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Original Article
- Distribution of Lung-RADS categories according to job type in a single shipyard workers
- Eui Yup Chung, Young Hoo Shin, Young Wook Kim, Jun Seok Son, Chan Woo Kim, Hyoung Ouk Park, Jun Ho Lee, Seung Hyun Park, Sung Joon Woo, Chang Ho Chae
- Ann Occup Environ Med 2021;33:e22. Published online June 23, 2021
- DOI: https://doi.org/10.35371/aoem.2021.33.e22
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Abstract
Abstract in Korean
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ePub Background Recently, lung cancer screenings based on age and smoking history using low-dose computed tomography (LDCT) have begun in Korea. This study aimed to evaluate the distribution of lung imaging reporting and data system (Lung-RADS) categories in shipyard workers exposed to lung carcinogens such as nickel, chromium, and welding fumes according to job type, to provide basic data regarding indications for LDCT in shipyard workers.
Methods This study included 6,326 workers from a single shipyard, who underwent health examinations with LDCT between January 2010 and December 2018. Data on age, smoking status and history, medical history, and job type were investigated. The participants were categorized into high-exposure, low-exposure, and non-exposure job groups based on the estimated exposure level of nickel, chromium, and welding fumes according to job type. Cox proportional hazard regression analysis was used to determine the difference between exposure groups in Lung-RADS category ≥ 3 (3, 4A, and 4B).
Results Out of all participants, 97 (1.5%) participants were classified into Lung-RADS category ≥ 3 and 7 (0.1%) participants were confirmed as lung cancer. The positive predictive value (ratio of diagnosed lung cancer cases to Lung-RADS category ≥ 3) was 7.2%. The hazard ratio (HR) of Lung-RADS category ≥ 3 was 1.451 (95% confidence interval [CI]: 0.911–2.309) in low-exposure and 1.692 (95% CI: 1.007–2.843) in high-exposure job group. Adjusting for age and pack-years, the HR was statistically significant only in the high-exposure job group (HR: 1.689; 95% CI: 1.004–2.841).
Conclusions Based on LDCT and Lung-RADS, among male shipyard workers, Lung-RADS category ≥ 3 were significantly higher in the high-exposure job group. Their HR tended to be > 1.0 and was statistically significant in the high-exposure job group. Additional studies should be conducted to establish more elaborate LDCT indications for occupational health examination.
- 일개 조선소 근로자의 직종간 Lung-RADS 비교
목적
최근 폐암의 조기 발견을 위해 저선량 흉부CT (LDCT)를 이용하기 시작했으며, 국내에서도 연령과 흡연력을 기준으로 한 국가폐암검진이 시작되었다. 니켈, 크롬, 용접흄은 조선소 근로자에서 흔히 노출될 수 있는 폐암 발암물질로 알려져 있으나, 이러한 위험 요인은 아직 폐암 검진의 기준이 되지 못하였다. 이 연구는 LDCT를 이용하여 니켈, 크롬, 용접흄에 노출되는 일개 조선소 근로자들에서 직종과 폐 CT 선별 판독 시스템 (Lung-RADS) 양상을 비교하여, 조선소 근로자의 LDCT 적응증에 대한 기초 자료를 생성하고자 하였다.
방법
2010년 1월부터 2018년 12월까지 건강검진에 참여한 경남지역 조선소 근로자 6,326명이 연구에 참여했다. 문진과 자기기입식 설문지를 이용하여 연령, 흡연력, 과거력, 직종 등을 확인하여, 직군에 따른 크롬, 니켈, 용접흄의 노출 추정 정도에 따라 고노출 직군, 저노출 직군, 비노출군으로 분류하였다. 그룹 간 Lung-RADS 3 이상인 군에 차이가 있는지 cox 비례위험 회귀분석을 시행하였다. 또한 연령과 갑년을 보정하여 그룹간 hazard ratio (HR)를 비교하였다.
결과
전체 대상자 6,326명 중 Lung-RADS 3 이상인 군은 97명, 폐암으로 확진된 대상자는 7명으로, 양성예측도 (PPV)는 7.2%이였다. Lung-RADS 3 이상에 대하여 직군에 따른 HR은 저노출 직군 1.451 (95% confidence interval [CI]: 0.911-2.309), 고노출 직군 1.692 (95% CI: 1.007-2.843)으로 나타났다. 연령과 갑년을 보정했을 시 HR은 고노출 직군에서만 유의하게 1.689 (95% CI: 1.004-2.841)로 나타났다.
결론
현행의 폐암검진 방법인 LDCT와 진단기준인 Lung-RADS를 이용하였을 때, 일개 조선소 남성 근로자 중 니켈, 크롬, 용접흄 노출 직군에서 Lung-RADS 3 이상군이 유의하게 많으며, HR이 1.0보다 높은 경향을 보이고, 고노출 직군에서는 유의한 결과를 보였다. 향후 추가적인 연구를 통해 보다 정밀한 근로자 건강검진 상 LDCT 적응증을 만들어야 한다. -
Citations
Citations to this article as recorded by
- Artificial intelligence-based graded training of pulmonary nodules for junior radiology residents and medical imaging students
Xiaohong Lyu, Liang Dong, Zhongkai Fan, Yu Sun, Xianglin Zhang, Ning Liu, Dongdong Wang
BMC Medical Education.2024;[Epub] CrossRef - The effect of occupational exposure to welding fumes on trachea, bronchus and lung cancer: A systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury
Dana Loomis, Angel M. Dzhambov, Natalie C. Momen, Nicholas Chartres, Alexis Descatha, Neela Guha, Seong-Kyu Kang, Alberto Modenese, Rebecca L. Morgan, Seoyeon Ahn, Martha S. Martínez-Silveira, Siyu Zhang, Frank Pega
Environment International.2022; 170: 107565. CrossRef
- Artificial intelligence-based graded training of pulmonary nodules for junior radiology residents and medical imaging students
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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
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Abstract
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- 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
- Effects of Welding Fume on Ventilatory Function
- Tae In Moon, Jung Wan Koo, Chee Kyung Chung
- Korean Journal of Occupational and Environmental Medicine 1996;8(3):383-391. Published online December 31, 1996
- DOI: https://doi.org/10.35371/kjoem.1996.8.3.383
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Abstract
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- In order to study the effects of welding fume on ventilatory function, forced expiratory spirogram was performed on 563 male workers exposed to welding fume in motor vehicles industry and 589 male control workers. Ventilatory indices such as forced vital capacity (FVC), forced expiratory volume in one second (FEV(1)), the ratio of one-second forced expiratory volume to forced vital capacity (FEV(1)%= FEV(1)/FVC) and maximal mid-expiratory flow(MMF) were obtained by analyzing forced expiratory spirogram which were measured by Vitalograph in standing position. The results were as follows: 1. Mean values of FVC, FEV(1), FEV(1)%, and MMF expressed as percent of the predicted were significantly lower in exposure group than in control group. 2. No significant differences for mean ventilatory indices were demonstrated between smokers and nonsmokers both in exposure group and control group. However, mean MMF of welders tended to reduce in smokers (77.4 %) than in nonsmokers (82.4 %). 3. In exposure group mean FEV(1) was significantly lower in more than 20 years than those of control group. However, mean MMF, FEV(1)% were significantly reduced with increasing exposure duration compared to control group, indicating 90.8 %; and 62.2 % of the predicted in more than 20 years group. 4. In exposure group workers with obstructive ventilatory impairment (7.5 %) was markedly higher than that with restrictive ventilatory impairment (2.0 %). 5. In exposure group the proportion of workers with low ventilatory indices was' the highest in MMF (26.8 %), and followed by FEV(1)(11.9 %), FEV(1)%(7.6 %) and FVC (2.1 %) in descending order. Workers with low MMF and PEV^% were significantly increased with increasing exposure duration compared to control group, indicating 64.3 % and 32.1 % in above 20 years group. With the above considerations in mind it suggested that the exposure to welding fume be associated with reduced pulmonary function and obstructive ventilratory impairment, increasing exposure duration be associated with reduced pulmonary function, and MMF be the most sensitive index in the evaluation of venfcilatory impairments of workers exposed to welding fume.
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