• Safety and Health at Work
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• 제14권2호
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• pp.141-152
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• 2023

Objective: We performed a meta-analysis of epidemiological results for the association between occupational exposure as a firefighter and cancer as part of the broader evidence synthesis work of the IARC Monographs program. Methods: A systematic literature search was conducted to identify cohort studies of firefighters followed for cancer incidence and mortality. Studies were evaluated for the influence of key biases on results. Random-effects meta-analysis models were used to estimate the association between ever-employment and duration of employment as a firefighter and risk of 12 selected cancers. The impact of bias was explored in sensitivity analyses. Results: Among the 16 included cancer incidence studies, the estimated meta-rate ratio, 95% confidence interval (CI), and heterogeneity statistic (I²) for ever-employment as a career firefighter compared mostly to general populations were 1.58 (1.14-2.20, 8%) for mesothelioma, 1.16 (1.08-1.26, 0%) for bladder cancer, 1.21 (1.12-1.32, 81%) for prostate cancer, 1.37 (1.03-1.82, 56%) for testicular cancer, 1.19 (1.07-1.32, 37%) for colon cancer, 1.36 (1.15-1.62, 83%) for melanoma, 1.12 (1.01-1.25, 0%) for non-Hodgkin lymphoma, 1.28 (1.02-1.61, 40%) for thyroid cancer, and 1.09 (0.92-1.29, 55%) for kidney cancer. Ever-employment as a firefighter was not positively associated with lung, nervous system, or stomach cancer. Results for mesothelioma and bladder cancer exhibited low heterogeneity and were largely robust across sensitivity analyses. Conclusions: There is epidemiological evidence to support a causal relationship between occupational exposure as a firefighter and certain cancers. Challenges persist in the body of evidence related to the quality of exposure assessment, confounding, and medical surveillance bias.

• 한국환경보건학회지
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• 제46권3호
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• pp.335-343
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• 2020

Objectives: The Korean Ministry of Environment has identified cases of people suspected of suffering lung disease potentially caused by polyhexamethylene guanidine (PHMG) used in humidifier disinfectants (HDs). Exposure assessment for the HDs was conducted using a questionnaire during face-to-face interview. The main purposes of this study were to develop a methodology to effectively classify levels of exposure to HDs based on a questionnaire. Methods: We first identified the overall participants' exposure characteristics by HD exposure levels; Second, we selected misclassified subjects and investigated characteristics of overestimated and underestimated subjects, focusing on exposure cases to PHMG-containing HDs. An inhalation reference concentration (RfC) for PHMG was produced on the basis of inhalation toxicity values. We made a cross-tabulation of the exposure classes (Exposure classes 1-to-4) by clinical classes based on the RfC. When the value of the exposure class minus the clinical class was 0 or 1, we assumed these were true values. When the value was ≥2 and ≤ -2, we assigned these cases to the overestimation group and underestimation group, respectively. Results: The overestimated group may have already recovered and responded excessively due to psychological anxiety or in order to receive compensation. On the other hand, relatively high mortality rates and surrogate responses for those under 10 years of age may have resulted in inaccurate exposure assessment for underestimated groups. For the characteristics of exposure, it was shown that for the underestimated group, the exposure was relatively weaker than the overestimated group, even though a high overall clinical rating was determined. Conclusions: This study may suggest ways to reduce bias and overcome the limitations of current HD exposure assessment.

• Tuberculosis and Respiratory Diseases
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• 제48권2호
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• pp.260-267
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• 2000

거대세포성 간질성 폐렴은 경금속 도구를 이용한 절삭, 연마공정에서 발생하는 경금속 분진을 흡입하여 발생하는 산업성 폐질환으로 알려져 있다. 저자들은 이러한 특징적인 경금속분진에 대한 노출력이 없이 발생하였던 거대세포성 간질성 폐렴을 수술적 폐생검과 폐조직내 금속 함유량 분석을 통해 진단하였기에 보고 하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제38권2호
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• pp.143-154
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• 1991

Pneumconiosis is a sort of pulmonary fibrosis consequent to the inhalation of the respirable dusts. Thus, the pathogenesis of silicosis have concentrated largely on the early response of alveolar macrophage and the later fibroblastic stimulation. But the role of the other cells and continuing cell injury in the pathogenesis has not been fully studied. And the chemical factors such as prostaglandin, fibroblast stimulating factor and inhibiting factor and chemotaxin are also participated in the mechanism of pulmonary fibrosis in silicosis. In order to clarify the role of alveolar cells and prostaglandin, we investigated the changes of the cellularities in bronchoalveolar lavage fluid and tissue pathology in the experimental silicosis with the time sequence. The experimental animals were divided into 3 groups; control group received only intratracheal injection of 0.5 ml saline, silica group received the intratracheal instillation of 40 mg silica with the same amount saline, and aspirin group received 450 mg/kg of aspirin after silica instillation. The results were as follows: 1) The total cells of bronchoalveolar lavage fluid in the silica group markedly increased in comparison with the control group, but there was no significant difference between the silica and aspirin groups. 2) The percentages of alveolar macrophages to the total number of cells in the silica group tended to be lower than those in the control group and also lower than those in the aspirin group at the 1st week after silica instillation. 3) The percentages of neutrophils to the total number of cells in the silica group were significantly higher than those in the control group during the entire period and also higher than those in the aspirin group at the 3rd day after silica instillation. 4) In the silica group, the percentages of lymphocytes to the total number of cells were increased 143 progressively with the time course and those were significantly higher than those in the control group from the 3rd week after silica administration. There were marked differences of lymphocyte percentages between the silica and aspirin groups at the 1st week after silica instillation. 5) The inflammatory change was observed in the rat lung at the 1st day after silica instillation. Also the silicotic nodule appeared in the silica group at the 1st week but we could not find out that nodule in the aspirin group at that time. The fibrotic changes in the rat lung tended to be increased progressively with the time course, therefore, the diffuse fibrotic pattern appeared in the whole field at the 20th week after silica instillation. 6) By the electron microscopy, there were gradual increases of phagosomes and vacuoles in the alveolar macrophage in the silica group as compared with the control group. These results suggest that the neutrophils and the lymphocytes have also participated in the pulmonary fibrosis even though the alveolar macrophage has a major role, and prostaglandin mediate the inflammation and pulmanary fibrosis in the experimental silicosis.

• 한국산업보건학회지
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• 제29권2호
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• pp.251-258
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• 2019

Objective: Chronic obstructive pulmonary disease(COPD) is characterized by persistent airflow limitations associated with chronic inflammatory response due to noxious particles or gases in the lung. Inflammation and oxidative stress are associated with COPD. The aim of this study was to evaluate the relationship among inflammation, oxidative stress, and airflow limitation severity in retired miners with COPD. Methods: The levels of serum high-sensitivity C-reactive protein(hsCRP) as a biomarker for inflammation, degree of reactive oxygen metabolites(dROMs) and biological antioxidants potential(BAP) in plasma as biomarkers for oxidative stress were measured in 211 male subjects with COPD. Degree of airflow limitation severity as determined by spirometry was divided into three grades grouped according to the classification of the Global Initiatives for Obstructive Lung Disease(GOLD)(1, mild; 2, moderate; $3{\leq}$, severe or more) using a fixed ratio, post- bronchodilator $FEV_1/FVC$ < 0.7. Results: Mean levels of dROMs significantly increased in relation to airflow limitation severity(GOLD 1, 317.8 U.CARR vs. GOLD 2, 320.3 U.CARR vs. GOLD $3{\leq}$, 350.9 U.CARR, p=0.047) and dROMs levels were correlated with serum hsCRP levels(r=0.514, p<0.001). Mean levels of hsCRP were higher in current smokers(non-smoker, 1.47 mg/L vs. smoker, 2.34 mg/L, p=0.006), and tended to increase with degree of airflow limitation severity(p=0.071). Mean levels of BAP were lower in current smokers(non-smoker, $1873{\mu}mol/L$ vs. smoker, $1754{\mu}mol/L$, p=0.006). Conclusions: These results suggest that inflammation and oxidative stress are related to airflow limitation severity in retired miners with COPD, and there was a correlation between inflammation and oxidative stress.

• 한국산업보건학회지
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• 제30권2호
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• pp.196-204
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• 2020

Objective: Chronic obstructive pulmonary disease(COPD) is characterized by persistent airflow limitations associated with chronic inflammatory response due to noxious particles or gases in the lung. Increasing oxidative stress associated with COPD. The aim of this study was to evaluate the influencing factors of biomarkers for oxidative stress in retired miners with COPD. Methods: The levels of total peroxide(TPx), total antioxidant capacity(TAC), and oxidative stress index(TPx/TAC ratio, OSI) in plasma as biomarkers for oxidative stress, serum C-reactive protein(CRP) as a biomarker for inflammation, and general characteristics were measured in 93 male subjects with COPD. COPD was defined as post bronchodilator FEV₁/FVC<0.7 by spirometry. Results: Mean levels of TPx(p=0.013), TAC(p=0.010), OSI(p=0.040), and CRP(p=0.024) were higher in current smokers. Levels of TPx(β=0.445, p<0.001), TAC(β=0.490, p<0.001), and OSI(β=0.351, p<0.001) were related to CRP levels, and CRP levels were related to %FEV₁ predicted(β=-0.295, p=0.003) and current smoking(β=0.214, p=0.032). Conclusions: These results suggest that oxidative stress was related to inflammation, and inflammation were related to decreasing %FEV₁ predicted and current smoking in retired miners with COPD.

• Journal of Preventive Medicine and Public Health
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• 제23권2호
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• pp.207-215
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• 1990

In order to investigate the occurrence characteristics of cancer in terms of industry in Kwangju-Chonnam area, medical utilization records of industrial medical insurance corporations during the period of 1987 to 1988 were reviewed for the identification of neoplastic disease. The cases obtained from the medical records were followed up for the verification and to get additional information. Standardized incidence data were compared by occupational characteristics. Multiple logistic regression analysis was applied to analyze the difference of incidence or distribution of cancer as a whole or of some selected cancer. Total cases of cancer identified were 242 during the study period. Annual incidence rate was calculated as 123.1 per 100,000 person. The frequent types of cancer were cancers of stomach, liver, lung, colon and rectum, bladder and lymphoma in descending order. Employees of mine and other sand handling industries showed significantly higher risks for cancer of stomach and cancer as a whole. Employees of the transportation industry showed the higher risk for cancer of liver, Workers in small-sized industry (${\leqq}100$) had a higher risk for cancer than who in large-sized industry (<100). These findings suggested the effect of occupational environmental exposure to cancer development.

• Tuberculosis and Respiratory Diseases
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• 제42권6호
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• pp.923-933
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• 1995

연구배경: 석면분진의 흡입으로 인한 호흡기 변화중 가장 조기에 그리고 가장 빈번하게 발견되는 것은 늑막 변화이다. 늑막변화에는 늑막상출액, 늑막반, 미만성늑막섬유화로 분류되기도 하나 일반적으로 늑막비후를 단순히 석면폭로의 지표로 여기고 간과하는 경우가 많다. 그러나 석면에 관련된 질환은 대부분이 만성적이고 뒤에 질환이 발현되는 경우가 빈번하여 늑막변화를 나타내는 근로자에 대한 합리적인 관리와 검사가 필요할 것으로 생각된다. 방법: 석면분진을 취급하는 9개 시업장의 작업장 부서별 석면분진농도를 측정하고 석면을 취급하는 업무에 종사하고 있는 222명을 대상으로 하여 설문조사, 흉부 방사선 사진, 폐기능검사를 실시하여 우리나라 석면 취급 근로자들에서 발생되는 늑막변화에 대한 역학조사와 함께 늑막변화에 따른 폐기능의 변화, 그리고 폐기능의 저하에 미치는 인자들에 대한 조사를 실시 하였고 성적은 SAS을 이용하여 분석하였다. 결과: 1) 조사대상 사업장은 총 9개 였으며 대상 사업장중 1개소를 제외하고는 석면분진 농도는 허용농도 이하였다. 조사대상 근로자중 폐기능 검사를 실시한 222명을 대상으로 하였고 남자가 196명(88.3%), 여자 26명(11.7%)였으며 평균 연령은 $41.9{\pm}9.8$세 이었고 평균 석면분진 폭로기간은 $10.6{\pm}7.8$년 이었다. 2) 흉부 방사선 소견상 정상소견을 보인 198명(89.19%), 결핵병변이 관찰된 경우 6명(2.7%), 늑막비후가 보인 경우 17명(7.66%), 망상형 간질성 음영이 의심되는 경우 2명(0.90%)이었다. 3) 늑막비후가 있는 군과 없는 군 사이에 평균신장, 흡연력, 분진농도에는 차이가 없으나, 늑막비후가 없는 군에 비하여 있는군에서 연령, 흡연자의 누적 흡연력, 분진 폭로기간이 유의하게 증가되어 있었다. 4) 늑막비후가 있는 군과 없는 군에서 폐기능의 차이를 보면, 모든 폐기능의 지표에서 늑막비후가 있는 군에서 늑막비후가 없는 군에 비해 유의한 감소를 보였다. 5) 단순회귀분석에서 누적흡연력이 클수록, 폭로기간이 길수록, 그리고 분진농도가 높을 수록 폐기능지표들은 감소하였으며 특히 소기도폐색의 지표인 $FEF_{75}$에서 유의하게 변화하였고 누적흡연력은 $FEF_{50}$의 변화에 유의한 영향을 미쳤다. 6) 다중회귀분석시 폐기능지표등이 누적흡연력이 증가할수록 감소하는 경향을 보였으나 주로 소기도폐색지표에 유의한 감소를 보였으며, 늑막비후가 있는 군에서 없는 군에 비하여 폐기능이 현저히 감소하였다. 결론: 석면 취급 근로자에서 여러가지 폐기능 검사 항목과 석면분진농도등 영향을 미칠수 있는 인자를 조사한 결과 분진폭로농도와 폭로기간에 따라 $FEF_{50}$와 $FEF_{75}$이 특히 민감하게 반응하여 석면에 대한 폐질환의 조기진단을 위하여 도움이 될 것으로 생각되며, 본 연구에서 폐실질병변은 없으나 늑막비후만 관찰되는 경우에도 폐기능이 현저하게 감소한 것으로 미루어 이에 대한 적극적인 관리가 필요하다.

• Journal of Chest Surgery
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• 제32권6호
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• pp.549-555
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• 1999

배경: 폐암을 비롯한 각종 폐질환에 있어서 중요한 외과적 치료방법인 폐절제술시 일반적으로 수술전에 폐기능 검사 및 기타 임상적 평가를 시행하여 수술후에 이환율과 사망율에 영향을 주는 위험 인자를 확인하고 있으나 아직까지 가장 확실하고 정확한 단일 검사방법과 검사치에 대한 기준 설정에는 논란의 여지가 있다. 대상 및 방법: 본 연구는 1994년 6월부터 1998년 2월까지 3년 8개월 동안 아주대학교 병원 흉부외과학 교실에서 폐암, 기관지 확장증, 그리고 폐결핵 등으로 주요 폐 절제술을 시행받은 167명의 환자를 대상으로 25개의 수술전 또는 수술중 위험인자와 19개의 수술후 합병증을 분석하여 그 관련성을 연구하였다. 19개의 수술후 합병증은 사망율 및 호흡기, 순환기, 그리고 기타 합병증 네 가지로 분류하였고 수술전 또는 수술중 위험 인자와의 연관성을 확인하기 위하여 로지스틱 회귀분석과 $\chi$2검정을 사용하였다. 결과: 합병증을 예견하는 인자로 술후 예측 폐확산능백분율(ppoDLCO%)이 호흡기(p<0.009), 순환기(p<0.003), 전체 이환율(p<0.004)에 가장 유의한 영향을 주는 것으로 평가되었다. 결론: 폐기능 검사중 폐확산능(Diffusing Capacity for Carbon Monoxide, DLCO)이 일반적으로 사용되는 페활량측정법(Spirometry) 보다 술후 합병증을 예견하는데 있어서 통계학적으로 유의성있는 인자로 평가되었다. 따라서, 주요 폐절제술의 적응증이 되는 환자들은 폐확산능 검사를 통상적으로 시행하여 술전 정확한 평가에 의하여 유용한 치료의 지침으로 삼아야 될 것으로 판단된다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권18호
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• pp.8149-8153
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• 2016

An oncopathological state assessment was conducted among adults, children and teenagers in Aktobe region for 2004-2013. Overall the burden of mortality was in the range of 94.8-100.2 per 100,000 population, without any obvious trend over time. Ranking by pathology, the highest incidences among women were registered for breast cancer (5.8-8.4), cervix uteri (2.9-4.6), ovary (2.4-3.6) and corpus uteri, stomach, esophagus, without any marked change over time except for a slight rise in cervical cancer rates. In males, the first place in rank was trachea, bronchus and lung, followed by stomach and esophagus, which are followed by bladder, lymphoid and hematopoietic tissues pathology. Agian no clear trends were apparent over time. In children, main localizations in cancer incidence blood (acute lymphocytic leukemia, lymphosarcoma, acute myeloid leukemia, Hodgkin's disease), brain and central nervous system, bones and articular cartilages, kidneys, and eye and it's appendages, in both sexes. Similarly, in young adults, the major percentage was in blood and lymphatic tissues (acute myeloid leukemia, acute lymphocytic leukemia, Hodgkin's disease) a significant percentage accruing to lymphosarcoma, lymphoma, other myeloid leukemia and hematological malignancies as well as tumors of brain and central nervous system, bones and articular cartilages. This initial survey provides the basis for more detailed investigation of cancer epidemiology in Aktobe, Kazakhstan.