Annals of Occupational and Environmental Medicine

Research Article

Morbidity patterns among the welders of eastern Nepal: a cross-sectional study: Shyam Sundar Budhathoki, Suman Bahadur Singh, Surya Raj Niraula, Paras K. Pokharel; Ann Occup Environ Med 2016;28:62. Published online November 15, 2016; DOI: https://doi.org/10.1186/s40557-016-0151-y

Background

Welding process has many hazards that the welders are exposed to resulting in numbers of health effects and diseases. Safety measures and practices among welders are important ways of preventing or reducing the health hazards associated with this occupation. We conducted this study to find out the morbidity patterns among the welders working in eastern Nepal.

Methods

A cross sectional study was conducted among 300 welders using semi structured questionnaire. Morbidity categories were classified based on symptoms experienced in past 6 months.

Results

All the welders learned welding by apprenticeship, without any formal health and safety training. Injury was the most common problem at work followed by skin problems and eye symptoms. Age of the welders, duration of employment & welding hours per day were associated with the morbidities among the welders.

Conclusions

There is a need for occupational health services for welders in Nepal. While further research may be required to make policy recommendations, the current study provides a baseline morbidity burden among these welders to look for interventions to promote health and safety at work for this neglected group of workers in Nepal.

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Ngozika E. Ezinne, Kingsley K. Ekemiri, Maryann A. Nwanali Daniel
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Tahra AlMahmoud, Ismail Elkonaisi, Michal Grivna, Fikri M. Abu-Zidan
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Catastrophic health expenditure among industrial workers in a large-scale industry in Nepal, 2017: a cross-sectional study
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BMJ Open.2018; 8(11): e022002. CrossRef

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Original Article

An Evaluation of the Ventilatory Function in Shipyard Welders Using the Lifetime Cumulative Exposure to Welding Fumes: Chun Hwa Jung, Hyeon Woo Yim, Jung Wan Koo, Chung Yill Park; Korean Journal of Occupational and Environmental Medicine 2002;14(4):364-376. Published online December 31, 2002; DOI: https://doi.org/10.35371/kjoem.2002.14.4.364

Abstract PDF: Objectives
This study was conducted to evaluate the ventilatory function in shipyard welders using the lifetime cumulative exposure to welding fumes.
METHODS
Ventilatory function tests were performed on 241 male welders at one large shipyard,exposed to welding fumes for over five years,and was compared to 80 male control subjects. Ventilatory function indices, such as forced vital capacity(FVC), one-second forced expiratory volume(FEV 1), ratio of FEV 1 to FVC(FEV 1%), maximal mid-expiratory flow(MMF), peak expiratory flow rate(PEFR)and maximal expiratory flow at 50 and 75% of expired FVC(FEF50 and FEF75), were obtained by analyzing forced expiratory spirograms and maximal expiratory flow-volume curves that were simultaneously measured by an Impulse ocillometry(IOS)program in the standing position.
RESULTS
FEF50 and FEF75 expressed as a percentage of the predicted values were significantly lower in the exposure group than in the controls, and the MMF tended to decrease.The means of all the ventilatory indices,expressed as percentage of the predicted values, were not significantly increased at the current exposure levels. The MMF, FEF50 and FEF75, expressed as a percentage of the predicted values, were significantly decreased with an increase in exposure duration.Only the FEF75 , expressed as a percentage of the predicted value, was significantly decreased with an increase in the cumulativeexposure to welding fumes(C1). The FEF75, expressed as a percentage of the predicted value, was significantly decreased with an increase in the cumulative exposure to welding fumes(C2). The above parameters were calculated to consider the current exposure level, exposure duration, application of the ventilatory system, production rate, personal protection evice, electrode and welding wire. The MMF and FEF50, expressed as a percentage of the predicted value, tended to decrease. The proportion of workers with abnormal MMF, FEF50 and FEF75 were significantly increased with an increase in the cumulative exposure to welding fumes(C2).
CONCLUSIONS
These findings suggested that the MMF, FEF50 and FEF75 are sensitive and practical indices for the evaluation of the ventilatory function of workers exposed to welding fumes, when the lifetime cumulative exposure(C2) is considered as a factor affecting exposure.

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Original Article

Assessment of Neurobehavioral Performance among Welders Exposed to Manganese: Nak Jung Sung, Joon Sakong, Jong Hak Chung, Dae Seong Kim, Joong Jung Lee, Jong Tae Park; Korean Journal of Occupational and Environmental Medicine 2000;12(3):327-337. Published online September 30, 2000; DOI: https://doi.org/10.35371/kjoem.2000.12.3.327

Abstract PDF

OBJECTIVES
A cross sectional study was carried out in the welders exposed to manganese and control group. The aim of this study was to assess the adverse effects of manganese on central nervous system of welders.
METHODS
The study group consisted of 49 welders and the reference group, 49 workers matched with welders for age and educational level in automobile manufacturing company. Concentration of manganese in welding hume, in blood, and cumulative exposure index(CEI) were determined for each subject. For each group, computerized neurobehavioral test including Simple Reaction Time, Digit Symbol, Digit Span, and Finger Tapping Speed of Swedish Performance Evaluation System were applied.
RESULTS
Exposure level of manganese in welders were very low(mean CEI 0.069). Welders exposed to manganese had slower response speed, slower motor steadiness, and shorter memory span than control group. But these differences were not statistically significant. The performance of Finger Tapping Speed tended to lower as environmental and biological exposure index got higher. Other neurobehavioral tests were found to have a little association with the exposure indices.
CONCLUSIONS
There was no significant difference of neurobehavioral performance between welders and control group. This study indicates that Finger Tapping Speed measuring motor steadiness might be a one of useful tests for early detection of adverse effects of welding on central nervous system.

Citations

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Effects of computer familiarity and computer type on the performance of Korean computerized neurobehavioral test
Nak Joon Baek, Gun Il Park, Young Seok Byun, Man Joong Jeon, Joon Sakong
Annals of Occupational and Environmental Medicine.2016;[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
Occupational Psychiatric Disorders in Korea
Kyeong-Sook Choi, Seong-Kyu Kang
Journal of Korean Medical Science.2010; 25(Suppl): S87. CrossRef
Neurobehavioral Changes of Shipyard Painters Exposed to Mixed Organic Solvents
Choong Ryeol LEE, Kyoung Sook JEONG, Yangho KIM, Cheol In YOO, Ji Ho LEE, Young Hee CHOI
INDUSTRIAL HEALTH.2005; 43(2): 320. CrossRef

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Original Article

Manganese Exposure and its Health Hazards of Welders: Deog Hwan Moon, Byung Chul Son, Dong Mug Kang; Korean Journal of Occupational and Environmental Medicine 1999;11(4):476-491. Published online December 31, 1999; DOI: https://doi.org/10.35371/kjoem.1999.11.4.476

Abstract PDF

OBJECTIVES
In order to evaluate the degree of manganese exposure and its health hazards effect on welders in manufacturing industry.
METHODS
The author measured airborne, blood and urine concentrations of manganese and blood chemistry, and also observed clinical symptoms and signs on 60 welders for case an.d 60 non-welders for control working in manufacturing industry by age maching method.
RESULTS
The geometric means of blood and urine concentrations of manganese were 1.13 +/- 1.38 microgram /dI and 2.52 +/- 1.37 microgram /I for Welders group, 1.09 +/- 1.68 microgram /dl and 1.86 +/- 1.34 microgram / I for Non-welders group. Airborne concentration of manganese was 0. 15 +/- 1.66 mg/m3 for exposured group, and the urinary mean concentration of manganese was statistically significant difference between exposured and non-welders group (P < 0.05). Clinical signs in welders group were palmomentle reflex (23.3%), tremor (20.0%) and grabellar sign (5.0%). Symptoms in welders group were fatigue (66.7%), amnesia (66.7%), excessive sweating (51.7%), nervousness (51.7%), general weakness (48. 3%) and arthralgia (46.7%) and so on, and there was statistically significant difference compared to non-welders group (P<0.05). Manganese exposure effects on blood chemistry were not observed. There were statistically significant correlation between manganese concent- ration in blood and urine (r=0. 269), airborne and urine (r=0. 601) and airborne and blood (r=0. 268).
CONCLUSION
The author suggest that further studies are followed to evaluate the health status of welders whose blood and urine manganese concentrations were below normal reference level, and to establish the questionnaire and the diagnostic tools for early detecting the chronic manganese poisioning on welders.

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Lisa A. Bailey, Laura E. Kerper, Julie E. Goodman
NeuroToxicology.2018; 64: 166. 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
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Neurobehavioral Deficits and Parkinsonism in Occupations with Manganese Exposure: A Review of Methodological Issues in the Epidemiological Literature
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Safety and Health at Work.2013; 4(3): 123. CrossRef
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Silvia Zoni, Giulia Bonetti, Roberto Lucchini
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Exposure-Response Relationship and Risk Assessment for Cognitive Deficits in Early Welding-Induced Manganism
Robert M. Park, Rosemarie M. Bowler, Harry A. Roels
Journal of Occupational & Environmental Medicine.2009; 51(10): 1125. CrossRef
Sequelae of fume exposure in confined space welding: A neurological and neuropsychological case series
Rosemarie M. Bowler, Sanae Nakagawa, Marija Drezgic, Harry A. Roels, Robert M. Park, Emily Diamond, Donna Mergler, Maryse Bouchard, Russell P. Bowler, William Koller
NeuroToxicology.2007; 28(2): 298. CrossRef
State-of-the-Science Review: Does Manganese Exposure During Welding Pose a Neurological Risk?
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Journal of Toxicology and Environmental Health, Part B.2007; 10(6): 417. CrossRef
Issues in neurological risk assessment for occupational exposures: The Bay Bridge welders
Robert M. Park, Rosemarie M. Bowler, Donald E. Eggerth, Emily Diamond, Katie J. Spencer, Donald Smith, Roberto Gwiazda
NeuroToxicology.2006; 27(3): 373. CrossRef
Potential occupational risks for neurodegenerative diseases
Robert M. Park, Paul A. Schulte, Joseph D. Bowman, James T. Walker, Stephen C. Bondy, Michael G. Yost, Jennifer A. Touchstone, Mustafa Dosemeci
American Journal of Industrial Medicine.2005; 48(1): 63. CrossRef

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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

Abstract 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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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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Case Report

Nasal Septum Perforation of Welders: Choong Ryeol Lee, Cheol In Ryu, Ji Ho Lee, Jeong Hak Kang, Seong Kyu Kang, Jung Sun Yang, Yong Cheol Shin; Korean Journal of Occupational and Environmental Medicine 1998;10(3):404-411. Published online August 31, 1998; DOI: https://doi.org/10.35371/kjoem.1998.10.3.404

Abstract PDF

Six cases of nasal septum perforation were found among welders during periodic physical checkup in 1997. Considering the size, shape and margin, the perforations were assumed to have been occurred several years before of which the diameter were 8~15 mm. To investigate the cause of perforation, we reviewed the past history of preemployment, the results of annual working environment survey and the material safety data sheets of welding rods and steels with which they have dealt, and analyzed the concentration of several metals of welding fume and the concentration of blood and urinary chromium. In the result, we presupposed that the nasal septum perforations of welders were due to chronic exposure to low level hexavalent chromium and/or nickel, and report these cases with literatures review.

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Changes of Glycoconjugate Expression in Nasal Respiratory Mucosa of Rats Exposed to Welding Fumes
Gil Nam Jeong, Un Bock Jo, Il Je Yu
Inhalation Toxicology.2007; 19(12): 987. CrossRef
Effects of repeated welding fumes exposure on the histological structure and mucins of nasal respiratory mucosa in rats
Gil Nam Jeong, Gi Jin Jo, Un Bock Jo, Il Je Yu
Toxicology Letters.2006; 167(1): 19. CrossRef

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Original Article

Plasma Malondialdehyde, alpha-tocopherol and Erythrocyte Superoxide Dismutase Activity with Blood Level of Heavy Metals in Welders: Won Jin Lee, Cheon Hyun Hwang, Soung Hoon Chang, Byung Chul Chun, Hae Joon Kim; Korean Journal of Occupational and Environmental Medicine 1998;10(2):240-250. Published online May 31, 1998; DOI: https://doi.org/10.35371/kjoem.1998.10.2.240

Abstract PDF: We investigated the association between the oxidative stress and the concentration of heavy metals in blood among welders. The study subjects were male manual CO2 welders(N=127) exposed to several heavy metals. The age distribution was from 20 to 63 (GM=33.7) and the geometric mean(GM) of work duration was 4.2 years. We analyze the level of blood lead, cadmium, managese and chromium which was related with the oxidative stress in the animal studies. Blood selenuim, plasma malondialdehyde (MDA), plasma alpha-tocopheol and orythrocyte superoxide dismutase (SOD) were analyzed as biological markers of the oxidative stress. The results of univariate analysis showed that the plasma MDA was significantly correlated with D-tocopherol (r=0.327) and blood selenium (r=0.313) concentration. But we could not find out any relationship between the erythrocyte SOD activities and those metal concentrations. Neither smoking nor alcohol consumption was related to the level of heavy metals and the oxidative stress biomarkers. As the results of multiple regression analysis with stepwise selection method, 1) the change of MDA level were dependant with the level of alpha-tocopherol and blood selenium concentration (R2=19.7), 2) the plasma alpha-tocopherol level was dependant with MDA and blood chromium concentration (R2=15.6), 3) in case of erythrocyte SOD activity, only the duration of work was significantly selected.

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Original Article

An Association between Brain MRI and Neurologic Findings in Welders Exposed to Manganese Fume: Hyeon Woo Yim, Ji Hong Kim, Young Gyu Phee, Jung Wan Koo, Kang Sook Lee, Chung Yill Park, Jeong Wook Lee, Si Ryung Han, Hye Suk Jang; Korean Journal of Occupational and Environmental Medicine 1998;10(2):161-171. Published online May 31, 1998; DOI: https://doi.org/10.35371/kjoem.1998.10.2.161

Abstract PDF

This study was carried out to investigate the relationship between brain magnetic resonance imaging (MRI) and neurological findings in welders exposed to manganese fume. Thirty five welders from a bus manufacturing factory who were occupationally exposed to low dose manganese fume were examined. We collected the information on the demo graphic factors and welding careers. Laboratory investigations included blood and urine manganese concentration and blood chemistry. Brain MRI was checked, and high signal intensity of the globus pallidus was graded from 0 to 3 compared to the white matter of the frontal lobe. Neurologic examination wart carried out. The results were as follows ; 1. The mean age of workers was 48.3+/-5.7 years, mean duration of welding was 21.4 +/-5.6 Years. 2. On brain MRI, high signal intensity in the globes pallidus was observed in 27 workers (77.1%) Among them, 18 cases (66.7%) showed remarkably high signal intensity (grade 2) Mean concentration of blood manganese was higher in those with high signal intensity and correlated to the grade of high signal intensity (p=0.02) 3. On neurologic examination, no workers showed the finding of typical parkinsonism. But 11 workers (31.4%) showed subtle neurological abnormalities such as gait without associated arm movement, postural instability, intention tremor, and so on. Blood manganese concentration of neurologically abnormal group was 2.4+/-0.7 microgram/dL, which was significantly higher, compared to 1.8+/-0.7 microgram/dL of neurologically normal group (p=0.03). 4. Among 27 workers who showed high signal intensity on brain MRI, 10 workers (37%) were neurologically abnormal. Higher grade of signal intensity on globus pallidus showed higher rate of neurologic abnormality (p<0.05) Especially postural instability and gait without associated arm movement were prominent findings. These bindings suggest that high signal intensity on brain MRI might be associated with a prodromal sign of manganese intoxication. Careful neurologic examination should be tool lowed up on welders showing high signal intensity in the golbus pallidus of brain MRI.

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Parkinson's disease in a worker exposed to insecticides at a greenhouse
Yangwoo Kim, Inah Kim, Jung-Min Sung, Jaechul Song
Annals of Occupational and Environmental Medicine.2021;[Epub] CrossRef
Association of MRI T1 relaxation time with neuropsychological test performance in manganese- exposed welders
R.M. Bowler, C-L. Yeh, S.W. Adams, E.J. Ward, R.E. Ma, S. Dharmadhikari, S.A. Snyder, S.E. Zauber, C.W. Wright, U. Dydak
NeuroToxicology.2018; 64: 19. CrossRef
Occupational Neurological Disorders in Korea
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Journal of Korean Medical Science.2010; 25(Suppl): S26. CrossRef
State-of-the-Science Review: Does Manganese Exposure During Welding Pose a Neurological Risk?
Annette B. Santamaria, Colleen A. Cushing, James M. Antonini, Brent L. Finley, Fionna S. Mowat
Journal of Toxicology and Environmental Health, Part B.2007; 10(6): 417. CrossRef
Sequelae of fume exposure in confined space welding: A neurological and neuropsychological case series
Rosemarie M. Bowler, Sanae Nakagawa, Marija Drezgic, Harry A. Roels, Robert M. Park, Emily Diamond, Donna Mergler, Maryse Bouchard, Russell P. Bowler, William Koller
NeuroToxicology.2007; 28(2): 298. CrossRef

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Original Article

A Study on Immunity of Welders: Su Ill Lee, Bong Soo Cho, Young Wook Kim, Kwang Wook Koh, Won Keun Cho, Young SIl Kim, Soo Yong Kang, In Kyung Hwang, Byung Man Cho, Don Kyoun Kim; Korean Journal of Occupational and Environmental Medicine 1997;9(1):75-84. Published online February 28, 1997; DOI: https://doi.org/10.35371/kjoem.1997.9.1.75

Abstract PDF: The authors examined human immunity indicators such as CD4, CD8, Natural Killer (NK) cell, IgG, IgA, and IgM, and heavy metals such as Pb, Cr, Cd to evaluate the health hazard of welders. We selected total 126 male subjects, 60 welders who had more than 5 year working history as an exposure group, and 66 office workers and medical college students as a control group. This immunity evaluation approach is the first newly designed study that has never been tried in past studios on welder's heath evaluation. And the results were as follows. 1. Total lymphocyte count of peripheral blood was significantly higher in welder group, 2,615+/-650 ea/microliter compared with 2,368+/-681 ea/microliter in control group (p<0.05). 2. The proportion of CD4, CD8, NK cell in welder group was 37 5+/-9.4%, 24.0+/-8.8%, and 21.0+/-9.5%, respectively, and 35.5+/-6.5%, 25.0+/-6.9%, and 19.6+/-8.8% in control group. CD4 and NK cell were slightly higher, and CD8 was slightly lower in welder group. But there was no statistical significance between two groups (p> or =0.05). 3. IgG, IgA, and IgM in welder group were 15.9 mg/dl, 2.7 mg/dl, and 1.5 mg/dl, respectively, and 15.6 mg/dl, 2.9 mg/dl and 1.7 mg/dl in control group. There was no statistical significance between two groups(p> or =0.05). 4. Blood lead, cadmium and chromium concentrations were 4.2+/-1.8 microgram/dl, 0.4+/-0.38 microgram/dl, 1.2+/-0.6 microgram/dl in welder group and 3.2+/-1.7 microgram/dl, 0.44+/-0.29 microgram/dl, 1.1+/-0.6 microgram/dl in control group, respectively, and these value were within normal ranges.

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Original Article

Welder' Pneumoconiosis of Shipyard and related Factors: Hae Sook Sohn, Seong Yong Choi, Young Jin Yu, Chae Un Lee; Korean Journal of Occupational and Environmental Medicine 1994;6(1):143-152. Published online February 28, 1994; DOI: https://doi.org/10.35371/kjoem.1994.6.1.143

Abstract PDF

Pneumoconiosis is one of the most important occupational disease in Korea. In Pusan, most of pneumoconiosis is welders' pneumoconiosis developed in shipyard. With clinical (including interview with every patients) and radiological (chest radiographs) methods, author purposed to know the factors related to development of pneumoconiosis in shipyard welders and to apply the results to the concept for health care (management) of shipyard welders. The prevalence rate of welders' pneumoconiosis was calculated by the means of reading of chest radiographs of 547 shipyard welders. The prevalence rate of welders' pneumoconiosis (including suspected pneumoconiosis, category 0/1) was 7.9%. It was lower than that (8.9%) in same area studied in 1989. Prevalence rate increased as total welding duration increased and the welding work began early. It was higher in welders who did not use antidust mask. Probability of the occurance of welder's pneumoconiosis was related with the time that the welder began welding work. Sixteen cases among the 37 who were diagnosed as pneumoconiosis returned normal in the follow-up chest radiographs. There was no case aggrevated. The pertinent management for the personnels and their working environment contributed to the decrease of incidence of the welders' pneumoconiosis and the improvement of the disease. To prevent the occurance of the pneumoconiosis in shipyard welders, it seems to be necessary for the company to be supervised under the any legislation and to educate the welder to use the protective apparatus. It is suggested that considerate and continuous observation under the adequate management is preferable to the immediate conversion of the working department for the pneumoconiotic welders.

Citations

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Occupational Diseases in Korea
Seong-Kyu Kang, Eun A Kim
Journal of Korean Medical Science.2010; 25(Suppl): S4. CrossRef

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