• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.20 no.3
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• pp.156-167
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• 2010

To evaluate the effect of lead biomarkers including bone lead on neurobehavioral test in retired lead workers, 131 retired lead workers without any occupational exposure to organic solvent, mercury and arsenic were agreed to participate this study. For the control subjects 56 non-occupationally lead exposed subjects were recruited from same area of retired lead workers with consideration of demographic characteristics. The mean levels of blood and bone lead of retired lead workers were significantly higher than control group and there were significant correlation among other lead biomarkers. Compared with controls without occupational lead exposure, lead exposured subjects had worse performance on 10 tests out of 12 neurobehavioral tests, but only two tests(Purdue pegboard nondominant and both hand) showed statistical significance of differences. In multiple linear regression analysis of neurobehavioral tests with lead biomarkers and demographic and lifestyle variables, age was associated negatively with 11 neurobehavioral tests, whereas log-transformed ZPP was associated with Purdue pegboard(both hand) and Santa Ana manual dexterity(non-dominant hand). On the other hand, tibia lead was associated Pursuit aiming test(correct) and Purdue pegboard(dominant hand) and calcaneal lead was associated with Purdue pegboard(dominant hand). This study confirmed that among all relevant variables age was most significantly associated with the poor performance of neurobehavioral tests. The blood lead did not have any significant association with neurobehavioral tests, but tibia and calcaneal bone lead and blood ZPP showed significant association with a few tests even after more than mean 9 years from their retirements.

• Safety and Health at Work
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• v.4 no.3
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• pp.123-135
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• 2013

Exposure to manganese (Mn) is associated with neurobehavioral effects. There is disagreement on whether commonly occurring exposures in welding, ferroalloy, and other industrial processes produce neurologically significant neurobehavioral changes representing parkinsonism. A reviewof methodological issues in the human epidemiological literature onMnidentified: (1) studies focused on idiopathic Parkinson disease without considering manganism, a parkinsonian syndrome; (2) studies with healthy worker effect bias; (3) studies with problematic statistical modeling; and (4) studies arising from case series derived from litigation. Investigations with adequate study design and exposure assessment revealed consistent neurobehavioral effects and attributable subclinical and clinical signs and symptoms of impairment. Twenty-eight studies show an exposure-response relationship between Mn and neurobehavioral effects, including 11 with continuous exposure metrics and six with three or four levels of contrasted exposure. The effects of sustained low-concentration exposures to Mn are consistent with the manifestations of early manganism, i.e., consistent with parkinsonism. This is compelling evidence thatMnis a neurotoxic chemical and there is good evidence that Mn exposures far below the current US standard of $5.0mg/m^3$ are causing impairment.

• Journal of Yeungnam Medical Science
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• v.33 no.2
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• pp.85-89
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• 2016

Background: Formaldehyde is used to preserve cadaver in medical schools, and students are exposed to formaldehyde during cadaver dissection classes. When humans are exposed to formaldehyde, it induces mucosal inflammation, skin inflammation, and declining of neurobehavioral function including attention and memory executive functions. The purpose of this study is to identify the effects of formaldehyde exposure on student's neurobehavioral performance during cadaver dissection classes. Methods: The level of formaldehyde was measured in a cadaver dissection class. A total of 16 students were randomly divided into two groups. One group wore respiratory protection masks, while the other group did not. Among many subtests in Korean Computerized Neurobehavioral test, backward digit span was tested on all subjects before and after the class. Results: The length of memorized digit span between the two groups was not significant; however there was a greater decrease in neurobehavioral function after formaldehyde exposure in the non-mask group than the mask group. Conclusion: Formaldehyde exposure during cadaver dissection may likely decrease neurobehavioral performance of students. Therefore, proper ventilation system and respiratory protective equipment are necessary to protect medical school students from adverse effects of formaldehyde exposure.

• Safety and Health at Work
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• v.9 no.4
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• pp.381-387
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• 2018

Background: Physician behaviors that undermine a culture of safety have gained increasing attention as health-care organizations strive to create a culture of safety and reduce medical errors. We developed, implemented, and assessed a course to teach physicians skills regarding effective coping and interpersonal communication skills and present our results regarding outcomes. Methods: We examined a professional development program specifically designed to address unprofessional or distressed behaviors of physicians, and we evaluated the impact on burnout, quality of life, and emotional flooding scores of the physicians. Assessments of burnout, quality of life, and emotional flooding were assessed preintervention and postintervention. Results: Results demonstrated statistically significant reductions over time in physicians' emotional flooding and emotional exhaustion (EE). Specifically, using a Wilcoxon Signed-Rank test, results revealed that flooding scores at follow-up were statistically significantly lower than at baseline, V = 590, p < 0.05, and EE and personal accomplishment distributions were found to significantly deviate from normal as indicated by Shapiroe-Wilks tests (p < 0.05). A Wilcoxon signed-rank test indicated that EE scores were significantly higher at baseline compared to follow-up 1, V = 285, p < 0.05. Conclusion: We conclude that the physician participants who enrolled in the educational skills training program improved scores on emotional flooding and EE and that this may be indicative of improved skills related to their experiences and learning in the program. These improved skills in physicians may have a positive impact on the overall culture of safety in the health system setting.

• Journal of Preventive Medicine and Public Health
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• v.26 no.2 s.42
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• pp.210-221
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• 1993

In order to evaluate the confounding factors of neurobehavioral tests and the neurobehavioral effects in the workers exposed to organic solvents, NCTB was carried out on 100 workers. 46 workers had never been exposed to neurotoxic substances, and the others were being exposed to the solvents, mainly toluene. Simple reaction time, digit symbol, Santa Ana dexterity test and persuit aiming were different with age in non exposure group. Simple reaction time was carried out well in males, and digit symbol and persuit aiming were in females. There was no difference at educational level when the subject was educated over 12 years. Santa Ana dexterity and Benton visual test differed according to exposure level to toluene, however simple reaction time didn't. The acute neurotoxic effect was not excluded in this study. But, NCTB could be used to evaluate and prevent neurobehavioral changes in workers exposed to neurotoxic solvents in Korea.

• Korean Journal of Occupational Health Nursing
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• v.6 no.1
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• pp.53-71
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• 1997

Across sectional study was performed to evaluate the chronic effects on central nerve system(CNS) of cumulative exposure of complex organic solvents, using neurobehavioral test. Subjects were 66 (male) dock yard painters of some large ship industry which is located in Ulsan. The neurobehavioral test battery used in this study was NCTB (Neurabehavioral Core Test Battery recommended by WHO(World Health Organization), which consisted of 7 items-Profile of mood states (POMS), Simple reaction time, Santa Ana dexterity test. Digit span, Digit symbol, Benton visual retention test and Pursuit aiming. The subjects were classified by 3 groups according to duration of employment(group 1 ; less than 9 years, group 2 ; 10-14 years, group 3 ; more than 15 years). The results of performance were analyzed considering of work duration, age, educational level, alcohol drinking, smoking and testing time as confounding factors. Benton visual retention test, pursuit aiming correct dot and sum of dot showed significant differences among the groups, and decreased with increasing work duration. It indicated that the mean scores of performance ability were lowering according to work duration. Besides, the tests that didn't show statistical significances but showed linear trends were depression-dejection, vigor, fatigue of POMS, slowest time of simple reaction time and digit span forward. Most of the neurobehavioral test items were correlated with age and educational level. After controlling of confounding factors-age and educational level, the results followed ; digit span backward was different significantly. Tension-anxiety, depression-dejection, anger-hostility of POMS, SD and slowest time of simple reaction time, Santa Ana dexterity test non-preferred hand, digit span forward, Benton visual retention test and pursuit aiming correct dot decreased with increasing of work duration. The correlation analysis was done in order to find out the relationship between subjective symptom and the scores of neurobehavioral core test battery. According to the results of analysis there were no items that had statistical significant relationship(p<0.05).

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.21 no.2
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• pp.116-122
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• 2011

Human occupational exposure to n-hexane has been associated with neurobehavioral symptoms such as depression, irritablity, acute irritation symptom, concentration disturbance and fatigue. Effects of monoamine oxidase (MAO) B and serotonin transporter receptor (5-HTTR) polymorphisms on the neurobehavioral symptoms were investigated in 70 male workers from TV and computer monitor manufacturing plants exposed to n-hexane. Neurobehavioral symptoms were assessed through a self-reported questionnaire and ambient level of n-hexane was measured by NIOSH method. Blood and urine were collected from each workers to determine the MAO(B), 5-HTTR and urinary 2,5-hexanedione(2,5-HD). The mean concentration of volatile n-hexane was $18.8{\pm}28.8ppm$ and that of urinary 2,5-HD was $1.07{\pm}1.47mg/g$ creatinine. Statistically significant associations with sexual disturbance were age and smoking. The frequencies of MAO(B) AA, AG and GG were 18.6%, 45.7% and 35.7%, respectively, and the frequencies of 5-HTTR ll, ls and ss genotype were 82.9%, 15.7% and 1.4%, respectively. MAO (B) gene polymorphisms had susceptibility to the neurobehavioral symptoms such as fatigue, concentration disturbance, irritability and acute irritation symptom and 5-HTTR gene polymorphism had susceptibility to the sleep disturbance and acute irritation symptom. On multiple logistic regression analysis for the neurobehavioral symptoms, memory disturbance was significantly associated with smoking(OR=6.752, 95% CI=37.46) and drinking(OR=4.033, 95% CI=1.252-12.98), emotional lability was MAO(B) genotype(OR=0.412, 95% CI=0.170-0.996), fatigue (OR=1.011, 95% CI=1.000-1.021) and acute irritation(OR=0.990, 95% CI=0.981-1.000) were working duration and sexual disturbance were significantly associated with age(OR=1.208, 95% CI=1.042-1.399), ambient n-hexane(OR=1.077, 95% CI=1.005-1.154) and 2,5-HD(OR=0.186, 95% CI=0.041-0.841). This finding implies that the MAO (B) and 5-HTTR polymorphisms may affect susceptibility for specific neurobehavioral symptoms associated with n-hexane exposure in workers.

• Toxicological Research
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• v.16 no.2
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• pp.117-124
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• 2000

The objective of this experiment is to investigate neurobehavioral and developmental effects of fumonisin B1 (FB1) after prenatal FB1 administration in rats. FB1 (0.8 or 1.6 mg/kg) was orally exposed to pregnant rats during gestational days 13 to 20, whereas the vehicle alone was administered to control group. Maternal and offspring body weights, physical landmarks of incisor eruption, eye opening, testes descending and vaginal opening, open field activity, running wheel activity, and complex maze performance were included as endpoints for developmental and neurobehavioral measurement. Maternal body weights were not signfficantly altered after FB1 exposure. Percentage of maternal weight gain difference between control and 1.6 mg/kg FBI groups was about 4%. Pre- and post-weanling weight of offsprings after prenatal exposure to FB1 was not signfficantly changed, suggesting that FB1 at 0.8 or 1.6 kg/kg doses may not cross the placenta. Significant gender difference in running wheel activity on postnatal days 57 to 63 and complex maze performance on postnatal days 75 to 78 was observed.

• Journal of Preventive Medicine and Public Health
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• v.30 no.3 s.58
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• pp.577-584
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• 1997

Validation and Standardization of neurobehavioral instrument in Korean occupational setting has not been studied ever. This study tried to validate the newly developed computerized psychomotor tests, Neurobehavioral Tests for Occupational Screening (NTOS). Male patients with Parkinson's disease(n=12) and male workers who never exposed to occupational neurotoxic materials and didn't have neurologic disease(n=21), performed some tests from NTOS; simple reaction time, choice reaction time(2 choice), and finger tapping(both hands). In simple analysis, difference between patient group and worker group was significantly great. Adjusted for age and education years, simple reaction time and finger tapping(both hand) were statistically significantly different between two groups(p<.05). Choice reaction time was also different(p<.1) but error frequency of choice reaction time test was not. Generally, this results showed NTOS could detect impairment of psychomotor function. But insensitive results of choice reaction time was partly due to small sample size and confounding variables and so required future study and refinement at improvement of NTOS.

• Safety and Health at Work
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• v.15 no.1
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• pp.9-16
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• 2024

Background: E-waste workers in Hong Kong are handling an unprecedented amount of e-waste, which contains various neurotoxic chemicals. However, no study has been conducted to evaluate the neurological health status of e-waste workers in Hong Kong. This study aimed to evaluate the prevalence of neurobehavioral alterations and to identify the vulnerable groups among Hong Kong e-waste workers. Methods: We recruited 109 Hong Kong e-waste workers from June 2021 to September 2022. Participants completed standard questionnaires and wore a GENEActiv accelerometer for seven days. Pittsburgh Sleep Quality Index and Questionnaire 16/18 (Q16/18) were used to assess subjective neurobehavioral alterations. The GENEActiv data generated objective sleep and circadian rhythm variables. Workers were grouped based on job designation and entity type according to the presumed hazardous level. Unconditional logistic regression models measured the associations of occupational characteristics with neurobehavioral alterations after adjusting for confounders. Results: While dismantlers/repairers and the workers in entities not funded by the government were more likely to suffer from neurotoxic symptoms in Q18 (adjusted odds ratio: 3.18 [1.18-9.39] and 2.77 [1.10-7.46], respectively), the workers from self-sustained recycling facilities also have poor performances in circadian rhythm. Results also showed that the dismantlers/repairers working in entities not funded by the government had the highest risk of neurotoxic symptoms compared to the lowest-risk group (i.e., workers in government-funded companies with other job designations). Conclusion: This timely and valuable study emphasizes the importance of improving the working conditions for high-risk e-waste workers, especially the dismantlers or repairers working in facilities not funded by the government.