Validation of health screening questionnaire used for screening gastrointestinal disorder in worker's special health examination for night time work

BACKGROUND: Since the night time work was introduced as a ‘harmful factor’ for the worker's special health examination (WSHE) in 2014, the validation of the questionnaire used for screening gastrointestinal (GI) disorder has not been conducted. The purpose of this study is to verify the validity of the questionnaire using the data of specific health screening cluster. METHODS: We used WSHE screening data for 3 years, from 2014 to 2016, in health screening cluster. The subjects who had received upper GI endoscopy in opportunistic screening and WSHE simultaneously regardless of the results of the questionnaire were selected. We tested the validity of the questionnaire using upper GI endoscopy as a gold standard. RESULTS: This study was conducted on 5,057 examinees in 2014, 8,352 examinees in 2015, and 10,587 examinees in 2016. The validity of the questionnaire for each year was as follows: sensitivity 12.3% (95% confidence interval [CI], 11.1–13.4), specificity 88.6% (95% CI, 87.2–90.1), accuracy 41.1% (95% CI, 39.8–42.5) in 2014, sensitivity 5.9% (95% CI, 5.2–6.5), specificity 93.6% (95% CI, 92.7–94.4), accuracy 38.6% (95% CI, 37.6–39.6) in 2015, sensitivity 6.0% (95% CI, 5.4–6.5), a specificity of 9.42% (95% CI, 93.4–95.0), accuracy of 34.2% (95% CI, 33.3–35.1) in 2016. In generally, questionnaire showed sensitivity of 10%, specificity of 90%, and accuracy of 40%. CONCLUSIONS: Despite the purpose of WSHEs aiming to identify target disease early, the sensitivity of the questionnaire for GI disease was too low as 10%. The reasons for this are the problem of the question itself, and the problem of ambiguous target disease. In the future, the questionnaire should be improved to meet the purpose of the WSHE, and further correction of the target disease should be made.

Blood lead levels of Korean lead workers in 2003-2011

OBJECTIVES: This study aimed to document the trend in blood lead levels in Korean lead workers from 2003 until 2011 and blood lead levels within each of the main industries. METHODS: Nine years (2003-2011) of blood lead level data measured during a special health examination of Korean lead workers and collected by the Korea Occupational Safety and Health Agency were analyzed. Blood lead levels were determined by year, and a geometric mean (GM) was calculated for each industry division. RESULTS: The overall GM blood lead level for all years combined (n = 365,331) was 4.35 mug/dL. The GM blood lead level decreased from 5.89 mug/dL in 2003 to 3.53 mug/dL in 2011. The proportion of the results > or =30 mug/dL decreased from 4.3% in 2003 to 0.8% in 2011. In the "Manufacture of Electrical Equipment" division, the GM blood lead level was 7.80 mug/dL, which was the highest among the industry divisions. The GM blood lead levels were 7.35 mug/dL and 6.77 mug/dL in the "Manufacturers of Rubber and Plastic Products" and the "Manufacture of Basic Metal Products" division, respectively. CONCLUSIONS: The blood lead levels in Korean lead workers decreased from 2003 to 2011 and were similar to those in the US and UK. Moreover, workers in industries conventionally considered to have a high risk of lead exposure also tended to have relatively high blood lead levels compared to those in other industries.

Analysis of Korean Analytical Quality Assurance Program for the Special Health Examination from 1995 to 1999 / 대한산업의학회지

OBJECTIVE: The accuracy of analytical results of blood and urine heavy metals came out to the main issue on occupational health from late eighties. The discrepancy of the results for same samples from different laboratories made the diagnosis for occupational diseases be unreliable. Therefore, a quality control program for analysis of samples taken from workplace had been introduced in Korea since 1992. This study aims to show the quality control program f'or analysis of blood and urine samples and its proficient rates from 1992 to 1999 and to know how they have been being used in occupational health. METHODS: The quality control program runs twice a year with mandatory items of blood lead and urine hippuvic acid and voluntary items of blood cadmium and manganese and urine mandellic acid and methyl hippuric acid. Participant laboratories are receiving three levels for each items and two out of three samples have to be qualified for being a proficient laboratory for the item. The acceptable range of blood lead and urine hippuric acid is +/-15% and that of the others is within 3 SD(standard deviation) from the reference values. RESULTS: The proficient rates of blood lead and urine hippuric acid was 89%, 90%, repectively, however those of the other voluntary items have been from 51% to 62%. The proficient rates of urine mercury and urine N-methylformamide(NMF), which are introduced since 1999, were very poor. Urine hippuric acid and blood lead were analyzed frequently for the purpose of biological monitoring conducting by special health examination organizations. Urine and blood manganese and urine metabolites of trichloroethylene, urine phenol, methylhippuric acid and cadmium were followed. CONCLUSIONS: In conclusion, the quality control program for biological monitoring has dramatically improve the ability of analysing blood and urine samples and eventually contributes to diagnose occupational diseases and to prevent occupational poisoning. However, some biological monitoring data, such as urine manganese, mercury and NMF, have been still reported from laboratories that were not accepted as a proficient laboratory.

A Study on Possibility of Special Health Examination to the Hospital Employees / 대한산업의학회지

This study was performed to decide the possibility of special health examination to the hospital employees. We carried out questionnaire survey for 830 subjects at 2 general hospitals located in Pusan city. The summary of this study are as follows. 1. Above 10% of total hospital employees were replied that they exposed to 16 hazard items, such as dust, noise, stress and etc. Among them, over 50% of hospital employees exposed to dust(69.8%), noise(52.3%), stress(60.1%). And hospital employees exposed to alcoholic disinfectant(41.3%), radiation(34.6%), drug(33.3%), VDT(25.2%), and aldehyde(18.7%) also. 2. 63% of the hospital employees replied that there were hazardous factors in hospital environments, and 80% insisted the necessity for hospital environment measuring. 35.7% of respondents replied that they had never taken the education about hazardous factors. 35.7% of the total respondents answered that they didn't use protective equipment when exposed to hazardous factors. And 48.6% answered they took periodic health examination. Only 7.2% replied that ventilation condition of office room was proper. As shown in above results, hospital employees are exposed to various hazards, and turn out neglecting to health problems caused these hazardous factors. So at first, it is necessary to measuring hospital working environment, and then will be decided the possibility of special health examination to the hospital employees.

A Study on Possibility of Special Health Examination to the Hospital Employees / 대한산업의학회지

This study was performed to decide the possibility of special health examination to the hospital employees. We carried out questionnaire survey for 830 subjects at 2 general hospitals located in Pusan city. The summary of this study are as follows. 1. Above 10% of total hospital employees were replied that they exposed to 16 hazard items, such as dust, noise, stress and etc. Among them, over 50% of hospital employees exposed to dust(69.8%), noise(52.3%), stress(60.1%). And hospital employees exposed to alcoholic disinfectant(41.3%), radiation(34.6%), drug(33.3%), VDT(25.2%), and aldehyde(18.7%) also. 2. 63% of the hospital employees replied that there were hazardous factors in hospital environments, and 80% insisted the necessity for hospital environment measuring. 35.7% of respondents replied that they had never taken the education about hazardous factors. 35.7% of the total respondents answered that they didn't use protective equipment when exposed to hazardous factors. And 48.6% answered they took periodic health examination. Only 7.2% replied that ventilation condition of office room was proper. As shown in above results, hospital employees are exposed to various hazards, and turn out neglecting to health problems caused these hazardous factors. So at first, it is necessary to measuring hospital working environment, and then will be decided the possibility of special health examination to the hospital employees.

An Analysis of Health Examination Outcome in the Special Health Examination Institute / 예방의학회지

Special health examination institute has done periodic health examination for workers who have worked in the hazardous workplace. However, assessment on outcome in special health examination institute about detection ability of occupational disease has not been. In this circumstances, we studied on the differences of health examination outcome among special health examination institutes and identified related factors which affected outcome of special health examination in the special health examination institutes. The summary of the results were as follows. 1. 50 special health examination institutes were examined in this study. Among them, university institutes were 13 cases(26.0%), hospitals were 20 cases(40.0%), a corporation aggregates were 9 cases(18.0%) and an auxiliary organs of company were 8 cases(16.0%). There were 29(58.0%) institutes with a preventive medicine specialist, but 21 institutes(42.0%) were not. 2. Total workers examined in 50 institutes were 606,948 and workers diagnosed as occupational disease(D1) were 3,156. The rate of occupational disease was 6 workers per 1,000 examined workers. Workers needed for close observation(C) were 95,809 and the rate of workers needed for close observation was 141 per 1,000 examined workers. 3. The rate of occupational disease of university institutes was highest(11.3 per l,000 examined workers) and followed by hospitals(6.0 per 1,000 examined workers), a corporation aggregates(4.2 per 1,000 examined workers), and an auxiliary organs of company(l.2 per 1,000 examined workers.). The difference of the rate of occupational disease between university institutes and an auxiliary organs of company was statistically moderate significant(p<.1).The rate of occupational disease in special health examination institutes with establishment duration was more than 10 years was statistically higher than institutes with establishment duration was less than 10 years(p<0.l). 4. The results of multiple regression, R2 was 0.3394(adjusted R2 was 0.2109), F-value was 2, fi41ft(p<0.5), and statistically significant variables were establishment duration(p<0.1), number of examined workers per one doctor(p<.l), and auxiliary organs of company(p<0.l), which dependent variable was the rate of occupational disease and independent variables were number of examined workers per one doctor, classification of institute, the rate of working environment exceeding TLV, duration of institute establishment, presence of a preventive medicine specialist.