Annals of Occupational and Environmental Medicine

Case Report

A Case of Reactive Airways Dysfunction Syndrome in a Synthetic Resin Manufacture Factory: So Young Park, Jong Seong Lee, Boo Wook Kim, Joung Oh Lee, Kyu Chul Park, Byung Soon Choi; Korean Journal of Occupational and Environmental Medicine 2008;20(4):372-378. Published online December 31, 2008; DOI: https://doi.org/10.35371/kjoem.2008.20.4.372

Abstract PDF: BACKGROUND
Reactive airways dysfunction syndrome (RADS), which represents between 5% and 18% of new-onset, work-related asthma, remains underreported in spite of increasing reports of occupational asthma cases through occupational asthma surveillance in Korea. We report a 61-year-old male who developed RADS after exposure to a high level of toxic gases from a workplace accident.
CASE
The patient who had worked for 21 years at a PVC manufacture factory and had retained good health until Aug 22, 2007, when he was exposed to PVC (polyvinyl chloride), DEHP (Di (2-Ethylhexyl) Phthalate), dibutyl tin maleate and epoxidized soybean oil gases from a heated mixer. Within several minutes of exposure, he developed coughing, rhinorrhea, dyspnea and wheezing. Pulmonary function tests (PFTs) showed an FVC of 3.81 L(82% of predicted), FEV1 of 1.63 L/s (50% of predicted), FEV1/FVC% of 43 %, and FEV1 of 1.80 L/s that increased by 170 ml and 10.4% in response to bronchodilator. After 7 months of treatment with inhaled steroids and bronchodilators, repeat PFTs showed an FVC of 6.56 L(143.5% of predicted), FEV1 of 3.21 L(99.3% of predicted), and FEV1/FVC% of 48.9%. A methacholine challenge test was negative at a concentration of 25 mg/ml.
CONCLUSION
RADS occurred due to exposure to raw material vapors or their thermal decomposition products.

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Original Article

Urinary Excretion of Thiodiglycolic Acid According to Sampling Time in Workers Exposed to Vinyl Chloride Monomer: Hyun Soo Kim, Chi Nyon Kim, Jong Uk Won, Bong Suk Cha, Kyung Jong Lee, Jaehoon Roh; Korean Journal of Occupational and Environmental Medicine 2006;18(2):138-145. Published online June 30, 2006; DOI: https://doi.org/10.35371/kjoem.2006.18.2.138

OBJECTIVES
The study was performed to investigate the changes of urinary thiodiglycolic acid (TDGA) concentration in workers exposed to vinyl chloride monomer (VCM) according to the time of sampling urine.
METHODS
The personal exposure to airborne VCM was assessed and urinary TDGA concentration was sampled in 31 workers employed in a VCM and polyvinyl chloride (PVC) manufacturing factory. Urinary TDGA was sampled three times: before the start of the shift after 3 days off (TDGA1), after the end of the first-day shift (TDGA2) and before starting the following day shift after completing the oneday shift (TDGA3). Urinary TDGA in 30 workers who had not been exposed to airborne VCM was sampled after the end of the shift. A gas chromatography/pulsed flame photometric detector (GC/PFPD) was utilized to analyze TDGA concentration in urine after the urine was methylated with trimethylsilyldiazomethane(2.0M in diethyl ether).
RESULTS
The creatinine level was 0.179+/-0.271 mg/g in the control workers and 0.218+/-0.443 mg/g in the workers before the start of the shift after 3 days off (TDGA1), showing no significant difference (p=0.7035). Urine samples were compared according to sampling time in order to investigate the change of urinary TDGA concentration in the case of continuous exposure to airborne VCM. In VCM-exposed workers, urinary creatinine concentration was 0.434+/-0.623 mg/g in TDGA2 and 0.767+/-1.056 mg/g in TDGA3, which indicated a gradual but significant increase (p=0.024). In terms of the statistical correlation between airborne VCM and urinary TDGA to evaluate exposure dose per day, of the three urinary TDGA concentrations, TDGA3 showed the highest degree of regression (R(2)=0.4215) with 8h-TWA airborne VCM concentration.
CONCLUSION
Based on this result, the excretion half-life of urinary TDGA was assumed to be less than 3 days, because the concentration of urinary TDGA at 3 days after exposure to airborne VCM was decreased to the level of urinary TDGA concentration in the control workers. The concentration of urinary TDGA increased in the case of continuous shift, due to the accumulation of residual metabolites of TDGA. It was considered that TDGA3 can be applied as a useful biological index to evaluate the exposure dose of airborne VCM during one day because TDGA3 showed the highest correlation with the exposure dose of airborne VCM in the previous shift day.

Citations

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Assessment of urinary thiodiglycolic acid exposure in school-aged children in the vicinity of a petrochemical complex in central Taiwan
Po-Chin Huang, Li-Hsuan Liu, Ruei-Hao Shie, Chih-Hsin Tsai, Wei-Yen Liang, Chih-Wen Wang, Cheng-Hsien Tsai, Hung-Che Chiang, Chang-Chuan Chan
Environmental Research.2016; 150: 566. CrossRef

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Original Article

The variation of thiodiglycolic acid concentration in urine with vinyl chloride exposure levels in rats: Seung Jun Wang, Bong Suk Cha, Jae Hoon Roh, Dong Chun Shin, Myung Su Kim, Keun Jae Jeon; Korean Journal of Occupational and Environmental Medicine 1999;11(4):431-438. Published online December 31, 1999; DOI: https://doi.org/10.35371/kjoem.1999.11.4.431

Abstract PDF: OBJECTIVES
It is the objective of this research to identify the variation of thiodiglycolic acid (TdGA) in urine with vinyl chloride monomer (VCM) exposure levels through methylation.
METHODS
After rats were exposed to vinyl chloride monomer of 4 levels, 0 mg/m3, 50 mg /m3, 150 mg/m3, 500 mg/m3, respectively, of which urine was sampled in each sampling time of 0 hour, 2 hours, 4 hours, 8 hours, 16 hours, 24 hours, 36 hours, 48 hours. After urine had been methylated with diazomethane in the preliminary experiment and the peak of 146 m/z had been verified, the main experiment was done.
RESULTS
In the variation of TdGA with sampling times, concentration of TdGA increased rapidly in 4 hours and then decreased after 8 hours. When the variation of urinary .TdGA concentration in urine according to exposure level of VCM was verified through Kruskal-Wallis statistical method at each sampling time, the significant increment with the exposure levels at 2 hours, 4 hours, 8 hours after exposure was clarified.
CONCLUSION
TdGA concentration in urine with increment of VCM exposure level increased, especially significantly at 2 hours, 4 hours, 8 hours of sampling time.

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Original Article

Development of Methods to Estimate Exposure Levels to Vinyl Chloride Monomer and Multiphasic Screening Tests for Workers of Polyvinyl Chloride Manufacturing Factories: Heon Kim, Youn Jeong Nam, Sung Taek Kim, Dae Young Kim, Sul Hui Han, Kuck Tae Park; Korean Journal of Occupational and Environmental Medicine 1994;6(2):201-218. Published online September 30, 1994; DOI: https://doi.org/10.35371/kjoem.1994.6.2.201

Abstract PDF: In order to develop questionnaire estimating vinyl chloride monomer(VCM) exposure levels, to reset selection criteria for detailed tests, to measure current VCM exposure levels, to evaluate the mutagenic effects of VCM exposures and to develop multiphasic screening method of PVC- or VCM-handling workers, VCM concentrations of work environments were measured and tentative self-administrative questionnaire, physical examination, sister chromatid exchange(SCE) test and some clinical chemical test were applied to 195 men who had been handling VCM or PVC(Exposed Group) and 37, in the same factories without exposure to VCM or in polyethylene- or polypropylene-related factories(Control Group). Mean VCM concentrations of work environments were 0.268+/-0.183 ppm under PVC synthesis processes, 0.160+/-0.200 ppm under VCM synthesis process, 0.076+/-0.111 ppm under PVC pipe producing processes, 0.090+/-0.108 ppm under PVC wall paper, sheet, or film producing processes, 0.071+/-0.051 ppm under PVC floor producing processes, 0.243+/-0.250 ppm under PVC sash producing processes, and 0.020+/-0.031 ppm under triming process. VCM levels of work environments under manual resin mixing processes (0.209+/-0.168 ppm)were higher than those of the others (0.209+/-0.168 ppm) (p-value<0.05). There was no VCM-related symptoms, the positive response rates of which were higher in the Exposed Group. Overall abnormal rate in clinical chemistry test of the Exposed Group was higher than that of the Control Group, but due to extermely low exposure level of exposure group and to small sample size of the Control Group, no statistical significance was found(p-value>0.05). SCE frequencies of the Exposed Group were significantly higher than those of Contorl Group(p-value<0.05) and those of test-abnormal persons were higher than those of test-normal persons. SCE frequencies linearly increased with not only current but also cumulative VCM exposure levels(p-value<0.05). These results suggest that adverse health effect may ensue from VCM exposure to as low as 1 ppm. But SCE frequencies had no statistically significant correlation with drinking amounts, smoking amoutns, or radiation dose equivalents. Questionnaire was revised by referring to these results and formula estimating cumulative VCM exposure levels based on occupational history in questionnaire were made. In addition, were presented methods evaluating work environments and multiphasic screening test for PVC workers.

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