A New Disability Rating Method according to the Job Using the Korean Academy of Medical Science Disability Guideline

The purpose of this study was to develop a disability rating scale according to job classification using the Korean Academy of Medical Society (KAMS) guidelines. All jobs were categorized based on their level of physical activity and professional skills. The KAMS guidelines were used for the impairment rating. We modified the California Schedule for rating permanent disabilities. The differences were plotted to compare between the impairment rate and the job-adjusted disability rate. The KAMS job-adjusted disability rates were then compared to the McBride and workers' compensation rates. A total of 1,206 occupations were classified into 44 groups. The occupational disability indexes were rated on a scale of 1 to 7. The differences in the McBride disability rates varied inconsistently from 0% to 35%, while the differences in the KAMS disability rates were between 0% and 18%. The KAMS disability rates were slightly higher than the McBride disability rates for the upper extremities, but were lower for the lower extremities and internal organs. This is the first Korean job-adjusted disability rating method. There are several limitations, but its impairment rating is more scientific and reflects the current Korean occupational environment.

Seven Cases of Respiratory Symptoms Caused by Acute Ozone Exposure from an Electronics Company / 대한산업의학회지

BACKGROUND: Ozone is a colorless, pungent, and highly reactive gas. It can cause headaches, burning eyes, irritation to the respiratory passages, and dyspnea. This article describes cases of respiratory difficulty associated with acute ozone exposure from an electronics company that manufactures touchscreen. CASE REPORT: Seven young female workers visited the Department of Occupational and Environmental Medicine, complaining of cough, dyspnea, and chest discomfort that started within two days at work processing a touchscreen with ozone (0.103 ppm ozone detected in the their workplace). Other; symptoms observed included rhinorrhea, headaches, and dizziness. There was a temporary improvement in symptoms upon taking a day off, but their symptoms deteriorated upon continuing work again-suggesting the ozone exposure in their work environment was responsible for their symptoms. The results of pulmonary function and blood laboratory tests were normal; however, laryngoscopy and nasal endoscopy identified three cases of inflammation on laryngeal, intranasal, or vocal cord regions. CONCLUSIONS: Based on the levels of ozone detected in the workplace and clinical symptoms presented, we conclude that the respiratory symptoms in these cases were caused by excessive ozone exposures.

Development of Korean Academy of Medical Sciences Guideline Rating the Physical Impairment: Lower Extremities

Lower Extremities Committee of Korean Academy of Medical Sciences Guideline for Impairment Rating develops new guidelines which are based on McBride method, American Medical Association Guides, Disability evaluation by The Korean Orthopaedic Association, The Korean Neurosurgery Society, and Korean Academy of Rehabilitation Medicine. The committee analyzed and discussed to create an ideal method practical in Korea. Our committee endeavors to develop new methods which are easy to use, but are suitable for professional use and also independent from the examinee's intentions. The lower extremities are evaluated on the basis of anatomic change, functional change, and diagnosis based evaluation. Nine methods are used to assess the lower extremities. Anatomic assessment includes leg length discrepancy, ankylosis, amputation, skin loss, peripheral nerve injury, and vascular disease. In functional assessment, range of motion and muscle strength are included. Diagnosis-based assessments are used to evaluate impairment caused by specific fractures, deformities, ligament instability, meniscectomies, post-traumatic arthritis, fusion of the foot, and lower extremity joint replacements.

A Case of Peripheral Polyneuropathy Induced by Occupational 2,5-hexanedione Exposure / 대한산업의학회지

OBJECTIVES: This study is a case report of 2,5-hexanedione induced occupational peripheral polyneuropathy. We also investigated the peripheral nerve function of all workers who had been exposed to 2,5-hexanedione in the same process. METHODS: In June, 2006, a 2,5-hexanedione exposed worker complained of both hand numbness. He received neurologic, radiologic, laboratorial and electrophysiologic evaluation, including measurements of workplace environment. Five months after cessation of exposure to 2,5-hexanedione, a follow-up electrophysiologic examination was done. We evaluated the peripheral nerve function of 2,5-hexanedione exposed workers by comparing 13 male 2,5-hexanedione exposed workers who were in same company with the patient and 5 male workers who had not been exposed to 2,5-hexanedione. RESULTS: Under electrophysiologic examination, there were abnormalities in sensory and motor nerve velocity, terminal latency, and F-latency of both median nerve and ulnar nerve. After 5 months, the patient symptoms and the results of follow-up electrophysiologic examinations were improved. Comparing the 2,5-hexanedione exposed group with the unexposed group, the sensory nerve velocity of the median and ulnar nerves in the exposed group was decreased. The motor nerve velocity of the peroneal nerve, and sensory nerve velocity of the median and sural nerves were decreased. Terminal latency of median, ulnar, peroneal, and tibial nerves in the exposed group were increased compared with the unexposed group(<0.05). CONCLUSIONS: 2.5-hexandione can induce peripheral polyneuropathy in male workers.

Application of Participatory Action-Oriented Training (PAOT) to Small and Medium sized Enterprises for Prevention of Work-related Musculoskeletal Disorders / 대한산업의학회지

OBJECTIVES: The purpose of this study was firstly to introduce a Participatory Action-Oriented Training (PAOT) program for the prevention of work-related musculoskeletal diseases (WRMSDs) in Small and Medium sized Enterprises in the Gumi Industrial Zone, and secondly to assess its effect. METHODS: Two PAOT workshops to prevent WRMSDs were conducted with 39 volunteer participants from 10 companies selected (on a first-come, first-served basis) among 200 small- or medium-sized enterprises in Gumi. These companies had been provided with mandatory occupational health management agency services for Small and Medium sized Enterprises by an occupational medicine clinic. Each workshop consisted of 6 technical sessions and one closing ceremony. At the 1st session, the principles of each action checklist item were explained and an on-site checklist exercise was carried out. The 2nd to 5th sessions presented good example pictures on 4 subjects: material storage and handling, working environment, work organization and work-related welfare. Group discussions were carried out by the participants. In the final 6th session on the implementation of improvement, each participant was asked to present 6 action plans, 3 short-term and 3 long-term, for their own workplace improvement. RESULTS: Overall, the participants worked out 47 real action plans, 27 short-term and 20 long-term, for improvement of their own workplaces. Three to 6 months after the workshops, through in-person visits to each company, it was confirmed that more than half of these 47 plans had been completed; 25 plans (53.2%) had been completed as planned, 8 (17.0%) were in processing, and 14 (29.8%) had not yet been put into practice. CONCLUSIONS: The study findings confirmed that the PAOT program holds strong potential as an intervention method to prevent WRMSDs in Small and Medium sized Enterprises, although the final results have not been fully assessed yet.

A Case of Toxic Hepatitis in a Worker Exposed to a Cleansing Agent Mainly Composed of Methylene Chloride / 대한산업의학회지

OBJECTIVES: To report a case of toxic hepatitis in a worker exposed to a cleansing agent mainly composed of methylene chloride. METHODS: A 27-year-old female worker who had worked in an inspection and packing position of semiconductor parts in a factory using methylene chloride as a metal cleansing solvent was hospitalized due to fever, chill and generalized aches. We evaluated her with blood tests, abdominal ultrasonographic scan and abdominal CT scan and also took her occupational history. RESULTS: The patient showed acute hepatitis in blood and radiologic tests after admission. The serologic tests for viral hepatitis A, B, C and autoimmune hepatitis were negative. She had no history of significant alcohol use, recent medication or drug allergy. After admission, her symptoms were improved and liver enzyme levels(AST and ALT) were markedly reduced. She returned to her workplace after discharge. Thereafter, however, her previous symptoms were recurred and she was hospitalized again 2 days after returning to her workplace. After this second admission, she showed acute hepatitis in blood tests and her symptoms were improved and liver enzyme levels were markedly reduced with the same pattern as those of the first admission. On the 11th day of the second admission, liver enzyme levels were normalized and she was discharged from hospital. CONCLUSIONS: We presume that this patient`s liver injury was related to the methylene chloride presence at her workplace due to her clinical symptoms, blood tests, radiologic tests and occupational history.

Ocular, Respiratory and Skin Symptoms Among Solderers Employed in Printed Circuit Board Assembly Units / 대한산업의학회지

OBJECTIVES: This study was conducted to evaluate the prevalence of ocular, respiratory and skin symptoms among solderers and to investigate the relationship between symptom prevalence and exposure intensity. METHODS: We analyzed 126 eligible participants out of a population of 146 male solderers who completed the symptom questionnaires. Fourteen symptoms including 'itchy and red eyes', 'itchy or prickly nose', 'sneezing', 'rhinorrhea', 'blocked nose', 'pricklythroat', 'foreign body sensation in throat', 'sudden bouts of coughing', 'exertional breathlessness ', 'wheezing', 'sputum production', 'itchy face or hands', 'acneiform eruptions on the face'and 'red spots on the face or hands'were contained. Blood lead levels of all the 126 participants were tested and the participants'own assessments of the health risk of soldering were collected. RESULTS: Of the 14 investigated symptoms, 'sudden bouts of coughing'was significantly more prevalent in solderers who worked 4 hours or more a day than those who worked less than 4 hours a day, as for the other symptoms, there were no significant differences in the preva1ences related to daily soldering hours. 2.8% of the solderers considered the risk of flux exposure to be serious. The mean blood lead level was 6.05 microgram/dL (maximum 15.50 microgram /dL). CONCLUSIONS: Soldering may increase the risk of respiratory symptoms. Further investigations on the hazards of soldering processes are warranted and solderers should be educated on these hazards.