Evaluation of the effect of photoplethysmograms on workers' exposure to methyl bromide using second derivative.

Methyl bromide (MB) is worldwide the only effective fumigant heavily used for quarantine pre-shipment treatment and has a critical use exemption for soil fumigations due to its excellent permeability and insecticidal effect. However, MB should be replaced as it is an an ozone-depleting substance and also highly toxic to humans. Recently, MB has been shown to be hazardous even for asymptomatic workers, affecting their central and autonomic nervous systems. However, the effects of MB exposure on vascular health have not been explored. This study aimed to determine whether MB affects the arterial system of asymptomatic workers. We measured the second derivative of the photoplethysmogram (SDPTG) indices, which are indicators of vascular load and aging, and urinary bromide ion (Br-) concentrations in 44 fumigators (study group) and 20 inspectors (control group) before and after fumigation. In fumigators, the mean values of post-work SDPTG indices (b/a, c/a, d/a, e/a, and SDPTG aging index) and Br- levels were significantly changed compared to their pre-work values (p < 0.05), indicating a negative effect on their cardiovascular health. In contrast, SDPTG indices and Br- levels in inspectors did not show any differences before and after work. All SDPTG indices except c/a showed significant correlations with Br- levels in all individuals (p < 0.05). In conclusion, the Br- levels and SDPTG indices of fumigators varied after MB work, and they experienced negative effects on their health despite being asymptomatic.

Resting-state prefrontal EEG biomarker in correlation with postoperative delirium in elderly patients.

Postoperative delirium (POD) is associated with adverse outcomes in elderly patients after surgery. Electroencephalography (EEG) can be used to develop a potential biomarker for degenerative cerebral dysfunctions, including mild cognitive impairment and dementia. This study aimed to explore the relationship between preoperative EEG and POD. We included 257 patients aged >70 years who underwent spinal surgery. We measured the median dominant frequency (MDF), which is a resting-state EEG biomarker involving intrinsic alpha oscillations that reflect an idle cortical state, from the prefrontal regions. Additionally, the mini-mental state examination and Montreal cognitive assessment (MoCA) were performed before surgery as well as 5 days after surgery. For long-term cognitive function follow up, the telephone interview for cognitive status™ (TICS) was performed 1 month and 1 year after surgery. Fifty-two (20.2%) patients were diagnosed with POD. A multivariable logistic regression analysis that included age, MoCA score, Charlson comorbidity index score, Mini Nutritional Assessment, and the MDF as variables revealed that the MDF had a significant odds ratio of 0.48 (95% confidence interval 0.27-0.85). Among the patients with POD, the postoperative neurocognitive disorders could last up to 1 year. Low MDF on preoperative EEG was associated with POD in elderly patients undergoing surgery. EEG could be a novel potential tool for identifying patients at a high risk of POD.

Prefrontal EEG slowing, synchronization, and ERP peak latency in association with predementia stages of Alzheimer's disease.

Background: Early screening of elderly individuals who are at risk of dementia allows timely medical interventions to prevent disease progression. The portable and low-cost electroencephalography (EEG) technique has the potential to serve it. Objective: We examined prefrontal EEG and event-related potential (ERP) variables in association with the predementia stages of Alzheimer's disease (AD). Methods: One hundred elderly individuals were recruited from the GARD cohort. The participants were classified into four groups according to their amyloid beta deposition (A+ or A-) and neurodegeneration status (N+ or N-): cognitively normal (CN; A-N-, n = 27), asymptomatic AD (aAD; A + N-, n = 15), mild cognitive impairment (MCI) with AD pathology (pAD; A+N+, n = 16), and MCI with non-AD pathology (MCI(-); A-N+, n = 42). Prefrontal resting-state eyes-closed EEG measurements were recorded for five minutes and auditory ERP measurements were recorded for 8 min. Three variables of median frequency (MDF), spectrum triangular index (STI), and positive-peak latency (PPL) were employed to reflect EEG slowing, temporal synchrony, and ERP latency, respectively. Results: Decreasing prefrontal MDF and increasing PPL were observed in the MCI with AD pathology. Interestingly, after controlling for age, sex, and education, we found a significant negative association between MDF and the aAD and pAD stages with an odds ratio (OR) of 0.58. Similarly, PPL exhibited a significant positive association with these AD stages with an OR of 2.36. Additionally, compared with the MCI(-) group, significant negative associations were demonstrated by the aAD group with STI and those in the pAD group with MDF with ORs of 0.30 and 0.42, respectively. Conclusion: Slow intrinsic EEG oscillation is associated with MCI due to AD, and a delayed ERP peak latency is likely associated with general cognitive impairment. MCI individuals without AD pathology exhibited better cortical temporal synchronization and faster EEG oscillations than those with aAD or pAD. Significance: The EEG/ERP variables obtained from prefrontal EEG techniques are associated with early cognitive impairment due to AD and non-AD pathology. This result suggests that prefrontal EEG/ERP metrics may serve as useful indicators to screen elderly individuals' early stages on the AD continuum as well as overall cognitive impairment.

Usual Interstitial Pneumonia Associated With Crystalline Silica Exposure in Pneumoconiosis: A Retrospective Cohort Study.

OBJECTIVE: We aimed to identify a relation between the level of silica exposure and the associated increase in the risk of radiologic usual interstitial pneumonia (UIP) pattern. METHODS: We selected data of 796 individuals with pneumoconiosis who had undergone a chest computed tomography (CT). We estimated the silica exposure by comparing their occupational history with the data silica dust exposure. RESULTS: Individuals employed as stonemasons demonstrated a 2.30-fold increase in the risk of developing UIP than coal mine workers (odds ratio [OR], 2.30; 95% confidence interval [CI], 1.04 to 5.07). The high silica exposure group was associated with a 2.23-fold increase in the risk of developing UIP than the low silica exposure group (OR, 2.23; 95% CI, 1.07 to 4.69). CONCLUSIONS: This study suggests that silica exposure is associated with an increased risk of developing UIP pattern, highlighting a dose-response relationship.

Occupational exposure to respirable crystalline silica in municipal household waste collection and road cleaning workers.

Despite the increase in the number of cases among South Korean sanitation workers, lung cancer as a result of exposure to occupational carcinogen has not been sufficiently investigated. This study aimed to identify exposure levels of sanitation workers to respirable crystalline silica (RCS) for various tasks and factors that affect individual RCS exposure. Exposure to RCS was assessed for 90 sanitation workers from seven companies. The obtained geometric mean value of the RCS was 2.6 µg m-3, which is a similar level to recommendations set by California's Office of Environmental Health Hazard Assessment's Recommended Exposure Limit. Meanwhile, coal briquette ash (CBA) collectors exhibited the highest RCS concentration (24 µg m-3), followed by road cleaning workers who used a blower, municipal household waste collectors, sweepers, and drivers (p < 0.05). Additionally, when the ANOVA was conducted, statistically significant differences were observed in RCS concentrations among various factors such as job task, season, employment type and city scale. Our study confirmed that sanitation workers who work outdoors could be exposed to RCS. Due to the possibility of exposure to high RCS concentrations, special attention should be paid to the collection of used CBA and road cleaning involving the use of a blower.

Psycho-Electrophysiological Benefits of Forest Therapies Focused on Qigong and Walking with Elderly Individuals.

We developed two distinct forest therapy programs (FTPs) and compared their effects on dementia prevention and related health problems for older adults. One was focused on Qigong practice in the forest (QP) and the other involved active walking in the forest (WP). Both FTPs consisted of twelve 2-h sessions over six weeks and were conducted in an urban forest. We obtained data from 25, 18, and 26 participants aged 65 years or above for the QP, WP, and control groups, respectively. Neuropsychological scores via cognition (MoCA), geriatric depression (GDS) and quality of life (EQ-5D), and electrophysiological variables (electroencephalography, bioimpedance, and heart rate variability) were measured. We analyzed the intervention effects with a generalized linear model. Compared to the control group, the WP group showed benefits in terms of neurocognition (increases in the MoCA score, and alpha and beta band power values in the electroencephalogram), sympathetic nervous activity, and bioimpedance in the lower body. On the other hand, the QP group showed alleviated depression and an increased bioimpedance phase angle in the upper body. In conclusion, both active walking and Qigong in the forest were shown to have distinctive neuropsychological and electrophysiological benefits, and both had beneficial effects in terms of preventing dementia and relieving related health problems for elderly individuals.

Assessment of Occupational Exposure to Indium Dust for Indium-Tin-Oxide Manufacturing Workers.

According to recent research, indium nanoparticles (NPs) are more toxic than micro-sized particles. While cases of indium lung disease have been reported worldwide, very little research has been conducted on the occupational exposure to indium NPs. Recently, an indium-related lung disease was reported in Korea, a global powerhouse for display manufacturing. In this study, we conducted an assessment ofoccupational exposure at an indium tin oxide (ITO) powder manufacturing plant, where the first case of indium lung disease in Korea occurred. Airborne dustwas obtained from a worker's breathing zone, and area sampling in the workplace environment was conducted using real-time monitoring devices. Personal samples were analyzed for the indium concentrations in total dust, respirable dust fraction, and NPs using personal NPs respiratory deposition samplers. The total indium concentration of the personal samples was lower than the threshold limit value recommended by the American Conference of Governmental Industrial Hygienists (ACGIH TLV), which was set as occupational exposure limit (OEL). However, the respirable indium concentration exceeded the recently set ACGIH TLV for the respirable fraction of indium dust. The concentration of indium NPs ranged between 0.003 and 0.010 × 10-2 mg/m3, accounting for only 0.4% of the total and 2.7% of the respirable indium particles. This was attributed to the aggregating of NPs at the µm sub-level. Given the extremely low fraction of indium NPs in the total and respirable dust, the current OEL values, set as the total and respirable indium concentrations, do not holistically represent the occupational exposure to indium NPs or prevent health hazards. Therefore, it is necessary to set separate OEL values for indium NPs. This study covers only the process of handling ITO powder. Therefore, follow-up studies need to be conducted on other ITO sputtering target polishing and milling processes, which typically generate more airborne NPs, to further investigate the effects of indium on workers and facilitate the necessary implementation of indium-reducing technologies.

Predicting Dementia With Prefrontal Electroencephalography and Event-Related Potential.

Objective: To examine whether prefrontal electroencephalography (EEG) can be used for screening dementia. Methods: We estimated the global cognitive decline using the results of Mini-Mental Status Examination (MMSE), measurements of brain activity from resting-state EEG, responses elicited by auditory stimulation [sensory event-related potential (ERP)], and selective attention tasks (selective-attention ERP) from 122 elderly participants (dementia, 35; control, 87). We investigated that the association between MMSE and each EEG/ERP variable by using Pearson's correlation coefficient and performing univariate linear regression analysis. Kernel density estimation was used to examine the distribution of each EEG/ERP variable in the dementia and non-dementia groups. Both Univariate and multiple logistic regression analyses with the estimated odds ratios were conducted to assess the associations between the EEG/ERP variables and dementia prevalence. To develop the predictive models, five-fold cross-validation was applied to multiple classification algorithms. Results: Most prefrontal EEG/ERP variables, previously known to be associated with cognitive decline, show correlations with the MMSE score (strongest correlation has |r| = 0.68). Although variables such as the frontal asymmetry of the resting-state EEG are not well correlated with the MMSE score, they indicate risk factors for dementia. The selective-attention ERP and resting-state EEG variables outperform the MMSE scores in dementia prediction (areas under the receiver operating characteristic curve of 0.891, 0.824, and 0.803, respectively). In addition, combining EEG/ERP variables and MMSE scores improves the model predictive performance, whereas adding demographic risk factors do not improve the prediction accuracy. Conclusion: Prefrontal EEG markers outperform MMSE scores in predicting dementia, and additional prediction accuracy is expected when combining them with MMSE scores. Significance: Prefrontal EEG is effective for screening dementia when used independently or in combination with MMSE.

Heart Rate Variability Analysis in Workers Exposed to Methyl Bromide as a Quarantine Treatment.

OBJECTIVE: To determine whether methyl bromide (MB) fumigation work for plants imported in Korea affects workers' health by assessing heart rate variability (HRV). METHODS: We measured HRV indices (TP, VLF, LF, HF, HR, SDNN, pNN50 and HRV-index) and urinary bromide ion (Br-) in 62 fumigators (study group) and 34 inspectors (the control group) before and after fumigation work. In addition, the relationship between Br- concentration and HRV indices was analysed. RESULTS: The fumigators' post-work HRV indices and Br- level were changed compared with their pre-work values (P < 0.001). Conversely, inspectors' values were not shown a difference before and after work. The HRV indices in all subjects were negatively correlated with the Br- levels (P < 0.05). CONCLUSIONS: Fumigators with high Br- concentrations and low post-work HRV indices following MB fumigation work experienced adverse effects on their autonomic nervous systems.

Declining Trends of Heart Rate Variability According to Aging in Healthy Asian Adults.

Heart rate variability (HRV) indices correlate with aging and are related to the autonomic nervous system. However, the trend of HRV with age has not been explored for the Asian population. Therefore, we proposed a linear regression model of HRV indices that decreased with aging in healthy Asian adults. HRV parameters [High frequency (HF), Low frequency (LF), Very low frequency (VLF), Total power (TP), HRV triangular index (HRV-index), Standard deviation of the normal-to-normal interval (SDNN), and Proportion of normal-to-normal intervals greater than 50 ms (pNN50)] were measured in a total of 300 healthy participants (150 men and 150 women) aged 19-69 years stratified into five age groups: 19-29, 30-39, 40-49, 50-59, and 60-69 years comprising 60 people each in Seoul, South Korea. A simple regression analysis was performed to reveal the linear declining trend of HRV indices with age. Independent t-tests were conducted to investigate the gender differences in HRV values depending on each age group. The values of all HRV indices showed a decreasing trend with age in healthy Korean adults, as observed in the Western population (P < 0.001 for all indices); HF (Y = -0.039x + 6.833, R 2 = 0.287), LF (Y = -0.047x + 7.197, R 2 = 0.414), VLF (Y = -0.025x + 6.861, R 2 = 0.177), TP (Y = -0.034x + 8.082, R 2 = 0.352), HRV-index (Y = -0.125x + 15.628, R 2 = 0.298), SDNN (Y = -0.502x + 53.907, R 2 = 0.343), and pNN50 (Y = -0.650x + 53.852, R 2 = 0.345) all decreased with age. There was no significant gender difference in any HRV parameter. A linear regression model of various HRV indices has been presented considering the age of healthy Asians, which may be useful to prevent diseases related to the autonomic nervous system by estimating or tracking autonomic functional degeneration in the Asian population.

Negative effect of methyl bromide fumigation work on the central nervous system.

Methyl bromide (MB) is a fumigant that has been widely used for killing pests on plants in trade, soils, and structures worldwide due to its excellent permeability and insecticidal effect; however, MB should be replaced because it is an ozone-depleting substance. It is well-known that MB is highly toxic and hazardous to workers, but the effects of exposure in asymptomatic workers have not been explored. The purpose of this study is to investigate the impact of MB fumigation on the health of fumigators at a sensitive level. The electroencephalogram (EEG) and urinary bromide ion levels of 44 fumigators (the study group) and 20 inspectors (the control) were measured before and after fumigation work from February to August 2019 in Busan, Korea. The mean post-work concentration of bromide ion (18.311 µg/mg CRE) in the fumigators was significantly increased from the pre-work level (7.390 µg/mg CRE) (P<0.001). The fumigator post-work median frequencies (MDF) and alpha-to-theta ratios (ATR) of EEG index were significantly decreased compared to the pre-work values (P<0.05 for all indices). In contrast, there were no significant differences in inspector EEG indices and urinary bromide ion. The urinary bromide ion levels in all the subjects were negatively correlated with MDF (P = 0.032). In conclusion, fumigators' EEG indices and urinary bromide ion suggested that occupational exposure to MB negatively affected the health of workers, although the workers were asymptomatic.

Assessing the Retest Reliability of Prefrontal EEG Markers of Brain Rhythm Slowing in the Eyes-Closed Resting State.

Objective. We examined whether prefrontal lobe EEG markers of slower brain rhythms, which are correlated with functional brain aging, can reliably reflect those of other brain lobes, as measured by a multichannel device. Methods. EEG measurements were taken of 112 healthy individuals aged 20 to 69 years in the eyes-closed resting state. A 5-minute measurement was taken at 8 regions (Fp1, Fp2, F3, F4, T3, T4, O1, O2). Indices (median frequency [MDF], peak frequency [PF]) that quantitatively reflect the characteristics of EEG slowing, and traditional commonly used spectral indices (absolute powers as delta, theta, alpha, beta, and relative power as alpha-to-theta ratio [ATR]), were extracted from the EEG signals. For these indices, the differences between the prefrontal lobe and other areas were analyzed and the test-retest reproducibility was investigated. Results. The EEG slowing indicators showed high conformity over all brain lobes and stable reproducibility. On the other hand, the typical EEG spectral indicators delta, theta, alpha, beta, and ATR differed between brain regions. Conclusion. It was found that EEG slowing markers, which were used for assessing the aging or degeneration of brain functions, could be reliably extracted from a prefrontal EEG alone. Significance. These findings suggest that EEG prefrontal markers may reflect markers of other brain regions when a multi-channel device is used. Thus, this method may constitute a low-cost, wearable, wireless, easily accessible, and noninvasive tool for neurological assessment that could be used in the early detection of cognitive decline and in the prevention of dementia.

Traditional Korean Medicine-Based Forest Therapy Programs Providing Electrophysiological Benefits for Elderly Individuals.

We aimed to develop forest therapy programs (FTPs) to prevent dementia and related health problems in the elderly population, with the assumption that health benefits are FTP-type specific and depend on the participant's psychophysiological traits. For this purpose, we developed two distinct FTPs, namely, a guided-breathing meditation program (BP) and a walking program (WP); we adopted the approach of Sasang constitutional (SC) medicine, which categorizes individuals into one of three SC types (SC1, SC2, or SC3) for medical care. The FTPs ran 11 sessions over 11 weeks. We recruited 29/31/28 participants who were 65 years of age or older for the BP/WP/control groups, respectively; obtained electrophysiological measurements via electroencephalogram (EEG), heart rate variability (HRV), and bioimpedance; and analyzed the intervention effects with analysis of covariance. Compared with the control, the BP and WP resulted in benefits for neural activity and parasympathetic nervous activity (PNA), respectively, and both FTPs yielded distinct beneficial effects on bioimpedance. Constitution-specific effects were also present. The SC1- and SC2-type participants gained positive effects in neural activity from the BP and WP, respectively. The SC3-type participants showed improvements in PNA from the WP. In conclusion, for older individuals, both programs conferred health benefits that would help prevent dementia, and the benefits were program-specific and constitution-specific.

Resting-state prefrontal EEG biomarkers in correlation with MMSE scores in elderly individuals.

We investigated whether cognitive decline could be explained by resting-state electroencephalography (EEG) biomarkers measured in prefrontal regions that reflect the slowing of intrinsic EEG oscillations. In an aged population dwelling in a rural community (total = 496, males = 165, females = 331), we estimated the global cognitive decline using the Mini-Mental State Examination (MMSE) and measured resting-state EEG parameters at the prefrontal regions of Fp1 and Fp2 in an eyes-closed state. Using a tertile split method, the subjects were classified as T3 (MMSE 28-30, N = 162), T2 (MMSE 25-27, N = 179), or T1 (MMSE ≤ 24, N = 155). The EEG slowing biomarkers of the median frequency, peak frequency and alpha-to-theta ratio decreased as the MMSE scores decreased from T2 to T1 for both sexes (-5.19 ≤ t-value ≤ -3.41 for males and -7.24 ≤ t-value ≤ -4.43 for females) after adjusting for age and education level. Using a double cross-validation procedure, we developed a prediction model for the MMSE scores using the EEG slowing biomarkers and demographic covariates of sex, age and education level. The maximum intraclass correlation coefficient between the MMSE scores and model-predicted values was 0.757 with RMSE = 2.685. The resting-state EEG biomarkers showed significant changes in people with early cognitive decline and correlated well with the MMSE scores. Resting-state EEG slowing measured in the prefrontal regions may be useful for the screening and follow-up of global cognitive decline in elderly individuals.

Extremely Low Frequency-Magnetic Field (ELF-MF) Exposure Characteristics among Semiconductor Workers.

We assessed the exposure of semiconductor workers to extremely low frequency-magnetic fields (ELF-MF) and identified job characteristics affecting ELF-MF exposure. These were demonstrated by assessing the exposure of 117 workers involved in wafer fabrication (fab) and chip packaging wearing personal dosimeters for a full shift. A portable device was used to monitor ELF-MF in high temporal resolution. All measurements were categorized by operation, job and working activity during working time. ELF-MF exposure of workers were classified based on the quartiles of ELF-MF distribution. The average levels of ELF-MF exposure were 0.56 µT for fab workers, 0.59 µT for chip packaging workers and 0.89 µT for electrical engineers, respectively. Exposure to ELF-MF differed among types of factory, operation, job and activity. Workers engaged in the diffusion and chip testing activities showed the highest ELF-MF exposure. The ELF-MF exposures of process operators were found to be higher than those of maintenance engineers, although peak exposure and/or patterns varied. The groups with the highest quartile ELF-MF exposure level are operators in diffusion, ion implantation, module and testing operations, and maintenance engineers in diffusion, module and testing operations. In conclusion, ELF-MF exposure among workers can be substantially affected by the type of operation and job, and the activity or location.