Trends in Occupational Infectious Diseases in South Korea and Classification of Industries According to the Risk of Biological Hazards Using K-Means Clustering.

Against the backdrop of the COVID-19 pandemic, it is necessary to identify these risks and determine whether the current level of management is appropriate to respond to the risk of biological hazards depending on the occupation. In this study, the incidence and fatality rates of occupational diseases were calculated using industrial accident statistics of South Korea, and trends by year using joinpoint regression and relative risk by industry using k-means clustering were evaluated for infectious diseases. We found that infectious diseases had the third highest incidence and fourth highest fatalities among all occupational diseases. In the incidence rate, joinpoints appeared in 2009 and 2018, and the annual percent change changed to 7.79, -16.63, and 82.11. The fatality rate showed a consistent increase with an annual percent change of 4.37, but it was not significant. Industries were classified into five groups according to risk, and the legal control measures of certain industries were not sufficient. Follow-up studies are needed to rectify the structural limitations of industrial accident statistics.

Review and Improvement of Chemical Hazard Risk Management of Korean Occupational Safety and Health Agency.

In 2012, the Korean Occupational Safety and Health Agency developed Chemical Hazard Risk Management (CHARM) as a risk assessment tool. This study aims to reorganize the CHARM technique by complementing its logical loopholes, while evaluating the risk to enterprises and verifying this technique by applying it to some enterprises in Korea. The optimized technique changed the method of quantitative assessment and evaluation criteria, matched the risk level with the required control level, and specified the use of control practice. For the target enterprises, for several assessment methods, risk levels, hazard bands, exposure bands, and the risk assessment results were derived, and the same types of options were compared. Fewer informational methods resulted in more conservative results of risk levels and hazard bands. Since the control status of the enterprises could not be confirmed and the substances handled at the target enterprises were limited in this study, a follow-up study should be performed with more target materials and additional information on the current control status of the enterprises.

Comparison of the Qualitative and the Quantitative Risk Assessment of Hazardous Substances Requiring Management under the Occupational Safety and Health Act in South Korea.

The risk assessment of hazardous substances has become increasingly important for the efficient prevention and management of various diseases or accidents caused by increased amounts of hazardous substances in the workplace. In this study, risk assessment was conducted for 36 kinds of hazardous substances requiring management by using qualitative and quantitative risk assessments. Qualitative risk assessment was performed by multiplying the exposure level class by the hazard class according to the Korea Occupational Safety and Health Agency's (KOSHA) Chemical Hazard Risk Management (CHARM). The quantitative risk assessment was followed by a four-step risk assessment system presented in the Guidelines for Hazard Risk Assessment of Chemicals (KOSHA GUIDE W-6-2016). In the quantitative assessments, we presented a new method of classifying risk levels into four steps, much like qualitative assessments. In this study, the quantitative risk assessment was considered difficult to predict through qualitative risk assessment. Therefore, it is necessary to perform a quantitative risk assessment after a qualitative risk assessment for a higher level of risk assessment.

Remifentanil-based propofol-supplemented vs. balanced sevoflurane-sufentanil anesthesia regimens on bispectral index recovery after cardiac surgery: a randomized controlled study.

BACKGROUND: The present study was to compare the potential impact of remifentanil-based propofol-supplemented anesthesia regimen vs. conventional sevoflurane-sufentanil balanced anesthesia on postoperative recovery of consciousness indicated by bispectral index (BIS) values in patients undergoing cardiac surgery. METHODS: Patients undergoing cardiac surgery were randomly allocated to get the remifentanil-based propofol-supplemented anesthesia employing target-controlled infusion (TCI) of remifentanil and propofol (Group-PR, n = 15) or a balanced-anesthesia employing sevoflurane-inhalation and TCI-sufentanil (Group-C, n = 19). In Group-PR, plasma concentration (Cp) of TCI-remifentanil was fixed at 20 ng/ml, and the effect-site concentration of TCI-propofol was adjusted within 0.8-2.0 µg/ml to maintain BIS value of 40-60. In Group-C, sevoflurane dosage was adjusted within 1-1.5 minimum alveolar concentration to maintain BIS of 40-60, and Cp of TCI-sufentanil was fixed at 0.4 ng/ml. The inter-group difference in the time for achieving postoperative BIS > 80 (T-BIS80) in the intensive care unit was determined as the primary outcome. The inter-group difference in the extubation time was determined as the secondary outcome. RESULTS: T-BIS80, was shorter in Group-PR than Group-C (121.4 ± 64.9 min vs. 182.9 ± 85.1 min, respectively; the difference of means -61.5 min; 95% CI -115.7 to -7.4 min; effect size 0.812; P = 0.027). The extubation time was shorter in Group-PR than in Group-C (434.7 ± 131.3 min vs. 946.6 ± 393.3 min, respectively, P < 0.001). CONCLUSIONS: Compared with the conventional sevoflurane-sufentanil balanced anesthesia, the remifentanil-based propofol-supplemented anesthesia showed significantly faster postoperative conscious recovery in patients undergoing cardiac surgery.

Development and Verification of a Risk Index for Evaluating the Chemical Accident Risk of Korean Chemical Enterprises.

The scale of the damage due to chemical accidents in Korea is significant, and appropriate preparation and response are required. Currently, Korean enterprises are managed on the basis of the presence of certain substances. However, chemicals other than these also cause chemical accidents. It is necessary to develop a relative ranking risk index that can be calculated through use of the chemical enterprise information on chemical enterprises that is available. The Korean chemical accident risk index (KCARI), which consists of the flammability, reactivity, explosiveness, corrosiveness, toxicity, and inventory sub-indices, was developed and verified by determining the for difference in KCARI was performed by accident, and accident severity category, calculating the correlation between the KCARI values, the factors, and some sub-indices, determining how an increase in the KCARI would impact how the incident rate changed as KCARI increased and how well the KCARI can predict the chemical accident risk of chemical handling enterprises, and confirming the consistency of the proposed index and the current system. These results indicated that the frequency and severity of chemical accidents, and the presence of accidental substances, showed significant differences in the KCARI values. However, there were limitations in the ability of the fitted model to precisely predict the accident. Thus, this model can be used as a tool for the early screening and management of enterprises with a high risk of chemical accident.

Exposure monitoring and risk assessment of biphenyl in the workplace.

This study was performed to assess exposure to and the risk caused by biphenyl in the workplace. Biphenyl is widely used as a heat transfer medium and as an emulsifier and polish in industry. Vapor or high levels of dust inhalation and dermal exposure to biphenyl can cause eye inflammation, irritation of respiratory organs, and permanent lesions in the liver and nervous system. In this study, the workplace environment concentrations were assessed as central tendency exposure and reasonable maximum exposure and were shown to be 0.03 and 0.12 mg/m³, respectively. In addition, the carcinogenic risk of biphenyl as determined by risk assessment was 0.14 × 10⁻4 (central tendency exposure) and 0.56 × 10⁻4 (reasonable maximum exposure), which is below the acceptable risk value of 1.0 × 10⁻4. Furthermore, the central tendency exposure and reasonable maximum exposure hazard quotients were 0.01 and 0.06 for oral toxicity, 0.05 and 0.23 for inhalation toxicity, and 0.08 and 0.39 for reproduction toxicity, respectively, which are all lower than the acceptable hazard quotient of 1.0. Therefore, exposure to biphenyl was found to be safe in current workplace environments. Because occupational exposure limits are based on socioeconomic assessment, they are generally higher than true values seen in toxicity experiments. Based on the results of exposure monitoring of biphenyl, the current occupational exposure limits in Korea could be reviewed.

Comparison of chemical risk assessment methods in South Korea and the United Kingdom.

OBJECTIVES: The objective of this study was to compare Control of Substances Hazard to Health (COSHH) Essentials (a chemical risk assessment method in the UK) with Chemical Hazard Risk Management (CHARM) (a chemical risk assessment method in South Korea). The differences between the two processes were explored with a particular focus on their features and distinctions. METHODS: The results obtained from applying COSHH Essentials and CHARM to 59 carcinogenic, mutagenic, and reprotoxic (CMR) substances were analyzed. The outcomes of the working environment assessments and the collated information about the usage of CMR chemicals were used for the analysis. RESULTS: Among the 59 substances tested, 56 substances were rated at a risk level lower than 2, when evaluated with CHARM. However, with COSHH, all 59 substances were rated at risk level 3 or higher. With COSHH Essentials, the highest hazard group of 4 was automatically assigned to category E substances, regardless of the exposure level assessment. However, for CHARM, the risk could be adjusted according to the exposure level assessment, even for hazard group of 4. CONCLUSIONS: CHARM allocated lower risk levels to hazardous substances than COSHH Essentials. Ultimately, COSHH Essentials assesses exposure level through the physical properties and overall handling, and considers hazard with H-statements and R-phrases. COSHH Essentials was deemed more conservative than CHARM. CHARM may have underestimated the risk according to exposure level, even though the chemicals were highly hazardous. Therefore, CHARM can be used for the localized risk assessment of chemicals used in individual workplaces.

A chemical risk ranking and scoring method for the selection of harmful substances to be specially controlled in occupational environments.

This study aimed to devise a method for prioritizing hazardous chemicals for further regulatory action. To accomplish this objective, we chose appropriate indicators and algorithms. Nine indicators from the Globally Harmonized System of Classification and Labeling of Chemicals were used to identify categories to which the authors assigned numerical scores. Exposure indicators included handling volume, distribution, and exposure level. To test the method devised by this study, sixty-two harmful substances controlled by the Occupational Safety and Health Act in Korea, including acrylamide, acrylonitrile, and styrene were ranked using this proposed method. The correlation coefficients between total score and each indicator ranged from 0.160 to 0.641, and those between total score and hazard indicators ranged from 0.603 to 0.641. The latter were higher than the correlation coefficients between total score and exposure indicators, which ranged from 0.160 to 0.421. Correlations between individual indicators were low (-0.240 to 0.376), except for those between handling volume and distribution (0.613), suggesting that each indicator was not strongly correlated. The low correlations between each indicator mean that the indicators and independent and were well chosen for prioritizing harmful chemicals. This method proposed by this study can improve the cost efficiency of chemical management as utilized in occupational regulatory systems.