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Assessment of dust exposure and personal protective equipment among dental technicians (치과기공사의 분진노출 수준 및 개인보호구 착용 실태 - 대구지역을 중심으로 -)

  • Park, Soo-Chul;Jeon, Man-Joong;SaKong, Joon
    • Journal of Technologic Dentistry
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    • v.33 no.1
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    • pp.93-102
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    • 2011
  • Purpose: The study aimed to evaluate working environment for dental technician by measuring dust level, ventilation conditions and the use of personal protective equipment and to provide basic information required to improve working environment and develop health education programs for dental technician. Methods: A total of 240 dental technician who are registered with the Daegu Association of Dental technician and working at 34 dental laboratories participated in the study. And the dust level was measured at 21 different spots in 16 dental laboratories out of 34. Results: Of 34 dental laboratories, 31 (91.2%) were equipped with a ventilator, but the remaining 3 (8.8%) did not have a ventilator. By the number of ventilator, 1 to 3 ventilators were found in 22 dental laboratories (71.0%), 4 to 6 ventilators were in 7 laboratories (22.5%) and more than 7 ventilators in 2 laboratories(6.5%). According to the frequence of changing filters in dust collector, 20 dental laboratories (58.9%) changed filters every four weeks, 10 laboratories (29.4%) changed them every six weeks and 4 laboratories (11.7%) changed them every eight weeks. Of total respondents, 114 (61.3%) said they wore a mask all the time while working, 56 (29.6%) said they frequently wore a mask, 19 (10.1%) said they did not wear a mask. As for the type of masks, 159 (84.1%) used a disposable mask, 25 (13.2%) used a cotton mask and 5 (2.7%) used an anti-dust mask. For dust sat on their outfits while working, 102 (54.0%) shook their uniforms inside workplace to keep dust off the uniforms, 64 (33.9%) did not anything until they wash their uniforms and 23 (12.1%) shook their uniforms outside workplace to keep dust off the uniforms. Of total respondents, 182 (96.3%) had a particle in their eyes while carrying out grinding work. Based on the measurement of floating dust at workplace, 3 dental laboratories showed dust concentration exceeding the minimum level of 10 mg/$m^3$ allowed under the permit for environment. Of those, 1 laboratory had the dust concentration that was more than 1.5 times higher than the minimum level. Dust concentration was higher in laboratories that used a dust collector with 0.5 horse power and changed filters more than 3 weeks ago. Dust comprised of nickel (more than 70%), chrome (9%) and others. The mean chrome concentration was more than twice higher than the minimum permissible level of 0.5 mg/$m^3$. There were two laboratories that showed chrome concentration exceeding the level of 0.4 mg/$m^3$. Like dust concentration, chrome level was higher in laboratories that used a dust collector with 0.5 horse power and changed filters more than 3 weeks ago. There were six laboratories that had nickel concentration exceeding the minimum permissible level of 1 mg/$m^3$. Of those, one laboratory had nickel concentration that was more than three times higher than the minimum permissible level. Nickel concentration was also higher in laboratories that used a dust collector with 0.5 horse power and changed filters more than 3 weeks ago. Conclusion: It is not likely that heavy metal concentrations found in the study constitute respiratory dust. It is however necessary for health of dental technician to apply the Industrial Safety and Healthy Law to dental laboratories and make recommendations for the use of personal protective equipment, installation of a proper number of ventilators, more frequent change of filters in dust collector and improved ventilation for polishing work. At the same time, dental technician need education on how to use personal protective equipment and how to efficiently remove dust from their uniforms.

Subhective Symptoms and Work-related Health Risk Factors in Korean Dental Laboratory Technicians (우리 나라 치과 기공사의 신체 자각 증상과 직업 관련 건강 위험 요인)

  • Kim, Woong-Chul;Lee, Se-Hoon
    • Journal of Technologic Dentistry
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    • v.22 no.1
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    • pp.89-112
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    • 2000
  • Although dental laboratory technicians are prone to be exposed to various work-related health hazardous materials such as dusts, chemicals, etc., the prevalence and nature of work-related health problems of them have not been a matter of great concern in the field of occupational health service in Korea. The purpose of the present investigation was to describe a collected profile of subjective health symptoms and their attributable factors in Korean dental laboratory technicians. A questionnaire listing five groups of health symptoms and five health symptom-related factors was mailed to randomly selected 1,900 dental laboratory technicians. Among them, 1,344 dental laboratory technicians filled out the questionnaires and returnde them. Five groups of health symptoms included musculoskeletal symptom, dermal symptoms, respiratory symptoms, eys symptoms, and ear symptoms. Five health symptom-related factors were occupational environment-related health risk factors, work history, health related habits and status, use of personal protective equipment and general characteristics. Detailed parameters of health risk factors were work posture, vibration, and chemical or physical hazards such as dust, fume, vapor, solvent, light, and noise for occupational environment-related factors; work place, area, number of employees, work hours, career, work part, and work load for work history; Broca's index, hours of sleep, eating, smoking, alcohol, exercise, health examination, and self assessed health status for health habits and status; face masks, goggles, and so on for use of personal protective equipment, and; age, sex, marital status, and education for general characteristics. Before the start of main survey, a pilot survey was carried out for validity and reliability tests of the questionnaire. All the data obtained were coded and analyzed with PC/SAS 6.12 program. The prevalence of health symptoms was the highest in musculoskelton (87.3%), and followde by eyes (78.9%), respiratory organs (64.3%), ears (57.8%), and skin (52.2%) in descending order. Statistically significant risk factors by multiple logistic regression analyses were sex, health examination, self assessed health status, and hand/finger posture in musculoskeletal symptoms; sex, self assessed health status, career, acid gas, and hand contact with resin mixture in deraml symptoms; Broka's smoking, exercise, self assessed health status, and face mask in respiratory symptoms; sex, hours of sleep, self assessed health status, work hours, work load, plaster dust, inadequate lighting, and goggle in eys symptoms, and eating, smoking, self assessed health status, and work load in ear symptoms. With the above considerations in mind, prevalence of subjective symptoms among Korean dental laboratory technicians was relatively high, and they were attributable to most of the occupational environment-related factors, work history, use of personal protective equipment, health habits and status, and general characteristics. Particularly, it is suggested that health promotion programs for promoting self- assessed health status and smoking cessation, preventive measures for protection of the female technicians’health, and reducing work load be necessary, since those factors were associated with more than one subjective symptom.

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In Search of a Performing Seal: Rethinking the Design of Tight-Fitting Respiratory Protective Equipment Facepieces for Users With Facial Hair

  • Meadwell, James;Paxman-Clarke, Lee;Terris, David;Ford, Peter
    • Safety and Health at Work
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    • v.10 no.3
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    • pp.275-304
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    • 2019
  • Background: Air-purifying, tight-fitting facepieces are examples of respiratory protective equipment and are worn to protect workers from potentially harmful particulate and vapors. Research shows that the presence of facial hair on users' face significantly reduces the efficacy of these devices. This article sets out to establish if an acceptable seal could be achieved between facial hair and the facepiece. The team also created and investigated a low-cost "pressure testing" method for assessing the efficacy of a seal to be used during the early design process for a facepiece designed to overcome the facial hair issue. Methods: Nine new designs for face mask seals were prototyped as flat samples. A researcher developed a test rig, and a test protocol was used to evaluate the efficacy of the new seal designs against facial hair. Six of the seal designs were also tested using a version of the conventional fit test. The results were compared with those of the researcher-developed test to look for a correlation between the two test methods. Results: None of the seals performed any better against facial hair than a typical, commercially available facepiece. The pressure testing method devised by the researchers performed well but was not as robust as the fit factor testing. Conclusion: The results show that sealing against facial hair is extremely problematic unless an excessive force is applied to the facepiece's seal area pushing it against the face. The means of pressure testing devised by the researchers could be seen as a low-cost technique to be used at the early stages of a the design process, before fit testing is viable.

Transmission Characteristics of SARS-CoV-2 That Hinder Effective Control

  • Seongman Bae;Joon Seo Lim;Ji Yeun Kim;Jiwon Jung;Sung-Han Kim
    • IMMUNE NETWORK
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    • v.21 no.1
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    • pp.9.1-9.8
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    • 2021
  • The most important characteristics of coronavirus disease 2019 (COVID-19) transmission that makes it difficult to control are 1) asymptomatic and presymptomatic transmission, 2) low incidence or lack of dominant systemic symptoms such as fever, 3) airborne transmission that may need a high infectious dose, and 4) super-spread events (SSEs). Patients with COVID-19 have high viral loads at symptom onset or even a few days prior to symptom onset, and most patients with COVID-19 have only mild respiratory symptoms or merely pauci-/null-symptoms. These characteristics of the virus enable it to easily spread to the community because most patients are unaware of their potential infectivity, and symptom-based control measures cannot prevent this type of transmission. Furthermore, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is also capable of airborne transmission in conditions such as aerosol-generating procedures, under-ventilated indoor spaces, and over-crowded areas. In this context, universal mask-wearing is important to prevent both outward and inward transmission until an adequate degree of herd immunity is achieved through vaccination. Lastly, the SSEs of SARS-CoV-2 transmission emphasize the importance of reducing contacts by limiting social gatherings. The above-mentioned transmission characteristics of SARS-CoV-2 have culminated in the failure of long-lasting quarantine measures, and indicate that only highly effective vaccines can keep the communities safe from this deadly, multifaceted virus.

Continuous Positive Airway Pressure during Bronchoalveolar Lavage in Patients with Severe Hypoxemia (심한 저산소혈증 환자에서 기관지폐포세척술 시 안면마스크를 이용한 지속성 기도양압의 유용성)

  • An, Chang Hyeok;Lim, Sung Yong;Suh, Gee Young;Park, Gye Young;Park, Jung Woong;Jeong, Seong Hwan;Lim, Si Young;Oui, Misook;Koh, Won-Jung;Chung, Man Pyo;Kim, Hojoong;Kwon, O Jung
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.1
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    • pp.71-79
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    • 2003
  • Background : A bronchoalveolar lavage(BAL) is useful in diagnosing the etiology of bilateral pulmonary infiltrations, but may worsen the oxygenation and clinical status in severely hypoxemic patients. This study assessed the safety and efficacy of the continuous positive airway pressure(CPAP) using a conventional mechanical ventilator via a face mask as a tool for maintaining the oxygenation level during BAL. Methods : Seven consecutive patients with the bilateral pulmonary infiltrates and severe hypoxemia ($PaO_2/FIO_2$ ratio ${\leq}200$ on oxygen 10 L/min via mask with reservoir bag) were enrolled. The CPAP 5-6 $cmH_2O(F_IO_2\;1.0)$ was delivered through an inflatable face mask using a conventional mechanical ventilator. The CPAP began 10 min before starting the BAL and continued for 30 min after the procedure was completed. A bronchoscope was passed through a T-adapter and advanced through the mouth. BAL was performed using the conventional method. The vital signs, pulse oxymetry values, and arterial blood gases were monitored during the study. Results : (1) Median age was 56 years(male:female=4:3). (2) The baseline $PaO_2$ was $78{\pm}16mmHg$, which increased significantly to $269{\pm}116mmHg$(p=0.018) with CPAP. After the BAL, the $PaO_2$ did not decrease significantly but returned to the baseline level after the CPAP was discontinued. The $SpO_2$ showed a similar trend with the $PaO_2$ and did not decrease to below 90 % during the duration of the study. (3) The $PaCO_2$ increased and the pH decreased significantly after the BAL but returned to the baseline level within 30 min after the BAL. (5) No complications directly related to the BAL procedure were encountered. However, intubation was necessary in 3 patients(43 %) due to the progression of the underlying diseases. Conclusion : In severe hypoxemic patients, CPAP using a face mask and conventional mechanical ventilator during a BAL might allow minimal alterations in oxygenation and prevent subsequent respiratory failure.

Clinical Significance of Nasal Peak Inspiratory Flow Rate in Patients with Chronic Cough (만성기침환자에서 비강최대흡기유속 측정의 의의)

  • An, Chang-Hyeok;Lee, Byung-Hun;Park, Yong-Bum;Choi, Jae-Chul;Jee, Hyun-Suk;Park, Sung-Jin;Kang, Sun-Bok;Kim, Jae-Yeol;Park, In-Won;Choi, Byung-Whi;Hue, Sung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.5
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    • pp.654-661
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    • 1999
  • Background : The upper respiratory tract is the primary target organ of various airborne pollutants and is easily accessible part of the respiratory tract, and also is the predominant structure where chronic cough originates. The nasal peak inspiratory flow(PIFn), which is the peak inspiratory flow via nose with nasal mask and spirometry, could be a reliable parameter of nasal obstruction. The validity of PIFn has been evaluated in several studies by assessing the correlation between PIFn measurements and other parameters of nasal air flow. This study was designed to show the reproducibility of PIFn, the difference of PIFn between patients with chronic cough and normal subjects, and the usefulness of PIFn in the evaluation of nasal obstruction in patients with chronic cough. Methods : PIFn was measured by spirometry with nasal mask, twice a day for 3 consecutive days in 7 young normal subjects to evaluate validity of the test. In 32 patients with chronic cough and 25 age-matched normal subjects, PIFn and pulmonary function test($FEV_1$, $FEV_1%$ pred, FVC, and FVC% pred) were measured at first visiting. Results : Values of PIFn, $FEV_1$, and FVC were nearly constant in 7 young normal adults. Patients with chronic cough were 32 (14 males and 18 females) and the mean age was $41.4{\pm}15.9$ years. Normal subjects were 32(22 males and 10 females) and the mean age was $39.8{\pm}18.6$ years. There was no significant difference of age and pulmonary function test between patients with chronic cough and normal subjects(p<0.05). The PIFn values in patients with chronic cough was significantly lower than those of normal subjects($2.25{\pm}0.68\;L/sec$ vs. $2.75{\pm}1.00\;L/sec$ ; p=0.02). The postnasal drip syndrome(PNDS) comprised the majority of patients with chronic cough(27). The PIFn in patients with PNDS was significantly lower than that of normal subjects (mean$\pm$SD ; $2.18{\pm}0.66$ vs. $2.75{\pm}1.00\;L/sec$, p=0.006). Conclusion : There was a significant difference of PIFn between patients with chronic cough and normal subjects. Among the patients with chronic cough, patients with PNDS showed the most significant difference with normal subjects in PIFn. The PIFn could be a useful parameter of nasal obstruction in patients with chronic cough, especially in patients with PNDS.

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Failed Airway Management in a Patient with Wound Hematoma After Partial Mandibulectomy and Reconstruction with Free Flap (하악골 부분절제술을 받은 환자에서 발생한 기도 관리 실패)

  • Kim, Seokkon;Song, Jaegyok;Kang, Bongjin;Choi, Cheolwhan;Choi, Gyuwoon
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.13 no.3
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    • pp.127-131
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    • 2013
  • We experienced failed airway management in a patient who had partial mandibulectomy and reconstruction with free-flap. 40 year-old man (height: 164 cm, body weight: 59 kg) with malignant melanoma on #38 tooth area of mandibular body was scheduled for partial mandibulectomy and reconstruction with free flap. Approximately fifteen-hours after surgery, the patient was extubated without complication. Seven hours after extubation, we experienced respiratory failure andfailed airway managementdue to airway edema and neck. We failed orotracheal intubation with direct laryngoscopy andlaryngeal mask airway, thus we tried tracheostomy but the patient was hypoxic state for more than 30 minutes. The patient had got hypoxic brain damage in whole cerebral cortex and basal ganglia. We should have the policy of airway management of the patients who have massive oro-maxillo-facial surgery and all medical personnel who treat these patients should be educated the policy and airway management methods.

Blood Gas Analysis of Respiratory Depression during Sevoflurane Inhalation Induction for General Anesthesia in the Disabled Patients (장애 환자의 전신 마취를 위한 세보플루란 흡입 유도 시 발생한 호흡 저하의 혈액 가스 분석)

  • Yoon, Taewan;Kim, Seungoh
    • Journal of the korean academy of Pediatric Dentistry
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    • v.45 no.4
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    • pp.508-513
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    • 2018
  • Tidal volume by sevoflurane in small amounts is stable due to the increase in the breathing rate. But alveolus ventilation decreases due to sevoflurane as the degree of sedation increases; this ultimately causes $PaCO_2$ to rise. The occurrence of suppression of breath increases the risk of severe hypoxia and hypercapnia in deeply sedated patients with disabilities. Sevoflurane inhalation anesthesia has a number of risks and may have unexpected problems with hemodynamic changes depending on the underlying state of the body. This study was conducted to examine the stability of internal acid-base system caused by respiratory depression occurring when patients with disabilities are induced by sevoflurane. Anesthetic induction was carried out by placing a mask on top of the patient's face and through voluntary breathing with 4 vol% of sevoflurane, 4 L/min of nitrous oxide, and 4 L/min of oxygen. After the patient's loss of consciousness and muscle relaxation, IV line was inserted by an expert and intravenous blood gas was analyzed by extracting blood from vein. In a deeply sedated state, the average amount of pH of the entire patients was measured as $7.36{\pm}0.06$. The average amount of $PvCO_2$ of the entire patients was measured as $48.8{\pm}8.50mmHg$. The average amount of $HCO_3{^-}$ of the entire patients was measured as $27.2{\pm}3.0mmol/L$. In conclusion, in dental treatment of patients with disabilities, the internal acid base response to inhalation sedation using sevoflurane is relatively stable.

Demand for Priorities for Preventing Occupational Diseases among Farmers (농업인들의 업무상질환 예방을 위한 우선순위에 대한 요구도)

  • Ae-Rim Seo;Ji-Youn Kim;Bokyoung Kim;Gyeong-Ye Lee;Kyungsu Kim;Ki-Soo Park
    • Journal of agricultural medicine and community health
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    • v.48 no.4
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    • pp.239-250
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    • 2023
  • Objective: This study was a preliminary study for the prevention programs for farmers' occupational diseases. It selected the priorities recognized by farmers, such as occupational diseases, and also identifies the effectiveness and feasibility of prevention programs among diseases recognized by farmers. Therefore, we plan to use it as basis data for future farmer safety and health programs. Method: The subjects of the study were farmers living in the region, selected through a snowball recruitment method, and a total of 671 people were targeted. The priority selection method was the Basic Priority Rating System (BPRS) method, and among the occupational diseases, programs to prevent musculoskeletal diseases, cardiovascular and respiratory diseases, and pesticide poisoning were surveyed on the effectiveness and feasibility of farmers. Results: Among occupational diseases, the highest priority was musculo-skeletal disease, followed by respiratory disease and pesticide poisoning. Among the programs for musculoskeletal disease, 'use of agricultural work convenience equipment and auxiliary tools' had the highest perceived effectiveness and feasibility. Among the five programs for pesticide poisoning, 'equipment of protective equipment such as pesticide protective clothing/glove' had the highest effectiveness at 67.4%, and 'compliance with pesticide use instructions' had the highest level of feasibility at 64.3%. Among the four programs to prevent respiratory diseases, 'wearing a dust mask or gas mask' was the highest at 65.5% in terms of both effectiveness and feasibility. Conclusion: When carrying out safety and health programs for farmers, the priorities recognized by farmers should be taken into consideration, and the program contents should also be developed taking into account the size of effect and feasibility recognized by farmers.

Comparison of Droplet Infection Prevention Activity and Knowledge of Cough Etiquette among Nursing Hospital Workers (요양병원 종사자들의 비말감염 예방 활동과 기침예절 지식 비교)

  • Park, Kyung-Hye;Kang, Sook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.3
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    • pp.360-369
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    • 2020
  • This study examined and compared the droplet infection prevention activity and cough etiquette knowledge among nursing hospital workers. Data were collected from March 4 to 29, 2019, through personal interviews using a questionnaire in 177 nursing hospital workers (health care provider: n=61, non-health care provider: n=116). The data were analyzed using a x2-test, Fisher's exact test, independent t-test, and ANOVA. The general characteristics were statistically significant between the two groups in terms of sex and age. The prevention activities of droplet infection showed statistically significant differences between the two groups in usually carrying a tissue, usually carrying a handkerchief, usually carrying a mask, carrying a handkerchief at respiratory symptoms, hand washing frequency, and cough etiquette compliance. Knowledge of cough etiquette showed significant differences between the two groups. The knowledge of cough etiquette, according to the non-health provider's prevention activities of droplet infection, was statistically significant in usually carrying a mask and cough etiquette education. Therefore, it is necessary to raise the knowledge about cough etiquette and develop strategies for habitual cough etiquette for each nursing hospital worker.