• Journal of Environmental Health Sciences
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• v.43 no.1
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• pp.1-22
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• 2017

'The worstest environment disaster', 'World's first biocide massacre', 'Home-based Sewol ferry disaster' are all phrases attached to the recent humidifier disinfectant disaster. In the spring of 2011, four of 8 pregnant women including 1 adult man passed away at a university hospital in Seoul due to breathing failure. Epidemiologic investigation conducted by the Korean CDC soon revealed the inhalation of humidifier disinfectant, which had been widely used in Korea during the winter, to be responsible for the disease. As well as lung fibrosis hardening of the lungs, other diseases including asthma, rhinitis, skin disease, liver disease, fetal disease or cancers have been researched for their relation with exposure to the products. By February 9, 2017, 5,342 cases had registered for health problems and 1,131 of them were already dead (20.8% mortality rate). Based on studies by government agencies and a telephone survey of the general population by Seoul National University and civic groups, around 20% of the general public of Korea has used these products. Since the market release of the first product by SK Chemical in 1994, over 7.1 million items from around 20 brands were sold up to 2011. Most of the products were manufactured by well-known large conglomerates such as SK, Lotte, Samsung, Shinsegye, LG, and GS, as well as some European companies including UK-based Reckitt Benckiser and TESCO, the German firm Henkel, the Danish firm KeTox, and an Irish company. Even though this disaster was unveiled in 2011 by the Korean government, the issue of the victims was neglected for over five years. In 2016, an unexpected but intensive investigation by prosecutors found that Reckitt Benckiser manipulated and concealed animal tests for its own brand and brought several university experts and company employees to court. The matter was an intense social issue in Korea from May to June with a surge in media coverage. The prosecutor's investigation and a nationwide boycott campaign organized by victims and environmental groups against Reckitt Benckiser, whose product had been used by more than 70% of victims, led to the producer's official apology and a compensation scheme. A legislative investigation organized after the April 2016 national election revealed the producers' faults and the government's responsibility, but failed to meet expectations. A special law for the victims passed the National Assembly in January 2017 and a punitive system together with a massive environmental epidemiology investigation are expected to be the only solutions for this tragedy. Sciences of medicine, toxicology and environmental health have provided decisive evidence so far, but for the remaining problems the perspectives of social sciences such as sociology and jurisprudence are highly necessary, similar to with the Minamata disease and Wonjin Rayon events. It may not be easy to follow this issue using unfamiliar terminology from medical and chemical science and the long, complicated history of the event. For these reasons the author has attempted to write this article in a question and answer format to render it easier to follow. The 17 questions are: Q1 What is humidifier disinfectant? Q2 What kind of health problems are caused by humidifier disinfectant? Q3 How many victims are there? Q4 What is the analysis of the 1,112 cases of death? Q5 What is the problem with the government's diagnostic criteria and the solution? Q6 Who made what brands? Q7 Has there been a recall? What is still on sale? Q8 Was safety not checked by any producers? Q9 What are the government's responsibilities? Q10 Is it true that these products were sold only in Korea? Q11 Why and how was it unveiled only in 2011 after 17 years of sales? Q12 What delayed the resolution of the victim issue? Q13 What is the background of the prosecutor's investigation in early 2016? Q14 Is it possible to report new victim cases without evidence of product purchase? Q15 What is happening with the victim issue? Q16 How does it compare with the cases of Minamata disease and Wonjin Rayon? Q17 Are there prevention measures and lessons?

• The korean journal of orthodontics
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• v.38 no.3
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• pp.202-213
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• 2008

Objective: The purpose of this study was to compare the cephalometric measurements of obese and non-obese Korean male patients with obstructive sleep apnea syndrome (OSA). Methods: Eighty-seven adults who had visited the Sleep Disorder Clinic Center in Keimyung University, Daegu, Korea were examined and evaluated with polysomnography (PSG) and lateral cephalogram. They were divided into 4 groups (non-obese simple snorers, obese simple snorers, non-obese OSA patients, obese OSA patients) according to AHI (Apnea-Hypopnea Index) and BMI (Body Mass Index). Results: The obese OSA group had the highest AHI among the 4 groups. The non-obese OSA group had a significantly steeper mandibular angle and shorter tongue length than the obese OSA group. The hyoid bone of the obese OSA group was positioned anterior and inferior as compared with the non-obese OSA group. Multiple regression analysis showed that tongue length in the obese OSA group and retroposition of hyoid bone in the non-obese OSA group were significant determinants for the severity of AHI. Conclusions: From a cephalometric point of view, the obese and non-obese pateints with OSA may be characterized by different pathogeneses. Therefore, they have to be managed by individualized treatment. For the obese OSA patients, weight control must be advised as a first choice and for the non-obese OSA patients, oral appliance, nasal CPAP, UPPP and others could be chosen according to the obstructive sites.

• Journal of Radiation Protection and Research
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• v.37 no.4
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• pp.208-212
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• 2012

In previous studies, ovarian follicle in rat has been used a higher radiation dose than that for cancer radiotherapy in clinical practice. The aim of this study was to evaluate the effect of radiation dose used for cancer radiotherapy on ovarian follicle atresia in rat. Mice of 4-week-old female were whole body irradiated with 2 cGy or 2 Gy (Mevatron 67, Siemens, Germany) and sacrificed by cervical dislocation. Ovaries were collected at 24 hours after irradiation to observe the degree of follicular atresia. Ovaries were fixed in neutral formaldehyde solution for 24 hours and embedded with paraffin. Cutted in $5{\mu}m$ thickness with microtome and stained with hematoxylin and eosin (H&E) and TUNEL immunohistochemical stain, and examined histologically under a light microscope. All data were presented as mean ${\pm}SD$, calculating the ratio of normal or atretic follicles to total ovarian follicles. Statistical analysis was performed by the Mann Whitney test using the SPSS ver 19.0. Ratio of atretic to total follicles of 2 Gy group was significantly higher than control or 2 cGy groups (p<0.05). Ratio of normal to total follicles of 2 Gy group was significantly lower than control group in preantral follicle (64.0 vs. 87.7, p=0.027). Ratio of normal to total follicles of 2 cGy group was significantly increased more than control or 2 Gy groups in antral follicle, and there were no significant difference between control and 2 Gy groups (p=0.522). Radiation dose of 2 Gy for cancer radiotherapy have a significant effect on ovarian follicle atresia in rat.

• Journal of Environmental Health Sciences
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• v.37 no.6
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• pp.429-439
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• 2011

Objectives: Ethylene oxide (EtO) is classified as a human carcinogen, but EtO is still widely used to sterilize heat-sensitive materials in hospitals. Employees working around sterilizers are exposed to EtO after sterilization. The aim of the present study was to assess the exposure of EtO level, coupled with occupationally induced micronuclei from hospital workers. The influence of genetic polymorphisms of detoxifying genes (GSTT1 and GSTM1) and DNA repair genes (XRCC1 and XRCC3) on the frequencies of micronuclei in relation to exposure of EtO was also investigated. Methods: The study population was composed of 35 occupationally exposed workers to EtO, 18 student controls and 44 unexposed hospital controls in Korea. Exposure to EtO is measured by passive personal samplers. We analyzed the frequencies of micronuclei by performing cytokinesis-block micronucleus assay (CBMN assay) and GSTM1, GSTT1, XRCC1, and XRCC3 were also genotyped by performing polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Results: The frequencies of micronuclei in EtO exposure group, student controls and hospital controls were $18.00{\pm}7.73$, $10.47{\pm}7.96$ and $13.86{\pm}6.35$ respectively and their differences were statistically significant, but no significant differences according to the level of EtO were observed. There was a dose-response relationship between the frequencies of micronuclei and cumulative dose of EtO, but no significantly differences were observed. We also investigated the influence of genetic polymorphisms (GSTM1, GSTT1, XRCC1, and XRCC3) on the frequencies of micronuclei, but there were no differences in the frequencies of micronuclei by genetic polymorphisms. Conclusions: The frequencies of micronuclei in EtO exposure group was significantly higher than control groups. A dose-response relationship was found between the level of EtO exposure and the frequencies of micronuclei, but no statistically differences were observed. We also found that the frequencies of micronuclei were increased according to cumulative EtO level. There was no association of the genetic GSTM1, GSTT1, XRCC1, and XRCC3 state with the frequency of micronuclei induced by EtO exposure.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.24 no.2
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• pp.113-121
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• 2014

Objectives: This study is intended to seek credible and efficient measurements on airborne asbestos concentrations that allow immediate action by establishing complementary data through comparative analysis with existing PCM and KF-100 method real-time monitoring equipment in working areas in Seoul where asbestos-containing buildings are being demolished, including living environment surroundings. Materials: We measured airborne asbestos concentrations using PCM and KF-100 at research institutes, monitoring networks, subway stations and demolition sites of asbestos-containing buildings. Through this measurement data and KF-100 performance testing, we drew a conversion factor and applied it via KF-100. Finally we verified the relationship between PCM and KF-100 with statistical methods. Results: The airborne asbestos concentrations by PCM for the objects of study were less than the detection limit(7 fiber/$mm^2$) in three (20%) out of 15 samples. The highest concentration was 0.009 f/cc. The airborne asbestos concentrations by PCM in laboratories, monitoring networks, subway stations and demolition sites of asbestos-containing buildings were respectively $0.002{\pm}0.000$ f/cc, $0.004{\pm}0.001$ f/cc, $0.009{\pm}0.001$ f/cc, and $0.002{\pm}0.000$ f/cc. As a result of KF-100 performance testson rooftops, the conversion factor was 0.1958. Applying the conversion factor to KF-100 for laboratories, the airborne asbestos concentrations ratio of the two ways was nearly 1:1.5($R^2$=0.8852). Also,the airborne asbestos concentration ratio of the two ways was nearly 1:1($R^2$=0.9071) for monitoring networks, subway stations, and demolition sites of asbestos-containing buildings. As a result of independent sample t-tests, there was no distinction between airborne asbestos concentrations monitored in the two ways. Conclusions: In working areas where asbestos-containing buildings are being demolished, including living environment surroundings, quickly and accurately monitoring airborne asbestos scattered in the air around the working area is highly important. For this, we believea mutual interface of existing PCM and a real-time monitoring equipment method is possible.

• Journal of Society of Preventive Korean Medicine
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• v.5 no.2
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• pp.8-28
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• 2001

This investigation grasps the level and relevant elements of performance of health promotional activities for the elderly in Korea. It provides fundamental data on health promoting projects targeting the elderly population from farming villages. Hence, this study gropes for an effective approach and measures of health promoting programs. The program needs to be developed with a focus on elderly people from farming villages. In addition, it was carried out in order to provide basic data for development of health projects for local communities. Data gathering was based on survey data targeting patients from the free clinic service. Service was rendered for the residents of farming villages, and conducted at the Offices of CheonBuk Province from October 2000 to December 2000. Analytical results were used to examine the health promotional method for the elderly in the aspect of Oriental Medicine. SPSS 9.0 version as well as T-test and ANOVA were used for survey data analysis. Piersons correlation coefficient was utilized for the relationship for each area, obtaining the following analytical results. 1. The average score for the activities of health promotion was 2.28. Looking at each subcategory, stress management was the highest at 3.65; interpersonal relationship, 3.00; nutrition, 2.55; health responsibility, 2.15; self-realization, 2.03; and exercise was the lowest at 1.89. 2. With respect to lifestyle of the health promotion secondary to general features of elderly people from farming villages, the level of activities of health promoting lifestyle was shown to be higher for males than that of females. Self-realization area was high among males in detailed particulars while the level of execution was high as age decreases in the stress area. 3. Regarding health promoting life style secondary to socioeconomic characteristics, the level of execution was higher for the individuals with a higher level of education and further utilization of spare time. With respect to occupation, the level was highest for people from the fishery. The level decreased in the order of other occupations such as trade, unemployed and agriculture, which was shown to be the lowest. In detailed particulars, it revealed that higher the individuals educational level, the higher the self-realization and stress management areas. The level of interpersonal relationship was the highest among people with little or no education. With respect to self-realization area, the level was highest among the cases where one paid living expenses along with their children. The lowest level of living expenses was seen in the cases where an individual pays for living expenses by himself/herself. There were significant results in all areas except for nutrition areas depending on occupation. The fishery was shown to be the highest. The level of activities was higher as one utilizes more spare time in all areas except for the area of interpersonal relationship.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.5
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• pp.549-556
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• 2017

This study investigated the importance of social cognitive intervention and the cognitive rehabilitation intervention by comparing the difference and examining the relationship between neurological cognitive function and social cognitive function of stroke patients in the acute phase and chronic stroke before returning to the community. LOTCA, cartoon intention inference task, and social behavior sequence task were performed on 30 acute stroke inpatients and 30 chronic stroke patients from May 2015 to June 2016. A two sample t test was conducted to examine the differences between the groups. The Pearson's correlations test was performed to examine the correlation among the variables in each group. As a result, there were statistically significant differences between the neurological cognitive function and social cognitive function of acute stroke patients and chronic stroke patients who were undergoing rehabilitation training before returning to the community (p<0.05). A linear relationship was found between the thinking operation and social behavior sequence task in the acute stroke group (r=0.539, p<0.05). In the chronic stroke group, visual perception (r=0.530, p<0.05), visual motor organization (r=0.655, p<0.05) and thinking operation (r=0.534, p<0.05) were correlated with the cartoon intention inference task. In addition, the social behavior sequence task were correlated with visual organization (r=0.534, p<0.05) and thinking operation (r=0.764, p<0.05). As a result of multiple regression analysis, the neurological cognitive functions influencing the social cognitive function in the cartoon task was found to be the thinking operation (B = 0.431) in acute stroke patients and the thinking operation (B=0.272) and visuomotor organization (B = 0.218) in the case of chronic stroke. In addition, the results of the social behavior sequence task revealed the thinking operation (B=0.417) in the acute stroke patients, and thinking operation (B=0.267), visual motor organization(B=0.274) and visual perception(B=151) in chronic stroke patients to be significant. According to this result, there is a difference in the neurological and social cognitive levels between the two groups. Therefore, the social cognition is strongly related to the high level cognitive function as thinking operation of the neurological cognitive function. Therefore, in further research, it would be necessary to determine if there is a change in higher cognitive function in neurological cognitive function after applying a social cognition intervention program for stroke.

• Journal of Environmental Health Sciences
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• v.37 no.2
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• pp.102-112
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• 2011

Objectives: The purpose of this study is to analyze the effects of chronic exposure by welders to manganese (Mn) through an analysis of the degree of brain activity in different activities such as cognition and motor activities using the neuroimaging technique of functional magnetic resonance imaging (fMRI). The neurotoxic effect that Mn has on the brain was examined as well as changes in the neuro-network in motor areas, and the usefulness of fMRI was evaluated as a tool to determine changes in brain function from occupational exposure to Mn. Methods: A survey was carried out from July 2010 to October 2010 targeting by means of a questionnaire 160 workers from the shipbuilding and other manufacturing industries. Among them, 14 welders with more than ten years of job-related exposure to Mn were recruited on a voluntary basis as an exposure group, and 13 workers from other manufacturing industries with corresponding gender and age were recruited as a control group. A questionnaire survey, a blood test, and an fMRI test were carried out with the study group as target. Results: Of 27 fMRI targets, blood Mn concentration of the exposure group was significantly higher than that of the control group (p<0.001), and Pallidal Index (PI) of the welder group was also significantly higher than that of the control group (p<0.001). As a result of the survey, the score of the exposure group in self-awareness of abnormal nerve symptoms and abnormal musculoskeletal symptoms was higher than those of the control group, and there was a significant difference between the two groups (p<0.05, respectively). In the correlation between PI and the results of blood tests, the correlation coefficient with blood Mn concentration was 0.893, revealing a significant amount of correlation (p<0.001). As for brain activity area within the control group, the right and the left areas of the superior frontal cortex showed significant activity, and the right area of superior parietal cortex, the left area of occipital cortex and cerebellum showed significant activity. Unlike the control group, the exposure group showed significant activity selectively on the right area of premotor cortex, at the center of supplementary motor area, and on the left side of superior temporal cortex. In the comparison of brain activity areas between the two groups, the exposure group showed a significantly higher activation state than did the control group in such areas as the right and the left superior parietal cortex, superior temporal cortex, and cerebellum including superior frontal cortex and the right area of premotor cortex. However, in nowhere did the control group show a more activated area than did the exposure group. Conclusions: Chronic exposure to Mn increased brain activity during implementation of hand motor tasks. In an identical task, activation increased in the premotor cortex, superior temporal cortex, and supplementary motor area. It was also discovered that brain activity increase in the frontal area and occipital area was more pronounced in the exposure group than in the control group. This result suggests that chronic exposure to Mn in the work environment affects brain activation neuro-networks.

• Journal of agricultural medicine and community health
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• v.12 no.1
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• pp.36-53
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• 1987

It is utmostly important to establish the efficient fitable way of peoples' active participation in primary health care especially in the areas where the public or governmental service input for the basic health care is insufficient like as in rural areas of Korea. In light of above reason, this study focused mainly on the evaluation of roles and activities of village health workers (VHWs) who were selected from grass- root level of village people in order to derive further motivation for active participation. This is believed to be a sort of feedback mechanisms. Actually, the authors collected the activity reports of VHWs who had been devoting themselves in the primary health care services of Jeomdong Area, of Yeoju Gun one of Korea University Community Health Action Programmes and survey record on the VHWs activity from correspondent people. 1 hose data were analyzed through computer programmed package. The activities performed by VHWs were limited to the performance in 1985 for conveniance. The summarized results were as follows; 1) General characteristics of VHWs. Among a total of 28 VHWs in the area, about 39.3g of them have been replaced up to the date since the implementation in 1983, because of moving out, occupational employment and of others. The age of majority (75.0%) lied between the range of 30-50, and educational background of 67.9% belonged to category of primary school graduation, about 50% of them experienced to be or were also entiled "chief of women club" of corresponding villages. 2) Work-load of VHWs. Each VHW was assigned for tasks of health care for average 55 households of 248 persons. They shared approximately 6 days a month for the activity in average and it covered 17 cases of basic health care in a month. A half of the VHWs performed home visits irregularly without solidified schedule. 3) Work performance analysis. Informations collected through VHWs were compared with data from official vital registration at local administration center "Myon Office" in 1985. VHWs collected 100.8 of new born, 116.2 of death, 58.3 of move in and 74.8 of move out in comparison with 100.0 of official registration each. Pregnant women of 79.8% of mothers among the total pregnancy of 94 which were confirmed as normally delivered or aborted cases by all means afterwards had been detected by VHWs as being pregnant and all of them received some of antenatal cares by VHWs. All(100%) of delivered women were detected by VHWs through home visits and they were cared postnatally. Whereas, according to the records of birth registration, the places of delivery were clinic in 33.7%, and mother's home in 66.3%, VHWs reported them to be clinic in 48.9%, midwifery in 20.2%. It was cleared that most of misinformation was caused by uncautious filling of birth registration at notification. Among the total of 717 eligible women under age 44 years, family planning status of 92.6% was reported by VHWs confirming practice of control to be 70.8% of reported fertile women. 4) Attitude of VHW on the roles and functions. Although 92.0% of VHWs expressed VHWs to be worthwhile, only 52.0% of them had dignity and satisfaction in their activity and 44.0% of them had passive attitude of working saying they followed direction regardlessly. Concerning difficulties in performance as a VHW, 60.7% of them pointed out lacking of medical and health related knowledge by themselves. Still, 64.0% of them thought visiting unfamilier house to be awful and 40.0% complained forms of activity to be difficult and hard. It was also revealed that 56.6% confessed lack of interest on community health service itself. Most of VHWs needed more educational training especially on clinical fields such as cares of gynecological diseases, hypertension, diabetes, and other chronic diseaes of the aged. Regular on-the-job basic trainings were said to be needed twice a year.

• Tuberculosis and Respiratory Diseases
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• v.60 no.3
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• pp.337-341
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• 2006

Objectives : Endobronchial anthracofibrotic pigmentation, which presents as dark black or brown pigmentation mucosal changes of multiple bronchi combined with bronchial fibrosis and obstruction, is not a rare finding when performing diagnostic bronchoscopy for Koreans. This study was performed to define the clinical characteristics and to determine the association of these finding with the Korean life style and such other diseases as coal workers, pneumoconiosis or tuberculosis in the patients with anthracofibrotic pigmentation. Methods : This retrospective analysis was conducted on 70 (5.2%) patients with endobronchial anthracofibrotic pigmentation, among a total of 1340 patients who underwent bronchoscopy. The distinctive clinical features, the personal life style, the past medical history, the histology and microbiology, the radiologic finding and the natures of the bronchoscopic lesions were analyzed. Results : This mean age of the patients with anthracofibrotic pigmentation was $60.6{\pm}9.2$ year old and the male to female ratio was 1:1.7. The common respiratory symptoms of these patients were coughing and sputum (81%, 57/70), and this was followed in order by dyspnea and hemoptysisir. The symptoms were not related with smoking and an occupational history such as being a coal worker and so on. Pneumonia was most common finding on the radiologic studies. On bronchoscopy, the right middle lobe bronchus was most commonly involved. The most common associated disease was tuberculosis, and 40 cases (57.1%) were diagnosed by AFB staining, TB PCR, bronchoscopic guided tissue biopsy and a past history of tuberculosis. Other diseases related with anthracotic pigmentation were hypertension, diabetes, COPD, lung cancer, pneumoconiosis and asthma. Conclusion : These results suggest that endobronchial anthracofibrotic pigmentation was mostly related with pulmonary tuberculosis rather than with coal- related disease. Endobronchial anthracofibrotic pigmentation was more prevalent in older age females in Korea.