Comparison of risk-assessment tools for cardio-cerebrovascular diseases (CVD) in male shipyard workers: a cross-sectional study

BACKGROUND: Periodic revision of assessment tools is essential to ensure risk assessment reliability and validity. Despite the recent revision of the Korea Occupational Safety and Health Agency (KOSHA) 2018, there is no evidence showing that the revision is superior to other cardio-cerebrovascular diseases (CVDs) risk-assessment tools for workplace health management. We conducted a comparative analysis using the Framingham risk score (FRS) as a gold standard to identify the most relevant CVDs risk-assessment tool for workplace health management. METHODS: We included 4,460 shipyard workers who had undergone a workers' health examination during January–December 2016. Risk levels for CVDs were calculated based on the FRS, KOSHA 2013, KOSHA 2017, KOSHA 2018 (2 methods), National Health Screening Program health risk appraisal (NHS HRA) 2017, and NHS HRA 2018. Study participants were categorized into low-risk, moderate-risk, or high-risk groups. Sensitivity, specificity, correlation, and agreement of each risk-assessment tool were calculated compared with the FRS as a gold standard. For statistical analyses, Spearman's rank correlation coefficient and the linearly weighted kappa coefficient were calculated. RESULTS: Sensitivity of the risk assessments was highest in the KOSHA 2018 (health risk appraisal [HRA]). The FRS showed correlation coefficients of 0.354 with the KOSHA 2013, 0.396 with the KOSHA 2017, 0.386 with the KOSHA 2018, 0.505 with the KOSHA 2018 (HRA), 0.288 with the NHS HRA 2017, and 0.622 with the NHS HRA 2018. Kappa values, calculated to examine the agreement in relation to the KOSHA 2013, KOSHA 2017, KOSHA 2018, KOSHA 2018 (HRA), NHS HRA 2017, and NHS HRA 2018 with the FRS, were 0.268, 0.322, 0.352, 0.136, 0.221, and 0.559, respectively. CONCLUSIONS: The NHS HRA 2018 risk calculation method is a useful risk-assessment tool for CVDs, but only when appropriate classification criteria are applied. In order to enhance the risk-group identification capability of the KOSHA guideline, we propose to apply the classification criteria set in this study based on the risk group definition of the 2018 Korean Society of Hypertension guidelines for the management of hypertension instead of the current classification criteria of the KOSHA 2018.

The effect of shift work on high sensitivity C-reactive protein level among female workers

BACKGROUND: This study assessed the association between shift work and high-sensitivity C-reactive protein (hs-CRP) level, a risk factor for cardiovascular disease (CVD), in female workers in electronics manufacturing services (EMS). METHODS: Female EMS workers who received special medical examinations for workers in Gyeongnam, Korea between January 2017 and December 2017 were enrolled in this study. Their age, marital status, education level, alcohol consumption, smoking habit, regular exercise, quality of sleep, work stress, and depression were investigated, and blood tests were conducted. The t- and χ2 tests were conducted to compare the general and biochemical characteristics between daytime and shift worker groups. Age-adjusted partial correlation analysis was performed to examine the linear relationship between hs-CRP level and other risk factors for CVDs. In addition, the difference in hs-CRP levels according to work schedule was analyzed by ANCOVA after adjusting for variables that could affect the hs-CRP level. RESULTS: Although the average hs-CRP levels did not differ significantly between daytime and shift workers (0.92 ± 1.87 and 1.07 ± 2.20 mg/dL, respectively), shift workers tended to show a higher hs-CRP level (p = 0.067). After adjusting for variables that can affect the hs-CRP level, the estimated average hs-CRP level was significantly higher in shift workers (1.325 ± 0.156 mg/dL) than that in daytime workers (0.652 ± 0.350 mg/dL) (p = 0.003). CONCLUSIONS: The results of this study identified a relationship between shift work and hs-CRP level increase in women. Because multiple studies have reported associations between increased hs-CRP and CVD, follow-up of hs-CRP may help early detection of CVD in shift workers.

Changes of depression and job stress in workers after merger without downsizing

BACKGROUND: Since the 1980s, restructuring, which includes downsizing, closures, mergers, and privatization, has expanded worldwide, and various studies have investigated its effect on health. However, previous studies have mainly focused on restructuring accompanied by massive lay-offs, and the effect of a merger on workers’ health is still controversial. This study aims to investigate changes in worker depression and job stress after a merger without downsizing, which is unusual in Korea. METHODS: Repeated surveys were done in April 2014, April 2015, and April 2016 involving the participation of 209 subjects. Participants were divided into two groups, which were comprised of blue-collar workers (104) and white-collar workers (105). Sociodemographic characteristics, including age, education level, job tenure, gender, marital status, smoking status, and alcohol consumption, were measured via a survey. To determine the level of depression, the Korean version of the Center for Epidemiologic Studies Depression Scale (CES-D) was employed, and to investigate job stress, the Korean Occupational Stress Scale-Short Form (KOSS-SF) was used. For statistical analyses, Pearson’s chi-square test, the Student’s t-test, and repeated measure analysis of variance (ANOVA) were performed. RESULTS: The results showed that depression (CES-D, F[2, 400] = 0.466, p = 0.628) was changed but without significance and job stress (KOSS-SF, F[1.899, 379.831] = 3.192, p = 0.045) were significantly different. The between-group difference in the CES-D score between the blue- and white-collar workers by survey administration time was not statistically significant (F = 0.316, p = 0.574). The interaction between the survey time and occupational group was also not statistically significant (F = 0.967, p = 0.381). The between-group difference in the KOSS-SF total score was not statistically significant (F = 1.132, p = 0.289), and the interaction between the survey administration time and occupational group was also not significant (F = 0.817, p = 0.437). In the job stress subgroup analyses Job insecurity and Lack of reward showed a significant difference by survey administration time. CONCLUSION: This study showed that a merger without massive downsizing can cause negative health effects such as an changes in depression and increase in job stress. To improve the health of workers, both the immediate negative effects on health, and the long-term effects or their resolution over time should be considered prior to the merger.

The relationship between serum vitamin D levels and sleep quality in fixed day indoor field workers in the electronics manufacturing industry in Korea

BACKGROUND: Although recent studies have investigated the influence of vitamin D on sleep patterns, there is a lack of research on the relationship between vitamin D and sleep patterns in Korean workers. This study focused on the relationship between serum vitamin D levels and sleep in fixed day indoor field workers in the electronics manufacturing industry in Korea. METHODS: The 1472 subjects who were included in this study were selected from fixed day workers in the electronics manufacturing industry who had received a worker’s special health examination at a hospital in Changwon, South Gyeongsang Province between January 2015 and December 2015. Nighttime workers and those who showed symptoms of depression were excluded from this study. The sociodemographic and lifestyle variables of the participants were investigated, including age, sex, marital status, level of education, body mass index, smoking habits, alcohol consumption habits, and regular exercise. Work-related factors were evaluated, such as employee tenure and occupational stress. Serum 25-hydroxyvitamin D was measured as an indicator of vitamin D levels, and quality of sleep was evaluated using the Pittsburgh Sleep Quality Index (PSQI) translated into Korean. RESULTS: The subjects had a mean serum vitamin D level of 13.70 ± 5.93 ng/mL. Vitamin D deficiency, defined as a serum vitamin D level of <10 ng/mL, was found in 24.8% of males and significantly more frequently in females (47.6%). Poor sleep quality was reported by 19.8% of participants with serum vitamin D levels ≥10 ng/mL and by 21.7% of those with serum vitamin D levels <10 ng/mL, which was a significant difference (P = .007). Multiple logistic regression analysis adjusting for significant variables found that poor sleep quality was more likely in those with vitamin D deficiency than those with higher serum vitamin D levels (odds ratio = 1.36; 95% CI, 1.01–1.82). A comparison of serum vitamin D levels and PSQI components showed that the mean scores for subjective sleep quality, sleep latency, and sleep duration were significantly higher in the vitamin D-deficient participants, indicating that the vitamin D-deficient participants had poorer sleep quality. CONCLUSIONS: This study investigated serum vitamin D levels in fixed day indoor field workers in the manufacturing industry in Korea and analyzed the relationship of vitamin D deficiency with sleep quality. A significant correlation was found between serum vitamin D deficiency and poor sleep quality. Based on the results of this study, sleep disorder management for workers can be improved by providing regular examinations checking their serum vitamin D levels and supplying vitamin D to workers with serum vitamin D deficiency to enhance their quality of sleep.

The Effect of Circuit Training and Workplace Improvement Program on the Prevention of Metabolic Syndrome and the Improvement of Physical Function in Office Workers

BACKGROUND: Physical inactivity and reduced energy expenditure lead to increase in obesity among office workers. In this study, we investigated how 10 weeks of high intensity circuit training and working environment improvement can change body composition, physical strength and markers of metabolic syndrome. METHODS: A total of 83 employees at risk for metabolic syndrome participated in 10 weeks program of one-hour circuit training (30 minutes twice weekly) and workplace improvement program, which consisted of dynamic stretching twice daily for all weekdays. Body composition, anthropometry, blood test, muscle strength/endurance and cardiopulmonary function of participants were assessed at the baseline and after 10 weeks. RESULTS: At the end of 10 weeks, significant increases in levels of body composition, serum lipids, muscle strength and cardiopulmonary were observed in metabolic syndrome risk factor group. In body composition, significant improvements of body weight, body mass index, lean body mass, %body fat, visceral adipose tissue, waist and hip circumference and systolic blood pressure, diastolic blood pressure were observed in metabolic syndrome risk factor group. In lipids, hemoglobin A1c and high density lipoprotein were increased significantly in metabolic syndrome risk factor group. In muscle strength and endurance, significant increases were found. Also, there was a significant difference in cardiovascular function of maximal oxygen uptake and total running time among the groups. CONCLUSIONS: These intensive 10 weeks of high intensity circuit training and workplace improvement program were effective in improving body composition, muscle strength/improvement and cardiopulmonary function. Therefore, based on this study result, workplace improvement programs might be more developed and applied for high-risk employees to improve their metabolic syndrome.

Erratum to: The relationship between quality of sleep and night shift rotation interval

There was an error in one of the author names in this article. The publisher apologises for any inconvenience caused.

The effect of organisational system on self-rated depression in a panel of male municipal firefighters

OBJECTIVES: The present study evaluated the effects of job stress, including organisational system to self-rated depression through a panel study of male municipal firefighters in the Republic of Korea. METHODS: A panel of 186 municipal firefighters reported self-rated depressive symptoms according to the Beck Depression Inventory (BDI). The effects of job stress were evaluated using the Korea Occupational Stress Scale, taken one year earlier and classified by the median value. Panel members were classified into Depression or Control groups according to BDI scores, with a cut-off level of \'over mild depression' in a follow-up survey. RESULTS: The Depression group included 17 (9.1%) workers. Firefighters who scored high on occupational system had an 8.3 times greater risk of being assigned to the Depression group than those who had not (adjusted odds ratio [OR] = 8.03, 95% confidence interval (CI) = [1.73-37.22]). In contrast, job stress from a \'difficult physical environment' revealed negative risks related to being classified in the Depression group (AOR = 0.20, 95% CI = [0.04-0.92]). CONCLUSIONS: Although the healthy worker effect may be involved, job stress based on perceptions of organisational system was a strong risk factor for depression. A comprehensive approach should be considered that encompasses social issues when assessing or mental health in high-risk groups, as well as the practical issue of physiochemical hazards.

Effects of High-speed Elastic Band Training on Physical Fitness and Muscle Function in Rural Community-dwelling Elderly: a Single-blinded Randomized Controlled Trial

BACKGROUND: Aging related decrease in muscle strength and flexibility leads to functional loss of physical ability. Power training is known to improve these capacities and helps in performing daily routine better. Therefore, we modified previously proven and certified sarcopenia intervention exercise for elderly in rural community and applied them to examine the effects on physical fitness and muscle functions to show its applicability. METHODS: Subjects were divided into control and exercise group using single-blind method. Exercise group underwent high-speed elastic band training(concentric contraction in 1 second) 2 days per week for 12 weeks. Before and after the intervention, we performed body composition analysis, anthropometric measurement, blood test, blood pressure check, senior fitness test (SFT), upper body and lower body strength examination. Korean version of Physical Activity Scale for the Elderly (K-PASE), and Center for Epidemiological Studies- Depression Scale (CES-D) were also assessed. RESULTS: Body weight in control group was significantly increased (Paired t-test: P=0.008), although it was consistent in exercise group (GroupxTime: P=0.013). 30-second chair stand (P<0.001) and 30-second arm curl (P<0.001) of the senior fitness test were also significantly improved in exercise group compared to control. In addition, muscle strength of knee flexion (P=0.034) and K-PASE score (P<0.001) were improved in training group with statistical significance. CONCLUSIONS: The modified high-speed elastic band training for rural elderly improved muscle strength and daily physical performance. This result suggests a simple and easy to perform band training could be an excellent solution to prevent sarcopenia in rural elderly. It also supports the evidence that this program would be widely distributed.

Relationship between Triglyceride and Bone Mineral Density in Healthy Korean Men

BACKGROUND: As the elderly population increasing, the interest in osteoporosis, hyperlipidemia, and cardiovascular diseases has increased in recent years. In accordance with such trend, many studies regarding correlations between bone density and hyperlipidemia have been conducted. However, the study outcomes have been inconsistent so far, and most of the studies focused on females. Therefore, this study aimed to investigate the correlation between serum lipid levels and bone density in healthy Korean male adults. METHODS: This study surveyed 851 male adults, who visited an examination center at a university hospital, on smoking, drinking, hypertension, and diabetes history. A laboratory examination measured total cholesterol, triglyceride, low density lipoprotein cholesterol, high density lipoprotein cholesterol, apolipoprotein A-1, and apolipoprotein B. For bone density, lumbar, femoral neck, and femur were measured using dual energy X-ray absorptiometry. RESULTS: Body mass index (BMI) and bone density T-value showed a positive correlation. Triglyceride exhibited a positive correlation with bone density T-value, and they still revealed a significant positive correlation after correcting for age and BMI. While high density lipoprotein cholesterol showed a negative correlation with bone density, they were not correlated significantly after correcting for age and BMI. There was no correlation found between low density lipoprotein cholesterol and bone density. CONCLUSIONS: This study confirmed that bone densities of all areas measured were significantly increased in Korean male adults as triglyceride increased. Total cholesterol, high density lipoprotein cholesterol, and low density lipoprotein cholesterol did not show a significant correlation with bone density.

Anxiety symptoms and occupational stress among young Korean female manufacturing workers

BACKGROUND: The prevalence of anxiety disorders has been increasing in South Korea, with recent studies reporting anxiety disorders as the most common mental disorder among all South Korean females. Anxiety disorders, which are independent risk factors of suicidal ideation and suicide attempts, are significantly correlated with productivity loss, high medical costs, impaired work performance, and frequent worker absence, and thus are potentially serious problems affecting the health of South Korean female workers. In previous studies, anxiety disorders were shown to have a significant correlation with occupational stress. This study seeks to examine the prevalence of anxiety symptoms as well as the relationship between occupational stress and anxiety symptoms among South Korean female manufacturing workers. METHODS: A structured self-reported questionnaire was administered to 1,141 female workers at an electrical appliance manufacturing plant. The questionnaire collected data on general characteristics, health behaviors, sleep quality, job characteristics (shift work, shift work schedule, and job tenure), occupational stress, and anxiety symptoms. Sleep quality was measured using the Pittsburgh Sleep Quality Index, occupational stress with the Korean Occupational Stress Scale-Short Form (KOSS-SF), and anxiety symptoms with the Korean version of the Beck Anxiety Inventory. A chi square test was conducted to determine the distribution differences in anxiety symptoms based on general characteristics, health behaviors, job characteristics, and sleep quality. A linear-by-linear association test was used to determine the distribution differences between anxietysymptoms and the levels of occupational stress. Last, logistic regression analysis was used in order to determine the association between occupational stress and anxiety symptoms. RESULTS: The prevalence of anxiety symptoms was 15.2 %. In the multivariate logistic regression analysis that adjusted for sleep quality and general characteristics, a significantassociation was found for those with anxiety disorders; the odds ratios (OR) were significantly higher the greater the total KOSS-SF score (moderate-risk group OR=2.85, 95 % CI=1.79-4.56; high-risk group OR=5.34, 95 % CI=3.59-7.96). In addition, excluding insufficient job control, all other KOSS-SF subscales were significantly associated with anxiety symptoms, and a relatively high OR was seen in the high-risk group for job demand (OR=3.19, 95 % CI=2.27-4.49), job insecurity (OR=4.52, 95 % CI=2.86-7.13), and occupational culture (OR=4.52, 95 % CI=2.90-7.04). CONCLUSION: There was a significant association between anxiety symptoms and occupational stress stemming from the psychosocial work environment among these South Korean female manufacturing workers. Future longitudinal studies are needed to examine the association between the occupational stress caused by the psychosocial work environment and the incidence of anxiety disorders and anxiety symptoms. Furthermore, intervention programs that aim to address the prevalence of anxiety symptoms and improve the psychosocial work environment, especially for younger female manufacturing workers, are needed.

Association between serum vitamin D and depressive symptoms among female workers in the manufacturing industry

BACKGROUND: Vitamin D has been known to maintain the body's balance of calcium and phosphorus as well as skeletal health. There has been increasing emphasis on the importance of vitamin D as recent studies have been reporting the specific functions of vitamin D in the cerebral nervous system and the association between the level of serum vitamin D and depressive symptoms. However, there is currently a paucity of research investigating the association between serum vitamin D and depressive symptoms in Korean subjects. Consequently, this study has aimed to determine the level of serum vitamin D and explore the association between serum vitamin D and depressive symptoms in Korean female workers. METHOD: A medical examination, questionnaire, anthropometric measurements, and a blood test were conducted between February 3 and March 7, 2014 in 1054 subjects among female workers in the manufacturing industry who underwent physical examinations in a university hospital. From this data, we identified the level of serum vitamin D and investigated the association between serum vitamin D deficiency and depressive symptoms. RESULTS: The average serum vitamin D level of the 1054 subjects was 9.07 +/- 3.25 ng/mL, and the number of subjects in the serum vitamin D deficiency group with less than 10 ng/mL was 721 (68.4 %). The odds ratio of the depressive symptom group with a CES-D score of 16 or above being in the deficiency group with a serum vitamin D level less than 10 ng/mL was found to be 1.55 (95 % CI = 1.15-2.07). CONCLUSION: 68.4 % of female workers in the manufacturing industry were in the deficiency group with serum vitamin D levels less than 10 ng/mL. Additionally, we identified an association between serum vitamin D deficiency and depressive symptoms. In the future, if serum vitamin D deficiency is checked regularly in workers, we expect to achieve better outcomes in managing their depressive symptoms.

Practical Application of Resistance Exercise for Prevention of Sarcopenia

Sarcopenia is a major component of age-related frailty and also a strong predictor of disability, morbidity, and mortality in the aging population. Resistance exercise could be the most effective intervention that improves muscle mass, muscle strength, and physical performance, thus preventing sarcopenia in older adults. The benefits of these exercise programs correlate with the intensity and the frequency of the exercise regimes used in the trials. Clinical trials vary in terms of population, setting, and exercise regimes; hence, more standardized clinical trials are required. In this review, we focus on the effects of resistance exercise on muscle mass, strength, cognitive and physical function, and the principle and applications of resistance exercise considering recent trends that include high-intensity interval training, high speed power training, eccentric exercise, and whole-body vibration exercise.

The relationship between quality of sleep and night shift rotation interval

BACKGROUND: Shift work is closely related with workers' health. In particular, sleep is thought to be affected by shift work. In addition, shift work has been reported to be associated with the type or direction of shift rotation, number of consecutive night shifts, and number of off-duty days. We aimed to analyze the association between the night shift rotation interval and the quality of sleep reported by Korean female shift workers. METHODS: In total, 2,818 female shift workers from the manufacturing industry who received an employee physical examination at a single university hospital from January to August in 2014 were included. Subjects were classified into three groups (A, B, and C) by their night shift rotation interval. The quality of sleep was measured using the Korean version of the Pittsburgh Sleep Quality Index (PSQI). Descriptive analysis, univariate logistic regression, and multivariate logistic regression were performed. RESULTS: With group A as the reference, the odds ratio (OR) for having a seriously low quality of sleep was 1.456 (95% CI 1.171-1.811) and 2.348 (95% CI 1.852-2.977) for groups B and C, respectively. Thus, group C with the shortest night shift rotation interval was most likely to have a low quality of sleep. After adjustment for age, obesity, smoking status, alcohol consumption, exercise, being allowed to sleep during night shifts, work experience, and shift work experience, groups B and C had ORs of 1.419 (95% CI 1.134-1.777) and 2.238 (95% CI 1.737-2.882), respectively, compared to group A. CONCLUSION: Our data suggest that a shorter night shift rotation interval does not provide enough recovery time to adjust the circadian rhythm, resulting in a low quality of sleep. Because shift work is influenced by many different factors, future studies should aim to determine the most optimal shift work model and collect accurate, prospective data.

Sex Differences in Lifestyle Factors of Metabolic Syndrome in Korean Adults

BACKGROUND: Metabolic syndrome is a major risk factor for cardiovascular disease. The combination of an aging population with a chronic diseased population is leading to an increase in the mortality rate due to cardiovascular diseases. The purpose of this study was to assess the prevalence of metabolic syndrome in the Korean population and to evaluate its related factors for sex differences. METHODS: From April 2007 to December 2008, a total of 2,729 volunteers aged 40-69 years living in Changwon city underwent a clinical examination at a hospital in Changwon, Korea. Metabolic syndrome was diagnosed following the criteria defined in Circulation 2009. The clinical examination included measuring anthropometric variables and cardiovascular risk factors, while lifestyle factors were assessed through a questionnaire. RESULTS: The prevalence of metabolic syndrome in our sampling pool was 25.2% with a break down by sex showing a rate of 30.2% in men and 22.2% in women. Related factors associated with metabolic syndrome common to both sex were age, self-health assessment, and alcohol consumption. Sleep duration seemed to be a related factor in men, while income, education, and menstruation status played significant roles in women. CONCLUSIONS: To better manage metabolic syndrome, men need to be educated on alcohol use and women of low socioeconomic status require particular attention as do the aging population and postmenopausal women.

The Relationship of Serum Vitamin D Levels and the Framingham Risk Score among Male Workers in the Manufacturing Sector / 대한산업의학회지

OBJECTIVES: A growing body of evidence states that vitamin D deficiencies may adversely affect cardiovascular disease, however data from Korean workers are lacking. The purpose of this study was to investigate the vitamin D level of the Korean worker and the relationship between vitamin D levels and the Framingham Risk Score. METHODS: 11,448 male workers who visited a university hospital for health screening between March 2010 and August 2011, were enrolled in the study. We measured their of serum vitamin D(25(OH)D) levels and calculated their Framingham Risk Score. RESULTS: The mean serum vitamin D(25(OH)D) level of the surveyed workers was 13.03+/-6.47 ng/mL. 12.4% of the total workers had adequate vitamin D levels. It was found that the lower the vitamin D level, the higher the risk of cardiovascular disease. The Framingham Risk Score and vitamin D levels were found to be significantly related (OR=1.39, 95% CI 1.14~1.68) through a multivariate logistic regression analysis. CONCLUSIONS: 87.6% of workers possessed inappropriate vitamin D levels. Management for this high risk group in regards to cardiovascular disease should be included in the evaluation and vitamin D levels should be corrected.

The Relationship between Fish Consumption and Blood Mercury Levels in Residents of Busan Metropolitan City and Gyeongnam Province / 農村醫學 地域保健

OBJECTIVES: The objective of this study was to identify the relationship between fish consumption and blood mercury levels in a sample of adult Koreans. METHODS: The study subjects were 299 residents of Busan (male: 65, female: 234) and 185 residents of Namhae (male: 69, female: 116), South Korea. Demographic characteristics, current smoking, current drinking, fish consumption per week, past history of amalgam treatment, and residential district were recorded by trained interviewers in June and July, 2009. We considered a portion of fish to be equivalent to 70 gm weight, and calculated amounts of fish consumed per week. Using chi-square tests, t-tests, ANOVA, and multiple linear regression analysis, we estimated the relationships between blood mercury levels and amount of fish consumed per week and other factors. RESULTS: The mean blood mercury level of our subjects was 6.61 microgram/L, higher than the criterion defined by the United States Environmental Protection Agency (EPA) (5.8 microgram/L). In multiple linear regression analysis, residential district and amount of fish consumed per week were associated with blood mercury levels. However, marital status, current drinking, and gender, and age were not associated with blood mercury levels. CONCLUSIONS: In conclusion, we suggest the implementation of systematic and periodic population-based studies to decrease the risks of mercury poisoning among South Koreans who consume fish as a regular part of the diet.

Delayed Response of Amylin Levels after an Oral Glucose Challenge in Children with Prader-Willi Syndrome

PURPOSE: Amylin secretion is increased parallel to insulin in obese subjects. Despite their marked obesity, a state of relative hypoinsulinemia occurs in children with Prader-Willi syndrome (PWS). Based on the hypothesis that amylin levels may be relatively low in PWS children, contributing to their excessive appetite, we studied amylin levels after oral glucose loading in children with PWS and overweight controls. MATERIALS AND METHODS: Plasma levels of amylin, glucagon, insulin, and glucose were measured at 0, 30, 60, 90, and 120 min after a glucose challenge in children with PWS (n = 18) and overweight controls (n = 25); the relationships among the variables were investigated in these two groups. RESULTS: Amylin levels were significantly correlated with insulin during fasting and during the oral glucose tolerance test in both groups. Amylin levels between 0 and 60 min after glucose loading were statistically different between the two groups. They were lower in children with PWS than in the controls between 0 and 30 min after glucose loading. CONCLUSION: The relatively low levels of amylin, compared to those in overweight controls, during the early phase of glucose loading in patients with PWS, may contribute, in part, to the excessive appetite of PWS patients as compared to the overweight controls.

A Study of the Results of Sputum Cytology as a Special Health Examination / 대한산업의학회지

OBJECTIVES: This study aims investigate the results of sputum cytology, which began its test period from 2009 as a special health examination for individuals whose lungs have been exposed to carcinogens. METHODS: 22,215 cases of sputum results were classified into six categories through Papanicolau classification. The sputum results were analyzed according to age, exposure degree to welding fumes and smoking status. Chi-square tests and logistic regression analysis were used to compare and analyze the associations between sputum results and smoking status, exposure degree and age classifications. RESULTS: The number of class I cases was 20,784 with a frequency of (93.6%), class II had 1,076 cases (4.8%), class III had 69 cases (0.3%), and the inadequate class had 286 cases (1.3%) and there were no cases in class VI and V. Patients in class III received CT scans of their chest for further evaluation, but no cancer patients were found from that. There were 2.48 times (95% CI 1.12~5.53) more smokers than non-smokers in class III and 1.70 times (95% CI 1.43~2.02) more in class II. The number of ex-smokers was 2.46 times (95% CI 1.01~5.99) larger than the number of non-smokers in class III and 1.28 times (95% CI 1.03~1.60) larger than the number of non-smokers in class II. There were 1.54 times (95% CI 1.28~1.85) more patients from the mid-exposure group than the low exposure group in class II. There were 1.62 times (95% CI 1.31~1.99) more patients from the high-exposure group than the low-exposure group in class II. CONCLUSIONS: As a screening test for lung cancer, the usefulness of sputum cytology is limited. However, the precancerous cells (class II, class III) varied according to welding fume exposure degree and smoking status.

The Effects of the Frequency of Fish Consumption on the Blood Mercury Levels in Koreans / 대한산업의학회지

OBJECTIVE: We studied two districts in Korea in order to investigate if the frequency of fish consumption has an effect on the blood mercury levels. METHODS: This survey was conducted on 164 fishing district residents in Geoje city and 219 agricultural district residents in Changwon city from July to August in 2008. The data on the demographic characteristics, the living environment, lifestyle habits and the frequency of fish consumption was collected by interviewers. We used ANOVA to estimate the particular relevance between the frequency of fish consumption and the blood mercury concentration, and other various factors. RESULTS: The mean total blood mercury level was 6.54+/-4.01 microgram/L for the total study population. Our results were even higher than that of the National Health and Nutrition Examination Survey (USA) in, 2001~2002 and the German Environmental Survey in, 1998. In this study, there was a significant difference for the frequency of eating fish between the groups. (p<0.01, The level of the groups that ate fish 3 to 4 times per week was significantly higher as compared with the level of the other groups that ate fish 2 to 3 times per month and 1 to 2 times per week, respectively). As the frequency of fish consumption increased, so did the blood mercury concentration. CONCLUSIONS: We found that the blood mercury concentration increases along with fish consumption and this was statistically significant and this fact reveals that fish consumption is positively related to the blood levels of mercury. Accordingly, we need systematic and periodic research on the general population to prevent mercury poisoning, which can be caused by low-level mercury exposure from dietary intake such as chronic fish consumption.

A Case of Lead Poisoning by Ingesting Herbal Pills Tainted by Lead during the Manufacturing Process / 대한산업의학회지

BACKGROUND: This is a case report of lead poisoning after herbal pill ingestion. We report this case here as a reminder that contamination during the manufacturing process is an important issue regarding herbal pills. Case Report: A 37-year-old male was admitted to the hospital with abdominal pain caused by cholecystitis. He was transferred to the Department of Occupational and Environmental Medicine on 26 December 2008, because of anemia. On follow-up examination post cholecystectomy, the patient had increasing blood lead levels. There was no specific finding in his medical history, but he had been taking herbal pills for 3 months to treat dyspepsia. We performed an analysis on the herbal pills, and determined a lead concentration of 1485 mg/kg. When he was admitted to the hospital, the patient had a blood lead level of 84.13 microgram/dL and a zinc protoporphyrin level was 230 microgram/dL. The patient was treated with 250 mg of Penicillamine, 4 times per day. During follow-up 3 weeks later, the patient's blood lead level had been reduced to 36.52 microgram/dL which allowed us to take him off of Penicillamine. By 7 months follow-up, the patient's blood lead concentration had fallen from 36.52 microgram/dL to 20.93 microgram/dL. CONCLUSION: Lead poisoning was confirmed by analyzing blood lead levels and the cause was herbal pills. Upon analysis of the herbal pills, we have discovered that the herbal pills contained an amount of lead acquired during the manufacturing process, based on the high levels of this heavy metal in comparison to other metals. Private herbal pill manufacturing plants need systematic management and oversight.