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Research Article
Validity assessment of self-reported smoking status in firefighters using the urine cotinine test
Han Cheol Heo, Young Seok Byun, Soo Ho Sohn, Seong Min Jo, Sung Kyu Park, Joon Sakong
Ann Occup Environ Med 2020;32:e2.   Published online January 2, 2020
DOI: https://doi.org/10.35371/aoem.2020.32.e2
AbstractAbstract PDFPubReaderePub
Background

In firefighters, smoking management is important because they are exposed to various harmful substances in their occupational environment. Accurate surveys of smoking status are essential to control tobacco use. The main disadvantage of self-report questionnaires, which are commonly used for investigating smoking status, is the possibility that the subjects' response are invalid. If the validity of firefighters' answers on smoking questionnaires is not adequate, different methods will be needed for investigating smoking status in firefighters.

Methods

This study was conducted on 445 male firefighters from 9 fire stations in Daegu (the city in South Korea) who visited a medical institution for medical checkup in 2016. The urine cotinine test strip (DCT-102; CLIAwaived Inc., cut-off value = 200 ng/mL) was used to classify the actual smoking status and to assess the validity of self-reported smoking status on questionnaires. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the smoking questionnaires were analyzed. Subjects testing positive in the urine cotinine test (assumed the actual current smokers) were selected. The frequency at which actual current smokers were misclassified as current non-smokers by the questionnaire was calculated. Subjects' characteristics were analyzed for possible association with any discrepancy between self-reported smoking status and urine cotinine test results.

Results

The smoking rates among firefighters surveyed using the smoking questionnaire and the urine cotinine test were 22.47% and 51.24%, respectively. Of the all subjects, 29.66% (n = 132) were misclassified. The sensitivity of the smoking questionnaire was 42.98%, the specificity was 99.08%, the PPV was 98.00%, and the NPV was 62.32%. In the 228 subjects classified as current actual smokers by the urine cotinine test, 57.02% (n = 130) were misclassified on the questionnaire. The misclassification rate increased with age. The degree of misclassification also increased when subjects had a history of disease.

Conclusions

In present study, the validity of the smoking questionnaire for firefighters was not suitable for investigating smoking status due to low sensitivity. To increase the validity of smoking status monitoring in firefighters, consideration of the various factors like survey environment, subjects' characteristics, and occupational factors is needed.


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  • Association between Smoking Status and the Risk of Hip Fracture in Patients with Type 2 Diabetes: A Nationwide Population-Based Study
    Se-Won Lee, Jun-Young Heu, Ju-Yeong Kim, Jinyoung Kim, Kyungdo Han, Hyuk-Sang Kwon
    Endocrinology and Metabolism.2023; 38(6): 679.     CrossRef
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    Takashi Yoshioka, Takahiro Tabuchi, Stanton A. Glantz
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    Biban Gill, Philip Britz-McKibbin
    Current Opinion in Environmental Science & Health.2020; 15: 57.     CrossRef
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Research Article
Association of cadmium with diabetes in middle-aged residents of abandoned metal mines: the first health effect surveillance for residents in abandoned metal mines
Hee-seung Son, Soo-geun Kim, Byung-seong Suh, Dong-uk Park, Dae-seon Kim, Seung-do Yu, Yeong-seoub Hong, Jung-duck Park, Byung-kook Lee, Jai-dong Moon, Joon Sakong
Ann Occup Environ Med 2015;27:20.   Published online August 24, 2015
DOI: https://doi.org/10.1186/s40557-015-0071-2
AbstractAbstract PDFPubReaderePub
Objective

The aim of this study was to determine the association between urinary cadmium (U-cd) concentration and diabetes in middle-aged Korean residents of abandoned mines using the first Health Effect Surveillance for Residents in Abandoned Metal mines (HESRAM).

Methods

This study was cross-sectional study conducted on 719 residents between 40–70 years in 38 abandoned metal mines in Korea. Data was collected by HESRAM from 2008 to 2011. The correlation coefficient of U-cd and fasting blood glucose, odds ratio in urinary cadmium tertiles and diabetes prevalence was analyzed according to the sex category.

Results

The correlation coefficient U-cd concentration and fasting blood glucose was 0.182 in male. Logistic regression analysis in male revealed a third tertile odds ratio of U-cd (2 μg/g creatinine < U-cd) while diabetes prevalence was 1.81 (95 % CI 1.05-3.12) with adjusted age, BMI, smoking and alcohol consumption, region, family income. On the other hand, the odds ratio for third tertile of U-cd (3 μg/g creatinine < U-cd) between diabetes prevalence in female was 1.39 (95 % CI 0.52-3.72) in addition to adjusted menopausal status.

Conclusions

Environmental exposure to cadmium in abandoned mine residents was associated with diabetes in male. Closed monitoring and periodic evaluation of the health effects of chronic environmental exposure on abandoned mines residents will be needed.


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    Amany El-Sikaily, Mohamed Helal
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Research Article
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
AbstractAbstract PDFPubReaderePub
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.


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  • Time trend of exposure to secondhand tobacco smoke and polycyclic aromatic hydrocarbons between 1995 and 2019 in Germany – Showcases for successful European legislation
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    Do-Won Kim, Jeongwon Ock, Kyong-Whan Moon, Choong-Hee Park
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Original Article
Second-hand Smoke Exposure and Urine Cotinine Levels by Occupation in the Busan, Ulsan, Kyeongnam Provinces
So Ryong Lee, Soo Jin Jeong, Chun Hui Suh, Chae Kwan Lee, Chang Hee Lee, Byung Chul Son, Dae Hwan Kim, Jeong Ho Kim, Jong Tae Lee, Jin Heon Lee, Moon Young Hwang, Choong Hee Park
Korean Journal of Occupational and Environmental Medicine 2011;23(1):42-52.   Published online March 31, 2011
DOI: https://doi.org/10.35371/kjoem.2011.23.1.42
AbstractAbstract PDF
OBJECTIVES
Exposure to second-hand smoke varied by smoking rate in the workplace and no-smoking policies. The purpose of this study was to estimate the status of second-hand smoke exposure by occupation through urine cotinine analysis in Busan, Ulsan, and Kyeongnam provinces.
METHODS
Data was obtained from the National Institute of Environmental Research of Korea as 'The 2008 Korea National Survey for Environmental Pollutants in Human Body'. We selected 629 non-smokers who lived in Busan, Ulsan and Gyeongnam provinces. General and occupational characteristics were gathered using a structured questionnaire. Urine cotinine concentrations were analyzed by a gas chromatograph-mass selective detector. Statistical analysis was carried out using the Chi-square test, Student t-test and ANOVA.
RESULTS
The geometric mean (geometric standard deviation) of urine cotinine concentration was 17.11 (2.74) ng/ml. The urine cotinine concentration of the middle school graduate group (18.47 (2.86) ng/ml) was higher than the college graduate group (15.64 (2.60) ng/ml, p=0.212). Also, the cotinine concentration of current drinkers (18.98 (2.47) ng/ml) was higher than non-drinkers (16.15 (2.88) ng/ml, p=0.054). The proportion who smelled smoke was higher in workers (38.5%) than in non-workers (29.7%, p=0.02). Therefore, urine cotinine concentration was higher in workers (17.29 (2.66) ng/ml) than in non-workers (16.97 (2.81) ng/ml) but not at a statistically significant amount (p=0.826). In addition, cotinine concentration between the group who smelled smoke (20.45 (2.42) ng/ml) and the group who did not smelled smoke (15.53 (2.78) ng/ml) was significantly different (p=0.016) in workers but not in non-workers (17.08 (2.42) ng/ml vs 16.92 (2.98) ng/ml, p=0.942). According to the National Center for Health Statistics occupational categories in the US and the Korea Standard Classification of Occupations, the urine cotinine concentration of white collar workers such as technical workers and administrators, professional specialists, and managers was higher (18.01 (2.55) ng/ml) than that of blue collar workers such as plant and machine operators and assemblers, elementary occupations, and craft and related trades workers (15.36 (3.48) ng/ml).
CONCLUSIONS
The workplace is an important contributor to second-hand smoke exposure in Busan, Ulsan and Kyeongnam provinces. Unlike in advanced countries, where anti-smoking policies have been implemented, urine cotinine concentration in people in Busan, Ulsan and Kyeongnam provinces was higher in the white collar group than in the blue collar group. This result might be due to a higher indoor second-hand smoking rate of workplaces in these areas. Further studies are needed to evaluate the correlation between regional characteristics of industries, anti-smoking policies in the workplace, smoking rates and urine cotinine concentrations of workers.

Citations

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  • Differences in Oral Health and Generalized Anxiety Disorder According to Secondhand Smoke Exposure in Public Places
    Yu-Rin Kim, Kyeung-Ae Jang
    Behavioral Sciences.2023; 13(6): 455.     CrossRef
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    Kiwoong Ko, Min-Jung Kwon, Song-Hyun Yang, Chul-Jin Moon, Eun Hee Lee, Hee-Yeon Woo, Hyosoon Park
    Annals of Laboratory Medicine.2016; 36(5): 427.     CrossRef
  • 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
    Annals of Occupational and Environmental Medicine.2015;[Epub]     CrossRef
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Original Article
The Concentration of Cadmium in Urine, and Its Role in Health-risk Assessment of Residents in the Vicinity of Abandoned Mines in Gyeongsangbuk-do, Korea
Sung Ho Yun, Chang Yoon Kim, Tae Yoon Hwang, Kyu Chang Won, Jun Young Do, Se Jin Lee, Yeong Mog Park, Kwan Soo Jun, Gae Ho Lee, Do Young Lee, Kwang Seub Park, Joon Sakong
Korean Journal of Occupational and Environmental Medicine 2010;22(3):251-261.   Published online September 30, 2010
DOI: https://doi.org/10.35371/kjoem.2010.22.3.251
AbstractAbstract PDF
OBJECTIVES
This study was conducted to assess the concentration of urine cadmium and health risks of residents in the vicinity of abandoned metal mines in Gyeongsangbuk-do.
METHODS
The concentration of cadmium in the soil, water, and agricultural crops was measured in Gyeongsangbuk-do, Butdeun and Suksan, which have abandoned metal mines. We measured the concentration of cadmium in the urine of residents from the following areas: 78 from village A, 99 from village C and 147 from control areas. Other health-risk assessments were performed on each resident, such as measuring the concentration of beta2-MG and a bone density test.
RESULTS
In abandoned mine areas, the mean concentration of cadmium was higher in agricultural soil and in the crops than in that of control areas. The concentration of cadmium in the stream exceeded the guideline level. In regard to provisional tolerable daily intake (PTDI) of cadmium, the actual intake rate through crops was 33.81%, 72.74% in abandoned mine areas and 5.03%, 6.16% in control areas. Residents in abandoned mine areas, A village and C village had a geometric mean of urine Cd of 1.90 microgram/g cr and 1.45 microgram/g cr. These measurements were significantly higher than those of residents in control areas, B village and D village, 0.59 microgram/g cr and 0.65 microgram/g cr (p<0.01). Following adjustments for age, sex, smoking habit, and occupational history, the concentration of urine cadmium of residents in the Butdeun abandoned meta mine was higher by 1.62 microgram/g cr as compared with the control group (p<0.01). Residents from the Suksan abandoned metal mine also had a higher concentration by 1.07 microgram/g cr (p<0.01). A multiple linear regression analysis was performed for the factors associated with T-score, and this showed that the concentration of urine cadmium was not an influential factor.
CONCLUSIONS
Based on these measurements, areas with abandoned metal mines contaminated streams, agricultural soil, and crops of the adjacent areas, with cadmium. Because residents in the adjacent areas intake contaminated crops, their urine cadmium was increased. Despite a lack of evidence demonstrating the detrimental effect of increased urine cadmium in residents, an additional study is needed to assess the health risks of residents in the vicinity of abandoned metal mines.

Citations

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    Scientific Reports.2023;[Epub]     CrossRef
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Original Article
Blood Pb, Urine Cd and Health Assessment of Residents in the Vicinity of Abandoned Mines in Gyeongsangbuk-do
Jong Hak Chung, Pock Soo Kang, Chang Yoon Kim, Kyung Soo Lee, Tae Yoon Hwang, Gyu Tae Kim, Jong Seo Park, Si Young Park, Dae Seop Kim, Ou Taek Lim, Joon Sakong
Korean Journal of Occupational and Environmental Medicine 2005;17(3):225-237.   Published online September 30, 2005
DOI: https://doi.org/10.35371/kjoem.2005.17.3.225
AbstractAbstract PDF
OBJECTIVES
The objective of this health assessment is to evaluate the health risks that may result from exposure to abandoned mine tailings in Gyeongsangbuk-do. The tailings are remnants from an earlier flotation mill and mining operation that was in business from the early 1930's until 1970.
METHODS
The soil, stream water, and drinking water in and around three abandoned mine areas, Soochul, Gumjang, Darock, and three control areas located in Gyeongsangbuk-do were analyzed for level of Cd, Pb, Cu, As, and Hg. Potential chronic health effects were evaluated by interview and medical examination.
RESULTS
Some soil and stream samples exceeded the Korean standard for soil contamination in farmland and the Korean standard of water contamination in streams respectively. Blood lead (5.37 microgram/dl) and urine cadmium (2.79 microgram/g Cr) levels of the residents in the vicinity of the abandoned mine sites were significantly higher than of the residents in the control areas (blood lead, 4.34 microgram/dl; urine cadmium, 1.62 microgram/g Cr). There were no significant differences between the mining and control areas in terms of blood pressure, Hb, BUN, creatinine, SGOT, SGPT, fasting blood sugar, and the prevalence of potential chronic diseases.
CONCLUSIONS
The results of the assessment suggested that the three abandoned mine sites do not pose an apparent health risk to nearby residents. Nevertheless, the elevated blood lead and urine cadmium levels in the residents of the abandoned mine site suggested that it might be an important source of heavy metals contamination. Therefore, a nationwide evaluation program is needed to assess the potential health risks of residents living in the vicinity of abandoned mine sites.

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    Young-Seoub Hong, Byung-Kook Lee, Jung-Duck Park, Joon Sakong, Jae-Wook Choi, Jai-Dong Moon, Dae-Seon Kim, Byoung-Gwon Kim
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    YongMin Cho, SungChul Seo, Seung-Hyun Choi, SeungKil Lee, KyungHee Kim, Hae-Joon Kim, Jae-Wook Choi
    International Journal of Hygiene and Environmental Health.2013; 216(3): 255.     CrossRef
  • Relationship between Urine Cadmium and Bone Mineral Density of Residents Around Abandoned Metal Mines
    Kyung-Sick Jung, Nam-Soo Kim, Seung-Chul Ahn, Byung-Kook Lee
    Korean Journal of Environmental Health Sciences.2012; 38(4): 323.     CrossRef
  • The association of heavy metals in blood, fish consumption frequency, and risk of cardiovascular diseases among Korean adults: The Korean National Health and Nutrition Examination Survey (2008-2010)
    Ji-Ye Shin, Ji-Myung Kim, Yuri Kim
    Korean Journal of Nutrition.2012; 45(4): 347.     CrossRef
  • Blood lead levels of residents living around 350 abandoned metal mines in Korea
    Nam-Soo Kim, Joon Sakong, Jae-Wook Choi, Young-Seoub Hong, Jai-Dong Moon, Byung-Kook Lee
    Environmental Monitoring and Assessment.2012; 184(7): 4139.     CrossRef
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    Sanghoo Kim, Yong-Min Cho, Seung-Hyun Choi, Hae-Joon Kim, Jaewook Choi
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    Ho-Jang Kwon
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    Bong-Ki Jang, Sang-Il Park, Nam-Soo Kim, Kyung-Sick Jung, Byung-Kook Lee, Jong-Wha Lee
    Korean Journal of Environmental Health Sciences.2011; 37(5): 348.     CrossRef
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    Journal of Korean Medical Science.2008; 23(3): 452.     CrossRef
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Original Article
Urinary 2-Ethoxyacetic Acid for Biological Monitoring of Workers Exposed to 2-Ethoxyethyl Acetate
Kwang Jong Kim, Sang Gyu Sung, Jung Chul Kim, Hae Joon Kim
Korean Journal of Occupational and Environmental Medicine 1999;11(2):276-286.   Published online June 30, 1999
DOI: https://doi.org/10.35371/kjoem.1999.11.2.276
AbstractAbstract PDF
This study was carried out to evaluate the association between urinary 2-ethoxyacetic acid(EAA) as a new indicator of biological monitoring for the workers exposed to 2-etho xyethyl acetate(EEA) and independent variables such as the EEA exposure concentration, exposure dose, total EEA absorption amount, work duration, and alcohol consumption. In this study the subjects were the total of 160 drawn from 75 workers who were occupationally exposed to EEA and 85 workers who were not. The results were as follows: 1. In the electronic painting workplace, EEA exposure concentration in the breathing zone of the spray workers was the highest, as showed 2. 88ppm(0. 01-15.1 ppm) and cases of exceeded threshold limit value(TLV = 5ppm) were 12.0% among the total of 75 exposed workers. 2. Four workers(5. 4%) of exposed workers indicated more than 50.0 mg/g creatinine of urinary EAA, the geometric mean urinary EAA in exposed workers was 2.49 mg/g creatinine, and was higher than that of workers who were not exposed. 3. In the spray workers of auto products, the geometric mean of urinary BAA was the highest showing 5.76 mg/g creatinine. 4. The difference of urinary BAA by EEA exposure level was significant and the correlation coefficient between urinary BAA and EEA in air was the highest showing 0. 53O(p < 0.01). In conclusion, the amount of urianry EAA proved to be a good parameter for biological monitoring of workers exposed to EEA.

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Original Article
Manganese Concentration in Blood and Urine of Manganese Exposed Welding Workers
Ho Chun Choi, Kangyoon Kim, Sun Hee An, Dae Woo Hyun
Korean Journal of Occupational and Environmental Medicine 1998;10(4):534-547.   Published online December 31, 1998
DOI: https://doi.org/10.35371/kjoem.1998.10.4.534
AbstractAbstract PDF
Blood and urine samples were taken from 447 welders exposed to manganese containing welding fumes and 127 office workers not exposed to welding fumes as a control. The air samples were analyzed by flame atomic absorption spectrophotometer (Varian 30A, Australia), and blood and urine samples were analyzed by flameless atomic absorption spectrophotometer(Z-8100, Hibachi, Japan). Data were evaluated in accordance with type of industry, smoking habits, and work duration. The results obtained were as follows: 1. The limit of detection(LOD) levels of manganese in blood and urine were 0.11 microgram/100ml of and 0.14 microgram/l, respectively. Our results of manganese concentration were shown within +/-2 standard deviation which was the upper and lower warning limit (UWL or LWL) on quality control chart. 2. The airborne concentrations of manganese in welding workplaces were 0.067 mg/m3 showing differences by type of industry ; 0.017 mg/m3 in automobile assembly and manufacturing industries, 0.084 mg/m3 in steel heavy industries and 0.180 mg/m3 in shipyards. 3. The blood manganese concentrations showed differences by type of industry showing the highest values of 1.70 microgram/100m1 in shipyards, 1.24 microgram/100m1 in automobile assembly and manufacturing industries and 1.11 microgram/100ml in steel heavy industries. Urinary manganese concentration corrected by urinary creatinine concentrations was 0.34 microgram/g creatinine in automobile assembly and manufacturing industries, 0.43 microgram/g creatinine in steel heavy industries and 0.48 microgram/g creatinine in shipyards. There were no difference urinary manganese concentrations by type of industry. 4. The overall blood manganese concentration was 1.26 microgram/100ml, and urinary manganese concentration was 0.35 microgram/g creatinine in welders. In contrast to these values, blood and urinary manganese concentrations were lower in control group showing 0.73 microgram/100m1, and 0.28 microgram/g creatinine, respectively. 5. Smoking habits did not seem to affect on blood and urinary manganese concentrations both in welders and office workers. 6. Blood manganese concentrations were significantly higher in welder who had worked longer than 10 years than in welder who had worked less than 10 years. 7. The blood manganese concentrations were significantly correlated to airborne manganese concentrations(r=0.318, n=64), work duration(r=0.425, n=538), and cumulative exposure indices(CEI) (r=0.354, n=64).

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  • Association of serum and hair antioxidant minerals with an oxidative stress marker in relation with characteristics of healthy adults: a cross-sectional study
    Yoo-Ree Kang, Mi-Kyung Sung, Hyun-Wook Baik, Mi-Kyeong Choi
    Scientific Reports.2024;[Epub]     CrossRef
  • A Study on the Total, Particle Size-Selective Mass Concentration of Airborne Manganese, and Blood Manganese Concentration of Welders in a Shipbuilding Yard
    Jong Su Park, Pan Gyi Kim, Jee Yeon Jeong
    Journal of Korean Society of Occupational and Environmental Hygiene.2015; 25(4): 472.     CrossRef
  • Associations between Airborne Manganese and Blood Manganese in the Korean General Population according to KNHANES 2008-2009
    Kyung Sick Jung, Jong Dae Lee, Yong Bae Kim
    Journal of Environmental Science International.2013; 22(12): 1589.     CrossRef
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Original Article
Renal Dysfunction Indicators in Lead Exposed Workers
Sang Ju Lee, Young Seoub Hong, Sung Ryul Kim, Dong Il Kim, Joon Youn Kim, Kap Yeol Jung
Korean Journal of Occupational and Environmental Medicine 1996;8(2):340-349.   Published online September 30, 1996
DOI: https://doi.org/10.35371/kjoem.1996.8.2.340
AbstractAbstract PDF
A range of indicators is available to assess renal dysfunction in lead exposure. This study was undertaken to find out which indicators were most valuable as markers of renal dysfunction. We selected 75 male workers from the secondary lead smelter, plastic stabilizer and radiator manufacturing industries (the "exposed" group) and 64 male office workers (the "control" group). Blood lead; blood zinc protoporphyrin; urine lead; urine coproporphyrin; delta-aminolevulinic acid dehydratase activity; and urine delta-aminolevulinic acid were chosen as indicators of lead exposure. Blood urea nitrogen; serum creatinine; serum uric acid; urine N-acetyl-beta-D-glucosaminidase; urine albumin; urine alpha1-microglobu-lin; and urine beta2-microglobulin were used as indicators of renal dysfunction. Urine alpha1-microglobulin level was significantly associated with, the lead exposure level. Blood urea nitrogen, urine N-acetyl-beta-D-glucosaminidase and urine alpha1-microglobulin levels were highly correlated with indicators of lead exposure. Urine alpha1-microglobulin had the highest correlation with other indicators of renal function. In addition, the proportion of subjects with high urine alpha1-microglobulin levels showed a gradient with lead exposure. Conclusively, Blood urea nitrogen, urine N-acetyl-beta-D-glucosaminidase and urine alpha1-microglobulin are useful indicators, but urine alpha1-microglobulin is ; the early 'and the most valuable indicator of renal dysfunction related to lead exposure.

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Original Article
Evaluation of Mercury Concentration in Spot Urine for Biological Monitoring Among Metallic Mercury Exposed Workers
Durumee Hong, Soon Duck Kim, Yong Tae Yum, Jae Wook Choi
Korean Journal of Occupational and Environmental Medicine 1996;8(1):127-136.   Published online February 29, 1996
DOI: https://doi.org/10.35371/kjoem.1996.8.1.127
AbstractAbstract PDF
Biological monitoring for exposures permits estimation of organ doses or body burdens from exposures through all relevant portals of entry. Biological monitoring data may be used to estimate environmental concentrations when the latter cannot be measured directly. Biological indices are usually surrogates for the concentration of a chemical or its metabolites or its effect at the true receptors. Mercury concentration in urine has-been most-coinmoialy-recommended as a biological exposure index of mercury. For data based on urine analysis, variation in urine volume is the most significant. The urinary concentration related to excretion of the solute provides some correction for fluctuation of urine output. Sampling time must be carefully observed because distribution and elimination of a chemical are kinetic events. This study has evaluated mercury concentration in spot urine compared to the results of 24 hour collected urine by the adjustment methods (specif ic gravity, creatinine) and sampling time. The subjects were 43 workers who had been exposed to the metallic mercury. The results were as follows: 1. The correlation coefficients between mercury concentration in 24 hour urine and that in spot urine were 0.639-0.715 and were not different by adjustment methods. 2. In the high exposure group who were over lOOug/1 of urinary mercury, the correlation coefficients between mercury concentration in 24 hour urine and that in spot urine were 0. 687-0.824 and were not different by adjustment methods. 3. Mercury concentration in spot urine were very variable by sampling time or exposure time. The correlation coefficients between mercury concentration in 24 hour urine and that in spot urine were most highest as 0.85-0.91 at first voiding urine in the morning, and were 0. 77-0.86 at urine collected within four hours before end of shift. In the biological monitoring to exposure of mercury, sampling of spot urine were most proper at first voiding urine in the morning, and then at urine collected within four hours before end of shift. But the adjustment methods of specific gravity and creatinine were no difference of the results.

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Original Article
Development of Urine CRM for the quality Control of Heavy Matal Determinations
Chang Joon Park, Kyung Haeng Cho, Jeong Kee Suh
Korean Journal of Occupational and Environmental Medicine 1995;7(2):235-248.   Published online October 31, 1995
DOI: https://doi.org/10.35371/kjoem.1995.7.2.235
AbstractAbstract PDF
Urine certified reference material (CRM) has been developed to help clinical labolatories control analytical accuracy. Two levels of freeze-dried urine were prepared. The low level CRM was made from normal urine and the abnormal level CRM was prepared by spiking the normal urine with As, Cd, Cr, Cu, Hg, Ni and Pb. Urine reference materials were analyzed by graphite furnace atomic absorption spectrometry (GFAAS) and inductively coupled plasma mass spectrometry (ICP-MS) . Analyte elements were separated from matrix elements by using ion exchange resin and hydride generation. Isotope dilution method was employed to enhance analytical accuracy. Round robin test results are also presented which were carried out with 5 clinical laboratories.

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Original Article
Assessment of Cadmium in Blood and Urine of Occupationally Exposed Workers and Renal Dysfunction by Cumulative Exposure Estimate
Seong Kyu Kang, Jeong Sun Yang, Ki Woong Kim, Jae Yeon Jang, Ho Keum Chung
Korean Journal of Occupational and Environmental Medicine 1995;7(1):101-110.   Published online February 28, 1995
DOI: https://doi.org/10.35371/kjoem.1995.7.1.101
AbstractAbstract PDF
88 workers exposed to cadmium were examined at the 12 factories using or producing cadmium in order to know the present state of cadmium exposure and renal dysfunction in 1992. Cadmium in blood and in urine were measured and compared by the 3 exposure level of cadmium in air. Cadmium in blood of low, moderate and high exposure group were 2.5, 3,8 and 7.6 microgram/L, respectively. Cadmium in urine were 1.8(1.3), 3.8(2,6) and 7.9 microgram/L(6.1 microgram/g creatinine) , resrectively. However, there was no relationship between Urinary cadmium and beta(2)-microglobulin. Cumulative exposure estimate (CEE) was calculated by multiplying the mean ambient cadmium level of the factory and working duration. CEE has a high correlation with cadmium in blood and urine, but no relation to beta(2)-microglobulin. Because working durations were relatively shorter than European workers', the highest CEE was just 300 microgram. year/m(3), which was not enough to induce renal tubular dysfunction. This study, however, suggested the possibility that renal tubular dysfunction caused by cadmium could be happened in Korea in the near future.

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  • Chronic Cadmium Intoxication and Renal Injury Among Workers of a Small-scale Silver Soldering Company
    Won-Jun Choi, Seong-Kyu Kang, Seunghon Ham, Wookyung Chung, Ae Jin Kim, Myunghee Kang
    Safety and Health at Work.2020; 11(2): 235.     CrossRef
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Original Article
Changes of Cadmium in Blood and Urine of Cadmium Exposed Rats
Jung Duck Park, Mee Jung Kim, Byung Sun Choi, Yeon Pyo Hong, Im Won Chang
Korean Journal of Occupational and Environmental Medicine 1994;6(2):316-322.   Published online September 30, 1994
DOI: https://doi.org/10.35371/kjoem.1994.6.2.316
AbstractAbstract PDF
The changes of Cadmium(Cd) in plasma, whole blood, erythrocyte and urine in Sprague-Dawley male rates exposed to intravenous single injection of 0.8 mg CdCl2/kg of body weight were investigated. Blood sample was taken at 0.5 to 672 hours, and 24 hour-urine was collected by using metabolic cage for the same period. The plasma level of Cd was reached to peak at 0.5 hour after injection and reduced rapidly in 1 hour. The Cd level in blood was the highest in plasma and the lowest in erythrocyte at 0.5 hour after injection. However, in one hour postinjection, the levels of Cd were higher in order of erythrocyte, whole blood and plasma, up to 4 weeks. The changes of urinary volume and creatinine were not significant between Cd-treated and saline-treated groups. However, urinary protein was slightly increased with time in Cd-treated group. Urinary Cd level was higher in Cd treated group than control. These results suggest that the measurement of Cd in erythrocyte and urine is valuable for the biological index to estimate recent Cd exposure.

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