An assessment of dust, endotoxin, and microorganism exposure during waste collection and sorting.

This study was conducted to assess inhalation exposure to dust, endotoxin, and microorganisms (including viable bacteria, Gram-negative bacteria [GNB], and fungi) during waste collection and sorting; to identify factors affecting this exposure; and to estimate the gastrointestinal exposure to microorganisms. A total of 48 or 49 workers involved in collecting and sorting waste from households or the street were studied. Each worker carried two personal samplers in which filters were placed in the breathing zone for estimation of inhalation exposure. To assess the possibility of gastrointestinal exposure, microorganisms on the workers' faces were collected before and after work and compared with those collected from office workers. Inhalation exposure levels were categorized according to job title, waste type handled, and working conditions and were compared using analysis of variance. Multiple regression models were developed to identify those factors that substantially affected inhalation exposure. The average exposure level to total dust was 0.9 mg/m3 (range = 0.05 to 4.51 mg/m3), and the average exposure to endotoxin was 1123 EU/m3. The average respective exposure levels to bacteria, GNB, and fungi each exceeded 10(4) colony forming units (CFU)/m3. The multiple regression models found several factors that significantly explained the variation in levels of inhalation exposure to endotoxin and microorganisms; namely, sex (dust, bacteria, and GNB), job title (GNB and fungi), collection day (dust, bacteria, and GNB), temperature (endotoxin and GNB), humidity (endotoxin and fungi), and region (endotoxin) were significantly associated with exposure to these agents. In addition, the workers' faces were highly contaminated with microorganisms. In conclusion, inhalation exposure to endotoxin and microorganisms was high during waste collection and sorting, which may place workers at risk of developing various health problems, including respiratory complaints.

Two Cases of Allergy to Insulin in Gestational Diabetes.

Allergic reaction to insulin is uncommon since the introduction of human recombinant insulin preparations and is more rare in pregnant than non-pregnant females due to altered immune reaction during pregnancy. Herein, we report two cases of allergic reaction to insulin in gestational diabetes that were successfully managed. One case was a 33-year-old female using isophane-neutral protamine Hagedorn human insulin and insulin lispro. She experienced dyspnea, cough, urticaria and itching sensation at the sites of insulin injection immediately after insulin administration. We discontinued insulin therapy and started oral hypoglycemic agents with metformin and glibenclamide. The other case was a 32-year-old female using insulin lispro and insulin detemer. She experienced pruritus and burning sensation and multiple nodules at the sites of insulin injection. We changed the insulin from insulin lispro to insulin aspart. Assessments including immunoglobulin E (IgE), IgG, eosinophil, insulin antibody level and skin biopsy were performed. In the two cases, the symptoms were resolved after changing the insulin to oral agents or other insulin preparations. We report two cases of allergic reaction to human insulin in gestational diabetes due to its rarity.

Supportive management resolved a colonic intramural hematoma in an anticoagulant user.

Intramural hematomas of the colon are rare. Intramural hematomas of the gastrointestinal tract often result from blunt trauma, although they may also occur spontaneously in patients taking anticoagulants or those with blood dyscrasia. Affected patients present with abdominal pain and lower gastrointestinal bleeding, as well as occasional signs of intestinal obstruction. The diagnosis is made using colonoscopy and abdominal CT. Resection of the involved bowel segment is accepted as the standard therapy; however, experience with conservative treatment has also been reported. We herein report the case of a 62-year-old woman taking warfarin who was diagnosed with a colonic intramural hematoma and completely recovered with conservative management.

Corrigendum: Necessity for a National Carcinogen List in Korea, Based on International Harmonization.

[This corrects the article on p. e2013008 in vol. 28, PMID: 23882448.].

Necessity for a national carcinogen list in Korea, based on international harmonization.

Cancer has been the leading cause of death in Korea for the last 30 years. Cancer patients' 5-year survival rate between 2005 and 2009 was 62.0%, representing a highly advanced standard of care, as much as developed countries in the EU and the US. The Korean government formulated its first 10-year plan for cancer control in 1996 and has been carrying out a second 10-year plan for cancer control since 2006. But despite the Korean government's efforts, the cancer burden in Korea continues to increase. Many separate laws have gone into effect concerning the management of carcinogen exposure. However, there are no integrated regulatory laws or management systems against carcinogen exposure in Korea. Dead zones remain where carcinogen exposure cannot be controlled properly in Korea. In this paper, we suggest the need to establish a national carcinogen list based on international harmonization as a prerequisite for a paradigm shift in cancer control policy from treatment to primary prevention.

The "Chair Campaign" in Korea: an alternative approach in occupational health and safety for service workers.

In spite of the increasing number of service workers in Korea, their occupational health and safety concerns have largely been neglected. It is in this context that the Chair Campaign, which lasted four months, was launched as an alternative occupational health approach for service workers. The campaign succeeded in getting wide public support, bringing about a special inspection by the Ministry of Labor. Finally, chairs were provided for workers at checkout counters in 71 department stores and 449 large discount stores. However, there are still many workplaces where workers cannot sit, whether chairs are provided or not. Although there is still much to be done, this campaign raised social awareness that service workers, mainly women, have the right to work in healthy and safe conditions. This paper will review the campaign and evaluate its achievements and limitations.

Vaporization and Conversion of Ethanolamines used in Metalworking Operations.

OBJECTIVES: This study examined how ethanolamines (EAs) with the same functional alcohol group (HOCH(2)CH(2)), such as mono-EA (MEA), di-EA (DEA), and tri-EA (TEA), in water-based metalworking fluids (wbMWFs) are vaporized, condensed, and transformed by heat generated during metalworking. METHODS: Two types of experimental apparatus were manufactured to achieve these objectives. RESULTS: Vaporization tests using a water bath showed that the vaporization rate increased markedly from 0.19 mg/m(2)·min at 23.5℃ to 8.04 mg/m(2)·min at 60℃. Chamber tests with a heat bulb revealed that "spiked" MEA was fully recovered, while only 13.32% of DEA and no TEA were recovered. Interestingly, non-spiked types of EAs were detected, indicating that heat could convert EAs with more alcohol groups (TEA or DEA) into other EAs with fewer group(s) (DEA or MEA). The EA composition in fresh fluid was 4% DEA, 66% TEA, and 30% MEA, and in used fluids (n = 5) was 12.4% DEA, 68% TEA, and 23% MEA. Conversion from TEA into DEA may therefore contribute to the DEA increment. Airborne TEA was not detected in 13 samples taken from the central coolant system and near a conveyor belt where no machining work was performed. The DEA concentration was 0.45 mg/m(3) in the only two samples from those locations. In contrast, airborne MEA was found in all samples (n = 53) regardless of the operation type. CONCLUSION: MEAs easily evaporated even when MWFs were applied, cleaned, refilled, and when they were in fluid storage tanks without any metalworking being performed. The conversion of TEA to DEA and MEA was found in the machining operations.

Loss of straight metalworking fluid samples from evaporation during sampling and desiccation.

Straight metalworking fluids (MWFs) were used to evaluate the potential for the loss of MWF mass from filters. Two methods were used to study the stability of MWF mass on filter media. The first was to spike known amounts of MWF onto polyvinyl chloride (PVC) filters, store the filters over silica gel desiccant, and take repeated gravimetric measurements of the filters at intervals of 1, 2, and 3 days. An MWF aerosol mist was generated in a test chamber and collected on PVC filters for the second experimental method. Additional clean air was drawn through a subset of filters (range 0.02-0.48 m(3)), which were then stored over silica gel prior to weighing. Losses due to desiccation were found in filters that had not been exposed to airflow, as well as for filters after aspiration. The losses occurring in spiked filters (range of mean 2.6-15.2%) were higher than those in collected filters (range 0.7-8.1%). The MWF aerosol mass collected on PVC filters decreased with the increasing volume of clean air passing through the filter. In a multiple regression model, to predict the loss of collected MWF due to desiccation, loading mass, fresh MWF, and air passing time of 10 min were significant predictors (p=.0001, R(2)=.374). In particular, only air passage of 10 min was significantly higher (2.13%) than the reference air passage (p=.0054). The investigators concluded that MWF aerosol collected on PVC filters may be lost to evaporation under conditions typical of shipment, storage, and desiccation of sample filters, and with airflow through the filter.