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.

The Association between Pneumoconiosis and Genetic Polymorphism of GSTM1, GSTT1, GSTP1, NAT2, CYP2E1 and CYP1A1 / 대한산업의학회지

OBJECTIVES: To investigate effects of genetic polymorphism of glutathione S-transferase M1 (GSTM1), glutathione S-transferase T1 (GSTT1), glutathione S-transferase P1 (GSTP1), N-acetyltransferase (NAT2), cytochrome P450 2E1 (CYP2E1) and cytochrome P450 1A1 (CYP1A1) on pneumoconiosis. METHODS: Eighty-five pneumoconiosis patients and 122 age and sex matched healthy controls were enrolled. Direct interview and standard questionnaire were conducted and the genotypes of GSTM1, GSTT1, GSTP1, NAT2, CYP2E1 and CYP1A1 were investigated using multiplex PCR or PCR-RFLP methods with DNA extracted from venous blood. The relationship was investigated between the severity of pneumoconiosis and the polymorphism of GSTM1, GSTT1, GSTP1, NAT2, CYP2E1 and CYP1A1, and also with various environmental factors including smoking. RESULTS: We observed a significantly higher rate of genetic polymorphism in pneumoconiosis patients than in normal subjects. The odds ratio (95% CI) of NAT2 was 2.09 (1.19-3.68). In addition, smoking was related significantly with pneumoconiosis (OR 2.89, 95% CI 1.40-5.95). In multiple logistic regression analyses, NAT2 and smoking were significant risk factors for the development of pneumoconiosis (OR 1.84, 95% CI 1.00-3.37; OR 2.98, 95% CI 1.40-6.35, respectively). The age of onset of the disease and smoking were significantly related with moderate or severe pneumoconiosis (OR 0.91, 95% CI 0.83-0.99; OR 6.94, 95% CI 1.54-31.30, respectively). However there was no significant difference between the rate of genetic polymorphism of GSTM1, GSTT1, GSTP1, CYP2E1 and CYP1A1 in the two groups. CONCLUSION: NAT2 genetic polymorphism was higher in pneumoconiosis patients than in normal subjects. The age of onset of the disease and smoking were significantly related with pneumoconiosis. However, the genetic polymorphism of GSTM1, GSTT1, GSTP1, CYP2E1 and CYP1A1 was not related with development or severity of pneumoconiosis.

Clinical Characteristics of a Cutaneous Anthrax Outbreak Occurred in the Chang-Nyeong, Kyoungsangnamdo, Korea / 감염

BACKGROUND: Anthrax is a zoonotic disease caused by Bacillus anthracis, a gram-positive, spore- forming bacillus. Several cases of anthrax have been reported in Korea; it occurred as an outbreak after ingesting raw meat of an anthrax-infected cow. Among those reported cases, most of them were of gastrointestinal anthrax and a case report of cutaneous anthrax was also included. An outbreak of anthrax occurred in a village of Chang-Nyeong, Kyoungsangnamdo, Korea on July, 2000. The source of infection was the meat of an infected cow. We investigated clinical features and epidemiologic characteristics of the outbreak. METHODS: Subjects were inhabitants and visitors who were exposed to the contaminated meat by ingestion or handling. Diagnosis and classification of clinical forms of anthrax were done according to the CDC case definition. A group of investigators composed of epidemiologists and medical doctors visited the village, and examined the residents and visitors exposed to contaminated meat by interviewing with standard questionare and physical examination. RESULTS: Among 40 persons who contacted meat by ingestion and/or handling, 5(12.5%) developed cutaneous anthrax and 2 of them died; 4 were confirmed cases and 1 was suspected case. B. anthracis was isolated from the vesicular lesions of hands or forearms in those 4 confirmed cases and, in one patient who died of meningitis, the organism was also isolated in blood culture. All patients were of cutaneous anthrax, 3 were recovered and 2 died due to complications : one of meningitis and the other of intracranial hemorrhage. All 40 people consumed meat in cooked state not in raw. No anthrax occurred in 28 persons who only ingested cooked meat without any contact with the raw meat. Five cases of cutaneous anthrax were developed among those 12 persons who handled raw meat in preparation for cooking. CONCLUSION: Anthrax should be suspected in patients with cutaneous lesions of vesicle or eschar on their exposed area after contacting animals or animal products, especially in an outbreak.