Risk perceptions of a population living near a municipal waste incinerator and associated factors with the prevalence of environmental disease.

Background: This study investigated the risk perceptions, prevalence of environmental diseases (EDs) and associated factors with the prevalence of environmental disease among the population living near an incinerator. Methods: Study area were divided into 3 local areas near the incinerator by distance (A, B, C) and control area (D) by distance and geographic isolation. A Questionnaire was conducted with 1,380 in local residents (A, B, C) and 390 in control area (D), gathered information of demographic characteristics, lifestyle, perception of damage by incinerators, experience of EDs (atopic dermatitis, allergic rhinitis, asthma) diagnosed by physician. Analysis of variance, χ2 test, and Kruskal Wallis test was applied to determine the difference by area. Logistic regression analysis was performed to identify factors associated with the prevalence of allergic rhinitis. Results: Residents residing closer to the incinerator had negative perception in most items in questionnaire compared with control. The prevalence of allergic rhinitis was higher as they lived nearby the incinerator (p = 0.008). The associated factors with the prevalence of allergic rhinitis were carpet (odds ratio [OR]: 1.79, p = 0.001), residential area (marginally significant), duration of residence (OR: 1.09, p < 0.001). The perception of environmental pollution around the residential area was inversely associated with the prevalence of allergic rhinitis: perceived as very dissatisfied (OR: 4.21, p = 0.02) compared with very satisfied. Conclusions: As closer to the incinerator, the risk perception tend to negative and prevalence of EDs were increased. Carpet, residential area, duration of residence and perception of environmental air pollution around the residential area were associated with prevalence of allergic rhinitis. These results may be useful for the communication with residents to discuss the environmental problems caused by the incinerator.

High Emotional Demands at Work and Poor Mental Health in Client-Facing Workers.

This study investigated the association between emotional demands and depression or anxiety in a wide range of jobs. We used data from the third Korean Working Conditions Survey (n = 50,032) for all occupational classifications, with no limitations placed on job title or employment type. Among the full set of regular paid workers in addition to self-employed, unpaid family workers, and informal employees such as independent contractors, 23,989 respondents worked with "customers, passengers, students, or patients" (i.e., clients). Emotional demands were evaluated using two questions: handling angry clients and needing to hide feelings for work performance. Any depression or anxiety over the last 12 months was taken to indicate poor mental health. Multivariable logistic regression modeling was performed to calculate adjusted ORs with 95% confidence intervals for the influence of emotional demands on mental health, adjusting for demographic factors (age, gender, education, income), occupational psychological demands, decision latitude, social support, weekly work hours and job insecurity. The prevalence of emotional demands was higher in self-employed and informal employees than in regular paid employees. The more frequent the exposure to the two emotional demands combined was, the higher the risk of depression or anxiety. High psychological demands, low social support, and low job security each further increased the risk of poor mental health. Emotional demands turned out to be widespread in the entire economy, were not limited to service or sales occupations, and were more evident in precarious work. The contribution of emotional demands and other preventable job stressors to the burden of depression or anxiety in society may be substantial.

Development of a Chatbot Program for Follow-Up Management of Workers' General Health Examinations in Korea: A Pilot Study.

(1) Background: Follow-up management of workers' general health examination (WGHE) is important, but it is not currently well done. Chatbot, a type of digital healthcare tool, is used in various medical fields but has never been developed for follow-up management of WGHE in Korea. (2) Methods: The database containing results and explanations related to WGHE was constructed. Then, the channel, which connects users with the database was created. A user survey regarding effectiveness was administered to 23 healthcare providers. Additionally, interviews on applicability for occupational health services were conducted with six nurses in the agency of occupational health management. (3) Results: Chatbot was implemented on a small scale on the Amazon cloud service (AWS) EC2 using KaKaoTalk and Web Chat as user channels. Regarding the effectiveness, 21 (91.30%) rated the need for chatbots as very high; however, 11 (47.83%) rated the usability as not high. Of the 23 participants, 14 (60.87%) expressed overall satisfaction. Nurses appreciated the chatbot program as a method for resolving accessibility and as an aid for explaining examination results and follow-up management. (4) Conclusions: The effectiveness of WGHE and the applicability in the occupational health service of the chatbot program for follow-up management can be confirmed.

Surface-acting emotional labor predicts depressive symptoms among health care workers over a 2-year prospective study.

OBJECTIVE: Surface-acting emotional labor (SaEL) is the requirement to hide or suppress felt emotions to achieve acceptable job performance. It is a common feature of jobs featuring interactions with the public, such as customers or patients. Resulting emotional inauthenticity is associated with psychological strain, but there have been few prospective studies of mental health outcomes. METHODS: A self-administered questionnaire was distributed in 24 skilled nursing facilities at baseline and 23 facilities 2 years later. Permanent full-time and part-time employees in all jobs were eligible to participate. Respondents in these analyses provided survey information on the frequency of SaEL at baseline and depressive symptoms on both occasions. Those without depression at baseline were deemed at risk. Multivariable logistic regression modeling estimated adjusted odds ratios (aOR) for SaEL, other job features, and demographic characteristics. RESULTS: A total of 939 eligible participants had no depression at baseline; 15% developed depressive symptoms. About two-thirds were direct care providers, including 38% nursing and medical assistants. Adjusted for potential confounders, workers with intermediate and high SaEL had a higher risk (aORs around 2). Symptom onset was also predicted by high work-family conflict, younger age and low decision latitude at work. CONCLUSIONS: In this prospective study of long-term care workers, those who reported experiencing high SaEL at the time of the baseline survey were at higher risk of developing depressive symptoms 2 years later. Both exposure and outcome could have suffered some misclassification. Future studies should examine a broader range of strategies for coping with emotional labor demands.

Validation of the Work Engagement Scale-3, used in the 5th Korean Working Conditions Survey.

BACKGROUND: The purpose of this study was to assess the reliability and validity of the 3-item version of the Work Engagement Scale (WES-3), which is based on the Job Demands-Resources (JD-R) model and was used in the 5th Korean Working Conditions Survey (KWCS). METHODS: This study used data from the 5th KWCS (n = 50,205), which was conducted in 2017 with a sample of the Korean working population. The survey gathered comprehensive information on working conditions to define workforce changes and the quality of work and life. The reliability and internal consistency of the WES-3 were assessed using the corrected item-total correlation and Cronbach's alpha coefficient. Confirmatory factor analysis (CFA) was used to test the construct validity of work engagement. The convergent validity was assessed using the correlation with the WHO-5 well-being index. Correlations between work engagement and JD-R factors were also calculated. RESULTS: The Cronbach's alpha for work engagement was 0.776, indicating acceptable internal consistency. The model comprising 3 work engagement and 2 burnout items showed an excellent fit (χ2: 382.05, Tucker-Lewis index: 0.984, comparative fit index: 0.994, root mean square error of approximation: 0.043). The convergent validity was significant (correlation coefficient: 0.42). Correlations with burnout and job demands were negligible, whereas correlations with job resources and job satisfaction were weakly positive. CONCLUSIONS: The results of our study confirm that the WES-3 has acceptable reliability and validity.

Korean translation and validation of the Workplace Positive emotion, Engagement, Relationships, Meaning, and Accomplishment (PERMA)-Profiler.

BACKGROUND: No tool is available for the multidimensional measurement of workplace well-being among Korean workers. In this study, the Workplace Positive emotion, Engagement, Relationships, Meaning, and Accomplishment (PERMA)-Profiler, a multidimensional workplace well-being measure, was translated into Korean, and its validity and reliability were assessed. METHODS: The Workplace PERMA-Profiler, including the positive emotion, engagement, relationships, meaning, and accomplishment domains, was translated according to international guidelines. The questionnaires included the Workplace PERMA-Profiler, Mental Health Continuum-Short Form, Utrecht Work Engagement Scale, Maslach Burnout Inventory-General Survey, Psychosocial Well-being Index-Short Form, and Korean Occupational Stress Scale-Short Form. A total of 316 Korean workers completed a web-based survey with adequate response. Cronbach's alpha values were calculated to assess scale reliability, and correlational and confirmatory factor analyses were used to assess validity. RESULTS: Cronbach's alpha values for the Korean Workplace PERMA-Profiler ranged from 0.70 to 0.95. Confirmatory factor analysis indicated that the 5-factor model had a marginally acceptable fit [χ2(80) = 383.04, comparative fit index = 0.909, Tucker-Lewis index = 0.881, root mean square error of approximation = 0.110, and standardized root mean square residual = 0.054]. The 5-factor PERMA domains were correlated positively with work engagement and mental well-being in life, and negatively with burnout, occupational stressors, and stress responses. These results showed that the Workplace PERMA-Profiler has good convergent and divergent validity. CONCLUSIONS: The Korean version of the Workplace PERMA-Profiler had good reliability and validity. It might be used as an indicator or evaluation tool for positive mental health interventions in the workplace.

The work-life balance and psychosocial well-being of South Korean workers.

BACKGROUND: It is challenging to balance work and life, and little attention has been paid to the work-life balance and psychosocial well-being of South Koreans. We assessed the association between work-life balance and psychosocial well-being among paid Korean workers. METHODS: This study was based on data from the fourth Korean Working Conditions Survey. We evaluated only paid workers, which constituted 30,649 of the total of 50,007 subjects surveyed. Poor work-life balance was defined based on the goodness of fit between working hours and social commitments. Well-being was measured using the World Health Organization WHO-5 index. Poisson regression with robust variances was used to calculate the estimated prevalence ratios (PRs) with confidence intervals. RESULTS: Poor work-life balance was associated with poor psychosocial well-being (PR = 1.25; 95% CI 1.21 to 1.28) even after adjusting for work-related and individual characteristics. Poor well-being was associated with low-level job autonomy (PR = 1.06; 95% CI 1.03 to 1.09), working for ≥53 h per week (PR = 1.10; 95% CI 1.06 to 1.14), blue-collar status (PR = 1.16; 95% CI 1.11 to 1.21), low-level support at work (PR = 1.32; 95% CI 1.29 to 1.36), age ≥ 50 years (PR = 1.21; 95% CI 1.15 to 1.26), the female gender (95% CI PR = 1.04; 95% CI 1.01 to 1.07), and cohabitation (living with somebody) (PR = 1.08; 95% CI 1.04 to 1.12). Good well-being was associated with high-intensity work (PR = 0.96; 95% CI 0.94 to 0.99), being the secondary earner in a household (PR = 0.82; 95% CI 0.79 to 0.85), and higher income (PR = 0.75; 95% CI 0.71 to 0.79). CONCLUSION: Work-life balance was associated with psychosocial well-being after adjusting for both work-related and individual characteristics.

Serum concentrations of per- and poly-fluoroalkyl substances and factors associated with exposure in the general adult population in South Korea.

Per- and polyfluoroalkyl substances (PFASs) are ubiquitous contaminants found worldwide, including in South Korea. As a result, they are frequently detected in Koreans. However, there is limited representative data and information on potential sources in Korea. Therefore, we measured the serum concentrations of ten PFASs in nationally representative samples of the Korean population (n=1874, 18-69 years) and evaluated the factors associated with their exposure. Serum PFOS, PFDA, PFOA, and PFNA were detected in nearly all participants (83.1-99.9%). However, serum PFPA, PFHxA, and PFHpA were almost undetected (<0.5% of participants). PFOS had the highest population-weighted geometric mean of 10.23ng/mL (95% CI: 9.99-10.47), which was followed by PFOA with 2.85ng/mL (95% CI: 2.73-2.97) and PFDA with 2.17ng/mL (95% CI: 2.12-2.23). PFNA, PFDA, PFHxS, PFOA, and PFOS concentrations were higher in males (p<0.001) and older adults (p<0.001). PFNA was higher in those who used wax, polish, and water-resistant materials (adjusted proportional change=1.14; 95% CI: 1.08-1.22), and those who ate cooked fish (1.16; 95% CI: 1.03-1.31) compared to those who ate nearly no fish. PFDA was higher in those who used herbicides and pesticides (1.05; 95% CI: 1.02-1.09), those who drank beverages in a plastic bag on a daily basis (1.10; 95% CI: 1.03-1.19), and those who ate raw fish (1.15; 95% CI: 1.03-1.29) or cooked fish (1.13; 95% CI: 1.05-1.23) compared to those who ate nearly no fish. PFHxS was higher in those who used traditional Korean health supplement foods (1.08; 95% CI: 1.01-1.15). PFOA was higher in those who used plastic wrap in a microwave daily or weekly (1.08; 95% CI: 1.00-1.16), and those who used disposable paper cups (1.07; 95% CI: 1.01-1.13). PFOS was lower in underweight participants (0.84; 95%CI: 0.75-0.93) compared to those who were obese, and higher in those who exercised regularly (1.08; 95% CI: 1.03-1.14) or irregularly (1.06, 95% CI: 1.01-1.12) compared to those who did not exercise. Subjects who used severely damaged Teflon appliances had lower concentrations of PFOA (0.78, 95% CI: 0.65-0.95), while regular use of Gore-Tex goods was related to higher PFNA (1.15, 95% CI: 1.03-1.28) and PFDA (1.11; 95% CI: 1.02-1.20) levels. These findings suggest that most Koreans are frequently exposed to PFASs, and that serum concentrations of PFASs vary with age, sex, and exposure factors.

Perception of and attitude toward ethical issues among Korean occupational physicians.

BACKGROUND: Occupational physicians (OPs) have complex relationships with employees, employers, and the general public. OPs may have simultaneous obligations towards third parties, which can lead to variable conflicts of interests. Among the various studies of ethical issues related to OPs, few have focused on the Korean OPs. The aim of the present survey was to investigate the ethical contexts, the practical resolutions, and the ethical principles for the Korean OPs. METHODS: An email with a self-administered questionnaire was sent to members of the Korean Society of Occupational and Environmental Medicine, comprising 150 specialists and 130 residents. The questionnaire was also distributed to 52 specialists and 46 residents who attended the annual meeting of the Korean Association of Occupational and Environmental Clinics in October 2015, and to 240 specialists by uploading the questionnaire to the online community 'oem-doctors' in February 2016. The responses to each question (perception of general ethical conflicts, recognition of various ethical codes for OPs, core professional values in ethics of occupational medicine, and a mock case study) were compared between specialists and residents by the chi-squared test and Fisher's exact test. RESULTS: Responses were received from 80 specialists and 71 residents. Most participants had experienced ethical conflicts at work and felt the need for systematic education and training. OPs suffered the most ethical conflicts in decisions regarding occupational health examination and evaluation for work relatedness. Over 60% of total participants were unaware of the ethical codes of other countries. Participants thought 'consideration of worker's health and safety' (26.0%) and 'neutrality' (24.7%) as the prominent ethical values in professionality ofoccupational medicine. In mock cases, participants chose beneficence and justice for fitness for work and confidential information acquired while on duty, and beneficence and respect for autonomy in pre-placement examinations. CONCLUSIONS: This study evaluated the current perception of and attitude toward ethical issues among the Korean OPs. These findings will facilitate the development of a code of ethics and the ethical decision-making program forthe Korean OPs.

The impact of long working hours on psychosocial stress response among white-collar workers.

This study examined the association between long working hours and psychosocial stress responses. In total, 1,122 white-collar workers from a company in Korea completed self-administered questionnaires following a lecture about the study aim, procedures, and confidentiality. Psychosocial stress responses were evaluated using the Psychosocial Well-being Index - Short Form (PWI-SF), and psychosocial working conditions were evaluated with the Korean Occupational Stress Scale - Short Form (KOSS-SF). Multivariate logistic regression analysis was performed after adjusting for demographic variables and psychosocial working conditions to examine associations between long working hours and psychosocial stress responses. In comparison with the reference group, which worked 40-44 hours per week, the crude odds ratio (OR) of the respondents who worked 60 or more hours was 4.56 (95% confidence interval (CI), 2.55-8.15) in terms of psychosocial stress responses. After adjusting for demographic variables, the adjusted OR of those working ≥60 hours was 5.61 (95% CI, 3.01-10.47). After adjusting for both demographic variables and psychosocial working conditions, the adjusted OR of those working ≥60 hours was 3.25 (95% CI, 1.56-6.79). This study found that long working hours are significantly related to psychosocial stress responses among white-collar workers in one Korean company.

Effects of shift work on abdominal obesity among 20-39-year-old female nurses: a 5-year retrospective longitudinal study.

BACKGROUND: This study aimed to investigate the effects of shift work on abdominal obesity among young and middle-aged female nurses during a 5-year retrospective study. METHODS: This retrospective study included female nurses (20-39 years old) who worked at a university hospital in Korea and had available health screening results from 2010-2015. Among 2,611 employees, 934 healthy 20-39-year-old female nurses were identified, and data regarding their demographic information (age and date of employment), waist circumferences (WC), and lifestyle factors (alcohol and exercise) were obtained. Abdominal obesity was defined as a WC of ≥80 cm, based on the World Health Organization's Asia-West Pacific standard in 2000. The mean WC change from baseline was analyzed using the paired t test, and the association between shift work and abdominal obesity was analyzed using the generalized estimating equation. RESULTS: Compared to all day workers (both age groups), the 20-29-year-old nurses did not exhibit significant changes in WC at each follow-up. However, among the 30-39-year-old nurses, shift workers exhibited a significant change in WC (vs. baseline) during years 4 and 5, compared to day workers. After adjusting for effective confounders and stratifying the participants according to age, the 20-29-year-old nurses exhibited an odds ratio of 3.21 (95 % confidence interval: 1.29-7.98) for shift work-associated obesity, although the odds ratio for the 30-39-year-old nurses was not statistically significant. CONCLUSION: In the study population, shift work was associated with a significant change in mean WC among 30-39-year-old nurses, and the shift work-associated risk of abdominal obesity was significant among 20-29-year-old nurses. These results indicate that shift work may influence abdominal obesity differently in 20-29-year-old and 30-39-year-old female nurses.

Factors associated with total mercury concentrations in maternal blood, cord blood, and breast milk among pregnant women in Busan, Korea.

This study investigated the concentration of total mercury (THg) in maternal blood, cord blood, and breast milk, and its association with dietary factors. A total of 127 pregnant women in Busan, Korea were recruited. Maternal blood, cord blood, and breast milk were collected at 36 weeks of gestation, at delivery, and at one week after birth, respectively. Information about dietary habits and other factors were obtained from each subject. The mean THg concentrations in maternal blood, cord blood, and breast milk were 3.12±1.36 µg/L, 5.46±2.41 µg/L, and 0.91±2.08 µg/L, respectively. Positive correlations were found between log-transformed THg concentrations in maternal blood and cord blood (r=0.829, p<0.001), and between maternal blood and breast milk (r=0.296, p=0.001). Multiple linear regression analysis showed that the log-transformed concentration of THg in maternal blood was positively correlated with fish consumption (ß=0.345, p<0.0001) and negatively correlated with bean consumption (ß=-0.055, p=0.048). Fish consumption (ß=0.482, p<0.0001) and maternal age (ß=0.025, p=0.033) were positively associated with the concentration of THg in cord blood, while negative correlations were found for bean consumption (ß=-0.134, p=0.027) and parity (ß=-0.172, p=0.015). Beef consumption (ß=0.031, p=0.007) was positively associated with log-transformed THg concentrations in breast milk, while negative correlations were found for bean consumption (ß=-0.019, p=0.003) and maternal age (ß=-0.083, p=0.004). Our study found that both the dietary and demographic factors differently affected to THg concentrations among samples of maternal blood, cord blood, and breast milk.

Decline in non-smoking workers' urine cotinine levels after increased smoking regulation in Korea.

OBJECTIVES: To identify any association between implementing smoking regulation policies and workers' urine cotinine concentration levels in Korea. METHODS: From the first stage of the Korean National Environmental Health Survey conducted by the National Institute of Environmental Research from 2009 to 2011, 2,475 non-smoking workers selected. We analyzed the trend in the changes of cotinine concentration in urine using the general linear model and linear regression, in various jobs as categorized by the National Center for Health Statistics (NCHS) and Korea Standard Classification of Occupations (KSCO). RESULTS: The urine cotinine concentration tended to decrease every year (2.91 ng/ml in 2009, 2.12 ng/ml in 2010, and 1.31 ng/ml in 2011), showing a decreasing trend (P < 0.001). The total subjects' decreased cotinine concentration in urine between 2009 and 2011 was 2.72 ng/ml (54.1 % relative decrease). The changes in each subgroup's urine cotinine concentration ranged from 1.59 to 6.03 ng/ml (33.2 to 77.5 %). All groups except for the managerial group (n = 49), which had a small sample size, had statistically significant negative regression coefficients (p < 0.05). The ranges of the decrease in urine cotinine were 2.75 ng/ml (53.6 %) for males and 2.72 ng/ml (54.9 %) for females. The negative slope in urine cotinine level was statistically significantly greater in men than women. The changes in urine cotinine by occupation as classified by the NCHS occupational categories ranged from 2.43 to 3.36 ng/ml (46.6 to 61.5 % relative decrease). The negative slopes in urine cotinine levels of the white-collar and farm workers were statistically significantly greater than those of the service workers and blue-collar workers. The change by occupation as classified by the KSCO ranged from 1.59 to 6.03 ng/ml (a 33.2 to 77.5 % relative decrease). The negative slopes in urine cotinine levels of the professionals and related workers and clerks were statistically significantly greater than those of the service workers and plant and machine operators and assemblers. CONCLUSIONS: The cotinine concentration in urine among non-smoking worker groups tended to decline from 2009 to 2011. Such a result may be an indirect indicator of the effectiveness of smoking regulation policies including the revision of the National Health Promotion Act.

The effect of applying ethnicity-specific spirometric reference equations to Asian migrant workers in Korea.

OBJECTIVES: Asian migrant workers in Korea have various ethnicities. The purpose of this study was to evaluate the difference in spirometric interpretation made using the set of third National Health and Nutrition Examination Survey (NHANES III) reference equations and the relevant ethnicity-specific reference sets. METHODS: Spirometry was performed on 166 migrant and 498 Korean male workers between March and November 2012. We analyzed the spirometric data of healthy never-smokers. Spirometric patterns were evaluated using the NHANES III reference set and some relevant ethnicity-specific equations (Eom's equation for Koreans, Ip's equation for East Asians, Crapo's equation for Central Asians, Memon's equation for South Asians, and Gnanou's equation for Southeast Asian people). RESULTS: In all migrant groups except the Central Asian group, the forced expiratory volume in 1 second percentage (FEV1%) and forced vital capacity percentage (FVC%) calculated using each of the ethnicity-specific reference equations considered were significantly higher than those calculated using the NHANES III reference set. This study showed that in the evaluation of the spirometric result of subjects from Southeast Asia or South Asia, the percentage of cases with an abnormal FEV1 or FVC increased when the NHANES III set of equations was used as compared to when the ethnicity-specific equations were used. CONCLUSIONS: We found that the spirometric results of all ethnic groups were higher and the composition of the abnormal spirometric result was lower when the ethnicity-specific reference equations were used instead of the NHANES III reference set.

Effectiveness of a comprehensive stress management program to reduce work-related stress in a medium-sized enterprise.

OBJECTIVES: To assess the effectiveness of a comprehensive workplace stress management program consisting of participatory action-oriented training (PAOT) and individual management. METHODS: A comprehensive workplace stress management program was conducted in a medium-sized enterprise. The baseline survey was conducted in September 2011, using the Korean Occupational Stress Scale (KOSS) and Worker's Stress Response Inventory (WSRI). After implementing both organizational and individual level interventions, the follow up evaluation was conducted in November 2011. RESULTS: Most of the workers participated in the organizational level PAOT and made Team-based improvement plans. Based on the stress survey, 24 workers were interviewed by a researcher. After the organizational and individual level interventions, there was a reduction of several adverse psychosocial factors and stress responses. In the case of blue-collar workers, psychosocial factors such as the physical environment, job demands, organizational system, lack of rewards, and occupational climate were significantly improved; in the case of white-collar workers, the occupational climate was improved. CONCLUSIONS: In light of these results, we concluded that the comprehensive stress management program was effective in reducing work-related stress in a short-term period. A persistent long-term follow up is necessary to determine whether the observed effects are maintained over time. Both team-based improvement activities and individual interviews have to be sustainable and complementary to each other under the long-term plan.

High lead exposure in two leaded bronze ingot foundry workers.

BACKGROUND: Awareness about lead poisoning in South Korea has increased; however, occupational exposures occurring in small-scale businesses have not been thoroughly investigated. We report two cases of high lead exposure in a leaded bronze ingot foundry. CASE PRESENTATION: Two employees, a 54-year-old primary operator and a 46-year-old assistant, at a small-scale metalworking company who had been employed for 18 years and 1 month, respectively, showed elevated blood lead levels (61.1 µg/dL and 51.7 µg/dL, respectively) at an occupational health checkup. Neither worker complained of abnormal symptoms nor signs related to lead poisoning. Health assessment follow-ups were conducted and biological exposure indices of lead were calculated every four weeks. After the initial follow-up assessment, both workers were relocated from the foundry process to the metalworking process. In addition, a localized exhaust system was installed after the second follow-up. CONCLUSIONS: Foundry workers in a small-scale businesses might be at high risk of lead exposure because these businesses might be vulnerable to poor industrial hygiene. Therefore, regular occupational health checkups are required.

Discordance in spirometric interpretations based on korean and non-korean reference equations.

OBJECTIVES: Korean regression models for spirometric reference values are different from those of other ethnic groups. The purpose of this study was to evaluate discordance in spirometric interpretations based on using Korean reference equations versus non-Korean reference equations. METHODS: Spirometry was performed on 825 Korean male workers from April 2009 to November 2011. The spirometric patterns and disease severity were evaluated using two Korean equations (Choi's and Lee's) and three equations for Caucasians (NHANES III, Morris's, and Knudson's), and the results of Choi's equation were compared with the non-Korean equations. The spirometric patterns were defined as normal, restrictive, and mild and moderate obstructive. RESULTS: The mean differences in the FEV1% and FVC% between the two Korean equations were 2.0 ± 1.3% and 3.5 ± 2.2%, respectively. Morris's equation had the greatest difference in the FEV1% from Choi's equation: 32.9 ± 8.5%. Knudson's equation had the greatest difference in the FVC% from Choi's equation: 10.5 ± 6.5%. CONCLUSIONS: The two Korean equations shared similar characteristics of spirometric interpretation. The spirometric interpretations of Choi's equation were significantly different from those of Morris's equation and Knudson's equation.