• Environmental Analysis Health and Toxicology
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• 제26권
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• pp.11.1-11.6
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• 2011

Objects: The prevalence of asthma has increased in recent decades globally. The objective of the present study is to elucidate whether hospitalization for bronchiolitis in infancy and low socioeconomic status interact for bronchial hyperreactivity during teenage years. Method: We studied 522 children age 13-14 years attending schools in rural and urban areas to investigate the risk factors for bronchial hyperreactivity (BHR), defined as a provocation concentration of methacholine that causes a decrease of 20% ($PC_{20}$) in forced expiratory volume within 1 second. Clinical examination, skin prick test, spirometry, and methacholine challenge were performed on all study subjects, who provided written consent. We used multivariate logistic regression to investigate the risk factors for BHR, and analyze the interaction between hospitalization for bronchiolitis in infancy and low socioeconomic status. Results: Forty-six (10.3%) positive BHR cases were identified. In the multivariate logistic analysis, as independent predictors of BHR, adjusted odds ratio of bronchiolitis diagnosed before 2 years of age in low income families was 13.7 (95% confidence interval, 1.4 to 135.0), compared to reference group, controlling for age, gender, parental allergy history, skin prick test, and environmental tobacco smoke (ETS) exposure. Interaction was observed between bronchiolitis before 2 years old and low socioeconomic status on children's bronchial hyperreactivity (p-interaction=0.025). Conclusions: This study showed that bronchiolitis diagnosed before 2 years of age and low socioeconomic status interacted on children's bronchial hyperreactivity. Prevention of acute respiratory infection in early childhood in low socioeconomic status is important to prevent BHR as a precursor of asthma.

• Korean Journal of Radiology
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• 제24권8호
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• pp.795-806
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• 2023

Occupational lung diseases (OLD) are a group of preventable conditions caused by noxious inhalation exposure in the workplace. Workers in various industries are at a higher risk of developing OLD. Despite regulations contributing to a decreased incidence, OLD remain among the most frequently diagnosed work-related conditions, contributing to significant morbidity and mortality. A multidisciplinary discussion (MDD) is necessary for a timely diagnosis. Imaging, particularly computed tomography, plays a central role in diagnosing OLD and excluding other inhalational lung diseases. OLD can be broadly classified into fibrotic and non-fibrotic forms. Imaging reflects variable degrees of inflammation and fibrosis involving the airways, parenchyma, and pleura. Common manifestations include classical pneumoconioses, chronic granulomatous diseases (CGD), and small and large airway diseases. Imaging is influenced by the type of inciting exposure. The findings of airway disease may be subtle or solely uncovered upon expiration. High-resolution chest CT, including expiratory-phase imaging, should be performed in all patients with suspected OLD. Radiologists should familiarize themselves with these imaging features to improve diagnostic accuracy.

• Safety and Health at Work
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• 제3권1호
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• pp.1-10
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• 2012

The aim of this review was to assess current knowledge related to the occupational exposure limit (OEL) for fluid aerosols including either mineral or chemical oil that are generated in metalworking operations, and to discuss whether their OEL can be appropriately used to prevent several health risks that may vary among metalworking fluid (MWF) types. The OEL (time-weighted average; 5 mg/$m^3$, short-term exposure limit ; 15 mg/$m^3$) has been applied to MWF aerosols without consideration of different fluid aerosol-size fractions. The OEL, is also based on the assumption that there are no significant differences in risk among fluid types, which may be contentious. Particularly, the health risks from exposure to water-soluble fluids may not have been sufficiently considered. Although adoption of The National Institute for Occupational Safety and Health's recommended exposure limit for MWF aerosol (0.5 mg/$m^3$ ) would be an effective step towards minimizing and evaluating the upper respiratory irritation that may be caused by neat or diluted MWF, this would fail to address the hazards (e.g., asthma and hypersensitivity pneumonitis) caused by microbial contaminants generated only by the use of water-soluble fluids. The absence of an OEL for the water-soluble fluids used in approximately 80-90 % of all applicants may result in limitations of the protection from health risks caused by exposure to those fluids.

• Annals of Occupational and Environmental Medicine
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• 제35권
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• pp.26.1-26.15
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• 2023

Background: The objective of this study is to investigate the differences in incidence rates of targeted diseases by classification of occupations among construction workers in Korea. Methods: In a subject-based cohort of the Korean Construction Worker's Cohort, we surveyed a total of 1,027 construction workers. As occupational exposure, the classification of occupations was developed using two axes: construction business and job type. To analyze disease incidence, we linked survey data with National Health Insurance Service data. Eleven target disease categories with high prevalence or estimated work-relatedness among construction workers were evaluated in our study. The average incidence rates were calculated as cases per 1,000 person-years (PY). Results: Injury, poisoning, and certain other consequences of external causes had the highest incidence rate of 344.08 per 1,000 PY, followed by disease of the musculoskeletal system and connective tissue for 208.64 and diseases of the skin and subcutaneous tissue for 197.87 in our cohort. We especially found that chronic obstructive pulmonary disease was more common in construction painters, civil engineering welders, and civil engineering frame mold carpenters, asthma in construction painters, landscape, and construction water proofers, interstitial lung diseases in construction water proofers. Conclusions: This is the first study to systematically classify complex construction occupations in order to analyze occupational diseases in Korean construction workers. There were differences in disease incidences among construction workers based on the classification of occupations. It is necessary to develop customized occupational safety and health policies for high-risk occupations for each disease in the construction industry.

• Journal of Preventive Medicine and Public Health
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• 제49권5호
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• pp.329-341
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• 2016

Objectives: The goal of this study was to investigate the short-term effect of ambient air pollution on emergency department (ED) visits in Seoul for asthma according to patients' prior history of allergic diseases. Methods: Data on ED visits from 2005 to 2009 were obtained from the Health Insurance Review and Assessment Service. To evaluate the risk of ED visits for asthma related to ambient air pollutants (carbon monoxide [CO], nitrogen dioxide [$NO_2$], ozone [$O_3$], sulfur dioxide [$SO_2$], and particulate matter with an aerodynamic diameter <$10{\mu}m$ [$PM_{10}$]), a generalized additive model with a Poisson distribution was used; a single-lag model and a cumulative-effect model (average concentration over the previous 1-7 days) were also explored. The percent increase and 95% confidence interval (CI) were calculated for each interquartile range (IQR) increment in the concentration of each air pollutant. Subgroup analyses were done by age, gender, the presence of allergic disease, and season. Results: A total of 33 751 asthma attack cases were observed during the study period. The strongest association was a 9.6% increase (95% CI, 6.9% to 12.3%) in the risk of ED visits for asthma per IQR increase in $O_3$ concentration. IQR changes in $NO_2$ and $PM_{10}$ concentrations were also significantly associated with ED visits in the cumulative lag 7 model. Among patients with a prior history of allergic rhinitis or atopic dermatitis, the risk of ED visits for asthma per IQR increase in $PM_{10}$ concentration was higher (3.9%; 95% CI, 1.2% to 6.7%) than in patients with no such history. Conclusions: Ambient air pollutants were positively associated with ED visits for asthma, especially among subjects with a prior history of allergic rhinitis or atopic dermatitis.

• 한국산업보건학회지
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• 제22권2호
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• pp.164-173
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• 2012

Objectives: Epichlorohydrin is a material that has been predicted to have high volatility and strong toxicity and is used normally in working area. Therefore, the hazardous and dangerous level and the foreign management system about epichlorohydrin should be invested at home and abroad and through hazard assessment for occupational environment measurement and exposure status of industrial workers in domestic working area. Methods: To assess risk and to suggest Development and Adoption to prevent health damage of workers owing to the epichlorohydrin exposure, the hazardousness and dangerousness of epichlorohydrin and its practical examples and regulation level for domestic and abroad health impairment are researched on the base of various references. Results: The epichlorohydrin caused skin and mucus membrane irritation, respiratory paralysis, kidney and live damage under the influence of acute toxicity and in animal study, it was confirmed as a doubtful carcinogenic substance to trigger reducement of sperm number and reproduction ability, abnormal spermatogenesis, mutagen, increase of forestomach epithelium and occurrence of papilloma and so on, as well as it induced stimulus asthma and allergic contact dermatitis for exposure workers. Conclusions: Epichlorohydrin was found to occur allergic contact dermatitis, carcinogenesis doubt and reproduction toxicity and was verified as a material which would be established reinforcement of management level to care health of handlers, such as denotement dangerousness of skin absorption.

• 한국환경보건학회지
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• 제47권3호
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• pp.279-291
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• 2021

Objectives: This study investigated the association between air pollutant levels and medical usage rates for environmental disease in a general residential area during the period 2015-2017. Methods: Air pollutant (PM₁₀, PM_2.5, SO₂, NO₂, CO, O₃) data were collected from Air-Korea. Medical usage data on environmental disease (asthma, allergic rhinitis, atopic dermatitis) for the period 2015-2017 in a general residential area in Gyeongsangnam-do Province were provided by the National Health Insurance Corporation. Pearson correlation analysis and multiple regression analysis were conducted to investigate the association between air pollutant levels and medical usage rates (SAS 9.4). In the multiple regression analysis, environmental disease was set as the dependent variable and air pollutants were set as independent variables and analyzed using the General Linear Model. Results: Except for PM_2.5, the average concentration of air pollutants in the surveyed area was below than the air environment standards of Korea. NO₂ was higher than Korea's national average, but CO was similar. The others were lower than the Korea's national average. The daily medical usage rates for environmental disease were 1.38‰ for asthma, 9.90‰ for allergic rhinitis, and 0.32‰ for atopic dermatitis. As a result of correlation analysis, PM₁₀ and SO₂, NO₂ and CO were significantly correlated with asthma, PM₁₀ and NO₂ and CO were correlated with allergic rhinitis, and PM₁₀ and PM_2.5, SO₂, NO₂ and CO were correlated with atopic dermatitis. As a result of multiple regression analysis, PM₁₀ and SO₂ were found to have a higher effect on asthma, PM₁₀ and NO₂ on allergic rhinitis, and SO₂ and NO₂ on atopic dermatitis, compared to other air pollutants. Conclusion: According to these results, air pollutants such as PM₁₀ and SO₂ and NO₂ were associated with the medical usage rates of environmental disease even in relatively low concentrations. Therefore, continuous monitoring will be required for general residential areas.

• 한국산업보건학회지
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• 제22권3호
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• pp.209-216
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• 2012

Objectives: Polyurethanes are usually formed by the reactions of liquid diisocyanate components with liquid polyol resin components. Although polyurethanes have advantageous properties, such as their versatility, the manufacturing process generates diisocyanates, which can cause asthma and respiratory irritation in exposed workers. This study compared the differences in diisocyante concentrations between two different (molded foam and slabstock foam) polyurethane foam manufacturing methods. Materials and Methods: Active samples and direct reading samples of diisocyanates (MDI, TDI) were collected in five polyurethane foam manufacturing companies. Results: Workers' exposure concentrations of diisocyanate (GM: 4.078 ppb, range: 1.190~23.770 ppb) in a slabstock foam manufacturing company were much higher than those (GM: 0.011 ppb, range: 0.001~0.055 ppb) in molded foam manufacturing companies. The results of the direct reading samples of diisocyanate indicated that the rapid reaction zone of the slabstock foam processes emitted large amounts of diisocyanates. Conclusions: The exposure levels of diisocyanates for all molded foam workers were much lower than the occupational exposure standard (5 ppb); however, exposure levels for many slabstock foam workers exceeded the standard.

• Journal of Preventive Medicine and Public Health
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• 제49권4호
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• pp.205-219
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• 2016

Objectives: No children-specified review and meta-analysis paper about the short-term effect of fine particulate matter ($PM_{2.5}$) on hospital admissions and emergency department visits for asthma has been published. We calculated more precise pooled effect estimates on this topic and evaluated the variation in effect size according to the differences in study characteristics not considered in previous studies. Methods: Two authors each independently searched PubMed and EMBASE for relevant studies in March, 2016. We conducted random effect meta-analyses and mixed-effect meta-regression analyses using retrieved summary effect estimates and 95% confidence intervals (CIs) and some characteristics of selected studies. The Egger's test and funnel plot were used to check publication bias. All analyses were done using R version 3.1.3. Results: We ultimately retrieved 26 time-series and case-crossover design studies about the short-term effect of $PM_{2.5}$ on children's hospital admissions and emergency department visits for asthma. In the primary meta-analysis, children's hospital admissions and emergency department visits for asthma were positively associated with a short-term $10{\mu}g/m^3$ increase in $PM_{2.5}$ (relative risk, 1.048; 95% CI, 1.028 to 1.067; $I^2=95.7%$). We also found different effect coefficients by region; the value in Asia was estimated to be lower than in North America or Europe. Conclusions: We strengthened the evidence on the short-term effect of $PM_{2.5}$ on children's hospital admissions and emergency department visits for asthma. Further studies from other regions outside North America and Europe regions are needed for more generalizable evidence.

• Journal of Preventive Medicine and Public Health
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• 제47권1호
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• pp.57-63
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• 2014

Objectives: We established a Wistar rat model of asthma caused by toluene diisocyanate (TDI) exposure, and investigated the relationship between TDI exposure concentrations and respiratory hypersensitivity, airway inflammation, and cytokine secretions in animals, to better understand the mechanism of TDI induced occupational asthma. Methods: Wistar rats were exposed to two different concentrations of TDI vapor four hours a day for five consecutive days. Bronchoalveolar lavage (BAL) was performed, and differential leucocytes from the BAL fluid were analyzed. Lung histopathological examination was carried out to investigate the inflammatory status in the airways. Production of cytokines interleukin (IL)-4 and IL-5 productions in the BAL fluid in vivo was determined with enzyme-linked immunosorbent assay kits. Results: The TDI-exposed rats exhibited greater airway hypersensitivity symptoms than the control rats. The BAL differential cell count and lung histopathological examination demonstrated that inflammation reactions were present in both the central and peripheral airways, characterized with marked infiltration of eosinophils in the TDI-exposed rats. The cytokine assay showed that IL-4 and IL-5 were predominantly produced in the BAL fluid in vivo. Conclusions: These findings imply that TDI exposure concentrations may greatly affect the occurrence and extent of inflammatory events and that Th2 type cytokines may play an important role in the immunopathogenesis of TDI-induced occupational respiratory hypersensitivity.