Risk Factors for Hepatitis C Virus (HCV) Infection in Areas with a High Prevalence of HCV in the Republic of Korea in 2013

BACKGROUND/AIMS: The prevalence of hepatitis C virus (HCV) infection in Busan, Gyeongnam, and Jeonnam Provinces in Korea is more than twice the national average. This study aimed to examine whether demographic and lifestyle characteristics are associated with HCV infection in these areas. METHODS: A case control study was performed at three study hospitals. HCV cases were matched with two controls for sex and age. Patient controls were selected from non-HCV patients at the same hospital. Healthy controls were subjects participating in medical checkups. Conditional logistic regression models were used. RESULTS: A total of 234 matched-case and patient- and healthy-control pairs were analyzed. The significant risk factors for both controls were sharing razors (adjusted odds ratio [aOR], 2.39 and 3.29, respectively) and having more than four lifetime sexual partners (aOR, 2.15 and 6.89, respectively). Contact dockworkers (aOR, 1.91) and tattoos (aOR, 2.20) were significant risk factors for the patient controls. Transfusion (aOR, 5.38), a bloody operation (aOR, 5.02), acupuncture (aOR, 2.08), and piercing (aOR, 5.95) were significant risk factors for the healthy controls. Needle stick injuries and intravenous drug abuse were significant in the univariate analysis. CONCLUSIONS: More education concerning the dangers of sharing razors, tattoos and piercings is required to prevent HCV infection. More attention should be paid to needle stick injuries in hospitals and the community.

The influence of regional deprivation index on personal happiness using multilevel analysis / 한국역학회지

OBJECTIVES: The objective of the present study was to identify the factors that influence the happiness index of community residents, by considering personal and regional aspects, and to use as evidence of efforts for improvement of the happiness index. METHODS: The study was conducted based on information from 16,270 participants who met the data requirement among those who participated in the 2011 South Gyeongsang Community Health Survey. Of the factors that can influence the happiness index, socioeconomic characteristics, health behavior, morbidity, and healthcare use, social contact, and participation in social activities were classified as personal factors; for regional factors, data from the 2010 census were used to extrapolate the regional deprivation indices at the submunicipal-level (eup, myeon, and dong) in South Gyeongsang Province. The happiness index for each characteristic was compared to that for others via t-test and ANOVA, and multilevel analysis was performed, using four models: a basic model for identification of only random effects, model 1 for identification of personal factors, model 2 for identification of regional factors, and model 3 for simultaneous consideration of both personal and regional factors. RESULTS: The mean happiness index was 63.2 points (64.6 points in males and 62.0 points in females), while the mean deprivation index was -1.58 points. In the multilevel analysis, the regional-level variance ratio of the basic model was 10.8%, confirming interregional differences. At the personal level, higher happiness indices were seen in groups consisting of males with high educational level, high income, high degree of physical activity, sufficient sleep, active social contact, and participation in social activities; whereas lower happiness indices were seen in people who frequently skipped breakfast, had unmet healthcare needs, and had accompanying diseases, as well as those with higher deprivation index. CONCLUSIONS: The study confirmed that the happiness index of community residents was influenced by not only personal aspects but also various regional characteristics. To increase the happiness index, interests at both personal and regional levels, as well as community emphasis on creating social rapport and engaging in selective efforts, are needed in vulnerable regions with relatively high deprivation index.

Poor agreement between QuantiFERON-TB Gold test and tuberculin skin test results for the diagnosis of latent tuberculosis infection in rheumatoid arthritis patients and healthy controls

BACKGROUND/AIMS: We investigated the agreement between the QuantiFERON-TB Gold (QFT-Gold) test and the tuberculin skin test (TST) in the diagnosis of latent tuberculosis infection in patients with rheumatoid arthritis (RA), compared with healthy controls, in Korea. METHODS: We recruited 64 patients with RA and 79 healthy controls at two university hospitals in South Korea. The participants underwent both the QFT-Gold test and the TST simultaneously between August 2006 and February 2009. All patients were diagnosed using the classification criteria for RA revised in 1987 by the American College of Rheumatology. Bacillus Calmette-Guerin vaccination status and current medications were evaluated, and disease activities were assessed using the Disease Activity Score in 28 joints. Eleven patients with RA produced indeterminate QFT-Gold test results and were thus excluded from the kappa analysis. RESULTS: Based on an induration of 10 mm in diameter as the TST cutoff value, the QFT-Gold test and TST demonstrated 75.0% agreement (kappa = 0.23) in patients with RA and 75.9% agreement (kappa = 0.19) in healthy controls. Among the 56 patients with RA who had negative TST results, 11 patients (17.2%) also yielded indeterminate QFT-Gold results. CONCLUSIONS: Our study showed poor agreement between the results of the QFT-Gold test and the TST in both RA patients and healthy controls. Based on these findings, we emphasize the importance of making clinical decisions in the diagnosis of latent tuberculosis in Koreans with or without RA.

Self-Rated Health of the Chronic Disease Patients with Depression in Aged over 65 / 農村醫學 地域保健

OBJECTIVES: To compare the self-rated health in chronic disease patients with depression, chronic disease patients, and depression patients, and to observe the related factors to the self-rated health of people age 65 and older. METHODS: The subjects were 2,549 elderly people, over 65 years old in Busan Metropolitan City who participated in 2009 community health survey. Association between self-rated health and general characteristics, life style and disease status were observed. Depressive symptoms were measured using the Centre for Epidemiologic Studies Depression Scale (CES-D). Analysis of complex sample was done with SAS (ver. 9.2), using chi2-test and multiple logistic regression. RESULTS: Among total 2,549, there were 740 normal people (29.8%), 50 people with depression (1.8%), 1,495 people with other chronic diseases (58.2%), and 264 people with the comobidity of depression and other chronic diseases (10.1%). Good self-related health accounted for 20.3% for the whole, 33.4% for normal, 16.7% for chronic disease, 16.1% for depression, and 3.2% for chronic diseases with depression. Disease, gender, education, income, alcohol drinking, regular exercise and regular walking were independent factors associated with the good self-related health. CONCLUSIONS: It is suggested that when the chronic disease control program for the elderly is developed, depression care should be considered along with the program. This program should be given priority to the women and the vulnerable classes and should also be related to the regular walking.

Effect of Medicine Adherence on the Occurrence of Cerebrovascular Disorders in Diabetes Mellitus Patients / 한국역학회지

OBJECTIVES: To assess the association between the occurrence of cerebrovascular disorders and a medication adherence in diabetes mellitus patients. METHODS: Medical records from 1,114 new patients with diabetes mellitus were collected and the occurrence of cerebrovascular disorders was observed. Data was gathered from the health examination records of diabetes mellitus patients registered at the Korean Metabolic Syndrome Research from 1996 to 2005, medication records from the National Health Insurance Corporation and death data from the National Statistics Office from 1997 to 2007. Hazard ratios were analyzed using the Cox proportional hazard model to test the association between the occurrence of cerebrovascular disorders and the level of medication adherence. Medication adherence was calculated using Continuous measure of Medication Acquisition (CMA). RESULTS: Of 1,114 diabetes mellitus patients, cerebrovascular disorders occurred in 67 cases (6.1%). The mean duration for the development of a cerebrovascular disorder was 3.82 yr. Medication adherence (> or =0.8 vs. or =0.8 vs. 0.5-0.7 HR, 0.99; 95% CI, 0.33-2.95) was an independent factor associated with the occurrence of cerebrovascular disorders in diabetes mellitus. CONCLUSION: Increased medication adherence is necessary to prevent the occurrence of cerebrovascular disorders in diabetes mellitus patients. Furthermore we propose that CMA be considered as a method for monitoring medication adherence in clinics.

The Prevalence of High Myopia in 19 Year-Old Men in Busan, Ulsan and Gyeongsangnam-Do / 예방의학회지

OBJECTIVES: The purpose of this study was to estimate the prevalence and correlated factors of high myopia in 19 year-old men in Southeast Korea. METHODS: This retrospective study was based on the medical checkup data of conscription during 2005. The study subjects were 19 years old men in Busan, Ulsan and Gyeongsangnam-do. The health checkup data of the conscripts consisted of noncycloplegic autorefraction test, the biometric data and social factors. To analyze the social and biometric effects, we classified the biometric factors into 4 or 5 groups and the social factors into 3 groups. High myopia was defined as a spherical equivalent of under -6.0 diopter. Data analysis was performed using the chi square test for trends and multiple logistic regression analysis. The SAS(version 9.1) program was used for all the analyses. RESULTS: The prevalence of high myopia was 12.39% (6256 / 50 508). The factors correlated with high myopia were the residence area (OR, 2.07; 95% CI, 1.77 to 2.4 for small city; OR, 2.01; 95% CI, 1.72 to 2.34 for metropolis; the reference group was rural area), academic achievement (OR, 1.43; 95% CI, 1.34 to 1.53 for students of 4-and 6-year-course university; the reference group was high school graduates & under) and blood pressure (OR, 1.54; 95% CI, 1.10 to 2.16 for hypertension; OR, 1.09; 95% CI, 1.02 to 1.17 for prehypertension; OR, 1.10; 95% CI, 1.01 to 1.20 for hypotension; the reference group was normal blood pressure). CONCLUSIONS: More than one tenth of the young men were high myopia as one of the risk factor for visual loss. Further studies on high myopia and its complications are needed to improve eye health in Southeast Korea.

The Relationship between Trust in Healthcare System and Health Examination Participation / 農村醫學 地域保健

OBJECTIVES: This study was conducted to investigate the relationship between vertical trust in the healthcare system and participation in routine health examinations. METHODS: Data from the 2008 Pusan Health Survey were analyzed for this study. Multiple logistic regression analyses were performed to investigate the influence of possible confounders (sex, age, education, monthly mean household income, horizontal trust) on participation in routine health examinations according to trust in the healthcare system. RESULTS: In a total sample of 7,683 participants, 3,756 (48.9%) were classified as health examination participants. Respondents with high trust in the healthcare system had significantly higher odds ratios of participation, 1.17 (95% CI 1.03-1.33), after multiple adjustments. CONCLUSION: Vertical trust in the healthcare system was significantly associated with higher odds of participation in routine health examinations. Improvements to the healthcare system have potential for increasing participation in routine health examinations.

The Association of Abdominal Fat with Serum Insulin and Atherogenic Index for Obese Females

BACKGROUND: The purpose of this study was to find an independent relationship between waist circumference/waist-to-hip ratio which estimates abdominal fat and fasting insulin/atherogenic index which is a predictor of coronary heart disease in obese women. METHODS: The subjects were 80 obese (BMI > or = 25 kg/m2) women. Whole body fat was estimated by body fat mass, % body fat using bioelectrical impedence, and by BMI. Abdominal fat was measured by waist circumference (WC) and waist-to-hip ratio. Fasting insulin was examined and atherogenic index was defined asthe ratio of serum total cholesterol to HDL-cholesterol. Independent association between abdominal fat and insulin/AI was analyzed using partial correlation, multiple regression and Hotelling t-test. RESULTS: Among subjects, 85.7% of obese women had WC greater or equal to 80 cm. The mean BMI was 30.3 kg/m2. The partial correlations between whole body fat and insulin/AI were not significantly different from the partial correlations between abdominal fat and insulin/AI. When age and height were adjusted, partial correlations between abdominal fat and insulin were 0.38 and 0.39. The partial correlations were reduced to 0.15-0.29 after further adjusting for whole body fat. Age and height-adjusted partial correlations between abdominal fat and AI were 0.34 and 0.36. The partial correlations were reduced to 0.11-0.17 when whole body fat was additionally adjusted. Whole body fat explained 9.9-13.7% for variability of insulin; abdominal fat explained 14.2% and 15.9%. Whole body fat explained 12.5-12.8% for variability of AI and abdominal fat explained 11.9%. CONCLUSION: Most of the obese women showed abdominal obesity. Abdominal fat did not seem to be independently associated with fasting insulin and atherogenic index.

Knowledges and Attitudes of College Student to Aquired Immune Deficiency Syndrome / 한국역학회지

OBJECTIVES: Though AIDS is one of the most serious and world-wide health problem, there have been developed no effective control measure but individually oriented prevention. This study was performed to help preparing the efficient control program for college student who are sexually active, considered as a risk group for HIV infection. METHODS: Subjects were 852 college students of one university in Gyungsangnam-do. From September to October 2001, questionnaire survey on the students' knowledge and attitude, and status of health education about AIDS (HEAIDS) was done. Collected data was analyzed using SAS (ver 6.21) program. RESULTS: The subjects were freshman (52.1%) and enrollment (47.9%), with department of medicine (19.1%), nursing (25.8%), health administration (9.1%), business (11.4%), chemical (16.2%), food (8.8%), gymnastics (9.5%). Though about 90% of them agreed with the necessity of HEAIDS, half of them (54.7%) had no experience of HEAIDS and most (88.1%) of them considered it had been insufficient. The informations about AIDS was acquired mainly from TV newspaper (73.0%), but partly from specified health education (16.1%). They have no experience of unsafe sexual contact (96.1%), however, they considered that they can have accidental sexual contact (22.7%) in the future. Response for intention to use of preventative condom use was certainly (66.7%) and questionable (33.3%). About the knowledges on HIV infection and transmission, most of them knew relatively well about no curative medicine (94.8%), infected by sexual contact (85.7%), common use of needle (96.4%), transfusion (95.2%), transplantation (89.8%), longitudinal infection (88.7%). However, the correct answer rate was relatively low in clinical spectrum; can maintain normal life with medical care (31.0%), and some transmission route; kiss (46.9%), cough sneezing (45.8%), common use of bowl towl (49.1%) and bath (43.4%), insect like mosquitos (49.1%), razor (35.4%). The mean level of the knowledges on HIV infection and transmission was 67.5 and 71.6 out of a possible 100, respectively. The knowledge level (p=0.003) and certainty to use of preventable condom use (p=0.001) was higher in HEAIDS experienced group. Experiences to HEAIDS was more in enrollment (50.5%) than freshman (40.5%) (p=0.004), medicine (51.4%) than health (32.1%) and general (41.9%) by department group (p=0.001). With regard to the attitudes on HIV infection, they didn't agreed with 'had intention to check themselves for HIV infection (94.2%)', 'case or suspected case can attend to same school with my children (71.8%)', 'had intention to join in clinical trial of new regimen for AIDS (74.4%)'. CONCLUSIONS: This result showed that present status of HEAIDS for college students is still insufficient. Because the knowledges and attitudes about AIDS are influenced by HEAIDS, professional and efficient education program would be emphasized on the practical level for health protection, eg, preventative condom use. This study has also another meanings to reveal the positive effect and to recall the motive for individual-based prevention

Work Related Musculoskeletal Disorders of Hairdresser / 대한산업의학회지

OBJECTIVES: To determine the prevalence and related factors of work related musculoskeletal symptoms in hairdressers. METHODS: Informations on general characteristics, job strain, and musculoskeletal symptoms were obtained by a self-administered questionnaire, through adopting NIOSH instrument and JCQ(Job content questionnaire), from 267 hairdressers, between March and May, 2000. RESULTS: The symptom prevalence by NIOSH surveillance criteria in total was high as 94.4%; shoulder (61.0%), neck (59.9%), low back (53.2%), hand and wrist (41.6%), etc. In multiple logistic regression, significant factors affecting the symptoms by body region; job insecurity on neck' gender, alcohol, decision latitude on low back; alcohol on hand and wrist; smoking on thigh and knee,' smoking, decision latitude on ankle and foot; job insecurity on upper back. CONCLUSIONS: Musculoskeletal symptoms of hairdresser were highly prevalent, and associated with job strain and their health habits. This is a basic data of work related musculoskeletal disorders among hairdressers who are not the subjects of occupational health service at the present time in Korea.

Comparison of Methods for the Detection of Anti-HBs for Hepatitis B Vaccination Program in Korea / 예방의학회지

OBJECTIVES: The purpose of this study was to suggest a proper method for the detection of heaptitis B surface antibody(anti-HBs) in a screening program for hepatitis B vaccination. METHODS: Sensivitity, specificity and predictive values were compared between Immunochromatographic assay (ICA) and passive hemagglutination(PHA) in 978 subjects(565 males, 413 females, 19-78 years ranging in age, mean 46.5 years old). EIA was used as a standard method for the detection of HBsAb. RESULTS: Sensitivity in the detection of anti-HBs of PHA and ICA was 88.7% and 94.9%, specificity was 94.3% and 96.6%, negative predictive value was 96.5% and 98.0%, and positive predictive value was 82.3% and 91.3%, respectively. False negative rate(11.3%) of PHA was higher than that(5.1%) of ICA. The higher the titer of anti-HBs in EIA was, the lower the false negative rate was. There was no false negative result in the cases with 101mIU/ml or more in EIA. CONCLUSION: We suggest that ICA should be the choice of screening method in the detection of anti-HBs in Hepatitis B vaccination program.

A Study on the Health Status of Korean Vietnam Veterans' Children: A Result of Questionnaire Survey on Vietnam Veterans of Pusan Area Who Diagnosed as Cases by Korean Veteran's Hospital Diagnostic Criteria / 예방의학회지

OBJECTIVES: To propose the referential data to evaluate the health impacts of Vietnam veterans' children whose father were exposed to herbicides in Vietnam War. METHODS: Vietnam veterans who visited to Pusan Veteran Hospital for medical care were recruited from April to October, 1998. They were 71 and asked about their own combat history, symptoms and illness, and health status of their 182 children. The informations were collected by direct and phone interview. Exposure estimation was also performed as exposure score depending on year and unit of participation, and personal episodes related to exposure to herbicide in the war. It classified into three groups; lower( or =53) exposure group. RESULTS: The mean age and the period into the combat of the veterans were 52.8 years and 15.0 months. The mean exposure score was 18.1+/-9.9, and mainly distributed in lower (46.5%) and moderate(52.1%) exposure group. Most(90.1%) of them were diagnosed as sequelae(21 cases) and suspected sequelae(43 cases) of the herbicides by Korean veteran's hospital diagnostic criteria. The major sequelae was peripheral neuropathy 13 cases, chloracne 5 cases, and the major suspected sequelae was hypertension 20 cases, diabetes mellitus 18 cases, liver disease 12 cases, central neuropathy 11 cases, etc. About birth, 42.2% and 16.9% experienced spontaneous abortion and stillbirth, respectively. The mean exposure score was higher in stillbirth experience group(p0.05). CONCLUSIONS: These results were depend on their own answers, and expectation for compensation did not excluded, therefore, this study may have limitations: inaccuracy of informations due to recall bias and response bias. Nevertheless, through this study, we could image the fundamental aspect for health impacts of Vietnam veterans' children for preparing the national control program and policy. A large scale epidemiologic study with valid exposure assessment on the health impacts of Vietnam veterans' children is recommneded.

Factors for Chronic Hepatitis Defined as Elevated Level of Aminotransferases among Koreans / 한국역학회지

Sustained abnormal liver function is closely associated with chronic hepatitis in Korea with high prevalence of hepatitis B infection. Follow up about AST and ALT on 839 adults(male 727, female 112) was executed with interval of at least 6 months for 2 years to evaluate the factors contribute to the progression of chronic hepatitis. HBsAg, HBsAb, anti-HCV, body mass index(BMI), total cholesterol, fasting blood sugar(FBS), Clonorchis sinensis in stool(Cs), fatty liver on abdominal sonogram and alcohol habit were also checked. We defined abnormal liver function as both of AST 35 U/L and ALT 50 U/L. As the result of first time liver function test(LFT), the frequency of abnormal liver function was 13.6%(114/839). The positive rate of HBsAg and HBsAb was 7.0% and 73.9%, respectively, and the positive rate of anti-HCV and Cs was 0.7% and 1.3%. As the result of the follow up, 6.2%(52/839) in total has a tendency of chronic hepatitis with sustained abnormal LFT. Among abnormal LFT, 45.6%(52/114) was sustained LFT abnormality, and 12.8%(93/725) was aggravated LFT abnormality from normal LFT at the first check. From these results, male and hepatitis B infection were evaluated as important factors for the progression of chronic hepatitis. HBsAb considered that has a protective effect to the progression of chronic hepatitis. Therefore, even though no symptoms or sign, periodic examination for hepatitis B marker and LFT is important to control the chronic hepatitis, especially for male. Furthermore, because only 25%(13/52) of sustained abnormal LFT was HBsAg positive, it suggests that further study for evaluating the factors except hepatitis B infection would be needed for the control of chronic hepatitis.

High-resolution CT Findings of Welders' Pneumoconiosis

PURPOSE: To describe the characteristic HRCT appearance and to evaluate the usefulness of HRCT in patients with welders' pneumoconiosis. MATERIALS AND METHODS: Chest radiographs and high-resolution computed tomography(HRCT) of 45 shipyard welders(male : female=41 : 4 ; age : 36-58 years, mean 47.8) with an occupational history of 4-25(mean 15.8) years were evaluated. Small rounded opacities in chest radiographs were read accordingto the ILO standard films(1980). HRCT were evaluated with micronodules, ground-glass attenuation, and other findings. Serial HRCT scans of seven welders taken 27 months apart were also evalauted. Two of these were still working in that job ; five had not worked as welders for 1-6(mean 4.4) years. RESULTS: HRCT of welders' pneumoconiosis showed poorly marginated centrilobular branching or dot opacities of low attenuation(n=36, 80.0%)with variable profusion and extent and ground-glass attenuation(n=8, 17.8%). HRCT abnormalities were seen in 39 welders(86.7%). It was able to depict micronodules(n=13) and/or ground-glass attenuation(n=3) in 15(68.2%) of 22welders with normal chest radiograph. Serial HRCT revealed no changes in parenchymal abnormalities(n=6) andslightly decreased profusion of micronodules(n=1). There was no HRCT abnormality suggesting gross parenchymal fibrosis. CONCLUSION: HRCT is more sensitive than chest radiography in detecting parenchymal changes in welders' pneumoconiosis, with characteristic poorly-marginated centrilobular branching opacities or dots and ground-glass attenuation. These HRCT appearances may be helpful in differentiating welders' pneumoconiosis from other diffuse lung diseases.

Risk Factors of Hypertension and The Effect of These Factors on Blood Pressure / 한국역학회지

This study was conducted to find out the risk factors of hypertension and the effect of thesefactors on blood pressure. The eighteen factors were collected on the subjects of 932 from November 1994 to January 1995 through questionnaire and laboratory test - those were age, sex, education level, body mass index(BMI), family history of hypertension (FHH), triglyceride (TG), blood sugar and lactate dehydrogenase(LDH), etc. The status of blood pressure was classified by the classification of hypertension proposed by Joint National Committee of hypertension, USA. The prevalence of diastolic hypertension was 17.7% and the prevalence of systolic hypertension was 11.6 %. In the frequency analysis on the status of blood pressure, by age, education level, smoking habit, RM, BMI, FBS, LDH, TG, the prevalences were significantly different for both diastolic and systolic hypertension(p(0. 05). By stepwise logistic regression with dichotemization of blood pressure, the following odds ratios were significantly high (p, 0.05) - for diastolic hypertension, age 1.973, BMI 2. 106, FHH 2, 102, LDH 2. 773, TG 1.715, and for systolic hypertension, age 4.414, BMI 1.563, FHH 2.125, RM 0.487, LDH 3.814, TG 2. 707. By multiple regression analysis with blood pressure as dependent variable and these factors as independent variables, the regression equationswere diastolic hypertension =51.07+0.20.age+0.07 BMI+0.02.TG+0.02.LDH+3.22.FHH, and systolic hypertension = 88. 59+0.23.age+0.06.BMI+5.46.FHH-2.62.RM+0.03.LDH+0,03.TG By this study, the significant risk factors of hypertension were age, BMI, TG, family history of hypertension, LDH, and efficient control of hypertension would be expected through control of these factors.

Welder' Pneumoconiosis of Shipyard and related Factors / 대한산업의학회지

Pneumoconiosis is one of the most important occupational disease in Korea. In Pusan, most of pneumoconiosis is welders' pneumoconiosis developed in shipyard. With clinical (including interview with every patients) and radiological (chest radiographs) methods, author purposed to know the factors related to development of pneumoconiosis in shipyard welders and to apply the results to the concept for health care (management) of shipyard welders. The prevalence rate of welders' pneumoconiosis was calculated by the means of reading of chest radiographs of 547 shipyard welders. The prevalence rate of welders' pneumoconiosis (including suspected pneumoconiosis, category 0/1) was 7.9%. It was lower than that (8.9%) in same area studied in 1989. Prevalence rate increased as total welding duration increased and the welding work began early. It was higher in welders who did not use antidust mask. Probability of the occurance of welder's pneumoconiosis was related with the time that the welder began welding work. Sixteen cases among the 37 who were diagnosed as pneumoconiosis returned normal in the follow-up chest radiographs. There was no case aggrevated. The pertinent management for the personnels and their working environment contributed to the decrease of incidence of the welders' pneumoconiosis and the improvement of the disease. To prevent the occurance of the pneumoconiosis in shipyard welders, it seems to be necessary for the company to be supervised under the any legislation and to educate the welder to use the protective apparatus. It is suggested that considerate and continuous observation under the adequate management is preferable to the immediate conversion of the working department for the pneumoconiotic welders.