The Relationship between the Occupational Exposure of Trichloroethylene and Kidney Cancer

Trichloroethylene (TCE) has been widely used as a degreasing agent in many manufacturing industries. Recently, the International Agency for Research on Cancer presented "sufficient evidence" for the causal relationship between TCE and kidney cancer. The aim of this study was to review the epidemiologic evidences regarding the relationship between TCE exposure and kidney cancer in Korean work environments. The results from the cohort studies were inconsistent, but according to the meta-analysis and case-control studies, an increased risk for kidney cancer was present in the exposure group and the dose-response relationship could be identified using various measures of exposure. In Korea, TCE is a commonly used chemical for cleaning or degreasing processes by various manufacturers; average exposure levels of TCE vary widely. When occupational physicians evaluate work-relatedness kidney cancers, they must consider past exposure levels, which could be very high (>100 ppm in some cases) and associated with jobs, such as plating, cleaning, or degreasing. The exposure levels at a manual job could be higher than an automated job. The peak level of TCE could also be considered an important exposure-related variable due to the possibility of carcinogenesis associated with high TCE doses. This review could be a comprehensive reference for assessing work-related TCE exposure and kidney cancer in Korea.

The Association between Nonstandard Employment and Suicidal Ideation: Data from the First~Fourth Korea National Health and Nutrition Examination Surveys / 대한산업의학회지

OBJECTIVES: In light of the high percentage of nonstandard workers and the high suicide rates in South Korea since the 1997 economic crisis, we examined the association between nonstandard employment and suicidal ideation among South Korean employees. METHODS: We analyzed data from the Korean National Health and Nutrition Examination Surveys (KNHANES) I, II, III and IV, conducted in 1998, 2001, 2005 and 2007-2009, respectively (13,632 waged workers aged 20-69 years). Employment status was categorized into standard and nonstandard (part-time, temporary and daily) employment. Prevalence ratios (PRs) for self-reported suicidal ideation were compared between nonstandard and standard workers according to each survey wave. RESULTS: After adjusting for background variables, the risk for suicidal ideation was consistently higher among nonstandard workers in every survey wave. In women, the PRs for suicidal ideation of nonstandard workers compared with standard ones were 1.24~1.37 and all of them were statistically significant. In men, those PRs were 1.36~1.52 with (marginal) statistical significance except for the First KNHANES (1998). Because nonstandard employment is closely related to other factors of suicidal ideation, these estimates are unlikely to have been underestimated. CONCLUSIONS: The findings suggest the impact of employment status on suicidal ideation and the need for further prospective investigation that lead to policies aimed at improving the problematic labor markets.

The Magnitude of Mortality from Ischemic Heart Disease Attributed to Occupational Factors in Korea: Attributable Fraction Estimation Using Meta-analysis

OBJECTIVES: Ischemic heart disease (IHD) is a major cause of death in Korea and known to result from several occupational factors. This study attempted to estimate the current magnitude of IHD mortality due to occupational factors in Korea. METHODS: After selecting occupational risk factors by literature investigation, we calculated attributable fractions (AFs) from relative risks and exposure data for each factor. Relative risks were estimated using meta-analysis based on published research. Exposure data were collected from the 2006 Survey of Korean Working Conditions. Finally, we estimated 2006 occupation-related IHD mortality. RESULTS: For the factors considered, we estimated the following relative risks: noise 1.06, environmental tobacco smoke 1.19 (men) and 1.22 (women), shift work 1.12, and low job control 1.15 (men) and 1.08 (women). Combined AFs of those factors in the IHD were estimated at 9.29% (0.3-18.51%) in men and 5.78% (-7.05-19.15%) in women. Based on these fractions, Korea's 2006 death toll from occupational IHD between the age of 15 and 69 was calculated at 353 in men (total 3,804) and 72 in women (total 1,246). CONCLUSION: We estimated occupational IHD mortality of Korea with updated data and more relevant evidence. Despite the efforts to obtain reliable estimates, there were many assumptions and limitations that must be overcome. Future research based on more precise design and reliable evidence is required for more accurate estimates.

The Effects of Smoking and Drinking on Blood Lead and Cadmium Levels: Data from the Fourth Korea National Health and Nutrition Examination Survey / 대한산업의학회지

OBJECTIVES: The purpose of this study is to assess the effects of smoking and drinking on blood lead and cadmium levels based on a dose-response relationship in the general Korean adult population. METHODS: The study population consisted of 1,901 Koreans, who took part in the 2008 Korean National Health and Nutrition Examination Survey, in which blood lead and cadmium levels were measured. Geometric mean concentrations and their 95% confidence intervals of metals in blood were estimated by analysis of covariance (ANCOVA) adjusting for demographic and lifestyle factors. RESULTS: We observed a statistically significant dose-response relationship with daily smoking amount/alcohol intake and blood lead/cadmium levels. While daily smoking amount was more consistent with blood cadmium level (0.1-0.2 microg/L per 5 cigarettes), blood lead concentrations were higher as daily alcohol intake increased (0.1-0.2 microg/dL per 10 gram of alcohol). CONCLUSIONS: Our findings clearly support a relationship between daily smoking amount/alcohol intake and blood lead/cadmium levels, suggesting an additional reason towards efforts to reduce smoking and drinking habits.

Cement Burn from Waterproof Work: A Case Study / 대한산업의학회지

BACKGROUND: Portland cement, which is a common material used in the construction industry, is known to cause caustic burns due to its alkalinity. Although cement burns are frequent and can be severe, many workers are inadequately aware of its risks. CASE: A 39-year-old man presented with exudative lesions and pain on his right hand after working with wet cement during waterproof work. The patient stated that wet cement entered his protective glove and he did not wash the cement off for 3 hours. Debridement of necrotic tissue and skin grafting was performed on his second and fifteenth hospital day respectively. CONCLUSION: The prevention of cement burns can be improved by extensive risk instruction and the provision of adequate skin protection.

Job Stress and Psychosocial Stress among Firefighters / 대한산업의학회지

OBJECTIVES: This study was performed to assess the level of job and psychosocial stresses in Korean firefighters, and to evaluate the determinants of psychosocial stress. METHODS: The study subjects comprised 1,712 male firefighters working in Seoul, Busan, and Kyungnam in 2006. We collected information about demographic and job-related characteristics, healthrelated behaviors, Korean Occupational Stress Scale (KOSS), and psychosocial Well-being Index (PWI) through self-administered questionnaires. Statistical analyses were done by using the chi-square-test and logistic regression model. RESULTS: The multiple logistic regression analyses indicated that the proportion of high-risk psychosocial stress is significantly higher in the groups with high job stress level in 'lack of rewards' (OR=2.90, 95% CI=2.18-3.85), 'occupational climate' (OR=1.92, 95% CI=1.47-2.51), 'job demand' (OR=1.72, 95% CI=1.32-2.23), 'job insecurity' (OR=1.53, 95% CI=1.17-2.01), 'interpersonal conflict' (OR=1.53, 95% CI=1.16-2.01), 'physical environment' (OR=1.45, 95% CI=1.11-1.89), and 'organizational injustice' (OR=1.38, 95% CI=1.04-1.85). CONCLUSIONS: Psychosocial stress might be adversely influenced by job stressors for the most part. Firefighters need job stress management to minimize their psychological problems.