The Association Between Blood Lead Levels and Coronary Artery Calcium Score Determined by Using Coronary Computed Tomography Angiography.

BACKGROUND: Lead exposure is a known risk factor for cardiovascular disease (CVD), and coronary artery calcification (CAC) is a biomarker for diagnosing atherosclerotic CVD. This study investigated the association between blood lead level (BLL) and CAC using coronary computed tomography (CT) angiography. METHODS: This study enrolled 2,189 participants from the general population with no history or symptoms of CVD. All participants underwent coronary CT angiography, health examination, and BLL testing. The association between coronary artery calcium score (CACS) and BLL was analyzed. RESULTS: The arithmetic mean of BLL was 2.71 ± 1.26 µg/dL, and the geometric mean was 2.42 (1.64) µg/dL, ranging from 0.12 to 10.14 µg/dL. There was a statistically significant positive correlation between CACS and BLL (r = 0.073, P < 0.001). Mean BLLs among predefined CACS categories were as follows: absent grade (CACS = 0), 2.67 ± 1.23 µg/dL; minimal grade (> 0, < 10), 2.81 ± 1.25 µg/dL; mild grade (≥ 10, < 100), 2.74 ± 1.29 µg/dL; moderate grade (≥ 100, < 400), 2.88 ± 1.38 µg/dL; severe grade (≥ 400): 3.22 ± 1.68 µg/dL. The odds ratio for severe CAC was 1.242 in association with an 1 µg/dL increase in BLL (P = 0.042). CONCLUSION: Using coronary CT angiography, we determined a positive correlation between BLL and CAC among participants without CVD from the general population. To reduce the burden of CVD, efforts and policies should be geared toward minimizing environmental lead exposure.

Obstructive sleep apnea risk and hearing impairment among occupational noise-exposed male workers.

This study aimed to investigate the association between obstructive sleep apnea (OSA) risk and hearing impairment among workers exposed to occupational noise. A cross-sectional study was conducted among 607 healthy male workers at a tire-manufacturing factory. The subjects underwent audiometric testing, and their OSA risk was examined based on the STOP-Bang questionnaire. Hearing impairment was defined as a hearing threshold >25 dB hearing level (HL) in any frequency of 1, 2, 3 and 4 kHz in either ear. High OSA risk was defined as a STOP-bang score of ≥3. Hearing thresholds at 1, 2, 3 and 4 kHz in both ears were significantly higher among workers with high OSA risk than among those with low OSA risk after adjusting for confounders. Multiple logistic regression analysis examining the association of OSA risk and STOP-Bang score with hearing impairment revealed an odds ratio of 1.738 (95% confidence interval [CI] 1.113-2.713, p = 0.015) and 1.256 (95% CI 1.031-1.529, p = 0.023), respectively, after adjusting for confounders. In addition, when the hearing impairment was reclassified into high- and low-frequency hearing impairment, a statistically significant OR was seen for high-frequency hearing impairment. In conclusion, high OSA risk was associated with hearing impairment in occupational noise-exposed workers, especially in the high-frequency range of 3 and 4 kHz. More efforts are required to improve the management of OSA and its risk factors to preserve hearing in occupational noise-exposed workers.

Seroprevalence of measles, mumps, rubella, and varicella-zoster antibodies in new female nurses in the Republic of Korea.

BACKGROUND: For health care workers, immune management plays an important role in the protection against infectious diseases. This study investigated the seroprevalence of measles, mumps, rubella, and varicella-zoster in newly employed female nurses. METHODS: We conducted a survey on the seroprevalence of measles, mumps, rubella, and varicella-zoster in newly employed female nurses at a university hospital from 2011 to 2019, before the nurses were given their department placements and duty start. Enzyme-linked immunosorbent and chemiluminescence immunoassays were used to detect immunoglobulin G antibodies. We analyzed whether there was a significant difference in seroprevalence depending on the age, birth year, birth season, and region of residence (metropolitan residency: yes or no). RESULTS: The arithmetic mean ages of the participants were 28.6 ± 4.8, 23.5 ± 3.2, 23.6 ± 3.0, and 26.1 ± 4.5 years for measles, mumps, rubella, and varicella-zoster, respectively. The seropositivity rates were 93.9% (551/587), 60.2% (50/83), 83.3% (3,093/3,711), and 89.5% (978/1,093) for measles, mumps, rubella, and varicella-zoster, respectively. Significant differences in the seroprevalence when assessed according to the age and birth year were noted with measles, while significant differences in the seroprevalence were only noted with rubella and varicella-zoster when assessed according to birth year and age, respectively. CONCLUSIONS: In this study, we identified the levels of antibody prevalence in new female nurses. Considering the seropositivity levels, cost-effectiveness, and convenience for the participants, we recommend that the measles-mumps-rubella vaccination be provided without serologic testing for all new female nurses and the varicella-zoster vaccination only be performed for persons who are negative after serologic testing. And it would be useful if the vaccinations were combined with compulsory worker health examinations, such as the pre-placement health examinations.

The relationship between chronotypes and musculoskeletal problems in male automobile manufacturing workers.

BACKGROUND: Previous studies have shown that morning types are less sensitive to pain. This study aimed to examine the relationship between chronotypes and musculoskeletal problems in workers with musculoskeletal burdens at work. METHODS: This cross-sectional study included 119 male production workers from a large automobile manufacturing plant. All the participants worked 2 shifts and worked on the automobile assembly line. Data were obtained using structured questionnaires, including the reduced Morningness-Eveningness Questionnaire (rMEQ), and musculoskeletal symptom questionnaire. Participants with an rMEQ score of 18 points or more were defined as morning-type workers (MTWs). Participants whose scores were less than 18 points were defined as neither-type workers (NTWs). RESULTS: The arithmetic mean age was 51.8 ± 5.3 years. MTWs and NTWs accounted for 35.3% and 64.7% of the total participants, respectively. Evening- and intermediate-type workers accounted form 6.7% and 58.0% of the participants, respectively. There was no significant difference in the health indicators when the MTW and NTW groups were compared. However, the musculoskeletal symptom questionnaire demonstrated a significant difference between the MTW and NTW groups. In the preceding year, the MTW group had significantly lower musculoskeletal pain and treatment ratios compared to the NTW group (35.7% vs. 62.3%, p = 0.005 and 14.3% vs. 32.5%, p = 0.031, respectively). After adjusting for variables, the odds ratio (OR) for musculoskeletal pain was significantly higher in the NTW group than in the MTW group (OR, 3.112; 95% confidence interval, 1.285-7.535; p = 0.012). CONCLUSIONS: In this study, the musculoskeletal pain ratio was significantly lower for MTWs when compared to NTWs. Chronotypes could play an important role in work-related musculoskeletal disorders. Further, larger-scale, follow-up studies on chronotypes are required to assist in the prevention of musculoskeletal disorders in future.

Associations between Blood Lead Levels and Coronary Artery Stenosis Measured Using Coronary Computed Tomography Angiography.

BACKGROUND: Lead exposure is a risk factor for increased blood pressure and cardiovascular disease, even when blood lead levels (BLLs) are within the normal range. OBJECTIVE: This study aimed to investigate the association between BLL and coronary artery stenosis (CAS) in asymptomatic adults using 128-slice dual-source coronary computed tomography (CT) angiography. METHODS: We analyzed medical records data from 2,193 adults (1,461 men and 732 women) who elected to complete a screening health examination, coronary CT angiography, and BLL measurement during 2011-2018 and had no history of CAS symptoms, cardiovascular disease, or occupational exposure to lead. Logistic regression models were used to estimate associations between moderate-to-severe CAS (≥25% stenosis) and a 1-µg/dL increase in blood lead, with and without adjustment for age, sex, hypertension, diabetes mellitus, dyslipidemia, body mass index, regular exercise, smoking status, and alcohol drinking. RESULTS: BLLs ranged from 0.12 to 10.14µg/dL, with an arithmetic mean of 2.71±1.26µg/dL. The arithmetic mean was higher for men than for women (2.98±1.26µg/dL vs. 2.18±1.08µg/dL, p<0.001) and higher in the moderate-to-severe CAS group than in the no-CAS or <25% stenosis group (3.02±1.44µg/dL vs. 2.67±1.23µg/dL, p<0.001). Moderate-to-severe CAS was significantly associated with BLL before and after adjustment, with an adjusted odds ratio for a 1-µg/dL increase in BLL of 1.14 (95% CI: 1.02, 1.26), p=0.017. CONCLUSIONS: BLL was positively associated with the prevalence of moderate-to-severe CAS in Korean adults who completed an elective screening examination for early cardiovascular disease, 94% of whom had a BLL of <5µg/dL. More efforts and a strict health policy are needed to further reduce BLLs in the general population. https://doi.org/10.1289/EHP7351.

Blood lead level and Helicobacter pylori infection in a healthy population: A cross-sectional study.

The aim of this study was to investigate whether elevated blood lead level (BLL) is a risk factor for Helicobacter pylori infection. Upper gastrointestinal endoscopy was performed on 2,625 subjects who visited a university hospital for general health examination. H. pylori infection was detected using histologic examination with Giemsa staining, and BLLs were measured. The mean BLL was 2.83 ± 1.31 µg/dL. The prevalence of H. pylori infection was 27.8%. The BLL was significantly higher in the H. pylori infection-positive group compared to the non-infected group (2.96 ± 1.33 µg/dL vs. 2.78 ± 1.30 µg/dL, p < 0.001), which remained significant after adjusting for other confounders. H. pylori infection significantly increased as the BLL increased (OR: 1.143, 95% CI 1.068-1.223). We found a relationship between BLL elevation and H. pylori infection rate.

The association between serum dehydroepiandrosterone sulfate (DHEAS) levels and job-related stress among female nurses.

BACKGROUND: Dehydroepiandrosterone sulfate (DHEAS) is an endogenous steroid hormone produced by the adrenal gland. DHEAS has been suggested to play a protective role against psychosocial stress. The aim of this study was to investigate the association between job-related stress and blood concentrations of DHEAS according to occupational stress factors among female nurses. METHODS: A cross-sectional study was conducted among 118 premenopausal nurses from 4 departments (operating room, emergency room [ER], intensive care unit, and ward) of a university hospital. Participants were all rotating night shift workers who have worked for over a year and mean age of 33.5 ± 4.8 years. Data from structured questionnaires including the Korean Occupational Stress Score, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Pittsburgh Sleep Quality Index (PSQI) were used. RESULTS: In the high job-related stressor group, scores of BDI, BAI, and PSQI were significantly higher than low-stressor group. ER nurses had relatively more work-burden related stressors, but they had significantly lower levels of anxiety and depression than other groups. And, ER nurses showed higher levels of DHEAS than the other department nurses. The differences were significant (p = 0.003). Additionally, there was a statistically significant difference even after adjusting for factors that could affect level of DHEAS, such as age, body mass index, drinking, and physical activity (p = 0.039). CONCLUSIONS: This result suggests the possibility that DHEAS may play a role as a marker of proper stress management. The capacity to secrete DHEAS is not simply due to workload or job stressor but could be determined depending on how individuals and groups deal with and resolve stress. Proper resolution of stress may affect positive hormone secretion.

Night shiftwork and prostate-specific antigen level in a tire manufacturing factory.

BACKGROUND: Recent studies suggest that night shiftwork may increase the risk of prostate cancer and elevated serum prostate-specific antigen (PSA) level. The purpose of this study was to verify whether rotating night shiftwork affects serum PSA level. METHODS: This study included 3,195 male production workers who work in a large tire manufacturing factory. Serum PSA levels were measured and the data on related factors were obtained. RESULTS: The mean serum PSA level was 0.98 ± 0.79 ng/mL. PSA levels were significantly lower in the younger age group, the obese group, and regular exercise group. PSA levels were lower in night shift workers (n = 2,832) compared to day workers (n = 363), but the difference was not statistically significant. CONCLUSIONS: Unlike previous studies, we did not find any evidence that night shiftwork results in an increase in serum PSA levels. Further research and consistent results are needed to elucidate the association between night shiftwork and the effect on the prostate.

Collective exposure to lead from an approved natural product-derived drug in Korea.

BACKGROUND: In Asian countries, including Korea, lead poisoning caused by traditional herbal medicines is often observed in the clinic. However, there have been no reports thus far of lead poisoning caused by drugs that were approved by the Korea Food and Drug Administration (KFDA). Here, we describe seven patients who ingested a problematic natural product-derived drug (NPD). CASE PRESENTATION: In July 2018, seven patients visited a university hospital after ingesting an NPD, S. capsules. These patients complained of various symptoms, and their blood lead levels (BLLs) were elevated relative to those of the general population (arithmetic mean: 19.5 ± 11.6 µg/dL, range: 6.28-35.25 µg/dL). The total doses and BLLs were directly proportional to each other among the patients (r = 0.943, p = 0.001). After the patients discontinued drug intake, their BLLs decreased gradually. The capsule was confirmed to contain lead above the standard value (arithmetic mean: 2,547 ± 1,821.9 ppm). CONCLUSION: This incident highlights the need to strengthen standards for the management of NPD ingredients in Korea. NPDs are more likely to be contaminated than other drugs. Thorough management by the KFDA is essential to prevent a recurrence. Moreover, systematic health care is needed for many patients who have taken problematic NPDs.

Acute radiation syndrome in a non-destructive testing worker: a case report.

BACKGROUND: In Korea, there were repeated radiation exposure accidents among non-destructive testing workers. Most of the cases involved local injury, such as radiation burns or hematopoietic cancer. Herein, we report a case of acute radiation syndrome caused by short periods of high exposure to ionizing radiation. CASE PRESENTATION: In January 2017, Korea Information System on Occupational Exposure (KISOE) found that a 31-year-old man who had worked in a non-destructive testing company had been overexposed to radiation. The patient complained of symptoms of anorexia, general weakness, prostration, and mild dizziness for several days. He was anemic. The venous injection areas had bruises and bleeding tendency. Blood and bone marrow testing showed pancytopenia and the patient was diagnosed with acute radiation syndrome (white blood cells: 1400/cubic mm, hemoglobin: 7.1 g/dL, platelets: 14000/cubic mm). He was immediately prohibited from working and blood transfusion was commenced. The patient's radiation exposure dose was over 1.4 Gy (95% confidence limits: 1.1-1.6) in lymphocyte depletion kinetics. It was revealed that the patient had been performing non-destructive tests without radiation shielding when working in high places of the large pipe surface. CONCLUSIONS: Exposure prevention is clearly possible in radiation-exposed workers. Strict legal amendments to safety procedures are essential to prevent repeated radiation exposure accidents.

Mercury poisoning in a fisherman working on a pelagic fishing vessel due to excessive tuna consumption.

OBJECTIVE: To report the case of a fisherman who developed chronic mercury poisoning due to excessive consumption of tuna while working on a pelagic fishing vessel. CASE REPORT: A 48-year-old male deep-sea fisherman developed paresthesia and pain in both legs while working at sea. He continued working for over 4 months on a pelagic fishing vessel but was eventually unable to function normally as his condition deteriorated. Upon arrival on land, he received specialist treatment, including imaging studies, for 2 months; however, the cause of the symptoms was not identified. An examination of his occupational history revealed that he had worked as a crew member on a pelagic fishing vessel catching tuna for the last 2 years and consumed tuna for two or more meals per day, every day. Two months after discontinuation of tuna consumption, he was tested for mercury. The result showed an elevated blood mercury level (BML) of 21.79 µg/l. Based on the half-life of mercury, the BML was evaluated as 38.70-53.20 µg/l when he was on board. Four months after discontinuing tuna consumption, his BML decreased to 14.18 µg/l, and the symptoms were almost ameliorated. The person responsible for preparing meals on a pelagic fishing ship should be aware that fish may contain high levels of heavy metals and should prepare meals for crew members according to the recommended levels. Crew members should also be aware that fish and shellfish may contain mercury, and hence, they should consume only an appropriate amount.

Insomnia and hearing impairment among occupational noise exposed male workers.

BACKGROUND: The aim of this study was to investigate the association between insomnia and hearing impairment among workers exposed to occupational noise. METHODS: This study included 809 male workers exposed to occupational noise. The participants underwent audiometric testing, and their insomnia was examined based on the Insomnia Severity Index test. Hearing impairment was defined as hearing threshold >25 dB hearing level in the range of 1-4 kHz. RESULTS: According to analysis of covariance, it was observed that pure tone audiometry thresholds at 1-2 kHz in the right ear and at 1 kHz in the left ear were significantly higher among workers with insomnia compared to those with no insomnia. Multiple logistic regression analysis of insomnia for hearing impairments was performed, which showed the odds ratio was 1.806 (95% confidence intervals: 1.022-3.188, p = 0.042) after adjustment for age, working period, noise level, snoring, use of protection devices, diabetes mellitus, hypertension, smoking, alcohol consumption, regular exercise, waist circumference, total cholesterol, triglyceride and high density lipoprotein cholesterol. CONCLUSION: Insomnia could be associated with hearing impairment in workers who are exposed to occupational noise. Additionally, insomnia may be associated with decreased hearing at low frequencies. Especially, more efforts are required to improve the quality of sleep for workers who are exposed to loud occupational noise. Further well- designed prospective studies are needed to clarify the relationship between insomnia and hearing impairment.

Urinary arsenic species concentration in residents living near abandoned metal mines in South Korea.

BACKGROUND: Arsenic is a carcinogenic heavy metal that has a species-dependent health effects and abandoned metal mines are a source of significant arsenic exposure. Therefore, the aims of this study were to analyze urinary arsenic species and their concentration in residents living near abandoned metal mines and to monitor the environmental health effects of abandoned metal mines in Korea. METHODS: This study was performed in 2014 to assess urinary arsenic excretion patterns of residents living near abandoned metal mines in South Korea. Demographic data such as gender, age, mine working history, period of residency, dietary patterns, smoking and alcohol use, and type of potable water consumed were obtaining using a questionnaire. Informed consent was also obtained from all study subjects (n = 119). Urinary arsenic species were quantified using high performance liquid chromatography (HPLC) and inductively coupled plasma mass spectrometry (ICP/MS). RESULTS: The geometric mean of urinary arsenic (sum of dimethylarsinic acid, monomethylarsonic acid, As3+, and As5+) concentration was determined to be 131.98 µg/L (geometric mean; 95% CI, 116.72-149.23) while urinary inorganic arsenic (As3+ and As5+) concentration was 0.81 µg/L (95% CI, 0.53-1.23). 66.3% (n = 79) and 21.8% (n = 26) of these samples exceeded ATSDR reference values for urinary arsenic (>100 µg/L) and inorganic arsenic (>10 µg/L), respectively. Mean urinary arsenic concentrations (geometric mean, GM) were higher in women then in men, and increased with age. Of the five regions evaluated, while four regions had inorganic arsenic concentrations less than 0.40 µg/L, one region showed a significantly higher concentration (GM 15.48 µg/L; 95% CI, 7.51-31.91) which investigates further studies to identify etiological factors. CONCLUSION: We propose that the observed elevation in urinary arsenic concentration in residents living near abandoned metal mines may be due to environmental contamination from the abandoned metal mine. TRIAL REGISTRATION: Not Applicable (We do not have health care intervention on human participants).

Comparison of anxiety and depression status between office and manufacturing job employees in a large manufacturing company: a cross sectional study.

BACKGROUND: The aim of this study was to investigate whether type of work is associated with anxiety and depression using the Hospital Anxiety and Depression Scale (HADS). Additionally, we investigated the impact of number of working hours on anxiety and depression. METHODS: A total of 1774 workers participated and completed the HADS to determine their levels of anxiety and depression. All subjects were employed at one of two manufacturing plants for the same company. Of all participants, 222 were employed in office jobs and 1552 in manufacturing jobs. RESULTS: Results of multivariate logistic regression analysis including age, sex, body mass index, smoking status, alcohol consumption, regular exercise, factory region, and working hours, indicated that employment in an office job was associated with a 2.17-fold increase in the odds of anxiety compared to a manufacturing job (odds ratio [OR] = 2.17; 95 % confidence interval [CI], 1.24-3.80). Office jobs were also associated with a 1.94-fold increase in the odds of depression (OR = 1.94; 95 % CI, 1.34-2.82). In addition, number of hours worked was significantly associated with depression, and working hours significantly modified the effect of office job employment on the risk of depression. CONCLUSIONS: Office job workers had higher levels of anxiety and depression than those working in manufacturing jobs. Our findings suggest that occupational physicians should consider the organizational risks faced by office job employees, and consider the differences in psychological health between office and manufacturing job workers when implementing interventions.

Occupational Lead Exposure from Indoor Firing Ranges in Korea.

Military personnel often use ammunitions that contain lead. The present study aimed to identify the risks for lead exposure and lead poisoning among workers at indoor firing ranges. A special health examination, including blood lead level (BLL) testing, was performed for all 120 workers at the indoor firing ranges of the Republic of Korea's Air Force, Navy, and Armed Forces Athletic Corps. The overall mean BLL was 11.3 ± 9.4 µg/dL (range: 2.0-64.0 µg/dL). The arithmetic mean of the BLL for professional shooters belong to Armed Forces Athletic Corps was 14.0 ± 8.3 µg/dL, while those of shooting range managers and shooting range supervisors were 13.8 ± 11.1 µg/dL and 6.4 ± 3.1 µg/dL, respectively. One individual had a BLL of 64 µg/dL, and ultimately completed chelation treatment (with CaNa2-ethylenediaminetetraacetic acid) without any adverse effects. These findings indicate that indoor firing range workers are exposed to elevated levels of lead. Therefore, when constructing an indoor firing range, a specialist should be engaged to design and assess the ventilation system; and safety guidelines regarding ammunition and waste handling must be mandatory. Moreover, workplace environmental monitoring should be implemented for indoor firing ranges, and the workers should undergo regularly scheduled special health examinations.

Coronary artery atherosclerosis associated with shift work in chemical plant workers by using coronary CT angiography.

OBJECTIVES: The aim of this study was to investigate whether shift work is related to elevated risk of coronary artery disease (CAD) by determining the coronary artery calcium (CAC) score and the presence of coronary artery stenosis by using coronary artery CT angiography (CCTA). METHODS: In this study, 110 male workers participated and underwent a CCTA examination for CAC scoring, which represents coronary artery plaque, and were evaluated for luminal stenosis. All of the participants were working in the same chemical plant, of whom 70 worked day shifts and 40 worked rotating shifts. RESULTS: In a multivariate logistic regression analysis, including age, smoking status, alcohol consumption, regular exercise and waist circumference, shift work was associated with a 2.89-fold increase in the odds of developing coronary plaque compared with day work (OR, 2.89; 95% CI 1.07 to 7.82). The association between shift work and coronary plaque was strong after adjustment for age, low-density lipoprotein cholesterol, hypertension and diabetes mellitus (OR, 2.92; 95% CI 1.02 to 8.33). In addition, the number of years of shift work employment was associated with coronary plaque. However, no association was found between shift work and coronary artery stenosis. CONCLUSIONS: Shift work could induce CAD onset via the atherosclerotic process, and shift work employment duration was associated with an increased risk of atherosclerosis in male workers.

Case series of keratitis in poultry abattoir workers induced by exposure to the ultraviolet disinfection lamp.

BACKGROUND: An outbreak of eye diseases occurred among workers at a poultry abattoir in South Korea from December 2012 to June 2013. An epidemiological investigation of the causative agent was conducted. The workers were given a special health examination and workplace environmental monitoring was performed. Workers with ocular symptoms subsequently underwent an ophthalmic examination. CASE PRESENTAION: From a total of 41 workers, 26 (63.4 %) were diagnosed with keratoepitheliopathy by ophthalmic examination. Environmental monitoring of the workplace revealed that the ultraviolet (UV) apron-disinfection lamp had not been turning off at the set times, and so the workers' faces had been exposed to UV radiation. Effective radiation dose measurement showed a UV-B exposure of 7-30 µW/cm(2), and a UV-C exposure of 40-200 µW/cm(2); both values exceed the occupational exposure limits. The outbreak ceased after the lamp was repaired. CONCLUSIONS: This case shows that inappropriate use of the UV disinfection lamp can cause mass photokeratitis. In order to prevent this, the UV disinfection lamp must be checked regularly, workers must be educated on the health effects of UV radiation, and appropriate eye protection must be worn.

Changes in the mean hearing threshold levels in military aircraft maintenance conscripts.

Aircraft maintenance crews are constantly exposed to severe aircraft noise. The purpose of this study was to verify whether noise from aircraft adversely affects the hearing threshold levels (HTLs) of aircraft maintenance conscripts during their 2 years of mandatory military service. This study included 3,000 male aircraft maintenance conscripts who work in the military runway area. We measured and analyzed HTLs at 2-4 kHz. The duration of exposure to noise increased with an increase in rank; however, HTLs showed a tendency to decrease. We attributed such contradicting results to the learning effect and adaptation to military service. However, we suspected that sudden deafness in 6 conscripts (0.2%) was due to loud noise in the runway area during military service. The effectiveness of the hearing conservation program for short-term military service personnel could be increased by focusing on preventing sudden deafness and preenlistment baseline audiogram tests.

Association of cadmium with diabetes in middle-aged residents of abandoned metal mines: the first health effect surveillance for residents in abandoned metal mines.

OBJECTIVE: The aim of this study was to determine the association between urinary cadmium (U-cd) concentration and diabetes in middle-aged Korean residents of abandoned mines using the first Health Effect Surveillance for Residents in Abandoned Metal mines (HESRAM). METHODS: This study was cross-sectional study conducted on 719 residents between 40-70 years in 38 abandoned metal mines in Korea. Data was collected by HESRAM from 2008 to 2011. The correlation coefficient of U-cd and fasting blood glucose, odds ratio in urinary cadmium tertiles and diabetes prevalence was analyzed according to the sex category. RESULTS: The correlation coefficient U-cd concentration and fasting blood glucose was 0.182 in male. Logistic regression analysis in male revealed a third tertile odds ratio of U-cd (2 µg/g creatinine < U-cd) while diabetes prevalence was 1.81 (95 % CI 1.05-3.12) with adjusted age, BMI, smoking and alcohol consumption, region, family income. On the other hand, the odds ratio for third tertile of U-cd (3 µg/g creatinine < U-cd) between diabetes prevalence in female was 1.39 (95 % CI 0.52-3.72) in addition to adjusted menopausal status. CONCLUSIONS: Environmental exposure to cadmium in abandoned mine residents was associated with diabetes in male. Closed monitoring and periodic evaluation of the health effects of chronic environmental exposure on abandoned mines residents will be needed.