Pulmonary Functions and Related Factors in Shipyard Workers

조선소 근로자들의 폐기능 관련 요인

  • Park, Mi-Hee (Department of Occupational and Environmental Medicine, College of Medicine & Institute of Environmental and Occupational Medicine, Inje University) ;
  • Suh, Chun-Hui (Department of Occupational and Environmental Medicine, College of Medicine & Institute of Environmental and Occupational Medicine, Inje University) ;
  • Lee, Chae-Gwan (Department of Occupational and Environmental Medicine, College of Medicine & Institute of Environmental and Occupational Medicine, Inje University) ;
  • Son, Byung-Chul (Department of Occupational and Environmental Medicine, College of Medicine & Institute of Environmental and Occupational Medicine, Inje University) ;
  • Kim, Dae-Hwan (Department of Occupational and Environmental Medicine, College of Medicine & Institute of Environmental and Occupational Medicine, Inje University) ;
  • Kim, Jeong-Ho (Department of Occupational and Environmental Medicine, College of Medicine & Institute of Environmental and Occupational Medicine, Inje University) ;
  • Lee, Jong-Tae (Department of Occupational and Environmental Medicine, College of Medicine & Institute of Environmental and Occupational Medicine, Inje University)
  • 박미희 (인제대학교 의과대학 산업의학교실 및 환경.산업의학연구소) ;
  • 서춘희 (인제대학교 의과대학 산업의학교실 및 환경.산업의학연구소) ;
  • 이채관 (인제대학교 의과대학 산업의학교실 및 환경.산업의학연구소) ;
  • 손병철 (인제대학교 의과대학 산업의학교실 및 환경.산업의학연구소) ;
  • 김대환 (인제대학교 의과대학 산업의학교실 및 환경.산업의학연구소) ;
  • 김정호 (인제대학교 의과대학 산업의학교실 및 환경.산업의학연구소) ;
  • 이종태 (인제대학교 의과대학 산업의학교실 및 환경.산업의학연구소)
  • Published : 2011.09.30

Abstract

Objectives: The purpose of this study was to evaluate the factors which affect pulmonary function in shipyard workers in order to build a body of basic information that can be used to prevent and manage pulmonary disorders in the future. Methods: We studied the respiratory symptoms, smoking history, chest radiographies, and pulmonary functions of 793 workers associated with two shipyards from April 2009 to July 2009. The workers were subdivided into 3 groups by job type: welders, grinders, and machinist-managers. The data was analyzed according to job type and other possible impact factors. Results: Significant differences among job type were seen with dyspnea and coughing during working hours and in the morning. In pulmonary functions, there were significant differences in forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF), and maximal midexpiratory flow (MMEF) (except FEV1/FVC%) among job types. Grinders especially showed significantly lower figures in the indices of FEV1, FVC, and MMEF. Conclusions: Pulmonary function was significantly lower in grinders. Grinders seem to be affected by exposure to a combination of dust particles (silica, lead, and manganese) and irritant gases in the workplace. These results suggested that workers and health officials should work together to adopt technical preventive measures, such as having well- ventilated work areas and appropriate respiratory protective devices.

목적: 본 연구에서는 경남 지역 2개 조선소와 그 협력업체 근로자들을 대상으로 폐기능에 영향을 미치는 요인 들을 파악하고, 구체적으로는 용접작업자의 폐기능 저하를 재확인하는 한편, 지금까지 연구가 드물었던 분쇄연마작업자와 다른 작업자의 폐기능을 평가해 보고자 하였다. 방법: 2009년 4월부터 2009년 7월까지 경남 지역 2개 조선소와 그 협력업체에서 근무하는 남성 근로자 793명을 대상으로 건강검진을 통한 설문조사와 신체계측, 흉부방사선 촬영, 폐기능 검사를 수행하였다. 이들 중 한국산업안전보건공단 진폐정도관리지침에 근거하여 적합성과 재현성이 인정되는 675명을 선별한 후 작업에 따라 용접군, 연마군, 기계-관리군으로 세분하였다. 폐기능 측정치와 호흡기 증상은 관련 인자들을 고려하여 단변량분석과 다중회귀분석을 실시하였다. 결과: 호흡기 증상 중 작업 중 기침과 호흡곤란은 연마군에서, 기상시 객담과 기침은 용접군에서 다른 두 군보다 많이 나타났다. 폐기능 검사 결과 $FEV_1$/FVC%을 제외한 폐기능 지표에서 작업공정에 따라 통계적으로 유의한 차이를 보였다. 사후 분석 결과 $FEV_{1},\;FEV_{1}$%, FVC 항목에서 연마군이 기계-관리군보다 유의하게 낮았고 PEF, MMEF, MMEF% 항목에서 연마군이 용접군보다 통계적으로 유의하게 낮았다. 폐기능 결과를 근무기간으로 층화한 후 작업공정에 따라 비교분석한 결과 근무기간이 5년 이하인 경우보다 5년 초과한 경우 작업공정간 폐기능의 차이가 더 잘 나타났다. 폐기능과 관련된 요인을 조사하기 위해 다중회귀분석을 실시한 결과 작업공정은 $FEV_1$, FVC, MMEF에서 유의한 독립변수였고 그중 연마군과 기계-관리군을 비교했을 때 뚜렷한 관련성을 볼 수 있었다. 결론: 조선소 근로자에서는 작업공정, 근무기간과 연령, 신장, 흉부방사선 이상소견 유무가 폐기능과 관련이 있는 인자였다. 특히 작업공정을 비교했을 때는 연마군에서 폐기능의 감소가 유의하게 나타났으며 이것은 연마하는 금속과 연마재에서 발생하는 유리규산과 납, 망간, 니켈 등 각종 금속 입자의 노출과 관련이 있을 것으로 생각된다. 따라서 특수건강검진에서 폐기능을 감시하는 한편, 작업공정에 따른 작업 환경 관리와 보호구 착용 및 보건교육 등의 다각적인 폐기능 관리가 필요할 것이다.

Keywords

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