A Case of Chronic Renal Failure and Renal Cancer in a Worker Exposed to Lead / 대한산업의학회지

INTRODUCTION: Studies evaluating rats and mice have provided convincing evidence that renal adenoma and carcinoma are induced by oral doses of lead acetate and lead subacetate, as well as by parenteral doses of lead phosphate. In addition, at least 2 cases of kidney cancer associated with heavy exposure to lead have been reported. However, there is still not enough information to confirm or rule out an association between kidney cancer and exposure to lead. CASE REPORT: In this study, we describe a case of kidney cancer in 54-year-old male worker that was exposed to lead-stearate while employed in the polyvinyl chloride processing industry for 17 years. The patient presented with gout and hypertension. Further examination revealed proteinuria, glucose in the urine and elevated blood urea nitrogen/creatinine levels. Renal ultrasonography, renal computed tomography and renal biopsy revealed chronic renal failure and renal cell cancer. CONCLUSION: We concluded that the gout and chronic renal failure in this case was caused by chronic lead exposure. However, further study is required to determine if the renal cancer was induced by lead exposure.

Cement Burn from Waterproof Work: A Case Study / 대한산업의학회지

BACKGROUND: Portland cement, which is a common material used in the construction industry, is known to cause caustic burns due to its alkalinity. Although cement burns are frequent and can be severe, many workers are inadequately aware of its risks. CASE: A 39-year-old man presented with exudative lesions and pain on his right hand after working with wet cement during waterproof work. The patient stated that wet cement entered his protective glove and he did not wash the cement off for 3 hours. Debridement of necrotic tissue and skin grafting was performed on his second and fifteenth hospital day respectively. CONCLUSION: The prevention of cement burns can be improved by extensive risk instruction and the provision of adequate skin protection.

Occupational disease surveillance system in Busan, Ulsan, Kyung-Nam area / 대한산업의학회지

OBJECTIVE: Occupational medicine specialists in the Busan, Ulsan and Kyung-Nam areas established an area-based occupational disease surveillance system and used this system to collected case information for the purpose of preventing occupational diseases METHODS: 11 hospitals participated in this system. The authors selected five main diseases, which were hand-arm vibration syndrome (HAVS), work-related musculoskeletal disorder (WRMSD), occupational asthma, occupational skin disease and occupational lung cancer and established their case definitions. All cases were reported on the web, and real time analysis was conducted. RESULTS: Between Apri1 2001 and April 2003, 192 cases of HAVS, 118 cases of WRMSD, 33 cases of occupational asthma, 17 cases of occupational skin disease and 17 cases of occupational lung cancer (for a total of 377 cases of these five main diseases) were reported. Most of the HAVS cases came from shipbuilding, and 172 of them (92.7 %) were associated with grinding. Of the four main types of WRMSD, carpal tunnel syndrome (CTS) was the most prevalent with 46 cases and shipbuilding was also the main industry involved (83.9 %). The ergonomic risk factors involved mainly associated with the hand. In 19 (57.6 %) and 4 (12.1 %) cases of occupational asthma, the agents included isocyanate and welding fume, respectively. 64.7 % of the cases of occupational skin diseases were contact dermatitis, and organic solvents and welding fume were the main agents involved. The causative agents of occupational lung cancer included Cr, welding fume, PAH, Ni, etc. 10 (58.8 %) of the cases were diagnosed as squamous cell carcinoma and 5 (29.4 %) as adenoma. CONCLUSION: This result showed that an area-based occupational disease surveillance system might provide an effective method of evaluating the prevalence of such diseases, however the Busan, Ulsan and Kyung-Nam provinces are too large to be treated as individual areas. Therefore, the authors suggest that each province should establish its own surveillance system.

Epidemiologic Characteristics of Hand-Arm Vibration Syndrome through Occupational Disease Surveillance System in Busan, Ulsan, Kyungnam Province / 대한산업의학회지

OBJECTIVES: The objectives of this study were to estimate the epidemiologic characteristics of hand-arm vibration syndrome (HAVS) due to occupational exposure of hand transmitted vibration and to identify the occupations and industries where such exposures arises, and the main sources of exposure. METHODS: In April 2001 the Busan, Ulsan, and Kyung-Nam Province occupational disease surveillance system was established to measure the incidence and prevalence of work-related HAVS and other occupational diseases in these Korean provinces. Occupational physicians of nine hospitals in Busan, Ulsan, and Kyung-nam Province were involved in this project between April 2001 and November 2002. Physicians collected information through questionnaires and interviews. Information gathered included age, occupation, types of vibration tools used and presence of subjective symptoms such as vibration-induced white finger (VWF), numbness and tingling. RESULTS: A total 192 cases were reported with 188 males and 4 females. The shipbuilding industry was the most common type of industry and grinders were the most common source of exposure. Symptoms of neurological disorder were more common than those of vascular disorder. CONCLUSIONS: The authors concluded that exposure to hand transmitted vibration is common and that HAVS is one of the most common occupational diseases in Korea. However, the range and extent of hand transmitted vibration and the overall prevalence of HAVS in Korea is still unknown. More extensive research on this syndrome in order to priorite necessary preventive measures is required.

Analysis of Claimed Cases as an Occupational Disease at Korea Occupational Safety and Health Agency from 1992 to 1999 / 대한산업의학회지

OBJECTIVES: Pneumoconisis and noise-induced hearing loss(NIHL) have been reported as main occupational diseases by the Special Health Examination. The Industrial Accident Compensation Insurance has reported various work-related diseases, however, these two diseases occupied almost a half of compensated cases. Therefore, it was not well known about the status of occupational diseases other than pneumoconiosis, NIHL, and cardiocerebrovascular accident(CVA). This study was conducted to analyze claimed cases as an occupational disease, that was requested to the Korea Industrial Safety and Health Agency (KOSHA). METHODS: The local office of the Korea Labor Welfare Corporation(KLWC) has asked the KOSHA for confirmation of claimed cases as an occupational disease. We analyzed 379 cases requested from KLWC, the Ministry of Labor, employers, unions and occupational health agencies from 1992 to 1999. RESULTS: Male was 80. 7 % of the requested cases. Their mean age was 42 years old and 75. 5 % of them were more than 35 years old. The requested cases were increased rapidly from 25 cases in 1992 to 108 cases in 1999 and the accept rate was 50. 7 %. The majority of requested cases were respiratory diseases(22.4 %), cancers(18.5 %), Neuropsychiatric problems (14. 5 %), and musculoskeletal problems (13. 5 %). The accept rate was high in reproductive, respiratory, musculoskeletal and digestive disorders and low in neuropsychiatric, renal and otologic problems and occupational cancers. 73. 6 % of them were caused by chemical agents, especially 28. 5 % were by organic solvents. 67 % of them were clinically confirmed at university hospitals. A half of the cases were from KyongIn area, even the request came from the whole country. CONCLUSIONS: A claim was common in workers whose age was over 35 years old and exposure history was over 10 years. The respiratory diseases and neuropsychiatric disorders were still main problems in occupational health and occupational cancers was increasing even though its accept rate was not high yet.

Factors Associated with Psychoneurobehavjral Outcomes in Workers Exposed to Manganese / 대한산업의학회지

The risk posed to human health by environmental manganese (Mn) exposure is unknown. The purpose of this study is to establish if subclinical effects related to Mn exposure and examine the factors influencing psychoneurobehaviral outcomes of Mn exposed workers. This study involved 121 male workers of welding, alloy furnace, and manufacturing of welding stick. Study investigations include: a questionnaire covering demographic characteristics, job and exposure history and medical symptoms and conditions, monitoring workplace air for personal exposure to respirable and inhalable manganese, analysis of blood and urine samples. psychoneurobehaviral test(neurobehaviral core test battery (NCTB), signal change on magnetic resonance imaging (MRJ) scans, minimental state and neurological examination). The main results of this study were as follows: 1. Preliminary results showed that, with increasing manganese exposure, neurobehaviral performance was poorer and signal change on MRI scans increased. 2. The results of examination revealed significant relations on psychoneurobehaviral out-comes (neurobehaviral performance, signal change on MRI scans, and neurological features). 3. In multiple regression, age and educational status as demographic variables and exposure level were significantly related to 4neurobehaviral test. Also exposure level and serum Mn concentrations were positively relatel to signal change on MRI scans and neurological features affected by Mn on the brain (signal change). 4. Psychoneurobehaviral outcomes from Mn exposure were related to neurobehaviral performance, signal change on MRJ scans, neurological features and profile of mood states (POMS), and influnced positively with age, alcohol and smoking history, and duration of Mn exposure, negatively with educational status. Serum Mn concentrations in combination with brain MRI scans, and perhaps a battery of neurobehaviral tests, appear to be the best way to monitor excessive exposure to Mn. These results are consistent with our knowledge on Mn action on the brain and are similar to the type of neurobehaviral dysfunction. They suggest that there may be age, educational status, and life style (alcohol and drinking history) differences with chronic environmental exposure. These findings suggest further evaluation, particularly on relationships between Mn exposure, aging, and susceptibility factors.

Performance of Neurobehavioral Tests Among Welders Exposed to Manganese / 대한산업의학회지

To study neurobehavioral effects for manganese fume exposure of welders, we administrated questionnaire about subjective symptom, related with manganese exposure. Neurobehavioral Core Test Battery of World Health Qrganization(NCTB) and finger tapping for 98 welders and 29 non-welding workers. We adopted welding duration as a criterion for exposure assessment, because of the lack of the longitudinal valid data and differences in airborne concentrations of manganese in welding types, such as shielded metal arc and CO2 arc welding. Neurologic, musculoskeletal and concentration symptoms were significantly increased by increase of welding duration. Performance of finger tapping preferred hand, Santa Ana dexterity test preferred hand and correct number of pursuit aiming were significantly decreased by increase of welding duration. These results comparable with previous studies that suggest neurobehavioral test, especially motor test, to be an appropriate tool to detect early neurobehavioral abnormalities related with manganeses exposure.

A Study on Risk Factors of Grain Dust-Induced Occupational Asthma in Grain Feedmill Workers / 대한산업의학회지

This study was carried out to manifest risk factors related grain dust induced asthma, especially allergic and immunologic factors. Six grain workers first diagnosed as grain dust induced asthma by specific antigen bronchial asthma challenge test (cases) and 37 grain workers showed negative finding (controls) in the same firm were selected. Questionnaire survey for respiratory symptoms, interview, physical examination, PFT, methacholine bronchial hyperresponsiveness, specific challenge tests and skin prick test for four grains (grain, corn, rye and seed dust) were conducted. To evaluate the role of specific antibodies to grain dust, we detected serum specific IgE and IgG antibodies by ELISA in 43 employees. The results were summarized as follows : 1. Compared with the group having no respiratory symptoms, odds ratio of grain dust induced asthma with respiratory symptoms was 3.04 (95% CI 0.32-28.80). 2. Compared with the group having no ventilatory impairment, odds ratio of grain dust induced asthma with ventilatory impairment was 0.54 (95% CI 0.06-5.21). 3. Compared with the group showed negative skin test for general respirable antigen, odds ratio of grain dust induced asthma with atopy was 8.02 (95% CI 0.42-153.25). 4. Compared with the group showed negative finding on specific allergic skin test, odds ratio of grain dust induced asthma with positive finding was 5.88 (95% CI 0.63-55.38). 5. In immunologic test, compared with the group not increased total IgE( or = 160 IU/ml) was 4.78 (95% CI 0.50-44.57). 6. Compared with the group showed negative finding on specific IgE antibody, odds ratio of grain dust induced asthma with positive finding was 2.63 (95% CI 0.43-16.16). 7. Compared with the group showed normal finding on nonspecific (methacholine) bronchial hyperresponsiveness, odds ratio of grain dust induced asthma with positive finding was 76.82(95% CI 3.37 - 1566.34). Statistically significant odds ratio were fecund for specific skin test with grain, total IgE and nonspecific (methacholine) bronchial hyperreponsiveness.

A Study on Risk Factors of Grain Dust-Induced Occupational Asthma in Grain Feedmill Workers / 대한산업의학회지

This study was carried out to manifest risk factors related grain dust induced asthma, especially allergic and immunologic factors. Six grain workers first diagnosed as grain dust induced asthma by specific antigen bronchial asthma challenge test (cases) and 37 grain workers showed negative finding (controls) in the same firm were selected. Questionnaire survey for respiratory symptoms, interview, physical examination, PFT, methacholine bronchial hyperresponsiveness, specific challenge tests and skin prick test for four grains (grain, corn, rye and seed dust) were conducted. To evaluate the role of specific antibodies to grain dust, we detected serum specific IgE and IgG antibodies by ELISA in 43 employees. The results were summarized as follows : 1. Compared with the group having no respiratory symptoms, odds ratio of grain dust induced asthma with respiratory symptoms was 3.04 (95% CI 0.32-28.80). 2. Compared with the group having no ventilatory impairment, odds ratio of grain dust induced asthma with ventilatory impairment was 0.54 (95% CI 0.06-5.21). 3. Compared with the group showed negative skin test for general respirable antigen, odds ratio of grain dust induced asthma with atopy was 8.02 (95% CI 0.42-153.25). 4. Compared with the group showed negative finding on specific allergic skin test, odds ratio of grain dust induced asthma with positive finding was 5.88 (95% CI 0.63-55.38). 5. In immunologic test, compared with the group not increased total IgE( or = 160 IU/ml) was 4.78 (95% CI 0.50-44.57). 6. Compared with the group showed negative finding on specific IgE antibody, odds ratio of grain dust induced asthma with positive finding was 2.63 (95% CI 0.43-16.16). 7. Compared with the group showed normal finding on nonspecific (methacholine) bronchial hyperresponsiveness, odds ratio of grain dust induced asthma with positive finding was 76.82(95% CI 3.37 - 1566.34). Statistically significant odds ratio were fecund for specific skin test with grain, total IgE and nonspecific (methacholine) bronchial hyperreponsiveness.

Change on Lens Accomodation and Pupil Light Reflex in VDT works / 예방의학회지

We studied on change of lens accommodation and pupil light reflex caused by VDT work in six women and compared them with those of other office works. The results were as follows. 1. In VDT work group, the accommodation contraction velocity decreased during the first 2-hr VDT task, then recovered markedly by the end of the one-hour lunch break, and then decreased again by the end of the 2nd 2-hr VDT task. Changes of relaxation velocity showed similar pattern although it was less typical than that of contraction velocity. 2. There was no marked change in accommodation contraction velocity and amplitude of accommodation in general office work group and near-distance office work group, and in the near-distance office work accommodation relaxation velocity decreased according to work load without recovery after lunch break. 3. Initial pupil diameter, initial pupil area of light reflex decreased significantly during VDT task only in VDT work group, and didn't recover after lunch break. These results suggest possibility that changes of accommodation contraction velocity, accommodation relaxation velocity, near point distance, and pupil diameter and area are useful in evaluating characteristics of VDT work. For this, more research adjusted individual differences, circadian rhythm, emotional stress needs.

Contact dermatitis among male workers exposed to metalworking fluids / 예방의학회지

In an epidemiological study of metal workers exposed to metalworking fluids(MWF), the prevalence time of evoultion, seasonal occurrence and clinical type of contact dermatitis were investigated. Composinal analyses of MWF with HPLC, dermatological examination and two consecutive questionnaire surveys were conducted. Study population was divided into two groups ; workers contact to cutting oil and workers contact to rust preventive oil. In the analysis of MWF, aliphatic hydrocarbons, having 12-20 carbons, was most common composition(49.04%) of cutting oil otherwise, major contents (90.99%) of the rust preventives oil were aliphatic hydrocarbons composed of 6-9 carbons. The frequency (point prevalence) of contact dermatitis(CD) was 7(12.7 per 100 subjects) in the dermatological examination of 55 workers. As the result of second survey for contact dermatitis, cumulative prevalence of oil working full-time and recent 1 year prevalence in two groups were 28.0, 16.7 and 15.1, 12.5 per 100 subjects. There were no difference in the prevalence of CD by oil, age, oil contact duration. Summer is the most common evolution season in workers exposed to cuttiogs, but not in workers exposed to rust preventive oil. Major clinical type of CD was erythematous papules in both groups. It presents the importance of preventive measures that 51.1% suffer from contact dermatitis had medical care at their own expense, and 47.1% of them felt serious about their contact dermatitis. From the fact that 68.6% think cotton gloves protective apparatus, we emphasize the need for health education.