong-yong Cho, Jong-min An, Gayoung Kim
Ann Occup Environ Med 2022;34:e16.   Published online June 27, 2022
DOI: https://doi.org/10.35371/aoem.2022.34.e16
AbstractAbstract AbstractAbstract in Korean PDFPubReaderePub
Background

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.

Case presentation

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).

Conclusions

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.

자동차 브레이크 라이닝 제조업에 근무하는 안티몬 노출 근로자의 심전도 이상: 사례 보고서
배경
안티몬은 촉매, 살충제, 브레이크 시스템 및 의약품에 사용되며 플라스틱, 페인트 및 고무 산업에서 합성 난연제로 사용된다. 3가 안티몬 화합물이 체내에 축적되면 심장 독성 효과를 일으켜 심전도(ECG) 이상 및 급사의 위험이 증가할 수 있다. 3가 안티몬 화합물의 직업적 노출은 활동 전위 연장을 일으켜 심장 재분극 지연을 유발할 수 있으며, 이는 QTc 연장과 T파 이상으로 나타난다. 아직 국내에서는 3가 안티몬 화합물 노출과 관련된 심장 독성에 관한 연구는 없다. 이에 본 연구에서는 경상북도 지역에 위치한 회사에서 삼황화 안티몬을 취급하는 작업자의 심전도 이상 사례를 보고한다.
증례
자동차 브레이크 라이닝 제조업체에 고용된 19명의 작업자가 열성형, 연삭 및 드릴링 공정을 통해 삼황화 안티몬 분진에 노출되어 왔다. 2020년에 삼황화 안티몬에 노출 공정 근로자 19명은 주 5일 12시간 교대로 근무하였다. 근로자에게서 측정한 삼황화 안티몬 노출의 시간 가중 평균(TWA)은 0.0028 mg/m3였다. 2명의 근로자는 심장질환 과거력으로 인해 분석에서 제외되었다. 나머지 17명의 작업자 중 41%에서 ECG 이상이 발견되었다(17명 중 7명의 작업자: QTc 연장 및 T 파 이상 4명, T 파 이상 2명, QTc 연장 1명).
고찰
이 증례 보고서는 국내 최초로 직업상 안티몬 노출로 인한 잠재적인 심장 독성이 확인된 증례에 관해 설명한다. 그러나 우리나라에서는 안티몬 노출에 의한 심장 독성에 대한 자료가 아직 부족한 실정이다. 따라서 인과관계를 규명하기 위해서는 추가적인 연구가 필요하다.
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Research Article
Relationship between shift work and age-related macular degeneration: a cross-sectional analysis of data from the 5th Korea National Health and Nutrition Examination Survey (2010–2012)
Kibeom Kim, Seongyong Yoon, Jinseok Kim, Kuck-Hyun Woo, Seong-yong Cho, Ha-ram Jo
Ann Occup Environ Med 2021;33:e7.   Published online February 8, 2021
DOI: https://doi.org/10.35371/aoem.2021.33.e7
AbstractAbstract PDFPubReaderePub
Background

Age-related macular degeneration (AMD) is the leading cause of blindness. Shift work has well-known adverse effects on health. However, few studies have investigated the relationship between shift work and AMD. This study was conducted to investigate the relationship between shift work and AMD.

Methods

This study used aggregated data from the 2010–2012 cycles of the Korea National Health and Nutrition Examination Survey. The work schedules were classified into 2 types: day work and shift work. AMD was determined using fundus photographs. The χ2 test and multiple logistic regression analysis were used to assess sex-stratified relationship between shift work and AMD.

Results

The odds ratio (OR) of AMD in male shift workers was higher (1.54 [95% confidence interval, CI: 1.01–2.36]) than that in male day workers after adjusting for covariates. After dividing into subgroups of the shift work pattern, the OR of AMD in male night shift workers was higher (1.75 [95% CI: 1.07–2.85]) than that in male day workers after adjusting for covariates. However, results of the female worker group were not significant.

Conclusions

The results of this study provide limited support for the hypothesis that shift work is related to AMD. Further prospective studies are needed to define the relationship between shift work and AMD.


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    Muhammed Batur, Pınar Güzel Özdemir, Rumeysa Bilmez Tan, Zeynep Şahin Taş
    Chronobiology International.2024; 41(3): 393.     CrossRef
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    Renata Skýpalová, Martin Šikýř, Roman Urban
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    Junhyeong Lee, Ui-Jin Kim, Yongho Lee, Eunseun Han, Seunghon Ham, Wanhyung Lee, Won-Jun Choi, Seong-Kyu Kang
    Annals of Occupational and Environmental Medicine.2021;[Epub]     CrossRef
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Research Article
Association of work–life balance with occupational injury and work-related musculoskeletal pain among Korean workers
Jong-min An, Jinseok Kim, Seongyong Yoon, Kuck-Hyun Woo, Seong-yong Cho, Kibeom Kim, Ha-ram Jo
Ann Occup Environ Med 2020;32:e20.   Published online June 30, 2020
DOI: https://doi.org/10.35371/aoem.2020.32.e20
AbstractAbstract PDFPubReaderePub
Background

The concept of work-life balance (WLB) has become an important issue in workers' health and safety. This study aims to investigate the relationship between WLB and occupational injury and work-related musculoskeletal pain.

Method

The study included 27,383 workers who participated in the Fifth Korean Working Conditions Survey. Participants were divided into good WLB and poor WLB groups based on their responses to the five question items which comprised two dimensions: work-on-life conflict (items, 1–3) and life-on-work conflict (items 4 and 5). Occupational injury and musculoskeletal pain were also assessed using the question items. The χ2 test and multivariate logistic regression analyses were performed to examine the relationship of WLB to occupational injury and musculoskeletal pain while considering socio-demographic and occupational characteristics and ergonomic and psychological risk factors.

Results

Of the 27,383 participants, 252 (0.9%) had experienced an occupational injury and 6,408 (23.4%) had musculoskeletal pain. The poor WLB group had higher injury rates for both men (1.7%) and women (0.9%) than the good WLB group (1.1% and 0.4%, respectively). Additionally, the prevalence of musculoskeletal pain was higher for both men and women in the poor WLB group (25.2% and 28.0%, respectively) than for men and women in the good WLB group (18.7% and 23.6%, respectively). In the logistic regression analysis, the adjusted odds ratio of WLB for occupational injury was 1.37 (95% confidence interval [CI]: 1.06–1.78), and that for musculoskeletal pain was 1.14 (95% CI: 1.07–1.21), showing positive associations of WLB with both occupational injury and musculoskeletal pain.

Conclusions

Poor WLB causes an increase in occupational injury and musculoskeletal pain. Therefore, an improvement in WLB may reduce the incidence of occupational injury and musculoskeletal pain among workers. Social and policy-related initiatives are needed to improve workers' WLB to reduce occupational injury and musculoskeletal pain.


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  • Construction and validation of a musculoskeletal disease risk prediction model for underground coal miners
    Haili Zhao, Hong Dou, Xianting Yong, Wei Liu, Saiyidan Yalimaimaiti, Ying Yang, Xiaoqiao Liang, Lili Sun, Jiwen Liu, Li Ning
    Frontiers in Public Health.2023;[Epub]     CrossRef
  • Exploring the relationship between work–family conflict and sleep disturbance: a study on stratification and interaction
    Jian Lee, Juyeon Oh, Heejoo Park, Juho Sim, Jongmin Lee, Yangwook Kim, Byungyoon Yun
    Frontiers in Psychology.2023;[Epub]     CrossRef
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Research Article
Difference in health status of Korean farmers according to gender
Ho Lee, Seong-yong Cho, Jin-seok Kim, Seong-yong Yoon, Bu-il Kim, Jong-min An, Ki-beom Kim
Ann Occup Environ Med 2019;31:7.   Published online March 8, 2019
DOI: https://doi.org/10.1186/s40557-019-0287-7
AbstractAbstract PDFPubReaderePub
Background

The objective of this study was to compare differences in lifestyle diseases, musculoskeletal pain, psychosocial stress, and self-health awareness according to gender in Korean farmers.

Methods

The study population comprised 436 farmers residing in rural areas in Korea. A self-administered questionnaire was used to survey demographic characteristics, health-related behaviors, and musculoskeletal pain. The psychosocial well-being index short form (PWI-SF) was used to survey psychosocial stress, and the 12-item short form health survey (SF-12) was used to survey self-health awareness. In addition, a clinical examination was performed for each participant, and lifestyle diseases were identified through a health checkup.

Results

Among lifestyle diseases, females showed a significantly higher proportion than males for metabolic syndrome (OR: 4.57 [95% CI, 1.67–12.51]). For musculoskeletal pain, females again showed significantly higher proportion than males for hand pain (OR: 16.79 [95% CI, 3.09–91.30]), and pain in at least one body part (OR: 2.34 [95% CI, 1.16–4.70]). For psychosocial stress, females showed a significantly higher proportion than males for high-risk stress (OR: 3.10 [95% CI, 1.17–8.24]). Among the items in self-health awareness, females showed significantly higher proportion than males for mental component score (MCS) (OR: 3.10 [95% CI, 1.52–6.31]) and total score (OR: 2.34 [95% CI, 1.11–4.90]).

Conclusions

For all items that showed significant differences, females showed higher proportion than males, which indicates that female farmers tended to have poorer overall health than male farmers. Therefore, specialized programs will have to be developed to improve the health of female farmers.


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    Religación. Revista de Ciencias Sociales y Humanidades.2022; 7(34): e210983.     CrossRef
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    International Journal of Environmental Research and Public Health.2019; 16(23): 4849.     CrossRef
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Research Article
Factors related with quality on sleep of daytime workers
Bu-il Kim, Seong-yong Yoon, Jin-seok Kim, Kuck-Hyeun Woo, Seong-yong Cho, Ho Lee, Jong-min An
Ann Occup Environ Med 2018;30:63.   Published online October 23, 2018
DOI: https://doi.org/10.1186/s40557-018-0271-7
AbstractAbstract PDFPubReaderePub
Background

This study was conducted to identify the sleep status of daytime workers who do not work in shifts. This study analyzed factors affecting sleep duration and sleep quality.

Methods

This study was conducted on 1171 daytime workers at a manufacturing workshop. We used a self-administered questionnaire to investigate demographic variables, work type, working period, musculoskeletal symptoms and the Pittsburgh Sleep Quality Index to assess sleep. Regular health checkup was conducted for the worker’s clinical examination.

Results

The mean sleep duration was 6.36 h and the mean score on the Pittsburgh Sleep Quality Index was 4.46. Work type and obesity were related to sleep duration. Age, obesity and musculoskeletal pain were significantly related to sleep quality. The prevalence ratio of researcher group for short sleep duration was 1.27 (95% confidence interval: 1.02–1.58). The prevalence ratio of those aged 50 years and over was 0.47 (0.25–0.91) and of those in their 40s was 0.56 (0.35–0.91) for poor sleep quality compared to those in their 20s. The prevalence ratio of the obesity group for poor sleep quality was 1.53 (1.10–2.12). The prevalence ratio of musculoskeletal pain group for poor sleep quality was 1.92 (1.29–2.84).

Conclusions

Age, obesity and musculoskeletal pain were factors affecting the poor quality on sleep of daytime workers. In addition, work type related to short sleep duration.


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    Vergílio Pereira Carvalho, Kênia Alves Barcelos, Ely Paula de Oliveira, Sarah Nogueira Marins, Isabella Beatriz Silva Rocha, Daniel Ferreira Moraes de Sousa, Bruno Cabral Moreira, Gunther Abreu de Almeida, Marina Luana Silva Carneiro, Jéssica Duarte de Fr
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  • Sleep quality and health-related quality of life in workers of Kermanshah Industrial Town: A correlation study
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    Indian Journal of Occupational and Environmental Medicine.2020; 24(2): 72.     CrossRef
  • Shift rotation, circadian misalignment and excessive body weight influence psychomotor performance: a prospective and observational study under real life conditions
    Dayane Eusenia Rosa, Luisa Pereira Marot, Marco Túlio de Mello, Fernanda Veruska Narciso, Bruno da Silva Brandão Gonçalves, Elaine Cristina Marqueze, Cibele Aparecida Crispim
    Scientific Reports.2019;[Epub]     CrossRef
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Research Article
Psychological effects of a disastrous hydrogen fluoride spillage on the local community
Seung-Hyun Yoo, Seong-Yong Yoon, Kuck-Hyun Woo, Jin-Seok Kim, Seong-Yong Cho, Sung-Soo Lee, Hyun-Sul Lim, Yeon-Soon Ahn, Won-Ho Yang
Ann Occup Environ Med 2017;29:40.   Published online September 11, 2017
DOI: https://doi.org/10.1186/s40557-017-0196-6
AbstractAbstract PDFPubReaderePub
Background

On September 27, 2012, at 3:43 pm, a hydrogen fluoride spill occurred in a manufacturing plant located at the 4th complex of the Gumi National Industrial Complex in Gumi City, South Korea. The present study aimed to evaluate the psychological effects of the hydrogen fluoride spill on the members of the community and to investigate their relationships with physical symptoms and changes in psychological effects occurring as time passed after the accident.

Methods

The 1st phase involved a survey of 1359 individuals that was conducted 1 month after the spill, and the 2nd phase involved a survey of 711 individuals that was conducted 7 months after the accident. The questionnaires included items for assessing demographic characteristics, hydrogen fluoride exposure level, physical symptoms, and psychological status. Physical symptoms were assessed to determine the persistence of irritations. Psychological status was assessed to investigate the impact of event level using the Impact of Event Scale – Revised Korean version (IES-R-K), and the anxiety level was assessed using the Beck Anxiety Inventory (BAI).

Results

As the hydrogen fluoride exposure level increased, the impact of event and anxiety levels increased significantly both 1 and 7 months after the accident (p < 0.05). The mean score of the impact of event levels decreased significantly from 33.33 ± 14.64 at 1 month after the accident to 28.68 ± 11.80 at 7 months after the accident (p < 0.05). The mean score of the anxiety levels increased significantly from 5.16 ± 6.59 at 1 month after the accident to 6.79 ± 8.41 at 7 months after the accident (p < 0.05). The risk of persistent physical symptoms at 7 months after the accident was significantly higher in females. The risk of persistent physical symptoms also increased significantly, with increasing age, hydrogen fluoride exposure, and impact of event levels (p < 0.05).

Conclusions

The present study found that the impact of event level and anxiety level increased with increasing hydrogen fluoride exposure. Anxiety levels persisted even after time passed. The risk of persistent physical symptoms at 7 months after the accident was higher in females, and it increased with increasing age, hydrogen fluoride exposure level, and impact of event levels.


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Research Article
Risks of borderline liver enzyme abnormalities to the incidence of impaired fasting glucose and diabetes mellitus: a 7 year follow up study of workers
Jin-Hyun Yu, Jin-Seok Kim, Mee-Ra Lee, Seong-Yong Yoon, Seong-Yong Cho, Seung-Hyun Yoo, Boo-Il Kim
Ann Occup Environ Med 2016;28:18.   Published online April 7, 2016
DOI: https://doi.org/10.1186/s40557-016-0105-4
AbstractAbstract PDFPubReaderePub
Background

The aim of this study was to identify the relationships between borderline serum liver enzyme abnormalities and the incidence of impaired fasting glucose (IFG) and diabetes mellitus (DM) during a 7-year follow-up of workers, and to evaluate the quantitative level of risks.

Methods

A total of 749 workers in an electronics manufacturing company were divided into the normal fasting blood glucose (n = 633), IFG (n = 98), and DM (n = 18) groups, according to the results of their health checkup in 2006. Among 633 workers in the normal group, excluding 55 workers who were impossible to follow, incidence rate and relative risks of 578 workers to the IFG or DM in 2013 according to the levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma-glutamyltransferase (γ-GTP) were investigated. The liver enzyme levels were categorized as A (normal), B (borderline elevation), and R (definite elevation) following the standard of the National Health Insurance Service of Korea.

Results

The incidence rate of IFG or DM based on ALT level was 9.7 % for the A, 30.0 % for B, and 15.4 % for R. According to γ-GTP, the incidence rate was 9.8 % for A, 34.5 % for B, and 25.0 % for R. The relative risk(RR) to the incidence of IFG or DM depending on the level of ALT were 3.09 in B and 1.59 in R compared to A. According to γ-GTP, RR was 3.52 in B and 2.55 in R compared to A. AST level was not related to the incidence of IFG or DM. A multiple logistic regression analysis with the incidence of IFG or DM as a dependent variable resulted in an odds ratio of 2.664(1.214–5.849) for B level ALT, 3.685(1.405–9.667) for B level of γ-GTP even after adjustment for other variables such as age, sex, body mass index, AUDIT score, systolic blood pressure, and triglyceride.

Conclusions

Even borderline elevations of ALT and γ-GTP, but not AST, increased the incidence and risk of IFG or DM after 7 years. Borderline elevation of ALT and γ-GTP was identified as an independent risk factor of IFG or DM.


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Case Report
Acute health effects of accidental chlorine gas exposure
Joo-An Kim, Seong-Yong Yoon, Seong-Yong Cho, Jin-Hyun Yu, Hwa-Sung Kim, Gune-Il Lim, Jin-Seok Kim
Ann Occup Environ Med 2014;26:29-29.   Published online October 1, 2014
DOI: https://doi.org/10.1186/s40557-014-0029-9
AbstractAbstract PDFPubReaderePub
Objectives

This study was conducted to report the course of an accidental release of chlorine gas that occurred in a factory in Gumi-si, South Korea, on March 5, 2013. We describe the analysis results of 2 patients hospitalized because of chlorine-induced acute health problems, as well as the clinical features of 209 non-hospitalized patients.

Methods

We analyzed the medical records of the 2 hospitalized patients admitted to the hospital, as well as the medical records and self-report questionnaires of 209 non-hospitalized patients completed during outpatient treatment.

Results

Immediately after the exposure, the 2 hospitalized patients developed acute asthma-like symptoms such as cough and dyspnea, and showed restrictive and combined pattern ventilatory defects on the pulmonary function test. The case 1 showed asthma-like symptoms over six months and diurnal variability in peak expiratory flow rate was 56.7%. In case 2, his FEV1 after treatment (93%) increased by 25% compared to initial FEV1 (68%). Both cases were diagnosed as chlorine-induced reactive airways dysfunction syndrome (RADS) on the basis of these clinical features. The most frequent chief complaints of the 209 non-hospitalized patients were headache (22.7%), followed by eye irritation (18.2%), nausea (11.2%), and sore throat (10.8%), with asymptomatic patients accounting for 36.5%. The multiple-response analysis of individual symptom revealed headache (42.4%) to be the most frequent symptom, followed by eye irritation (30.5%), sore throat (30.0%), cough (29.6%), nausea (27.6%), and dizziness (27.3%).

Conclusions

The 2 patients hospitalized after exposure to chlorine gas at the leakage site showed a clinical course corresponding to RADS. All of the 209 non-hospitalized patients only complained of symptoms of the upper airways and mucous membrane irritation.


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Research Article
Occupational Factors Associated with Changes in the Body Mass Index of Korean Male Manual Workers
In-Woong Song, Kuck-Hyun Woo, Jin-Seok Kim, Seong-Yong Yoon, Joo-Yong Na, Jin-Hyun Yu, Seong-Yong Cho
Ann Occup Environ Med 2013;25:40-40.   Published online December 27, 2013
DOI: https://doi.org/10.1186/2052-4374-25-40
AbstractAbstract PDFPubReaderePub
Objectives

This study was carried out to analyze and compare the occupational factors that could influence changes in body mass index (BMI) in male manual workers stratified into short-term and long-term work experience groups.

Methods

The subjects were 299 male manual workers (sampled systematically) from 27 workplaces, who had undergone travelling medical examinations at a university hospital between March 28 and May 10, 2013, and had also undergone medical examinations at the same hospital in 2012. Their general and occupational characteristics were investigated through a structured, self-administered questionnaire. The BMI at each point in time was calculated based on the anthropometric results of the medical examinations. Multiple regression analyses were conducted on outcomes of the BMI change and predictors composed of the general and occupational characteristics, with the subjects stratified into groups with 5 years or less (short-term) versus more than 5 years (long-term) of work experience at the present post.

Results

In the short-term work experience group, the BMI increases of 3-shift workers and groups reporting disagreement with feeling “insufficient job control” and “lack of reward” at work, two of the subscales of job stress, were significantly higher than those of daytime workers and high-stress groups, respectively. In the long-term work experience group, However, although the BMI increase for 3-shift workers was also significantly higher than that of daytime workers, none of the job stress factors were significantly associated with a BMI increase, whereas the social factors of education and marital status were significant, and some lifestyle factors (such as smoking and regular exercise) were also significant.

Conclusion

This study showed that, except for 3-shift work, the factors associated with BMI increase could differ depending on the length of job experience. Consequently, different strategies may be needed for workers with short-term versus long-term job experience when designing interventions for preventing their obesity.


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    Zsolt Szakály, Zsófia Pápai, Zsuzsanna Liszkai, József Bognár, Csaba András Dézsi
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Research Article
Acute Symptoms in Firefighters who Participated in Collection Work after the Community Hydrogen Fluoride Spill Accident
Seong-Yong Cho, Kuck-Hyun Woo, Jin-Seok Kim, Seong-Yong Yoon, Joo-Yong Na, Jin-Hyun Yu, Yong-Bae Kim
Ann Occup Environ Med 2013;25:36-36.   Published online November 28, 2013
DOI: https://doi.org/10.1186/2052-4374-25-36
AbstractAbstract PDFPubReaderePub
Objectives

This study aimed to analyze the relationship between clinical status and work characteristics of firefighters and other public officers who engaged on collection duties in the site of the hydrogen fluoride spill that occurred on September 27, 2012, in Gumi City, South Korea.

Methods

We investigated the clinical status, personal history, and work characteristics of the study subjects and performed physical examination and several clinical examinations, including chest radiography, echocardiography, pulmonary function test, and blood testing in 348 firefighters, police officers, volunteer firefighters, and special warfare reserved force who worked at the hydrogen fluoride spill area.

Results

The subjects who worked near the accident site more frequently experienced eye symptoms (p = 0.026), cough (p = 0.017), and headache (p = 0.003) than the subjects who worked farther from the accident site. The longer the working hours at the accident area, the more frequently the subjects experienced pulmonary (p = 0.027), sputum (p = 0.043), and vomiting symptoms (p = 0.003). The subjects who did not wear respiratory protective devices more frequently experienced dyspnea than those who wore respiratory protective devices (p = 0.013). In the pulmonary function test, the subjects who worked near the accident site had a higher decease in forced vital capacity than the subjects who worked farther from the site (p = 0.019); however, no statistical association was found between serum calcium/phosphate level, echocardiography result, chest radiographic result, and probation work characteristics.

Conclusions

The subjects who worked near the site of the hydrogen fluoride spill, worked for an extended period, or worked without wearing respiratory protective devices more frequently experienced upper/lower respiratory, gastrointestinal, and neurological symptoms. Further follow-up examination is needed for the workers who were exposed to hydrogen fluoride during their collection duties in the chemical plant in Gumi City.


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Research Article
Acute Symptoms after a Community Hydrogen Fluoride Spill
Joo-Yong Na, Kuck-Hyun Woo, Seong-Yong Yoon, Seong-Yong Cho, In-Ung Song, Joo-An Kim, Jin-Seok Kim
Ann Occup Environ Med 2013;25:17-17.   Published online September 19, 2013
DOI: https://doi.org/10.1186/2052-4374-25-17
AbstractAbstract PDFPubReaderePub
Objectives

This study was conducted to describe the demographic characteristics, and clinical signs and symptoms of patients who visited a general hospital because of the release of chemically hazardous hydrogen fluoride that occurred on September 27, 2012 in Gumi City, Korea.

Methods

The medical records at 1 general hospital 9 km from the accident site were reviewed using a standardized survey format. There were 1,890 non-hospitalized and 12 hospitalized patients exposed to hydrogen fluoride between September 27 and October 13 2012.

Results

Among the 12 hospitalized patients, 11 were discharged within 1 week and the other was hospitalized for 10 days. The chief complaints were respiratory symptoms such as hemoptysis and shortness of breath, gastrointestinal symptoms, neurologic symptoms, sore throat, and lip burn.

The number of non-hospitalized patients exhibited a bimodal distribution, peaking on the first and twelfth days after the accident. Their chief complaints were sore throat (24.1%), headache (19.1%), cough (13.1%), and eye irritation (9.2%); some patients were asymptomatic (6.2%). Patients who visited the hospital within 3 days (early patients) of the spill more often had shortness of breath (27.0%) and nausea (6.3%) as the chief complaints than patients who visited after 3 days (late patients) (3.5% and 2.6%, respectively). However, cough and rhinorrhea were more common in the late patients (14.0% and 3.3%, respectively) than in the early patients (5.0% and 0.0%, respectively). Patients who were closer to the accident site more often had shortness of breath and sputum as the chief complaints than patients who were farther away. The mean serum calcium concentration was 9.37 mg/dL (range: 8.4–11.0 mg/dL); none of the patients had a decreased serum calcium level. Among 48 pulmonary function test results, 4 showed decreased lung function. None of the patients had abnormal urine fluoride levels on the eighth day after exposure.

Conclusions

Patients hospitalized due to chemical hazard release of hydrogen fluoride had acute respiratory, gastrointestinal, and neurologic health problems. Non-hospitalized patients have acute symptoms mainly related to upper respiratory irritation.


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