A Study on Olfactory Function in Painters Exposed to Organic Solvent in a Shipyard / 대한산업의학회지

OBJECTIVES: To investigate the effect of the occupational exposure to organic solvent on the olfactory function of shipyard painters; we measured the prevalence of olfactory function impairment between the exposure group and the controls by using the Korean Version of the Sniffin'Stick (KVSS) test through smell, and by analyzing factors related to olfactory alteration. METHODS: The olfactory function of 245 painters exposed to organic solvents was compared to that of 122 unexposed controls. A total of 367 shipyard subjects underwent questionnaire study and the olfactory function test was performed by KVSS test I from April to August 2007. Suspected subjects of abnormal findings were referred to an otorhinolaryngologist. In addition, the Biologic Exposure Index (BEI) and industrial hygiene laboratory data were collected as well as analyzed by job title in the exposure group. RESULTS: The difference in the result of KVSS test I was significantly different from the exposure group and the controls (P<0.05). For the exposure group, reduced olfaction and exposure group were correlated with statistical significance when compared to the controls (P<0.01). Adjusting for work duration, smoking, rhinitis or sinusitis history, exposure of the organic solvent (OR 1.76, 95% CI=1.05-2.96) had a statistically meaningful relationship with decreased olfaction. The data on BEI for the exposure group were collected; the difference in methylhippuric acid was significant between spray workers and others, but did not correlate well with decreased olfaction. CONCLUSION: Occupational exposure to organic solvents in shipyard painters may affect the olfactory function. Therefore, shipyard painters should be monitored on a periodic bases by the quantitative test such as KVSS test. There is no other quantitative testing method or standardized procedure that can objectively diagnose the neurotoxic effect, further enhanced quality research in this field is necessary.

Prevalence of Spondylolysis in Pre-employment Screening Examination

OBJECTIVE: In Korea, there appears to be an increase in the diagnosis of lumbar spine disorders recently. This trend has urged employers to screen new employees for this disorder. One of the methods for the investigation is the radiological examination of the lumbar spine. We studied the prevalence of spondylolysis according to age and sex with lumbar X-ray (anterior-posterior view and lateral view) of new employees in pre-employment screening examination. We also estimated the outbreak period of spondylolysis by analysing the prevalence rates at each age group, which were the results of our study. METHODS: We gathered the data of lumbar X-ray findings for new employees, who had recieved pre-employment screening examinations in the department of occupational and environmental medicine of Masan Samsung Hospital Korea during a period from January 1, 2002 to December 31, 2005. We analyzed the data to obtain the age and sex prevalence of spondylolysis and spina bifida. RESULTS: The prevalence of spondylolysis for the pre-employment screening examination was 5.9% (male 6.6%; female 4.3%) in this study. The prevalence of spondylolysis after adjusting age and sex was 9.0%. The prevalence of spondylolysis was positively correlated with age, and showed to be higher in female than male. Body mass index of spondylolytic subjects was higher than that of normal. The prevalence of spondylolysis was significantly higher in those with spina bifida than normal subjects. CONCLUSION: The prevalence of spondylolysis of the pre-employment screening examination was 5.9% in this study. The factors which relates with spondylolysis were age, BMI and the prevalence of spina bifida.

Development of Korean Academy of Medical Sciences Guideline for Rating Physical Disability of Upper Extremity

While the lower extremities support the weight and move the body, the upper extremities are essential for the activities of daily living, which require many detailed movements. Therefore, a disability of the upper extremity function should include a limitation of all motions of the joints and sensory loss, which affects the activities. In this study, disabilities of the upper extremities were evaluated according to the following conditions: 1) amputation, 2) joint contracture, 3) diseases of upper extremity, 4) weakness, 5) sensory loss of the finger tips, and 6) vascular and lymphatic diseases. The order of 1) to 6) is the order of major disability and there is no need to evaluate a lower order disability when a higher order one exists in the same joint or a part of the upper extremity. However, some disabilities can be either added or substituted when there are special contributions from multiple disabilities. An upper extremity disability should be evaluated after the completion of treatment and full adaptation when further functional changes are not expected. The dominance of the right or left hand before the disability should not be considered when there is a higher rate of disability.

Analysis of Worker's Compensation Claims for the Cerebrovascular and Cardiovascular Diseases / 대한산업의학회지

OBJECTIVES: This study was performed to provide fundamental data to judge whether or not cerebro and cardiovascular diseases are work-related, by comparing the characteristics between approved and non-approved cases among the worker's compensation claims. METHODS: We collected 12,309 cerebro and cardiovascular disease claims based on the worker's compensation records of the Labor Welfare Corporation from 2000 to 2004. The approved and non-approved cases were analyzed according to factors such as the calendar year, industry, company size, occupation, gender, age group, classification of cerebro and cardiovascular diseases, fatality and underlying diseases. We used x2-test and multivariate logistic regression for the analysis. RESULTS: According to multivariate logistic regression, electricity gas and water supply (OR=4.18, 95% CI=1.43~12.17), construction (OR=2.39, 95% CI=1.22~4.69) and manufacturing (OR=2.10, 95% CI=1.08~4.07) industries had a higher approval rate than mining and quarrying industries. Service workers and sales & marketing department workers (OR=1.90, 95% CI=1.47~2.47), professionals (OR=1.83, 95% CI=1.50~2.23), technicians and associate professionals (OR=1.63, 95% CI=1.35~1.97) and legislators and senior officials and managers (OR=1.62, 95% CI=1.24~2.12) had a higher approval rate than plant and machine operators and assemblers. Female workers had a higher approval rate (OR=1.31, 95% CI=1.13~1.53) than male workers. Cerebrovascular diseases had a higher approval rate (OR=2.75, 95% CI=2.42~3.13) than cardiovascular diseases. Fatal cases had a higher approval rate (OR=6.01, 95% CI=4.89~7.38) than surviving cases. CONCLUSION: For cerebro and cardiovascular diseases, workers' compensation claims are increasing, approval rates are relatively high and factors such as industry, company size, occupation, gender and fatality are related. A remarkable difference in the approval rate was found according to industry and occupation, suggesting the need for further study to identify which factors influence the approval rate. The approval rate for intracerebral hemorrhage arising in the course of employment (COE) was significantly higher than that arising out of employment (AOE), suggesting the need to correct the approval criteria.

A case of Peripheral Neuropathy After High Electrical Injury / 대한산업의학회지

BACKGROUND: With increasing industrial development, opportunities are growing to contact electricity in the workplace or home. Therefore, the risk of electrical accident has been increased gradually. In general, electrical injuries involve the extremities and result in amputation or severe disability of limbs. Delayed spinal cord injury and peripheral neuropathies following electrical accidents are extremely rare. CASE REPORT: A 32-year-old man with 10 years working experience at a CRT-monitor manufacturer with repetitive exposures to high voltage current visited our hosipital. He complained of left leg weakness and atrophy, and intermittent pain. The symptoms were progressive. Other symptoms occurred such as nocturia, hesitancy, and weak urinary stream. We examined the patient and conducted EMG, L-spine MRI, neurometer test, isokinetic strength test, and physical examination. The results showed neural injuries due to anterior horn lesions or compression of the left femoral nerve pathway, with a consequent diagnosis of neurogenic bladder.

Occupational disease surveillance system in Busan, Ulsan, Kyung-Nam area / 대한산업의학회지

OBJECTIVE: Occupational medicine specialists in the Busan, Ulsan and Kyung-Nam areas established an area-based occupational disease surveillance system and used this system to collected case information for the purpose of preventing occupational diseases METHODS: 11 hospitals participated in this system. The authors selected five main diseases, which were hand-arm vibration syndrome (HAVS), work-related musculoskeletal disorder (WRMSD), occupational asthma, occupational skin disease and occupational lung cancer and established their case definitions. All cases were reported on the web, and real time analysis was conducted. RESULTS: Between Apri1 2001 and April 2003, 192 cases of HAVS, 118 cases of WRMSD, 33 cases of occupational asthma, 17 cases of occupational skin disease and 17 cases of occupational lung cancer (for a total of 377 cases of these five main diseases) were reported. Most of the HAVS cases came from shipbuilding, and 172 of them (92.7 %) were associated with grinding. Of the four main types of WRMSD, carpal tunnel syndrome (CTS) was the most prevalent with 46 cases and shipbuilding was also the main industry involved (83.9 %). The ergonomic risk factors involved mainly associated with the hand. In 19 (57.6 %) and 4 (12.1 %) cases of occupational asthma, the agents included isocyanate and welding fume, respectively. 64.7 % of the cases of occupational skin diseases were contact dermatitis, and organic solvents and welding fume were the main agents involved. The causative agents of occupational lung cancer included Cr, welding fume, PAH, Ni, etc. 10 (58.8 %) of the cases were diagnosed as squamous cell carcinoma and 5 (29.4 %) as adenoma. CONCLUSION: This result showed that an area-based occupational disease surveillance system might provide an effective method of evaluating the prevalence of such diseases, however the Busan, Ulsan and Kyung-Nam provinces are too large to be treated as individual areas. Therefore, the authors suggest that each province should establish its own surveillance system.

The Serum Copper and Zinc Concentration according to the Progression of Pneumoconiosis / 대한산업의학회지

OBJECTIVES: Copper and Zinc, the trace elements of a living body, take a part in immunologic mechanism and induce the pulmonary fibrosis which is the pathologic progress of pneumoconiosis. This study was performed to assist the identification of the pathologic process of pulmonary fibrosis in pneumoconiosis. METHODS: The subjects of this study was 200 diagnosed persons as pneumoconiosis, of whom 100 persons was the visitors in the outpatients departments of pneumoconiosis and 100 admissive pneumoconiosis patients. The serum copper and zinc are measured and com pared. RESULTS: The mean serum copper concentration of visitor group was significantly higher than that of control group, and that of stage V3 subgroup of visitor group was highest because of their advanced fibrosis. But, there was not the difference of serum copper concentration between patient and control group. We thought that the reason was poor nutritional and health status of the patient. The mean of serum zinc concentration of visitor and patient control was lower than that of control group. As the degree of pulmonary fibrosis was more severe from stage Vl, V2, V3 of visitor to stage Pl, P2, P3 of patient, the mean of serum zinc concentration was lower. The ratio of serum copper/zinc of visitor and patient was higher than that of control, and that of patient was higher than that of visitor. Those results showed that the ratio of serum copper/zinc ratio more greatly expressed the degree of progression of pneumoconiosis than only copper or zinc concentration by adjustment of nutritional and health status of the patient. CONCLUSIONS: As above study results, the degree of pulmonary fibrosis of pneumoconiosis could be estimated by means of serum copper/zinc ratio.

A Study on the Risk Factors of Low Back Pain in Computer Terminal Operators / 대한산업의학회지

Low back pain in computer terminal operators is a very common but important symptom. While the occupational risk factors of low back pain were approved obscurely, there have been few studies on analysis or understanding of occupational risk factors. Therefore, we studied occupational risk factors of low back pain, especially for ergonomic factors as well as general characteristics of workers. We selected 98 subjects for this study, computer terminal operators ordinary using computers in Pusan. We calculated the subjective severity of low back pain of each operator by the Low Back Pain Scoring System. The relation of low back pain score to general characteristics of worker was also analyzed. We analyzed the relationship between low back pain score and individual efforts to prevent low back pain. We measured the ergonomic factors of each computer terminal operator - Trunk Jnclination(TI), Arm Flexion(AF), Elbow Angle(EA), Head Tilting(HT), Knee Angle(KA), using of foot plate and gap between the popliteum and chair. The correlations between these ergonomic factors and low back pain score were then analyzed. And the results are as follows: 1. The prevalence rate of low back pain in computer terminal operators was 39.8% in this study, when low back pain score was converted by the low back pain scoring system. 2. According to general characteristics of workers related to low back pain, the scores were higher in the older age group, the married and the longer work carriers. (p < 0.05) 3. In the analysis of the relationship between low back pain score and individual effort to prevent low back pain, regular exercise, history of schooling for prevention of low back pain, and declaration of intention to participate in low back pain education or exercise were stastistically significant(p < 0.05). And the more severe the low back pain, the higher the intention to participate in low back pain education they had in this study. 4. In the analyses of relationships or correlations between low back pain score and each of the 7 categories of ergonomic factors, only head tilting had a weak reverse correlation with low back pain(r=-0.2999, p < 0.01). From now on, cohort studies for the risk factors of low back pain of workers, who have been forced to work in non-ergonomical positioning at the work site, will be necessary. On the background of these ergonomic studies, the occupational health profession should be required to manage ergonomic working conditions.

A Study on obesity pattern and related factors of the doctors / 예방의학회지

The author surveyed overall obesity indicies and factors concerned with obesity such as dietary intake, physical activity, stress and life style with the subject of doctors. The number of subjects was total 508 with 396 men and 112 women. They were subgrouped into surgical part, medical part and service and basic part by speciality. And also subgrouped into intern and resident, pay doctor, and practitioner by working type. The results were as follows. 1) Obesity indices: BMI of total doctor was 23.1+/-2.8, and WHR was 0.87+/-0.08 and overweight prevalence(BMI>25.0) was 23.6 %. It was within normal limit but slightly over the Korean standard. The degree of obesity indices of subgroups by speciality was "surgical part > medical part > service and basic part", and by working type was "practitioner > pay doctor > intern and resident". 2) Dietary intake and Physical activity: Average dietary intake was 2148+/-451 kcal/day. The degree of dietary intake by speciality was "surgical part > medical part > service and basic part". By working type it was "practitioner > pay doctor > intern and resident". Average physical activity was 29+/-5 METs/day. The degree of physical activity also showed similar pattern. But there was no significant difference among each groups. 3) Comparison between over-weight and non-over-weight group: The items that showed significant difference between two groups were dietary intake, skip breakfast, regular exercise, smoking, heavy drinking, chronic disease etc.