Achievements, Problems, and Future Direction of the Quality Control Program for Special Periodic Health Examination Agencies in Republic of Korea

The ultimate goal of the quality control program for special periodic health examination agencies is to diagnose the health condition of a worker correctly, based on accurate examination and analysis skills, leading to protect the worker’s health. The quality control program on three areas, chemical analysis for biological monitoring since 1995, and pneumoconiosis, audiometric testing since 1996, has contributed to improve the reliability of occupational health screenings by improving the issues including standardization of testing methods, tools, diagnostic opinions, and reliability of analysis for biological monitoring. It has contributed to improving the reliability of occupational health monitoring by rectifying the following issues associated with previous monitoring: absence of standardized testing methods, testing tools that are not upgraded, mismatching diagnostic opinions, and unreliable results of biological specimen analysis. Nevertheless, there are issues in need of further improvement such as lack of expertise or the use of inappropriate method for health examination, and passive and unwilling participation in the quality control. We suggested solutions to these problems for each area of quality control program. Above all, it is essential to provide active support for health examiners to develop their expertise, while encouraging all the health screening agencies, employers, and workers to develop the desire to improve the system and to maintain the relevance.

The roles of doctors, nurses, and industrial hygienists in the healthcare management services in Korea: a comparison of the opinions of specialized health management institutions and entrusted enterprises

BACKGROUND: This study aimed to identify the difference of perception about the role of appointing health officers by comparing and analyzing the response of entrustment workplace (EW) and specialized health management institution (SI). This is considered an important aspect of an institutional assessment to improve the quality of health management services. METHODS: A survey questionnaire was mailed to 122 SIs and 319 EWs nationwide. The questionnaire survey was about the general characteristics of SIs and EWs and main occupations for each evaluation item. In total, 81 SIs (66.4%) and 30 EWs responded to the questionnaire. A logistic regression analysis was performed to compare the opinions of SI and EW. RESULTS: Based on the analysis, the items showing statistically significant differences were as follows. Doctors’ main tasks survey: “Guidance on their wearing personal protective equipment (PPE)” (OR: 4.58), “Guidance of improvement of work environment (WE)” (OR: 3.33), etc.; Nurses’ main tasks survey: “Guidance on their wearing PPE” (OR: 3.86), “Guidance for programs on health process in confined space (CS)” (OR: 0.36), “Guidance on the hearing conservation program (HCP)” (OR: 0.28), etc.; Industrial hygienist (IH)‘s main tasks survey: “Guidance of work through inspection (WTI)” (OR: 0.15), “Guidance on the improvement of WE” (OR: 0.32), “Management confirmation of substances used by process and Material Safety Data Sheet (MSDS)” (OR: 0.08), “Guidance on posting or keeping of MSDS and warning signs” (OR: 0.03), “Prevention of dust-induced medical problems” (OR: 0.28), “Guidance for programs of health process in CS” (OR: 0.39), etc. CONCLUSIONS: It is necessary to educate the EWs to recognize the need for physicians to perform tasks, such as wearing a PPE, and instruction to improve WE. As for nurses’ tasks, such as education about the CS and the noise work, educating the nurses of the SI is regarded necessary as the demand of the EWs is considered. With respect to the unique tasks of IH, such as WE management and instructions for wearing PPE, among several other tasks of IH, training should be provided for improved IH recognition.

The Effects of Hazardous Chemical Exposure on Cardiovascular Disease in Chemical Products Manufacturing Workers

The purpose of this study was to understand the mechanism of cardiovascular disease (CVD) caused by exposure to hazardous chemicals. We investigated changes in the symptoms of metabolic syndrome, which is strongly related to CVD, and in levels of other CVD risk factors, with a special emphasis on the roles of catecholamines and oxidative stress. The results revealed that neither body mass index (BMI) nor waist and hip circumferences were associated with exposure to hazardous chemicals. Among metabolic syndrome criteria, only HDL-cholesterol level increased on exposure to hazardous chemicals. Levels of epinephrine (EP) and norepinephrine (NEP) were not influenced by exposure to hazardous chemicals; however, the total antioxidative capacity (TAC) reduced because of increased oxidative stress. Both hazardous chemical exposure level and metabolite excretion were related to EP, NEP, and the oxidative stress index (OSI). Logistic regression analysis with these factors as independent variables and metabolic syndrome criteria as dependent variables revealed that EP was associated with blood pressure, and NEP with metabolic syndrome in the chemical-exposed group. In conclusion, the results suggest that reactive oxygen species generated and oxidative stress due to exposure to hazardous chemicals act as mediators and cause changes in the physiological levels of EP and NEP to increase blood pressure. This ultimately leads to the development of CVD through increase in cholesterol, triglyceride, and blood glucose levels by lipid peroxidation.

The Effects of Long-Term, Low-Level Exposure to Monocyclic Aromatic Hydrocarbons on Worker's Insulin Resistance

OBJECTIVES: This study was designed to investigate whether long-term, low-level exposure to monocyclic aromatic hydrocarbons (MAHs) induced insulin resistance. METHODS: The subjects were 110 male workers who were occupationally exposed to styrene, toluene, and xylene. One hundred and ten age-matched male workers who had never been occupationally exposed to organic solvents were selected as a control group. Cytokines, which have played a key role in the pathogenesis of insulin resistance, and oxidative stress indices were measured. Assessment of exposure to MAHs was performed by measuring their ambient levels and their urinary metabolites in exposed workers, and the resulting parameters between the exposed group and non-exposed control groups were compared. RESULTS: There was no significant difference in general characteristics and anthropometric parameters between the two groups; however, total cholesterol, fasting glucose, fasting insulin, and homeostasis model assessment of insulin resistance levels were significantly higher in the exposed group. Phenylglyoxylic acid levels showed significant association with tumor necrosis factor-alpha, total oxidative status, and oxidative stress index via multiple linear regression analysis. Further, there was a negative correlation between methylhippuric acid levels and total anti-oxidative capacity, and there was a significant relationship between MAHs exposure and fasting glucose levels, as found by multiple logistic regression analysis (odds ratio = 3.95, 95% confidence interval = 1.074-14.530). CONCLUSION: This study indicated that MAHs increase fasting glucose level and insulin resistance. Furthermore, these results suggested that absorbing the organic solvent itself and active metabolic intermediates can increase oxidative stress and cytokine levels, resulting in the changes in glucose metabolism and the induction of insulin resistance.

Effects of Obesity on the Physiological Levels of Adiponectin, Leptin and Diagnostic Indices of Metabolic Syndrome in Male Workers / 산업간호학회지

PURPOSE: The aim of this study was to examine the effects of obesity on the physiological levels of adiponectin, leptin and components of metabolic syndrome (MS) in male workers, aged 30-40 years. METHODS: Body mass index (BMI) was measured with Anthropometric equipment. Blood pressure and serum parameters were measured with an automatic digital sphygmomanometer and autochemical analyzer, respectively. Adiponectin and leptin were analysed by ELISA kits and MS was defined based on the NCEP-ATP III. RESULTS: Body fat mass of waist and hip, systolic and diastolic blood pressure were significantly higher, as expected, in the BMI> 25kg/m2 in comparison with the BMI25kg/m2 were also significantly higher compared with BMI< or =25kg/m2, HDL- cholesterol and adiponectin were significantly higher in BMI< or =25kg/m2. On multiple logistic regression analysis for the components of MS, exercise, adiponectin and leptin were an only independent factor for MS in non-obese male workers(BMI< or =25kg/m2) after adjustment for age, cigarette smoking and drinking habits. CONCLUSION: These results suggested that the obesity in men was associated with physiological levels of adiponectin and leptin contributing to feedback control of MS and that dysfunction and/or declination in feedback control system associated with changes in physiological levels of neurptrophics: adiponectin and leptin might ultimately induce MS.

Effects of Obesity on the Physiological Levels of Adiponectin, Leptin and Diagnostic Indices of Metabolic Syndrome in Male Workers / 산업간호학회지

PURPOSE: The aim of this study was to examine the effects of obesity on the physiological levels of adiponectin, leptin and components of metabolic syndrome (MS) in male workers, aged 30-40 years. METHODS: Body mass index (BMI) was measured with Anthropometric equipment. Blood pressure and serum parameters were measured with an automatic digital sphygmomanometer and autochemical analyzer, respectively. Adiponectin and leptin were analysed by ELISA kits and MS was defined based on the NCEP-ATP III. RESULTS: Body fat mass of waist and hip, systolic and diastolic blood pressure were significantly higher, as expected, in the BMI> 25kg/m2 in comparison with the BMI25kg/m2 were also significantly higher compared with BMI< or =25kg/m2, HDL- cholesterol and adiponectin were significantly higher in BMI< or =25kg/m2. On multiple logistic regression analysis for the components of MS, exercise, adiponectin and leptin were an only independent factor for MS in non-obese male workers(BMI< or =25kg/m2) after adjustment for age, cigarette smoking and drinking habits. CONCLUSION: These results suggested that the obesity in men was associated with physiological levels of adiponectin and leptin contributing to feedback control of MS and that dysfunction and/or declination in feedback control system associated with changes in physiological levels of neurptrophics: adiponectin and leptin might ultimately induce MS.