RÉSUMÉ
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.
Sujet(s)
Adénomes , Asthme professionnel , Carcinome épidermoïde , Syndrome du canal carpien , Eczéma de contact , Main , Syndrome des vibrations du système main-bras , Tumeurs du poumon , Maladies professionnelles , Médecine du travail , Prévalence , Facteurs de risque , Maladies de la peau , Solvants , Spécialisation , SoudageRÉSUMÉ
Following recent advanced industrialization. the amount of polyurethane to use as thermal insulating materials, upholstery mattresses and packing materials in automotive and furniture industry is increasing world-widely, and the number of polyurethane-producing worker will be increased. Because the numerous organic solvents are used in polyurethane-producing factory, the workers in this work site is exposed to many organic solvents. Of the organic solvents. Toluene Diisocyanate(TDI) has many hazardous effects to human. The effects of TDI on human are the irritation to respiratory mucosa and gastrointestinal symptoms. Conjunctival irritation, dermal inflammation (redness, pain, vesicular formation) and gastrointestinal symptom(nausea, vomiting, abdominal pain) are reported just after short-term exposure of TDI. TDI is known to give rise to bronchial asthma, as the immune disorder. And because of strongly volatile characteristics of TDI, it is suggested as a more injurious material to human health, especially human immune system, than other organic solvents. Bronchial asthma inducing mechanism of TDI is not clearly known, but on the analogy of TDI-induced symptoms and recent studies, early-onset asthma is type I hypersensitivity reaction mediated by immunoglobulin E(IgE), and late-onset asthma is maybe type III hypersensitivity reaction by circulating IgG. And we know that the complicated human immune function is likely to move in such that mechanisms, there are not studies on immune indices evaluating the bronchial asthma-related immune function. The evaluation of change patterns of humoral immunity including IgE and IgG and cellular immunity including T-helper cell, T-suppressor cell and T-cytotoxic cell will be helpful to evaluate exposure degrees and prognosis in TDI-exposed workers. Because TDA(toluene diamine) as a biological exposure index of TDI becomes the focus of interest, we know that a study on the correlation between urinary TDA and air TDI and immunological indices will make a contribution to biological effect monitoring indicies. We examined human immunity indicators such as WBC. %Lymph (percentile of Lymphocyte in WBC). %T-cell(percentile of T-lymphocyte in total lymphocyte). CD4, CD8, C3, C4, IgA, IgG, IgM, IgE in peripheral blood to evaluate the health hazard of the TDI-exposed workers. And we examined TDA to evaluate correlation between exposure and effect. Total 90 subjects was selected, 45 workers who worked in the polyurethane-producing factories as an exposed group, and 45 cases who were office workers(10 cases), other blue collors(27 cases), and medical college students(8 cases) as a control group. And the results were as follows ; 1. The logarithm of IgE -Log10(IgE)+/-SD- in peripheral blood of a exposed group was significantly higher than a control group, 2 22+/-.62 in case group compared with 1.98+/-.53 in control group.(p0.05). 3. WBC, %Lymph, %T-cell, C3, C4, CD4, CD8, CD4/CDB ratio and IgG in case group were 6,391.1 ea/ml, 37.53%, 59.54%, 76.68 mg/dl, 30.54 mg/dl, 0.76x10(9) ea/L, 0.63x10(9) ea/L, 1.39, and 1606.29 mg/dl, respectively, and 6,974.7 ea/ml, 35.12%, 59.64%, 71.95 mg/dl, 33.94 mg/dl, 0.80x109 ea/L, 0.61x10(9) ea/L, 1.39, and 1581.51 mg/dl in control group. There was no statistical sinificance between two groups. (p>0.05) 4. In the comparison of each other companies, average of individual urinary TDA in polyurethane paint manufacturing companies is higher than that of polyurethane sponge foaming companies. And, the concentration of 2,6-TDA which is a metabolite of well-vaporized 2,6-TDI is higher than that of 2,4-TDA in the polyurethane sponge foaming companies. But, the concentration of 2,4-TDA which is a metabolite of illvaporized but well skin-absorbed 2,4-TDI is higher in polyurethane paint manufactures. 5. There were no statistical significance in the correlations between individual urinary TDA and immunologic indices.
Sujet(s)
Humains , Asthme , Lits , Hypersensibilité immédiate , Maladies à complexes immuns , Système immunitaire , Maladies du système immunitaire , Immunité cellulaire , Immunité humorale , Immunoglobuline A , Immunoglobuline E , Immunoglobuline G , Immunoglobuline M , Immunoglobulines , Inflammation , Architecture d'intérieur et mobilier , Lymphocytes , Peinture , Polyuréthanes , Porifera , Pronostic , Muqueuse respiratoire , Solvants , Lymphocytes T , Toluène , Vomissement , Lieu de travailRÉSUMÉ
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 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.