• Journal of Preventive Medicine and Public Health
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• v.32 no.1
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• pp.17-29
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• 1999

Objectives. This study was carried out to analyze the hearingthreshold levels and relating factors of 1,048 workers with noiseinduced hearing loss$(D_1)$. Methods. We analyzed the hearing-threshold levels and relating factors of 1,048 workers with noise-induced hearing loss$(D_1)$ examined by the summary reports of specific health examination results of industries and personal reports of specific health examination results reported by 58 specific health examination institutes and 8 secondary pneumoconiosis examination institutes in 1996. Results. Among 1,048 workers at 510 workplaces, male workers were 1,009 (96.3%) and female workers were 39 (3.7%). The mean ages of workers initially exposed to noise and at present were 28.7 and 47.2, respectively. The duration of total exposure was 16.5 years. Average hearing-threshold levels analyzed by three-divided classification of the study subjects were 43.7dB(Lt) and 42.6dB(Rt). Those analyzed by six-divided classification were 50.5dB(Lt) and 48.6d8(Rt). Among workers with noise-induced shearing loss$(D_1)$, 16.3% was unilateral hearing loss and 84.6% was classified to compensation case. 8.8%(Rt) and 10.2%(Lt) of them were suspected to be conductive hearing loss by differences of air-bone hearing-threshold levels. Hearing-threshold levels of workers in manufacturing industry were significantly increased during the short exposure compared with the levels in mining industry. Among manufacturing industries, hearing-threshold levels of workers in trailer and other transportation equipment manufacturing industry were significantly increased. Age and duration of total noise exposure were not significantly related to the average hearing-threshold levels analyzed by three-divided classification. Hearing-threshold levels of female workers were significantly increased during the short exposure compared with those of male workers. Hearing-threshold levels of workers at the high risk group, ages of 20s, 30s and total exposure duration of less than 10 years, were not significantly increased compared with those of the other groups. However, they were exposed at young ages. The 3 leading industries of workers at high risk group were trailer and other transportation equipment manufacturing, automobile manufacturing and assemble-metal manufacturing industries. Conclusions. This study was the first nationwide analysis of the hearing-threshold levels and relating factors of workers with noise. induced hearing loss$(D_1)$. We found the differences of the real number by the statistics of the department of labour and the expected number of worker' s compensations for occupationally-induced hearing loss estimated by this study. According to the results of this study, we should carefully examine the methods to narrow this difference.

• Journal of Environmental Policy
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• v.12 no.1
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• pp.75-100
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• 2013

Health damages such as pneumoconiosis and kidney damage, caused by environmental hazardous factors are being reported in health impact assessment conducted on environmentally vulnerable areas, including cement factories and refineries. Current legal system for relieving the environmental victims is not effective enough because the environmental health act does not specify the environmental hazardous factors to be considered for the relief. The aim of this study is to examine the problems of the existing system by making empirical analysis on health damages and afflicted people as well as on cases when afflicted people were able to be covered by remedy system. The results show that, insufficiencies of the relief system are due to the following reasons: First, current Environmental Health Act does not act well as a remedy system. Second, due to its unique nature of environmental health damage, it is hard to identify and prove the cause of health damage and unlawful actions of violators in the process of environmental dispute conciliation and lawsuits against polluters. This paper suggests following solutions on above mentioned problems. First, in defining the range and definition of environmental diseases, negative system should be used alongside with the current positive system. Second, we suggest adding the nature of public law to relief system, in order to ease the legal burden of proof. Third, in case when it is hard to identify the polluters and one cannot expect reliefs for their damage, it is possible to elevate the effectiveness of the relief measure by expanding scope of the search for possible environmental hazardous factors that caused the health damage. It is urgent to improve the relief system so as to secure the environmental rights of Koreans.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.15
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• pp.6401-6406
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• 2015

Background: It is sometimes difficult to assess patients who have multiple hilar and mediastinal lymph nodes (MHMLN) with FDG accumulation in PET-CT. Since it is uncertain whether diffusion-weighted magnetic resonance imaging (DWI) is useful in the assessment of such patients, its diagnostic performance was assessed. Materials and Methods: Twenty-three patients who had three or more stations of hilar and mediastinal lymph nodes with SUVmax of 3 or more in PET-CT were included in this study. Results: For diagnosis of disease, there were 20 malignancies (lung cancers 17, malignant lymphomas 2 and metastatic lung tumor 1), and 3 benign cases (sarcoidosis 2 and benign disease 1). For diagnosis of lymph nodes, there were 7 malignancies (metastasis of lung cancer 7 and malignant lymphoma 1) and 16 benign lymphadenopathies (pneumoconiosis/silicosis 7, sarcoidosis 4, benign disease 4, and atypical lymphocyte infiltration 1). The ADC value ($1.57{\pm}0.29{\times}10^{-3}mm^2/sec$) of malignant MHMLN was significantly lower than that ($1.99{\pm}0.24{\times}10^{-3}mm^2/sec$) of benign MHMLN (P=0.0437). However, the SUVmax was not significantly higher ($10.0{\pm}7.34$ as compared to $6.38{\pm}4.31$) (P=0.15). The sensitivity (86%) by PET-CT was not significantly higher than that (71%) by DWI for malignant MHMLN (P=1.0). The specificity (100%) by DWI was significantly higher than that (31%) for benign MHMLN (P=0.0098). Furthermore, the accuracy (91%) with DWI was significantly higher than that (48%) with PET-CT for MHMLN (P=0.0129). Conclusions: Evaluation by DWI for patients with MHMLN with FDG accumulation is useful for distinguishing benign from malignant conditions.

• Journal of Korean Tunnelling and Underground Space Association
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• v.19 no.4
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• pp.589-609
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• 2017

This study carried out the density and energy dispersive X-ray spectroscopy and particle size analysis which are the physical characteristics of coal dust by collecting samples of coal dust in the five domestic mines to control the coal dust through ventilation in the workplace for coal mining in the country. This will contribute to a more comfortable working environment by understanding the physical characteristics of the coal dust which is derived from any hard coal produced domestically. In particular, the result of PSA analysis showed that the size of coal dust sample for this study ranged from $0.007{\sim}88.614{\mu}m$ were the particles less than $3.5{\mu}m$, the size range responsible for pneumoconiosis. To observe the flow of coal dust collected on the wind speed, the fallout of coal dust produced by the wind tunnel for the wind was measured and the particle size analysis of coal dust fallout was carried out. In addition, airborne dust is measured according to the mine velocity by using a multi-stage Anderson sampler in the mine where fine dust is generated in a large amount and the wind speed is found out to control the coal dust below $3.5{\mu}m$. In addition, natural ventilation pressure of A mine was calculated to prevent over design of the main fan.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.9 no.1
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• pp.99-111
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• 1999

The purpose of this study was to evaluate crystalline silica contents in airborne respirable dusts from various manufacturing industries and to compare analytical ability of two different methods of quantifying crystalline silica, X-ray diffraction(XRD) and Fourie transform infrared spectroscopy(FTIR). Various manufacturing industries with a history of having pneumoconiosis cases and also known to generate dusts containing crystalline silica were investigated. These industries include: ceramics, brick, concrete, and abrasive material etc. The personal respirable dust samples were collected using l0mm, Dorr-Oliver nylon cyclone equipped with 37mm, $5{\mu}m$ pore size. polyvinylchloride (PVC) filters as collection media. All samples were weighed before and after sampling and were pretreated according to the NIOSH sampling and analytical methods 7500, and 7602 for dust collection and quartz analysis. A total of 48 samples were collected from these industries. Initial analyses of these samples showed log-normal distributions for dust and quartz concentrations. Some results from ceramics and stone exceeded current Korean Occupational Exposure Limits. The average concentrations of personal respirable dust by cyclone were 0.43, 0.24, 0.26, 0.42, 0.53 and $0.29mg/m^3$ in ceramics, stone, concrete, glass, briquets, and others, respectively. A comparison of performance of two analytical methods for quantifying crystalline silica was performed using data from ceramics. The results showed that no significant difference was found between two methods for ceramics. The mean crystalline silica contents determined by XRD were 3.41 % of samples from briquets and 7.18 % from ceramics and were 2.58 % from concrete and 10.33 % from ceramics by FTIR. For crystalline silica analysis, two analytical techniques were highly correlated with $r^2=0.81$ from ceramics. Both cristobalite and tridymite were not detected by XRD and FTIR.

• Journal of Preventive Medicine and Public Health
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• v.30 no.2 s.57
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• pp.392-401
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• 1997

Generally working environment and worker's health status of small scale industries (SSI) which employ less than 50 workers are known to be poorer than those of large scale industries(LSI) which employ more than 500 workers. However, according to the analysis of occupational injuries in Korea, prevalence rate of occupational injuries of SSI was 3.1 times as high as LSI. But there was no difference in prevalence rate of occupational disease and werkers with suspected occupational disease(D1) between SSI and LSI. To confirm these two different facts, we surveyed working environment and worker's health status of SSI and LSI in Kyeungin industrial complex. Workers in SSI were 10,878 and workers in LSI were 8,291 and number of hazardous agents in SSI were 3,554 and those of LSI were 1,916. We found following results. First, proportion of male workers and workers who were less than 30 yens old and more than 50 yens old was higher in SSI compared to LSI. Second, worker in SSI had more liver disease, viral hepatitis, and pneumoconiosis than in LSI, and there were more worker with suspected occupational disease, general disease, and worker needed close observation in SSI. But these effects had not statistical significance under the condition controlled by age and sex with logistic regression. Third, the numbers measured for specific chemicals, organic solvents, and heavy metals in SSI was more than in LSI. However there was on difference in the excess rate of each hazardous agent between SSI and LSI. As the above results workers' health status in SSI was poorer than in LSI, but these results were mainly due to the population structure difference. Although there were some limitation of this study and problems of sensitivity and validity for periodic health examination and working environment evaluation method, the concept that working environment and worker's health status in SSI should be reviewed. In future the study that will reveal the real weak point of SSI should be performed.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.31 no.3
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• pp.286-293
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• 2021

Objectives: Inorganic dust is known to be a risk factor for chronic obstructive pulmonary disease (COPD) regardless of smoking and pneumoconiosis. Adaptive and innate immunity, including lymphocyte infiltrate, are involved in the pathogenesis of COPD. The purpose of this study was to analyze the lymphocyte subsets in the blood of workers exposed to inorganic dust and confirm the influencing factors. Methods: The general characteristics of the subjects (n=107) were analyzed through a personal questionnaire. Diagnosis of COPD was established according to pulmonary function tests with FEV₁/FVC post bronchodilator lower than 70%, according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. For lymphocyte analysis, blood was stained with a fluorescent CD marker and analyzed by flow cytometry. Results: The increase in CD4⁺ T lymphocytes was associated with a decrease in age (𝛽=-0.273, p=0.008) and an increase in the cumulative smoking amount (𝛽=0.205, p=0.034). The increase in NK cells was associated with an increase in age (𝛽=0.325, p=0.001) and a decrease in cumulative smoking (𝛽=-0.220, p=0.019). The period of exposure to dust, %FVC predicted and %FEV₁/FVC, and the relative population of peripheral blood lymphocytes did not show a statistically significant relationship. Conclusions: CD4⁺ T lymphocytes and CD56⁺CD16⁺ NK cells in peripheral blood were more related to age and cumulative smoking than the duration of dust exposure. Age and smoking are major risk factors for the development of COPD, so it can be predicted that peripheral blood CD4⁺ T lymphocytes and CD56⁺CD16⁺ NK cells are related to the development of COPD in workers exposed to inorganic dust.

• Tuberculosis and Respiratory Diseases
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• v.53 no.5
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• pp.510-518
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• 2002

Background : Bronchial anthracofibrosis (BAF) is a dark black or brown pigmentation of multiple large bronchi associated with a fibrotic stenosis or obliteration that is incidentally found during a diagnostic bronchoscopy some reporters have suggested endobronchial tuberculosis or tuberculous lymphadenitis as a possible cause of BAF. However, some BAF patients do not have any medical history of tuberculosis. The aim of this study was to elucidate the clinical features of simple BAF patients, which were not associated with tuberculosis. Methods : We reviewed the patients' charts retrospectiely and interviewed all BAF patients who were followed up for 1 year or more. Among the 114 BAF patients, 43 patents (38 %) had no associated tuberculosis, cancer and pneumoconiosis. The clinical characteristics, radiological findings and associated pulmonary diseases of these patients were evaluated. Results : Most patients were non-smokers, old aged, housewifes who resided in a farming village. The common respiratory symptoms were dyspnea, cough and hemoptysis. The predominant X-ray findings were a multiple bronchial wall thickening(89%), bronchial narrowing or atelectasis (76%) and a mediastinal lymph node enlargement with/without calcification (78%). Pulmonary function test usually showed mild obstructive ventilatory abnormalities but no patient showed a restrictive ventilatory pattern and the patients were frequently affected with chronic bronchitis(51%), post-obstructive pneumonia(40%) and chronic asthma(4%). Conclusion : Because BAF is frequently associated with chronic bronchitis and obstructive pneumonia as well as tuberculosis, a careful clinical evaluation and accurate differential diagnosis is more essential than empirical anti-tuberculous medication.

• Tuberculosis and Respiratory Diseases
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• v.38 no.2
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• pp.155-163
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• 1991

Bronchoalveolar lavage had been done as the treatment of some diseases such as alveolar proteinsois, bronchiectasis, and severe asthma to remove excessive secretion or mucus. But in the recent decade it has been done as a diagnostic method and a tool to understand and evaluate the pathophysiology of diffuse interstitial lung diseases such as sarcoidosis, pneumoconiosis and hypersensitivity pneumonitis. To analyse the bronchoalveolar fluid, it might be useful to have a standard reference (especially cell counts and differetial count of the cells from bronchoalveolar lavage fluid) of normal person. But it is difficult to study the normal volunteers. We investgated the bronchoalveolar lavage fluid of 48 patients (28 nonsmokers, 20 smokers) who visited Severance Hospital because of minor pulmonary symptoms such as cough and sputum. They did neither complain of dyspnea nor cyanosis, and had normal or unilateral minor lesion on physical examination and chest X-ray. We analysed the recovery rate, viability, total cell count and differential count of the cells in fluid obtained by bronchoalveolar lavage. The following results were obtained: 1) Age ranged from 17 to 72 years-old with the mean age of 36.7; there was no difference of age between the nonsmoker and the smoker gorup. Male to female ratio was 2.43:1 for total group, 1.15:1 for nonsmokers, and 19:1 for smokers. 2) The diagnoses of the patients were undetermined in 41.9%, healed pulmonary tuberculosis in 37.5%, laryngitis or pharyngitis in 10.4% and others in 10.4%. 3) Total cell number of the recovered fluid by bronchoalveolar lavage was significantly higher in male[$9.6{\pm}6.2({\times}10^6)$] than in female[$5.1{\pm}3.0({\times}10^6)$](p<0.05), and there was no significant difference in the total cell number between the smokers and nonsmokers [$9.3{\pm}5.8({\times}10^6)$ vs $7.5{\pm}5.8({\times}10^6)$]. 4) The differential count of the cells from bronchoalveolar lavage fluid had no difference between the nonsmokers and the smokers. 5) There was no correlation between the total cell count and smoking or age. 6) In the smoker group, there was no correlation between the amount of smoking and the total cell count of the bronchoalveolar fluid. In conclusion, it should be careful to regard the patients with symptoms or minor radiologic abnormalities as a control group in bronchoalveolar lavage study and further study of cell analysis in bronchoalveolar lavage will be needed between smoker and nonsmoker in the male and female healthy people.

• Journal of the Korean Society of Radiology
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• v.82 no.3
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• pp.562-574
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• 2021

MRI has the advantages of having excellent soft-tissue contrast and providing functional information without any harmful ionizing radiation. Although previous technical limitations restricted the use of chest MRI, recent technological advances and expansion of insurance coverage are increasing the demand for chest MRI. Recognizing the need for guidelines on appropriate use of chest MRI in Korean clinical settings, the Korean Society of Radiology has composed a development committee, working committee, and advisory committee to develop Korean chest MRI justification guidelines. Five key questions were selected and recommendations have been made with the evidence-based clinical imaging guideline adaptation methodology. Recommendations are as follows. Chest MRI can be considered in the following circumstances: for patients with incidentally found anterior mediastinal masses to exclude non-neoplastic conditions, for pneumoconiosis patients with lung masses to differentiate progressive massive fibrosis from lung cancer, and when invasion of the chest wall, vertebrae, diaphragm, or major vessels by malignant pleural mesothelioma or non-small cell lung cancer is suspected. Chest MRI without contrast enhancement or with minimal dose low-risk contrast media can be considered for pregnant women with suspected pulmonary embolism. Lastly, chest MRI is recommended for patients with pancoast tumors planned for radical surgery.