• Title/Summary/Keyword: hospital exposure

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Organic solvent exposure for the chronic kidney disease: updated systematic review with meta-analysis

  • Chaeseong Lim;Hyeoncheol Oh
    • Annals of Occupational and Environmental Medicine
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    • v.35
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    • pp.11.1-11.17
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    • 2023
  • Background: Studies on the relationship between organic solvent exposure and chronic kidney disease (CKD) have presented inconsistent results. Definition of CKD has changed in 2012, and other cohort studies have been newly published. Therefore, this study aimed to newly confirm the relationship between organic solvent exposure and CKD through an updated meta-analysis including additional studies. Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The search was conducted on January 2, 2023 using Embase and MEDLINE databases. Case-control and cohort studies on the relationship between organic solvent exposure and CKD were included. Two authors independently reviewed full-text. Results: Of 5,109 studies identified, a total of 19 studies (control studies: 14 and cohort studies: 5) were finally included in our meta-analysis. The pooled risk of CKD in the organic solvent exposed group was 2.44 (1.72-3.47). The risk of a low-level exposure group was 1.07 (0.77-1.49). The total risk of a high-level exposure group was 2.44 (1.19-5.00). The risk of glomerulonephritis was 2.69 (1.18-6.11). The risk was 1.46 (1.29-1.64) for worsening of renal function. The pooled risk was 2.41 (1.57-3.70) in case-control studies and 2.51 (1.34-4.70) in cohort studies. The risk of subgroup classified as 'good' by the Newcastle Ottawa scale score was 1.93 (1.43-2.61). Conclusions: This study confirmed that the risk of CKD was significantly increased in workers exposed to mixed organic solvents. Further research is needed to determine the exact mechanisms and thresholds. Surveillance for kidney damage in the group exposed to high levels of organic solvents should be conducted.

Entrance Skin Dose According to Age and Body Size for Pediatric Chest Radiography (소아 흉부촬영 시 나이와 체격에 따른 입사피부선량)

  • Shin, Gwi-Soon;Min, Ki-Yeul;Kim, Doo-Han;Lee, Kwang-Jae;Park, Ji-Hwan;Lee, Gui-Won
    • Journal of radiological science and technology
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    • v.33 no.4
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    • pp.327-334
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    • 2010
  • Exposure during childhood results in higher risk for certain detrimental cancers than exposure during adulthood. We measured entrance skin dose (ESD) under 7-year children undergoing chest imaging and compared the relationship between ESD and age, height, weight, chest thickness. Though it is important to measure chest thickness for setting up the exposure condition of chest examination, it is difficult to measure chest thickness of children. We set up exposure parameters according to age because chest thickness of children has correlation with age. In the exposure parameters, for chest A-P examination under 2 year-children, tube voltage (kVp) in hospital A was higher than that in hospital B while tube current (mAs) was higher in hospital B, thus the ESD values were about 1.7 times higher in hospital B. However, for chest P-A examination over 4 year-children, the tube voltage was 7 kVp higher in hospital B, the tube current were same in all two systems, and focus to image receptor distance (FID) in hospital B (180 cm) was longer than that in hospital A (130 cm), thus the ESD values were 1.4 times higher in hospital A. For same ages, the ESD values for chest A-P examinations were higher than those for chest P-A examinations. Comparing ESD according to age, ESD values were $154{\mu}Gy$, $194{\mu}Gy$ and $138{\mu}Gy$ for children under 1 year, 1 to under 4 years and 4 to under 7 years of age, respectively. These values were lower than reference level ($200{\mu}Gy$) recommended in JART (japan association of radiological technologists), however these were higher than reference values recommended by EC (european commission), NRPB (national radiological protection board) and NIFDS (national institute of food & drug safety evaluation). In conclusion, the values of ESD were affected by exposure parameters from radiographer's past experience more than x-ray system. ESD values for older children were not always higher than those for younger children. Therefore we need to establish our own DRLs (diagnostic reference levels) according to age of the children in order to optimize pediatric patient protection.

Evaluation of Image According to Exposure Conditions using Contrast-Detail Phantom for Chest Digital Radiography (흉부 디지털 방사선 촬영 시 C-D phantom을 이용한 촬영조건에 따른 영상 평가)

  • Lee, In-Ja;Kim, You-Hyun;Kim, Chang-Nam;Lee, Chang-Yeob;Park, Kye-Yeon
    • Journal of radiological science and technology
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    • v.32 no.1
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    • pp.25-32
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    • 2009
  • To find out proper photographing conditions in the chest DR imaging, the evaluation of images using the C-D phantom was carried out on relationship of identification capability, graininess, and exposure ratio. The conclusions were obtained as follows. 1. The patient's entrance skin Exposure (ESE) was decreased as tube voltage was increased. 2. According to the tube voltage change, the C-D phantom's identification capability of the exposure conditions was most visible at 110 kVp. 3. The identification capability according to the exposure ratio (mAs) change was most visible at 90 kVp for 0.5 times of low exposure ratio and at 110 kVp for 1.5 times. Therefore, it is known that the images were able to be better identified at a high exposure than a low exposure. 4. The graininess according to the exposure ratio at tube voltage of 110 kVp resulted in the best thing at 1.5 times of ratio when the exposure ratio was 1.5 times increased and the tube voltage was changed, the graininess showed the best result at 110 kVp. Therefore, the patient's exposure dose was low when kVp was increased and the adequate kVp was found to be 110. The image was better identified when exposure ratio was 1.5 times compared to 1.0 times. The graininess was also good when the exposure ratio became 1.5 times. The tube voltage was good at 110 kVp. However, once the exposure ratio is increased, the amount of radiation dose that the patients received get increased, so that the exposure condition has to be thoroughly considered.

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Hospital Visits, Admissions and Hospital Costs among Patients with Respiratory and Cardiovascular Diseases according to Particulate Matter in Seoul (서울지역 미세먼지 농도가 호흡기계 및 심혈관계의 외래 방문 및 입원과 진료비에 미치는 영향)

  • Lee, Hyeong Suk
    • Journal of Environmental Health Sciences
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    • v.42 no.5
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    • pp.324-332
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    • 2016
  • Objectives: The annual average of PM10 in Seoul was $45{\mu}/m^3$, which surpasses the WHO annual guidelines ($20{\mu}/m^3$). Most previous analyses of the effects of PM exposure have been retrospective studies using single hospital data, and fewer studies have attempted to address the relationship of PM10 and hospital costs. This study was conducted to investigate the effects of the concentration of PM10 on hospital visits, admissions and hospital costs in patients with respiratory and cardiovascular diseases. Methods: Medical data from the National Health Insurance Service and the monthly average of PM10 from National Institute of Environmental Research were used to identify the effects of PM10 on hospital visits, admissions and hospital costs. We applied Poisson regression and linear regression to perform the analysis. Results: The relative risks for admissions per $10{\mu}/m^3$ increase in PM10 were 23.11%, 10.2% and 6.9% increases for acute bronchiolitis, asthma and bronchitis, respectively. The relative risk for hospital visits per $10{\mu}/m^3$ increase in PM10 were 10.4%, 6.7% and 5.9% for chronic obstructive pulmonary disease, asthma and chronic sinusitis, respectively. For cardiovascular disease, the relative risk for admissions per $10{\mu}/m^3$ increase in PM10 were 2.2% and 2.1% increases in angina and acute myocardial infarction, respectively. A $10{\mu}/m^3$ increase in the monthly average of PM10 corresponded to 170,723,000 won (95% CI: 125,587,000-215,860,000 won), 123,636,000 won (95% CI: 47,784,000-199,487,000 won) and 78,571,000 won (95% CI: 29,062,000-128,081,000 won) increases in hospital costs for asthma, acute tonsillitis and chronic sinusitis, respectively. Conclusion: Hospital admissions for respiratory and cardiovascular disease were associated with PM10 levels. PM10 exposure is also associated with increased costs for respiratory diseases.

Level of radiation dose in university hospital non-insured private health screening programs in Korea

  • Lee, Yun-Keun
    • Environmental Analysis Health and Toxicology
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    • v.31
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    • pp.7.1-7.6
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    • 2016
  • Objectives The aim of this study is to evaluate radiation exposure resulting from the comprehensive health examinations of selected university hospital programs and to present basic data for research and management strategies on the health effects of medical radiation exposure. Methods Radiation-based diagnostic studies of the comprehensive health examination programs of ten university hospitals in Seoul, Korea, as introduced in their websites, were analyzed. The medical radiation studies of the programs were reviewed by radiologists. Only the effective doses of the basic studies were included in the analysis. The optional studies of the programs were excluded. Results Among the 190 comprehensive health examination programs, 132 programs (69.5%) included computed tomography studies, with an average of 1.4 scans. The average effective dose of radiation by program was 3.62 mSv for an intensive program for specific diseases; 11.12 mSv for an intensive program for cancer; 18.14 mSv for a premium program; and 24.08 mSv for an overnight program. A higher cost of a programs was linked to a higher effective dose (r=0.812). The effective doses of the examination programs for the same purposes differed by as much as 2.1 times by hospital. Inclusion of positron emission tomography-computed tomography was the most critical factor in determining the level of effective dose. Conclusions It was found that radiation exposure dose from comprehensive health exam programs targeted for an asymptomatic, healthy public reached between 3.6 and 24 times the annual dose limit for the general public. Relevant management policies at the national level should be provided to minimize medical radiation exposure.

Moist and Mold Exposure is Associated With High Prevalence of Neurological Symptoms and MCS in a Finnish Hospital Workers Cohort

  • Hyvonen, Saija;Lohi, Jouni;Tuuminen, Tamara
    • Safety and Health at Work
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    • v.11 no.2
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    • pp.173-177
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    • 2020
  • Background: Indoor air dampness microbiota (DM) is a big health hazard. Sufficient evidence exists that exposure to DM causes new asthma or exacerbation, dyspnea, infections of upper airways and allergic alveolitis. Less convincing evidence has yet been published for extrapulmonary manifestations of dampness and mold hypersensitivity syndrome). Methods: We investigated the prevalence of extrapulmonary in addition to respiratory symptoms with a questionnaire in a cohort of nurses and midwives (n = 90) exposed to DM in a Helsinki Obstetric Hospital. The corresponding prevalence was compared with an unexposed cohort (n = 45). Particular interest was put on neurological symptoms and multiple chemical sensitivity. Results: The results show that respiratory symptoms were more common among participants of the study vs. control cohort, that is, 80 vs 29%, respectively (risk ratio [RR]: 2.56, p < 0.001). Symptoms of the central or peripheral nervous system were also more common in study vs. control cohort: 81 vs 11% (RR: 6.63, p < 0.001). Fatigue was reported in 77 vs. 24%, (RR: 3.05, p < 0.001) and multiple chemical sensitivity in 40 vs. 9%, (RR: 3.44, p = 0.01), the so-called "brain fog", was prevalent in 62 vs 11% (RR: 4.94, p < 0.001), arrhythmias were reported in 57 vs. 2.4% (RR: 19.75, p < 0.001) and musculoskeletal pain in 51 vs 22% (RR: 2.02, p = 0.02) among participants of the study vs. control cohort, respectively. Conclusion: The results indicate that the exposure to DM is associated with a plethora of extrapulmonary symptoms. Presented data corroborate our recent reports on the health effects of moist and mold exposure in a workplace.

Effects of sun exposure and dietary vitamin D intake on serum 25-hydroxyvitamin D status in hemodialysis patients

  • Lee, Yeon Joo;Oh, Il Hwan;Baek, Hee Jun;Lee, Chang Hwa;Lee, Sang Sun
    • Nutrition Research and Practice
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    • v.9 no.2
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    • pp.158-164
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    • 2015
  • BACKGROUND/OBJECTIVES: Vitamin D deficiency is common in hemodialysis patients. The aim of this study was to identify whether or not sun exposure and dietary vitamin D intake have effects on serum 25-hydroxyvitamin D (25(OH)D) status in hemodialysis (HD) patients. The objective was to identify the main determinants of serum vitamin D status in the study subjects. SUBJECTS/METHODS: A cross-sectional study of 47 HD patients (19 males and 28 females) was performed. We assessed serum 25(OH)D and $1,25(OH)_2D$ levels between August and September 2012 and analyzed the prevalence of vitamin D deficiency in HD patients. To evaluate the determinants of serum 25(OH)D levels, we surveyed dietary vitamin D intake, degree of sun exposure, and outdoor activities. To compare biological variables, serum 25(OH)D was stratified as below 15 ng/ml or above 15 ng/ml. RESULTS: Mean 25(OH)D and $1,25(OH)_2D$ levels were $13.5{\pm}5.8ng/ml$ and $20.6{\pm}11.8pg/ml$, respectively. The proportions of serum 25(OH)D deficiency (< 15 ng/ml), insufficiency (15-< 30 ng/ml), and sufficiency (${\geq}30ng/ml$) in subjects were 72.4%, 23.4%, and 4.3%, respectively. Prevalence of vitamin D deficiency in female patients was 78.6%, whereas that in males was 63.2% (P = 0.046). Vitamin D intake and sun exposure time were not significantly different between the two stratified serum 25(OH)D levels. Dietary intake of vitamin D did not contribute to increased serum 25(OH)D levels in HD patients. The main effective factors affecting serum 25(OH)D status were found to be the sun exposure and active outdoor exercise. CONCLUSIONS: Hypovitaminosis D is common in HD patients and is higher in females than in males. Sun exposure is the most important determinant of serum 25(OH)D status in HD patients.

Effects of the Stepwise Exposure Treatments Before Freezing on the Survival Capacity of the Frozen-Thawed Mouse Mature Oocytes by Vitrification or Ultra-Rapid Freezing (동결 전 단계적 노출처리방법이 유리화동결 및 초급속동결-융해 후 생쥐 성숙난자의 생존력에 미치는 영향에 관한 연구)

  • Kim, Sang-Woo;Lee, Jae-Ik;Kim, Mi-Kyung;Lee, Young-Ah;Lee, Kyu-Sup;Yoon, Man-Soo
    • Clinical and Experimental Reproductive Medicine
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    • v.27 no.2
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    • pp.191-200
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    • 2000
  • Objective: This study was carried out to compare the effects of the stepwise exposure treatments on the morphological normality, fertilization and blastocyst formation rate of the frozen-thawed mouse mature oocytes by vitrification or ultra-rapid freezing and to use as a fundamental data for the cryopreservation of human oocytes. Materials and Methods: The morphological normality and fertilization rates of the vitrified and ultra-rapid frozen mouse mature oocytes after three-stepwise exposure treatments (1step, 3step and 5step) were observed. After choosing the 3step exposure treatment groups, we observed the morphological normality and fertilization, blastocyst formation rate of the vitrified and ultra-rapid frozen mouse mature oocytes. Results: The morphological normality and fertilization rates of the vitrified mouse mature oocytes after three-stepwise exposure treatments (1step, 3step and 5step) were 75%, 85%, 88% and 58%, 61 %, 54% respectively. There were no significant differences among treatments(p>0.05). The morphological normality and fertilization rate of the control was 92% and 65%. There were no significant differences in fertilization rate among control and treatments (p>0.05). The morphological normality and fertilization rates of the ultra-rapid frozen mouse mature oocytes after three-stepwise exposure treatments (1step, 3step and 5step) were 83%, 83%, 84% and 75%, 63%, 56% respectively. There were no significant differences among treatments (p>0.05). The morphological normality and fertilization rate of the control was 95% and 67%. There were no significant differences among control and treatments (p>0.05). The morphological normality and fertilization rate of the vitrified or ultra-rapid frozen mouse mature oocytes after 3step exposure treatment were 69% and 75%, respectively. The blastocyst formation rate was 60% and 57%. The results did not differ significantly between vitrification and ultra-rapid freezing (p>0.05). Conclusion: As known in the above results, there were no significant differences in the fertilization and blastocyst formation rate of the frozen-thawed mouse mature oocytes by vitrification or ultra-rapid freezing among the control and treatments. It is suggested that vitrification and ultra-rapid freezing method were effective for the cryopreservation of mouse mature oocytes.

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A Study on the Radiation Exposure Dose of Clinical Trainees in the Department of Radiology: A Case Study at C University Hospital (방사선(학)과 임상실습생의 수시출입자 피폭선량에 대한 고찰: C 대학병원 사례 연구)

  • Joo-Ah Lee
    • Journal of the Korean Society of Radiology
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    • v.17 no.2
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    • pp.249-255
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    • 2023
  • In this study, radiation exposure doses were measured in the course of clinical practice of radiation workers, radiological technologists in the radiation-related worker group, and preliminary-radiological technologists who were classified as frequent visitors. Radiological technologists who worked in the radiation area of C University Hospital in Incheon for a year from January 2021 and 121 students who completed clinical practice at the same medical institution from July 1 to August 31 were the subjects of the study. The nominal risk factor based on ICRP 103 was used to evaluate the probability of side effects due to the exposure dose to the lungs, which are organs at risk of damage due to radiation exposure dose. During the clinical practice period, radiology students, who were classified as frequent visitors, had a surface dose of 0.98 ± 0.14 mSv and a deep dose of 0.93 ± 0.14 mSv. In other words, 6.7 per 1,000,000 for shallow dose and 6.4 per 1,000,000 for deep dose were found to have side effects due to exposure to the lungs. This is a value in terms of exposure dose in one year. Considering that the radiation (science) education course is 3 or 4 years, systematic management and attention to prospective radiation workers who are going to clinical practice are required, and the stochastic effect of radiation In relation to this, it is considered that it will be used as basic data for radiation safety management.

The Study of Radiation Reducing Method during Injection Radiopharmaceuticals (방사성의약품 투여 시 피폭선량 저감에 대한 연구)

  • Cho, Seok-Won;Jung, Seok;Park, June-Young;Oh, Shin-Hyun;NamKoong, Hyuk;Oh, Ki-Beak;Kim, Jae-Sam;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.16 no.1
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    • pp.80-85
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    • 2012
  • Purpose: The whole body bone scan is an examination that visualizing physiological change of bones and using bone-congenial radiopharmaceutical. The patients are intravenous injected radiopharmaceutical which labeled with radioactive isotope ($^{99m}Tc$) emitting 140 keV gammarays and scanned after injection. The 3 principles of radiation protection from external exposureare time, distance and shielding. On the 3 principles of radiation protection basis, radiopharmaceutical might just as well be injected rapidly for reducing radiation because it might be the unopened radiation source. However the radiopharmaceuticals are injected into patient directly and there is a limitation of distance control. This study confirmed the change of radiation exposure as change of distance from radiopharmaceutical and observed the change of radiation exposure afte rsetting a shelter for help to control radio-technician's exposure. Materials & methods: For calculate the average of injection time, the trained injector measured the injection time for 50 times and calculated the average (2 minutes). We made a source as filled the 99mTc-HDP 925 MBq 0.2 mL in a 1 mL syringe and measured the radiation exposure from 50 cm,100 cm,150 cm and 200 cm by using Geiger-Mueller counter (FH-40, Thermo Scientific, USA). Then we settled a lead shielding (lead equivalent 6 mm) from the source 25 cm distance and measured the radiation exposure from 50 cm distance. For verify the reproducibility, the measurement was done among 20 times. The correlation between before and after shielding was verified by using SPSS (ver. 18) as paired t-test. Results: The radiation doses according to distance during 2 minutes from the source without shielding were $1.986{\pm}0.052{\mu}$ Sv in 50 cm, $0.515{\pm}0.022{\mu}$ Sv in 100 cm, $0.251{\pm}0.012{\mu}$ Sv in 150 cm, $0.148{\pm}0.006{\mu}$ Sv in 200 cm. After setting the shielding, the radiation dose was $0.035{\pm}0.003{\mu}$ Sv. Therefore, there was a statistical significant difference between the radiation doses with shielding and without shielding ($p$<0.001). Conclusion: Because the great importance of whole body bone scan in the nuclear medicine, we should make an effort to reduce radiation exposure during radiopharmaceutical injections by referring the principles of radiation protection from external exposure. However there is a limitation of distance for direct injection and time for patients having attenuated tubules. We confirmed the reduction of radiation exposure by increasing distance. In case of setting shield from source 25 cm away, we confirmed reducing of radiation exposure. Therefore it would be better for reducing of radiation exposure to using shield during radiopharmaceutical injection.

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