Degenerative Changes of Spine in Helicopter Pilots

OBJECTIVE: To determine the relationship between whole body vibration (WBV) induced helicopter flights and degenerative changes of the cervical and lumbar spine. METHODS: We examined 186 helicopter pilots who were exposed to WBV and 94 military clerical workers at a military hospital. Questionnaires and interviews were completed for 164 of the 186 pilots (response rate, 88.2%) and 88 of the 94 clerical workers (response rate, 93.6%). Radiographic examinations of the cervical and the lumbar spines were performed after obtaining informed consent in both groups. Degenerative changes of the cervical and lumbar spines were determined using four radiographs per subject, and diagnosed by two independent, blinded radiologists. RESULTS: There was no significant difference in general and work-related characteristics except for flight hours and frequency between helicopter pilots and clerical workers. Degenerative changes in the cervical spine were significantly more prevalent in the helicopter pilots compared with control group. In the cervical spine multivariate model, accumulated flight hours (per 100 hours) was associated with degenerative changes. And in the lumbar spine multivariate model, accumulated flight hours (per 100 hours) and age were associated with degenerative changes. CONCLUSION: Accumulated flight hours were associated with degenerative changes of the cervical and lumbar spines in helicopter pilots.

The Effect of Socio-Economic Factors on Occupational Injuries in Korea: A Time Series Analysis / 대한산업의학회지

OBJECTIVES: We performed a time series analysis in order to identify the relationship between the occupational injury rate and socio-economic factors, and through this predict the occupational injury occurrence rate. METHODS: We reviewed 168 sets of monthly data. For the statistical analysis, we used the economic index data provided by Statics Korea and the occupational injury index provided by the Workers' Compensation & Welfare Service gathered from 1994 to 2007. We performed a correlation analysis to find relationship between the occupation injury rate and economic factors. Using the correlation analysis result, we used time series analysis for the data in order to find out the association between occupational injuries and socio-economic indicators. We performed time series analysis to find out association occupation injury rate with socio-economic factors. In addition we ran a prediction occupational injury rate for 2008 and compared the result to the actual value. RESULTS: The factors associated with occupational injuries were the daily worker index (b=0.394, p<0.0001), the mechanical index (b=-0.023, p=0.0043), the manufacturing operation index (b=0.152, p<0.0001), the workers compensation coverage expansion (b=1.189, p=0.015), the IMF index (b=-2.05, p<0.0001), and the after IMF index (b=-1.565, p=0.01). The daily worker index, manufacturing operation index, and workers compensation coverage expansion had an effect that increased the occupational injury rate. Conversely, the mechanical index and IMF variable tended to decrease the occupational injury rate. CONCLUSIONS: This study suggests that the daily worker index, manufacturing operation index, workers compensation coverage expansion, and IMF variables are related factors in regards to occupational injury.

A Case of Kienbock's Disease from Repetitive Contact Stress / 대한산업의학회지

OBJECTIVES: Kienbock's disease, which is characterized by osteonecrosis of the lunate bone, causes progressive chronic pain and dysfunction of the hand and wrist. Even though occurrence of the disease was reported approximately 100 years ago and it is suspected to be work-related to some degree, the etiology has not been clearly discribed and the disease has rarely been considered as an occupation-related disease. As such, we submit this case as the first report of Kienbock's disease in Korea, with clinical findings, x-ray, MRI (magnetic resonance imaging) and strain index results along with a literature review. METHODS: The patient was carefully interviewed and her medical records were properly reviewed by the authors with her consent. The authors also visited her factory work site to inspect and videotape the working environment and to conduct an ergonomic evaluation with a strain index. RESULTS: Excessively repeated contact stress was found to be concentrated on her right hand and the environment was discovered to be hazardous from an ergonomic standpoint. The literature review revealed that heavy loads on the hand might be related to the cause or deterioration associated with Kienbock's disease. ; therefore, it is very likely that her disease is related to her work. CONCLUSIONS: There is much evidence to suggest that heavy workloads involving hand and wrist intensive tasks may cause and worsen Kienbock's disease. However, to date epidemiologic studies clarifying the etiology of the disease have not been sufficiently reported. Therefore, further research focusing on the etiology and prevention of the disease are required. In addition, practical guidelines for hand and wrist intensive tasks are needed to prevent disease development and worsening.

Factors Associated with Unmet Needs for Medical Care among Island Inhabitants in Korea / 農村醫學 地域保健

OBJECTIVE: Korea has 3,170 islands with about 188,000 inhabitants. These inhabitants' needs for health services might go unmet because of geographic isolation, slimmer availability of health services, and higher proportion of the elderly compared with the mainland population. Unmet health service needs might result in serious health problems for these island residents. Therefore, the purpose of this study was to investigate their unmet health service needs and related factors from population of Nowha island. METHODS: The survey was conducted from July 30 to August 1 by trained interviewers. Target population were residents in Nohwa island and the sampling method was incomplete quota sampling. General characteristics, socioeconomic status, utilization of health service, and unmet medical service needs were investigated. First univariate and then multivariate logistic analyses were done for the statistical analysis. RESULTS: 324 residents were surveyed and the proportion of unmet health services needs was 26.5%. People living alone and of female sex had increased health services needs based on univariable analysis. From the multivariate analysis, those living alone increased the health services needs. Self-determined low socioeconomic status and medical aid increased the proportion of unmet medical needs, but these were not statistically significant. CONCLUSION: In Nowha island, those who are elder, and of lower socioeconomic status had much higher unmet medical needs. The results suggest the need for more social support by qualified health services to solve this unmet medical needs problem.

Influencing Factors in Approving Cerebrovascular and Cardiovascular Diseases as Occupational Disease in Seoul / 대한산업의학회지

OBJECTIVES: This study was performed to analyze the factors that affected the decision making process in approving workers' compensation claims for cerebrovascular and cardiovascular diseases cases that occurred just before refoming approval standards of Industrial Accident Compensation Insurance Act on 1 July 2008 and to provide fundamental information in preparing better standards. METHODS: We examined 283 claims cases involving cerebrovascular and cardiovascular diseases that occurred between 1 January, 2006 and 31 December, 2007 and collected data based on the worker's compensation records from 3 Seoul Regional Centers of the Workers' Compensation & Welfare Service. We analyzed the approval rates and odds ratios according to the general characteristics, injury information, past medical histories, and work related information using chi-square or univariate logistic regression. In addition, we identified the factors affecting the approval using multivariate logistic regression. RESULTS: Overall, 101 of the 283 cases were approved and approval rate was 35.7%. Approval rates differed significantly according to type of disease, survival, accident site, accident time, the presence of associated disease and overwork (p-value <0.05). In the multivariate logistic regression analysis with adjusted for age and sex, approval rate of death cases with associated disease was lower than cases without associated disease (OR 0.22, 95% CI 0.12~0.42). Approval rate of cases occurred in worksite was higher than others (OR 4.81, 95% CI 2.22~10.40). Cases of accepted overwork had a higher approval rate significantly than cases of not accepted (OR 28.53, 95% CI 9.74~83.52). CONCLUSION: Factors in approving cases of cerebrovascular and cardiovascular disease as cases involving occupational disease included conditions of overwork, high rate of accidents in the workplace and the presence of associated disease. It is necessary to investigate further behaviors of work and chronic work-related stress.

Validity and Reliability Assessment of Korean Migraine Assessment of Current Therapy (Migraine-ACT)

BACKGROUND: Migraine can cause suffering and reduce functioning and productivity. Migraine is usually suboptimally treated, with many migraineurs not being satisfied with the applied acute treatment. Migraine-ACT is a four-item assessment tool used by clinicians to identify patients who require a change in their acute treatment. The objective of this study was to determine validity and reliability of the Korean Migraine-ACT. METHODS: Participants who visited Hallym University Sacred Heart Hospital neurology clinic for headache were recruited. The survey employed SF-36, HIT-6, and Migraine-ACT. Headache diagnosis was assigned on ICHD-II after completing a semistructured diagnostic interview. RESULTS: A total of 52 migraine patients aged 38.7+/-14.7 years (mean+/-SD) were recruited. There was a positive correlation between general summary scores on SF-36 and Migraine-ACT (Spearman's correlation coefficient=0.39, p<0.05) and a negative correlation between HIT-6 scores and Migraine-ACT scores (Spearman's correlation coefficient=.0.52, p<0.05). Cronbach's alpha of Migraine-ACT was 0.78. CONCLUSIONS: These results indicate that Korean Migraine-ACT is a valid and reliable instrument to identify migraine patients who require a change in their acute treatment.

The PTSD Symptom and Related Factors among the Residents after Samsung-Hebei Spirits Oil Spill / 대한산업의학회지

BACKGROUND: The purpose of the study was to estimate the mental health problems and other related factors in residents that experienced the Samsung-Hebei spirits oil spill by surveying PTSD symptoms. METHOD: Trained interviewers performed direct interviews of the residents approximately 70 days after the oil spill. We investigated PTSD symptoms through PTSD Symptom Scale Interview Version (PSS-I). To determine those factors related to PTSD symptoms, the following factors were determined as part of the survey: gender, age, occupation, duration of cleanup activity, monthly income and amount of debt. Logistic regression analysis was used to analyze all factors. RESULTS: Of the 318 residents investigated, 56.6% of the subjects had PTSD symptoms related to the spirits oil spill (about 70 days post spill). With regard to occupation, those subjects answering fishery (POR:3.05) and commerce (POR:4.24) as their occupations experienced higher PTSD symptoms than residents answering farming as their occupation. Residents who answered that they had debt over 10 million KRW (POR:2.61) were more vulnerable to PTSD symptoms compared to residents without debt; residents with acute physical symptoms were vulnerable (POR:5.11) to PTSD symptom compared to residents without acute physical symptoms. The results of multiple logistic analysis, including the cleanup activity, age, gender, occupation, acute physical symptoms and amount of debt in the model suggest that only cleanup activity increased PTSD symptoms. The subjects who had engaged in cleanup activities for longer periods of time had more PTSD symptoms and an additional dose-response relationship. CONCLUSION: Many residents in Samsung-Hebei spirits oil spill area had PTSD symptoms. This suggests that there were serious mental health problems among the residents, who might require specific social supports and psychiatric interventions as a result of the oil spill.

Factors Related to Occupational Injuries and Health Problems for Some Female Workers in Non-standard Employment / 대한산업의학회지

OBJECTIVES: The purpose of this study was to examine certain factors associated with occupational injuries and health problems for some female workers in non-standard employment. METHODS: We enrolled 754 female workers that were selected from 1,040 people who had agreed to be surveyed as part of a group or company in either the Seoul and the Kyonggi area. We performed univariate logistic regression on survey data and again performed multivariate logistic regression on those variables that were statistically significant. RESULTS: In this study, the overall incidence of occupational injury for all workers was 12.5%. The incidence rates by position were as follows: 12.9%(insurance saleswoman), 7.4%(telemarketer), 9.2%(visiting teacher), 22%(golf caddy). The most frequent complaint was lower back pain(12.8%) in insurance saleswomen, voice symptoms(37%) in telemarketers, knee and ankle symptoms(33.8%) in golf caddies, and voice symptoms(14.4%) in visiting teachers. The factors related to occupational injuries included job type, and age. The factors related to health problems were job type, psychosocial stress, accident risk, and social support. The percentage of the cases that occurred without fringe benefits including social welfare was 30.4%, and the percentage of "paid out of the person's own pocket" of ways to arrange costs of accidents was 32.5%. CONCLUSIONS: In this study, some female workers in non-standard employment had relatively high level of occupational injuries, accompanied by various health problems. In these occupational classes, the conditions for social insurance and social welfare were poor. It is necessary to expand the application of social insurances including industrial accident compensation insurance. Regardless of job category, psychosocial stress and social support were statistically significant for many symptoms. We believe that measurement of these factors is necessary. In the future, additional studies are required with the use of objective methods for additional job categories.

Validity and Reliability Assessment of Korean Headache Impact Test-6 (HIT-6)

BACKGROUND: Quality-of-life measurement represents an important tool for evaluating the management and impact of headache on individuals and society. The Headache Impact Test-6 (HIT-6) is a simple instrument developed to assess headache-related disability in Western countries. The objective of this study was to determine the reliability and validity of the Korean HIT-6. METHODS: Participants were recruited from patients who visited the Neurology Clinic of Hallym University Sacred Heart Hospital due to headache. The survey included the SF-36 and HIT-6. Headache diagnosis was assigned using ICHD-II after completing a semistructured diagnostic interview. RESULTS: A total of 43 patients were recruited, who were aged 35.2+/-13.6 years (mean+/-SD). Thirty-three and three were diagnosed as having migraine and probable migraine, respectively. Eight and two were diagnosed with tension-type and probable tension-type headache, respectively. There was a negative correlation between the total SF-36 and HIT-6 scores (Spearman's correlation coefficient=-0.64, p<0.01). Similar significant negative correlations were also observed between SF-36 physical health summary and HIT-6 scores (Spearman's correlation coefficient=-0.54, p<0.01), and between SF-36 mental summary and HIT-6 scores (Spearman's correlation coefficient=-0.60, p<0.01). The Cronbach's alpha of HIT-6 was 0.85. CONCLUSIONS: The Korean HIT-6 is a valid and reliable instrument for assessing headache-related quality of life.

The Comparative Study on the Prevalence of Injury/Poisoning in the Agricultural and Fishery Population and the General Population / 農村醫學 地域保健

OBJECTIVE: We compared the prevalence of injury and poisoning in the agricultural and fishery population with that of the general population. METHODS: The national health insurance data and agricultural and fishery qualification data were used for this study. The age-adjusted standardized morbidity ratio was used to compare the prevalence of all injuries and poisonings of the agricultural and fishery population with that of the general population for the year 2002, as well as the prevalence of certain injuries and poisonings common to the agricultural and fishery population. The age-adjusted standardized morbidity ratio and 95% confidence intervals were attained by using the general population as the standard population group. RESULTS: The age-adjusted standardized morbidity ratio of total injuries and poisonings was significantly high in the agriculture and fishery population. The standardized morbidity ratio was 137.6 in the male agriculture and fishery population and 123.3 in the female agriculture and fishery population. In terms of injuries and poisonings common to the agriculture and fishery population, the age-adjusted standardized morbidity ratio was significantly high regarding the dislocations and strains of lumbar spine/pelvis, shoulder and neck, the fracture of rib/thoracic spine/sternum and pesticide poisoning. CONCLUSIONS: The overall prevalence of injury/poisoning was significantly higher in the agriculture and fishery population than in the general population. Various forms of research should be conducted on the injuries of the agriculture and fishery population in the future. In order to compare the differences in the prevalence rates of injuries according to time and region, standard definitions of injuries and occupation related injuries are required.

The Epidemiologic Characteristics of Drowning in Korea

PURPOSE: In spite of preventive measures and excellent prognosis with immediate treatments, drowning and drowning- related injuries remain as one of the leading causes of accidental death in Korea. However, abundant statistical data for drowning has yet to be collected. Thus, this study aimed to describe the epidemiologic characteristics of drowning in terms of demographic characteristics, geopolitical factors and socio-economic status. METHODS: This study was conducted with drowning patients who either visited hospitals or died between January 2001 and December 2003. Of these patients, we enrolled individuals registered for such coverages as automobile insurance, national health service and work injury insurance and we reviewed death records reported to the Korea National Statistical office. NISS (New Injury Severity Scale) and EMR-ISS (the Excessive Mortality Ratio -adjusted Injury Severity Score) values were calculated for each patients and the results were classified 4-into four different severity groups. After analysis, we drew conclusions in terms of year, gender, age, region, insurance type, daily rate of incidences and severity. RESULTS: The incidences of drowning-related injury were 2,486 in 2001, 2,364 in 2002, and 2,595 in 2003 (average of 2,482). The average annual death were 1,954. Victims were more likely to be male and especially high incidence rates were found for two groups: (1) Children aged 5-9 years, (2) Adults aged 40 and older. Seoul and Gyeonggi had the largest total numbers of injury cases, while JeJu had the highest per capita incidence rate (106 per 1,000,000 population). The seasonal distribution of incidence rates showed that predictably, incidents were most frequent between the beginning of July and September. CONCLUSION: The average number of incidents was 55.73 per 1,000,000 population, which constitutes approximately 0.02% of all injuries. Based on this data, we recommand continuing studies and further evaluations in order to develop specific measures to combat drowning.

Percutaneous Needle Aspiration Biopsy (PCNA) of Pulmonary Lesions: Evaluation of a Reaspiration or a Rebiopsy (second PCNA)

PURPOSE: To evaluate the effectiveness of the reaspiration or rebiopsy of pulmonary lesions (second PCNA) in cases where the pathologic results are inconclusive upon initial percutaneous needle aspiration biopsy (PCNA). MATERIALS AND METHODS: A total of 364 PCNA cases (350 initial PCNA, 14 second PCNA) were performed under CT or fluoroscopy guidance for all the 350 patients enrolled. The procedure was performed by either using an automated biopsy gun with a 20-G needle (298 cases) or a 20-G aspiration needle (66 cases). The pathologic agreement rates between the initial and second PCNA, as well as the causes for a second PCNA, were evaluated. Finally the type and rate of complication were also evaluated. RESULTS: The second PCNA rate was 4.0% (14/350). The causes for a second PCNA, following the initial PCNA included unexpected pathologic results (n = 7) and inconclusive pathologic results (n = 7). Of the seven cases which had unexpected pathologic results from their initial PCNAs, five had similar pathologic results after a second PCNA. Also, of the seven cases of inconclusive pathologic results, such as atypical cells, the scanty cellularity or necrosis upon an initial PCNA, six cases revealed a malignancy on a second PCNA. The overall complication rate, including both the initial and second PCNAs was 14.0% (51/364). CONCLUSION: A second PCNA was performed to help resolve the exact diagnosis for a pulmonary lesion in cases of inconclusive pathologic results upon an initial PCNA.

Prevalence of Baker's Asthma among Workers in an Industrial Bakery / 대한산업의학회지

OBJECTIVES: To determine the prevalence of baker's asthma due to flour dust in an industrial bakery in Korea. METHODS: Of the 596 active workers, 380 were allocated to a category of either direct exposure (DE) or indirect exposure (IE) to flour dust and completed a modified ISAAC questionnaire. Of the 380 participants, 233 were screened by an occupational physician interview, a skin prick test, and an ELISA for serum-specific IgE antibodies to wheat flour extracts. Selected workers received serial monitoring of peak expiratory flow rate (PEFR), and positive PEFR respondents received a methacholine challenge test. The diagnosis of baker's asthma was confirmed by a specific inhalation challenge with wheat flour extracts. RESULTS: The prevalence of sensitization to wheat flour and baker's asthma was 21.0% (25.9% DE, 13.3% IE) and 3.2% (5.1% DE, 1.8% IE), respectively. DE had an increased risk of sensitization to wheat flour (OR 2.15, 95% CI = 1.03~4.51). Sensitization to wheat flour and the prevalence of baker's asthma correlated significantly (PR 38.63, 95% CI = 6.14~243.22). CONCLUSIONS: These findings indicate a considerable prevalence of baker's asthma among flourexposed workers in Korea. Future studies will be required to survey the situation in flour mill companies and seek ways to protect the health and socioeconomic position of flour industry workers.

Patient Satisfaction in Workers' Compensation Medical Care / 대한산업의학회지

OBJECTIVES: To evaluate the patient satisfaction and its influencing factors after medical care for workrelated injuries. METHODS: A self-reported questionnaire was mailed to 921 workers who had experienced workers' compensation medical care. The data from 335 respondents (response rate was 36.4%) were merged and analysed with the data from the Korea Labor Welfare Corporation (KLWC) which contain other general information of the respondents. RESULTS: Dissatisfaction with their medical care was reported by 17.3% of the respondents. Overall patient satisfaction (OPS) was highly correlated with the medical treatment process such as hospital facility, medical therapy, surgical therapy, doctor's explanation and physical therapy. However, OPS was negatively influenced by three factors: 1) unsatisfactory hospital care during waiting period before the approval of workers' compensation, 2) forced end of the hospital care by the workers' compensation, and 3) end of the hospital care with no further improvement. CONCLUSIONS: To improve the satisfaction of patients with work-related injuries, both the practice of medical treatment and also the administrative process of workers' compensation must be reformed. These reforms are needed to improve the quality of workers' compensation medical care and prevent abnormal illness behavior such as inappropriate treatment seeking.

The Therapeutic Effect of Inhibitory Repetitive Transcranial Magnetic Stimulation on Right Inferior Frontal Gyrus in Subcortical Aphasia

OBJECTIVE: To investigate whether suppression of right inferior frontal gyrus (Broca's homologue) by 1 Hz repetitive transcranial magnetic stimulation (rTMS) can improve speech recovery. METHOD: We applied low frequency rTMS on right Broca's homologue twice a week for 6 weeks in eight subcortical aphasia patients who were 3 months to 3 years poststroke onset. They were tested with Korean Version-Western Aphasia Battery before and after procedure. Also, they were tested with Parallel Short Forms for the Korean-BostonNaming Test and Animal Naming Test serially for outcome measure. rTMS was performed with intensity of 80% of motor threshold for 10 min (600 pulses) at 1 Hz frequency. RESULTS: Significant improvement was observed in picture naming at post-rTMS only in nonfluent aphasia patients but not in fluent aphasia patients. CONCLUSION: rTMS may provide a novel treatment for aphasia by possibly modulating the distributed, bi-hemispheric language network.

Predictors of Return to Work and Job Retention after Work-Related Injury or Illness / 대한산업의학회지

OBJECTIVES: This research was conducted to investigate workers'return to work rate after work-related injury or illness and to determine which factors could predict return to work and job retention. METHODS: From the documents held by the six local branches of the Korea Labor Welfare Corporation(KLWP), 2,464 cases of work-related injury or illness which had telephone numbers were identified from September to December, 2003. Data about the employment status was gained from 921 occupationally injured workers through telephone questionnaire and was merged with the electronic data obtained from KLWP with included information of the workers whose worker's compensation period was ended from 2002 to 2004. Finally the data for 516 workers was analysed by logistic regression using SAS 9.0. RESULTS: The return to work rate was 50.3% and the job retention rate was 28.3%. Decreased return to work rate was associated with old age, shorter employment duration, longer treatment duration, higher disability grade, lower average wage and manual worker. Decreased job retention rate was associated with a smaller number of employees, shorter employment duration and work in the construction industry. CONCLUSIONS: This research highlighted the numerous occupationally injured workers who couldn't return to work and the multiple factors that were associated with the return to work or job retention. Based on this and related research, rehabilitation programs which consider the issues of return to work and job retention have to be implemented.

The Prevalence of Isolated Systolic Hypertension Among Routine Health Examines in A University Hospital in Korea

OBJECTIVES: Recently, there are many studies that highlights the importance of the systolic blood pressure and pulse pressure as a better prognostic factor than diastolic blood pressure especially in older persons. In this study, we investigated the prevalence of isolated systolic hypertension in the elderly aged more than 60 years old who visit to hospital for routine health exam. METHODS: This study was done in one university hospital in a mid-sized city in Kyungki-provine of Korea, during one year from Feb. 1st, 2005. The study participants were people aged 60-yr-old or over who came to hospital for taking routine health examination offered by Korea's national health insurance corporation. We investigated the proportion of the isolated systolic hypertension among untreated hypertension by double-checked blood pressure. Besides we got information about eating habits, drinking and smoking status, exercise and stress, fasting blood glucose, serum total cholesterol, proteinuria and hematuria by standardized questionnaire and blood and unine test. RESULTS: The total number of participants were 2,480. Among them, 1,181 persons (47.6%) were males, 1,299 persons females (52.4%). 1,706 persons (68.8%) were in their sixties, 774 persons (31.2%) in their seventies or more. In males, 494 (41.8% of total males) had hypertension. Among 211 males with untreated hypertension, 109 (51.7%) had isolated systolic hypertension (ISH). In females, 551 (42.4% of total temales) had hypertension. Among 201 females with untreated hypertension, 132 (65.7%) had ISH. In male, body mass in dex (BMI), fasting blood gulcose and total cholesterol were significantly associated with ISH. In female BMI, age, drinking status were significant. In female, drinking status was a protective factor. CONCLUSIONS: In Korea older people aged 60 or more, isolated systolic hypertension is occupying most part of hypertension. As Korea is entering into a rapidly aging society, from now on, older persons with isolated systolic hypertension is expected to increase rapidly. In the future, The more studies and more active treatment for isolated systolic hypertension is to be required.

Usefulness of High Resolution Computed Tomography (HRCT) in the Diagnosis of Asbestos-Related Lung Diseases / 대한산업의학회지

OBJECTIVES: This study was carried out to improve the medical surveillance program of workers exposed to asbestos by examining the usefulness of High Resolution Computed Tomography (HRCT) in the diagnosis of asbestos-related lung disease. METHODS: The study subjects comprised 162 workers in a ship-repairing yard, 68 of whom had been directly exposed to asbestos and 94 indirectly exposed. The 'Occupational Safety & Health Administration (OSHA) asbestos standard, medical surveillance program' and HRCT were conducted to analyze the aspects of the asbestos-related lung disease. The OSHA asbestos standard, medical surveillance program consists of simple chest x-ray, spirometry and medical questionnaire. RESULTS: Seventeen (10.5%) of the 162 subjects, 10 (14.7%) directly exposed and 7 (7.4%) indirectly exposed, revealed asbestos-related lung disease on HRCT. The sensitivity and specificity of simple chest x-ray for asbestos-related lung disease were 70.6% and 98.6%, and the positive and negative predictive values were 85.7% and 96.6% respectively, as compared with HRCT. HRCT was an effective diagnostic tool especially to detect early asbestos-related lung disease. The study results indicated a relative significant association between the results of spirometry and HRCT. The variables significantly associated with asbestos-related lung disease on HRCT were work duration, smoking history (pack-years), past history of respiratory disease, cough and dyspnea. CONCLUSIONS: In the diagnosis of asbestos-related lung disease, HRCT should be considered not only for workers with positive findings on simple chest x-ray, but also workers with specific findings on spirometry, occupational history, smoking history, and past history of respiratory disease, or with respiratory symptoms such as cough and dyspnea.

Effect Assessment of Worksite-based, Post-examination, Health Care Management System / 대한산업의학회지

OBJECTIVES: This study was conducted to develop a worksite-based, post-examination, health care management system for continuous and systematic management of workers with hypertension, diabetes mellitus, hyperlipidemia, and abnormal LFT detected by periodic health examination and to assess the effectiveness such a system as an intervention study. METHODS: Study subjects were selected from workers with hypertension, diabetes mellitus, hyperlipidemia, and abnormal LFT according to the selection criteria. The intervention group, but not the control group, received medical treatment of disease, follow up examination, and health education which consisted of information about the disease and the importance of life-style modification through periodic interview using the resources of occupational health service center in the worksite. To assess the effectiveness of this system, we compared follow up examination data from the intervention group with periodic examination data from the worksite control group. RESULTS: In the intervention group a significant reduction trend was recorded for systolic and diastolic blood pressure, fasting blood sugar, postprandial 2 hour glucose, total cholesterol, triglyceride, LDL-cholesterol, AST, ALT, and gamma-GTP, and a rising trend for HDL-cholesterol. Significant group differences ware recorded for fasting blood sugar, postprandial 2 hour glucose, total cholesterol, AST, and ALT. CONCLUSIONS: The worksite-based, post-examination, health care management system was effective for the continuous and systematic management of workers who had abnormal findings detected by periodic health examination.

Perceptions of the Asian Dust: Analysis of the Newspaper Articles about the Asian Dust / 예방의학회지

OBJECTIVES: There is an increasing concern for the social, economic, environmental and health effects of the Asian dust (Hwang-sa in Korean language) in Korea. In this study, we intended to indirectly determine ordinary people's perception about the Asian dust by analyzing the contents of newspaper articles dealing with it. METHODS: By using article searching services in the internet websites of three newspaper companies, we collected newspaper articles dealing with the Asian dust during the period from January 1st of 1998 to December 31st of 2002. We classified the articles into four categories: those forecasting the occurrence of the Asian dust, those about measures to cope with it, those about its occurrence in the neighboring foreign countries, and those about its effects. In particular, we analyzed articles about the health effects of the Asian dust more distinctly. RESULTS: A total of 1, 225 articles dealing with the Asian dust were found during the 5 year period. The number of articles increased from 102 in 1998 to 518 in 2002, approximately a five-fold increase. The numbers of articles about health effects, environmental effects and economical effects were 191 (44%), 171 (41%) and 147 (34%), respectively. It was reported that various diseases such as respiratory diseases (87%), eye problems (69%), and skin diseases (12%) were associated with the Asian dust. CONCLUSION: The increasing concern for the negative effects of the Asian dust necessitates more studies about this field. As the effects of the Asian dust are various, the information on the major concern of ordinary people could help establish the research agendas and measures for the Asian dust.