The Relationship between Job Stress and Needlestick Injury among Nurses at a University Hospital / 대한산업의학회지

OBJECTIVES: This cross-sectional study investigated the relationship between job stress and needlestick injury the nurses at a University hospital in Incheon, Korea. METHODS: A questionnaire survey was conducted targeting 476 nurses, of which 320 (67.2%) questionnaires were returned and 256 (53.8%) were regarded as being reliable data for analyses. We estimated the relation of job stress to needlestick injury using univariate and multiple logistic regression analyses. RESULTS: One hundred sixty-five nurses (64.5%) had suffered at least one needlestick injury (included sharp injuries) during the previous year. After adjusting for potential confounders, we found that the high job control group was less likely than the other group to experience needlestick injury (OR=0.51, 95% CI=0.27-0.97). Job demand and social support, however, were unrelated to needlestick injury. The high job strain group was more likely to experience needlestick injury (OR=2.57, CI=1.13-5.83) than the low job strain group. CONCLUSIONS: Our results tend to suggest that nurses who were in the low job control or high job strain status were more likely to suffer a high rate of needlestick injury.

The Clinical Importance of an Increase in Serum Gamma-glutamyltransferase Concentration / 대한산업의학회지

OBJECTIVES: Incresed gamma-glutamyltransferase (GGT) concentration has mainly been used as a biologic marker of alcohol drinking and liver diseases. However, some recent reports have suggested that serum GGT concentration may be an early biomarker of oxidative stress and associated with chronic diseases like hypertension, DM, hyperlipidemia, CHD, stroke etc. In this study, we analysed the factors associated with increased serum GGT level and evaluated the clinical application of serum GGT in predicting the risk of chronic diseases. METHODS: The data were collected from 15,546 periodic health examinations, 9,660 males and 5,886 females, done at one university hospital from 2001 to 2003. We analysed self-questionnaire, physical examination and laboratory data. Statistical analyses(t-test, ANOVA, Pearson's correlation analysis, multiple regression analysis and logistic regression analysis) were done by SPSS for windows 10.0. RESULTS: Mean serum GGT levels were quite different according to age, sex, BMI, smoking and alcohol drinking (all P-value < 0.001), but were not different by regular vitamin intake or not (P-value=0.117). There was significant correlation between serum GGT level and the variables (of age, BMI, blood pressure, Hb, fasting blood sugar, total cholesterol, AST and ALT) (all P-value < 0.001). In sex-specific multiple regression analysis, increased serum GGT level was significantly associated with age, alcohol drinking, smoking, blood pressure, fasting blood sugar and ALT in males (all P-value < 0.001), and with age, alcohol drinking, smoking, Hb, blood pressure, total cholesterol and ALT in females (all P-value < 0.05). In sex-specific logistic regression analysis, increased serum GGT level was significantly associated with risk of 'clinical abnormalities'. This risk increased about 13-fold in males and 4.6-fold in females for serum GGT level over the third quatile, compared with under the first quartile. CONCLUSIONS: Serum GGT level is increased not only by alcohol drinking or liver diseases, but also by many other factors associated with chronic diseases and behavioral factors. Thus many factors should be considered in evaluating an increase in GGT level, even when within the upper normal range. Serum GGT level may be a predictor for the early development of chronic diseases.

A case of peripheral polyneuropathy occurring in a small enterprise processing mobile phone cases / 대한산업의학회지

OBJECTIVES: We report a case of n-hexane-induced occupational peripheral polyneuropathy. The patient had been cleaning mobile phone cases using n-hexane for 3 years without proper protection in the workplace. Method : Physical examinations, detailed history taking, laboratory studies and electrophysiological study were done. The n-hexane concentration in the ambient air of the workplace was analysed. RESULTS: The findings of the electrophysiological study revealed that the worker's neurologic symptoms were due to peripheral polyneuropathy. The average n-hexane concentration in the ambient air sampled at the workplace for 59 minutes was 1411.24ppm, from which the 8 hour time-weighted-average(TWA) was estimated as 882ppm. Because other alternative causes for peripheral polyneuropathy were ruled out by laboratory findings and detailed history taking, this TWA level strongly suggested that the disease was caused by n-hexane exposure. Conclusion : Although the neuro-toxicity of n-hexane is relatively well known, many problems have been identified in the management of this toxic material in terms of preventing toxic diseases in the workplace. We expect that this case will help in the planning of health management strategies for using n-hexane in the workplace.

The effect of Smoking and Residential environment on Urinary 2-naphthol / 대한산업의학회지

OBJECTIVES: To evaluate the association of urinary 2-naphthol level and air pollution caused by exposure to smoking, traffic and residential factors. METHODS: The study subjects consisted of 300 university students in Incheon. The questionnaires concerning subject characteristics, smoking amount, traffic, distance between housing and main road, heating and cooking fuel including urinary cotinine levels were checked. RESULTS: There was not any significant association between urinary 2-naphthol level and age, sex, body mass index, distance from mainroad, traffic, heating and cooking fuel. The urinary 2-naphthol level was higher in smokers or high urinary cotinine level group(p=0.0001)than in nonsmokers or low urinary cotinine group. After adjusting for age, sex, and body mass index in the basic model, the 2-naphthol level was also higher in the smokers or high urinary cotinine level group, too(p<0.0005). The model included both traffic and residential variables and it had a good fitness as compared to other models. CONCLUSIONS: It has been known that as one of PAH metabolites, urinary 2-naphthol is a respiration-selective biological marker. We showed that tabacco smoking has a much stronger effects on urinary 2-naphthol levels than when subjects were exposed to air pollution, such as traffic, and other residential factors at the same time.

Prevalence of Occupational Asthma in TDI-Exposed Workers / 대한산업의학회지

OBJECTIVES: This study was carried out to estimate the prevalence of isocyanate-induced occupational asthma in toluene diisocyanate (TDI) exposed workers. METHODS: We examined 170 workers who had been directly exposed to TDI through a medical questionnaire, physical examination, and pulmonary function test. Based on screening examination, workers with suspected occupational asthma were selected for further evaluation such as methacholine and TDI challenge tests. RESULTS: Eleven (6.9%) among 170 workers complained of symptoms of occupational asthma, and 7 among these 11 symptomatic workers showed positive responses to the methacholine challenge test (4.1%). One spray painter was confirmed as having the TDI induced occupational asthma following a positive response to TDI challenge test. CONCLUSIONS: The prevalence of TDI-induced asthma was at 0.58% was lower than that for former studies (2-20%). Improved workplace environment, lower level of TDI exposure compared to the past, and the healthy workers effect may have contributed to this low rate of asthma prevalence in workers with TDI exposure.

Occupational Allergic Contact Dermatitis Like Erythema Multiforme Induced by Bolivian Rosewood / 대한산업의학회지

BACKGROUND: Woods are capable of causing allergic or irritant contact dermatitis which typically occurs on exposed areas. Because Bolivian rosewood exclusively contains the strong sensitizer R-3,4-dimethoxydalbergione, an increasing number of cases of irritant and allergic contact dermatitis has been reported. CASE REPORT: A 49-year-old, male, wood worker, who handled a variety of woods, developed allergic contact dermatitis. A patch test confirmed a positive reaction to one of the exotic woods, Bolivian rosewood. Allergens found in Bolivian rosewood caused this patient's dermatitis, which cleared when he avoided this wood. CONCLUSION: Exotic woods such as Bolivian rosewood can induce occupational contact dermatitis. Measures to lower the incidence of work-related dermatitis are needed in the workplace. Especially, when cutting or sanding woods, workers should wear proper personal protection.

Characteristics of Occupational Asthma Reported by Surveillance System in Incheon / 대한산업의학회지

OBJECTIVES: This study was carried out to estimate the magnitude of occupational asthma and to determine its characteristics. METHODS: We collected and analyzed 121 cases of occupational asthma reported by a surveillance system in Incheon for 5 years. The cases were classified according to industry and causing gent. We attached the data to worker's compensation records to establish the degree of agreement between the two sources. RESULTS: The industry of musical instrument manufacture was the most common (31 cases, 25.6%), followed by furniture manufacture, dye making, and machinery manufacture. TDI was the most common causing agents (52 cases, 43%), followed by reactive dye, wood dust, and organic dust. There was poor agreement with the worker's compensation records (2 cases, 8%). CONCLUSIONS: TDI and reactive dyes were the major materials causing occupational asthma. Most cases reported by the surveillance system were not applied to the worker's compensation system. Therefore, the surveillance system should be used to estimate the magnitude of occupational asthma and to determine its characteristics.

Effect of Commuting Time on Male Worker's Serum Gamma-glutamyltransferase Level / 대한산업의학회지

OBJECTIVES: Alcohol drinking, obesity, and reduced physical activity are commonly related to oxidative stress, which induces plasma membrane-bound protein damage in hepatic cells and elevates serum gamma-GTP. We have a hypothesis that a long commuting time may induce oxidative stress. This study was undertaken to investigate the relationship between commuting time and serum gamma-GTP level. METHODS: Questionnaires were administered to 717 male workers who had worked at Kimpo airport until the year 2000,and had then moved to Incheon airport and were working there in 2002. The questionnaire included items concerning commuting time, sleeping time and alcohol consumption. Physical examination and laboratory data were also collected. RESULTS: Serum gamma-GTP level was significantly and positively correlated with commuting time, body mass index, systolic blood pressure,diastolic blood pressure, hemoglobin, glucose, total cholesterol, AST, ALT and alcohol consumption. Multivariate regression analysis demonstrated that serum gamma-GTP level is significantly associated with commuting time, after considering the other covariates. CONCLUSIONS: Commuting time is one of the factors that affects serum gamma-GTP level in male workers.

The Analysis of Disease Distribution and Referral Routes of Patients in an Occupational and Environmental Medicine Clinic of a University Hospital / 대한산업의학회지

OBJECTIVES: The occupational & environmental medicine clinic plays an important role in the growth and advance of occupational & environmental medicine.This study analyzes the disease distribution and referral routes of patients in an occupational & environmental medicine clinic of a university hospital. METHODS: 843 Agent Orange cases and 839 other cases were treated in the clinic over a period of 4 years. The Agent Orange cases were excluded from this study.Distributions of age, sex, disease and referral route were examined according to the medical records of the hospital. RESULTS: 654 of the patients in the study population were male (77.9 %)and 185 were female (22.1 %).The most common age group consisted of patients in their forties.The number of cases has been increasing annually(1998,146 cases;1999,174 cases; 2000, 247 cases; 2001, 272 cases). The source of the cases were as follows: health examination, 548(65.4 %); health management service, 132(15.7 %);self-referral,125(14.9 %); physicians in other hospitals, clinics, 18 (2.1 %); and physicians in other clinic in the hospital, 16(1.9 %). The most commonly occurring disease was liver disease(28.6 %),followed by respiratory disease(12.8 %), gastroenteric disease (10.3 %)and musculoskeletal disease (8.7%).When the clinic was first opened, most cases came through 'health examination'. Subsequently the number of cases arising from 'self-refferal' and 'health management services' were increased.The disease distribution has also changed as the referral route distribution evolved. CONCLUSIONS: In order to expand the work of the clinic, primary cares for patients who came from 'health examination' will be needed to settle down the clinic at the beginning. Thereafter,specialized services need to be developed for cases originating from 'self-refer-ral' and from referral by other organizations.Increasing the number of cases needs to go hand in hand with the development of good management skills.