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Water-blocking Asphyxia of N95 Medical Respirator During Hot Environment Work Tasks With Whole-body Enclosed Anti-bioaerosol Suit

  • Jintuo Zhu;Qijun Jiang;Yuxuan Ye;Xinjian He;Jiang Shao;Xinyu Li;Xijie Zhao; Huan Xu;Qi Hu
    • Safety and Health at Work
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    • v.14 no.4
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    • pp.457-466
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    • 2023
  • Background: During hot environment work tasks with whole-body enclosed anti-bioaerosol suit, the combined effect of heavy sweating and exhaled hot humid air may cause the N95 medical respirator to saturate with water/sweat (i.e., water-blocking). Methods: 32 young male subjects with different body mass indexes (BMI) in whole-body protection (N95 medical respirator + one-piece protective suit + head covering + protective face screen + gloves + shoe covers) were asked to simulate waste collecting from each isolated room in a seven-story building at 27-28℃, and the weight, inhalation resistance (Rf), and aerosol penetration of the respirator before worn and after water-blocking were analyzed. Results: All subjects reported water-blocking asphyxia of the N95 respirators within 36-67 min of the task. When water-blocking occurred, the Rf and 10-200 nm total aerosol penetration (Pt) of the respirators reached up to 1270-1810 Pa and 17.3-23.3%, respectively, which were 10 and 8 times of that before wearing. The most penetration particle size of the respirators increased from 49-65 nm before worn to 115-154 nm under water-blocking condition, and the corresponding maximum size-dependent aerosol penetration increased from 2.5-3.5% to 20-27%. With the increase of BMI, the water-blocking occurrence time firstly increased then reduced, while the Rf, Pt, and absorbed water all increased significantly. Conclusions: This study reveals respirator water-blocking and its serious negative impacts on respiratory protection. When performing moderate-to-high-load tasks with whole-body protection in a hot environment, it is recommended that respirator be replaced with a new one at least every hour to avoid water-blocking asphyxia.

Evaluation of Steroid Therapy in Tuberculous Pleurisy - A prospective, randomized study - (결핵성 흉막염에서 스테로이드의 치료 효과 - 전향적, 임의추출법에 의한 비교 -)

  • Bang, Jei So;Kim, Myong Sik;Kwak, Seung Min;Cho, Chul Ho
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.1
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    • pp.52-58
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    • 1997
  • Background : Tuberculous pleurisy has been treated With a combined regimen of corticosteroids- antimicrobial therapy. But whether such combination therapy add to benefits is unknown. We evaluate the effects of corticosteroid and its routine application in relief of clinical symptoms, absorption of pleural effusion, and pleural adhesions. Methods : A prospective, randomized study of the role of corticosteroid in the treatment of tuberculous pleurisy was performed in 83 patients(nonsteroid group: 50 patients, steroid group: 33 patients) from June, 1991 to September, 1994. Results : 1) The mean duration from symptoms(fever, chest pain, dyspnea) to relief was 3.8 days in the steroid group, and 7.4 days in the nonsteroid group(P<0.05). Clinical symptoms including fever, chest pain, sputum and weight loss were relieved more rapidly in the steroid group than other symptoms(weakness, night sweating and dyspnea). 2) Pleural effusion was taken an averge of 88 days in the steroid group and 101 days in the nonsteroid group 10 be absorbed completely(p>0.05) 3) The incidence of pleural adhesions was 17/33(5l.5%) in the steroid group and 32/50(64%) in the nonsteroid group(p>0.05) 4) Side effects of corticosteroids were observed in only one patient causing epigastric pain and discontinuation of drug. Conclusion : Corticosteroid exert benefitial role in the more rapid relief of clinical symptoms to patients with tuberculous pleurisy, but absortion of pleural effusion and occurrence of pleural adhesions was not influenced significantly Therefore, its routine application should be reevaluated.

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Status and Awareness of Excessive Heat Exposure among Agricultural Workers (일부 농업인의 고온노출에 대한 실태와 인지도 조사)

  • Lee, Dong-Hyun;Kim, Dong-Seob;Chung, Jin-Wook;Lee, Kwan;Lim, Hyun-Sul
    • Journal of agricultural medicine and community health
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    • v.43 no.1
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    • pp.9-17
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    • 2018
  • Objectives: This study was to assess the status and awareness of excessive heat exposure among agricultural workers. Methods: We selected a total of 90 farmers from a villages of Gyeongju-si, during August, 2015. We carried out the temperature measurement for nine times and derived Health Index (HI) and Wet Bulb Globe Temperature (WBGT) index. We compared the HI, WBGT and excessive heat warnings. Status of high temperature exposure, lifestyle, medical history, and awareness about excessive health related exposure illness assessed using survey questionnaires. Results: The matching rates between the WBGT and the HI during excessive heat warning were high, but when it was a non-excessive heat warning, there were days of excessive HI or WBGT. Out of 90 farmers surveyed, 78 cases (86.7%) were in their 60s and older age group. Slightly more than two third (71.1%) farmers were farming in the dawn-morning (71.1%), and the daily working hours were less than 4 hours (54.4 %), but only 23.3% among farmers took regular breaks. Of total, 14.4% farmers experienced excessive heat exposure related illness in order of tiredness, lethargy, dizziness, headaches, and sweating. Overall, the awareness of the danger for excessive heat and the heat wave warnings were high at 70.0% and 74.4%, respectively. Conclusions: Politically, the excessive heat warnings should not be taken into account the simple temperature measurement but, have to consider WBGT and HI standards at the same time. Farmers need to be promoted and educated to prevent the excessive heat related illness by periodically increasing their rest time during farming.

Relationship between Alcohol Withdrawal Symptoms and Dopaminergic Gene Polymorphisms(DRD2, DAT, COMT) in Alcohol Dependence Patients (알코올 의존 환자의 금단 증상에 영향을 미치는 도파민계(DRD2, DAT, COMT) 유전자 다형성)

  • Choi, Tai Young;Kim, Ho-Nam;Han, Doug-Hyun;Min, Kyung-Jun;Lee, Young-Sik;Na, Chul
    • Korean Journal of Biological Psychiatry
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    • v.13 no.3
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    • pp.178-190
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    • 2006
  • Objectives : We investigated the relationship of the alcohol withdrawal symptoms with genetic polymorphism among alcohol dependence patients. Method : The measuring instruments used in this study were the Clinical Institute Withdrawal Assessment for Alcohol(CIWA-Ar). We analyzed DRD2 TaqI A polymorphism, dopamine transporter(DAT 1) polymorphism, and catechol-O-methyltransferase(COMT) polymorphism in 108 male alcoholics and 76 healthy controls. Results : The major findings was as follows. No significant differences for genotype distribution or allele frequency were revealed comparing controls and alcoholic patients. DRD2 Taq I : The subscale score of auditory hallucination among CIWA-Ar scale in homozygote was significantly higher than in heterozygote(OR=1.34). The total score of CIWA-Ar scale in heterozygote was significantly higher than in homozygote. DAT1 : In the subject without DAT-9 gene allele, it was significantly higher of the subscale score of sweating, anxiety among CIWA-Ar scale than in the subject with DAT-9 gene allele. And The total score of CIWA-Ar scale in the subject without DAT-9 gene allele was significantly higher than in the subject with DAT-9 gene allele. COMT : The total score of CIWA-Ar scale in heterozygote was significantly higher than in homozygote. Conclusion : Our results suggest the relationship between specific genetic factors and the withdrawal symptoms of alcohol dependent patients. As the candidate gene of the severity of alcohol withdrawal syndrome, DRD2 Taq1 gene was recommended.

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Clinical Review of Pulmonary Tuberculosis in Teenagers According to the Involved Lung (소아청소년기 폐결핵의 방사선상 침범위치에 따른 배양 양성률과 임상양상에 대한 연구)

  • Im, Bong Chil;Kim, Young;Kim, Kyoung Sim;Kim, Yong Wook;Kim, Eun Young;You, Eun Jung;You, Ju Hee;Cho, Hyoung Min
    • Pediatric Infection and Vaccine
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    • v.17 no.2
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    • pp.148-155
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    • 2010
  • Purpose : The purpose of this study was to investigate clinical features and culture-positive rates according to the involved lung in adolescent pulmonary tuberculosis (TB). Methods : We retrospectively reviewed the medical records of adolescents who ranged in age from 10 to 20 years and who had been hospitalized with a diagnosis of TB at Kwangju Christian Hospital from 2000 to 2008. Results : Sixty-six patients were identified with pulmonary TB: median age 16.82 years; 48.5% males. Among them, 90.9% of patients were between 15 and 20 years of age. Most patients presented with multiple symptoms, and the most common included cough (74.2%), sputum (60.6%), fever (39.5%), and night sweating (18.2%). Sputum samples were smear-positive in 28 (42.4%), culture-positive in 40 (60.6%), and PCR-positive in 46 (69.7%). The most common radiological patterns included cavitation in 18 (27.3%), pleural effusion in 18 (27.3%), lymphadenopathy in 10 (15.2%), and tuberculoma in 5 (7.6%). The prevalence of smear, culture, and PCR positive rates increased as the number of involved lobes increased (P<0.05, P<0.01, P<0.05). The median treatment duration was 7 months. Twelve patients (18.2%) had lower lung field TB (Group A) and forty-four patients (66.7%) had other areas involving TB, except for Group A (Group B), and ten patients (15.1%) had only TB pleurisy (Group C). The difference of clinical characteristics and culture rates between group A and group B was not significant. Conclusion : Pulmonary TB toward late adolescence is increasing. We need to pay more attention to lower lung field TB, which is difficult to detect with specific radiographic findings.

A CLINICAL STUDY OF THE JUDGMENT OF SASANG CONSTITUTION ACCORDING TO QUESTIONNAIRE (설문지(設問紙)를 통한 사상체질(四象體質)의 임상적(臨床的) 분류방안(分類方案) 연구(硏究))

  • Kim, Young-woo;Kim, Jong-weon
    • Journal of Sasang Constitutional Medicine
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    • v.10 no.1
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    • pp.215-233
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    • 1998
  • The object of this study is 27 patients who had been treated in the Oriental Medical Hospital at Dong Eui Medical Center during 6 months from January 1998 to June 1998. We proceeded the judgment of Sasang Constitution by Questionaire of Sasang Constitution Classification II(QSCC II). The following conclusion were made in comparison with Questionaire of Sasang Constitution Classification II(QSCC II) and Questionaire of Pusan Sasang seminar. 1. The subject of "the facial type is small and sharp" is significant differences in Sasang Constitution classification. The frequency of Soeumin group is more than Taeumin group and Soyangin group. 2. The subject of "the walking form is fast and shake the body" is significant differences in Sasang Constitution classification. The frequency of Taeumin group and Soeumin group is less than Soyangin group. 3. The subject of "the skin type is white and thin" is significant differences in Sasang Constitution classification. The frequency of Soeumin group is more than Soyangin group, and the frequency of Taeumin group is low marks. 4. The subject of "the skin type is tender and dry" is significant differences in Sasang Constitution classification. The frequency of Taeumin group and Soyangin group is less than Soeumin group. 5. The subject of "the image of face is smart" is significant differences in Sasang Constitution classification. The frequency of Soeumin group is more than Taeumin group and the frequency of Soyangin group is low marks. 6. The subject of "the sweating type is not sweatier" is significant differences in Sasang Constitution classification. The frequency of Taeumin group and Soeumin group is less than Soyangin group. 7. The subject of "the desire of eating is changeable accoding to emotion" is significant differences in Sasang Constitution classification. The frequency of Soeumin group is more than Taeumin group and Soyangin group. 8. The subject of "the health is changeable accoding to the type of stool" is significant differences in Sasang Constitution classification. The frequency of Soeumin group is more than Soyangin group and the frequency of Taeumin group is low marks. 9. The subject of "the type of voiding is changeable accoding to the drinking when they have a fever" is significant differences in Sasang Constitution classification. The frequency of Taeumin group and Soyangin group is less than Soeumin group. 10. The subject of "the skin type is soft" is significant differences in Sasang Constitution classification. The frequency of Soeumin group is more than Taeumin group and Soyangin group. 11. The subject of "the chief complaint is the forgetfulness" is significant differences in Sasang Constitution classification. The frequency of Soeumin group is less than Taeumin group and Soyangin group.

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A Literature Review of The Senile Hypotension (노인(老人) 저혈압(低血壓)에 대(對)한 문헌적(文獻的) 고찰(考察))

  • Kwak, Ik-Hoon;Kim, Jong-Dae;Jeong, Ji-Cheon
    • The Journal of Dong Guk Oriental Medicine
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    • v.4
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    • pp.161-187
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    • 1995
  • This study was perfomed to investigate causes of the senile hypotension, pathogenic mechanism, symptoms, and therapies through medical literatures, recent chinese medical literatures and chinese medical journals. The results are as follows ; 1. The senile hypotension has major symptoms of dizziness, weakness, syncope, palpitation, shortness of breath, and deficiency of Qi. Additionally, it has minor symtoms of letharhy, isomnia, tinnitus, amnesia etc... 2. The prodromal symptoms of Kwul and Kwul are relating to the symptoms of tachycardia, facial pallor, sweating, anxietas, ambiguous consciousness, and fainting. Weakness and dizziness due to deficiency make the symptoms of exhaustion, fatigue, vertigo, lethargy, and brachycardia. 3. The most principal cause of the senile hypotension is deficiency of Shen due to aging, congenital deficiency, and chronic illness. The rest of causes are defciency of Qi and blood, phlegm of retention, stagnation of Qi, blood stasis, blood prostration etc... In the view of the occidental meicine, the causes of the senile hypotension came from the reduction of cardiac output, the decretion of cardiovascular system's extention due to aging, hereditary factor, secondary factor due to exsanguination, diabetes mellitus, C.V.A etc..., and factor of neurogenic system's degeneration. 4. The principal pathogenic mechanisms are the insufficiency of Xing-Yang, the deficiency of Qi in middle jiao, and deficiency of Shen-Qi. The rest of mechanisms are the deficiency of both Qi and blood, stagnation of the Gan-Qi, and the deficiency of Gan and Shen. Zang-Pu Organs have something to do with Xing, Bi, and Shen. 5. As principal therapies, there are warming and recuperation the Xing-Yang, strengthing the middle-jiao and replenishing Qi, replenishing vital essence to tonify the Shen, and warming and recuperation the Shen-Yang. Additionally, the therapies of invigorating the Bi and relieving mental stress, strengthning the Bi and tonifing the Shen, invigorating Qi and nourishing Yin, soothing the Gan and regulating the circulation of Qi, and tonifing the Shen and nourishing the Gan help the cure of the senile hypotension. In prescriptions there are Baohe Yuan Tang, Buzhong Yigi Tang, Zuoguei Yin, Yougui Yin, Guipi Tang, Zhu Fu Tang, Shengmai San, Sini San, and Qi Ju Dihuang Wan. The medical herbs of Astragali Radix, Codonopsitis Pilosulae Radix, Ginseng Radix, Aconiti Tuber, Ephedrae Herba, Cinnamomi Ramulus, Cinnamomi Corfex Spissus, Zingiberis Rhizoma, Polygalae Radix, Liriopis Tuber, Polygonati Sibirici Rhifoma, Lycii Fructus, Schizandrae Fructus, and Glycyrrhizae Radix can be treated. 6. According to the clinical report, the principal causes are the deficiency of Qi, and insufficiency of Yang which symptoms are dizziness, vitality fatigue and acratia, amnesia, body cold and alger of extremity, spontaneous perspiration, and therady and weak pulse. It was improved by taking WenYang YiQi Tang, Zhu Fu Tang about 20-30 days. The improvement was shown on disappearance of subjective symptoms or the ascending of blood pressure to normal figure, and the rate of improvement was over 70%. 7. As regimens, taking warming and recuperating food(a sheep mutton, juglans regia, chiness date, longan aril etc...) and pungent food(chinese green onion, fress ginger, pipers fructns etc...), doing physical training, not being ill in bed at a long time, and preventing descent of blood pressure coming from sudden change of posture are needed. Additionally, the usage of diuretic, abirritant, and depressor needs to be extra cautious.

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A Clinical study on the Treatment of Pruritus (피부소양증(皮膚瘙痒症) 치료(治療)에 관(關)한 임상적(臨床的) 연구(硏究))

  • Park, Seong-sik
    • Journal of Sasang Constitutional Medicine
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    • v.11 no.2
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    • pp.361-376
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    • 1999
  • 1. Backgrounds and Purpose : Pruritus, one of the most common dermatological symptoms, was clinically examined with a view to a better understanding of its characteristics for more accurate treatment. 2. Method : For 22 months from November in 1997 to September in 1999 we selected outpatients who had consulted for itchiness more than twice in the department of Sasang Constitution of the Pundang Oriental medical hospital, Dongkook University, and 59 of those (35 males and 24 females) were confirmed of their course of treatment. From their medical records and history, we learned the general characteristics and patterns of pruritus, and the qualities and effects of its various treatments. 3. Result and Conclusion : Pruritus was more complained by men than by women and the largest age groups were 20's and 30's. For its suffering period, the duration of 1 month to less than 1 year was the greatest, and most patients had already experienced western medical care. Itchiness affected them almost day and night. In addition, many patients had abnormal bowel habits as a general symptom. According to Sasang Constitution, the Soeumin gave sleep disturbance and indigestion; the Soyangin showed a different pattern in their tongue coatings and bowel habits; the Taeumin had different tongue coatings and sweating pattern. The commonly prescribed herbal formula for pruritus was Gakhangjungisan, Yangkyuksanhwatang, Chungsimyonjatang. As for their efficiency, 61.0 % of patients improved, whereas 39.0 percent did not. Patients aged over 30 showed a more significant improvement than those of 20 years or under, and the duration of less than 1 year was more significantly improved than that of 1 year or more. Those who had no experience in western medical care or had been continuously treated showed a more significant improvement than those with intermittent treatments, and severe pruritus was more significantly improved than mild pruritus.

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The Epidemiologic and Clinical Study of Pulmonary Tuberculosis - Among Students at One Women's University for Recent 10 Years - (일개 여자대학교 학생의 최근 10년간 폐결핵 동태 및 임상경과에 관한 고찰)

  • Choi, Hee-Jung;Hong, Young-Sun;Oh, Ji-Yong;Cheon, Seon-Hee;Kim, Kyung-Ja;Kim, Man-Ae;Min, Hong-Ki;Choi, Sam-Sub;Lee, Kee-Young
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.4
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    • pp.465-473
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    • 1995
  • Background: The prevalence of pulmonary tuberculosis has decreased progressively after the control of the tuberculosis began as national control. But as diabetes, malignancy, immunodeficiency disease recently tend to be increased, the tuberculosis become to the important national health problem. So, this study was designed to observe the state and the change of the prevalence and the clinical status of pulmonary tuberculosis for recent 10 years at one women's university. Method: We retrospectively investigated the epidemiology and the clinical status of 612 patients who were registered at the Ewha Womans University Health Center by analyzing records from 1983 to 1992. Results: 1) The prevalence rate had been steadily decreased from 0.63% in 1983 to 0.11 % in 1992. The prevalence of freshman and the incidence rate according to the entrance year while in the university significantly decreased since 1989. 2) In classifying by registered source, 45.6% of students were detected by annual periodical health examination, 34.5% by entrance physical examination, 12.0% by hospital, 5.4% by health center clinic, 2.5% by reentrance physical examination, sequentially. 3) The students with past history of tuberculosis were 70(11.4%) and 61(10%) suffered from pulmonary tuberculosis. The patients with family history of tuberculosis were 142(23.3%). 4) There were 530(86.6%) with minimal disease, 79(12.9%) with moderate and only 3(0.5%) with far advanced, when classified by the severity of disease. 5) The initial symptoms were mild breathing difficulty in 30.1%, sweating in 14.9%, fatigue in 14.3%, febrile sense in 11.7%, hemoptysis in 8.2%, sequentially. 6) The duration of treatment was $10.6{\pm}3.6$ months in mild group, $14.9{\pm}5.2$ months in the moderate group(P<0.05). 7) The side reactions of the drug were GI trouble in 7.2%, hepatitis in 1.8%, skin rash in 0.8% and streptomycin side in used patients in 9.1%. Conclusion: The prevalence of pulmonary tuberculosis among the students in one women's university was significantly lower than that of university students and 20-24 year-old age group announced in tuberculosis survey on a national scale, and significantly decreased since 1989. The treatment effect was desirable in student's group managed by university health center.

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Weaning Following a 60 Minutes Spontaneous Breathing Trial (1시간 자가호흡관찰에 의한 기계적 호흡치료로부터의 이탈)

  • Park, Keon-Uk;Won, Kyoung-Sook;Koh, Young-Min;Baik, Jae-Jung;Chung, Yeon-Tae
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.3
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    • pp.361-369
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    • 1995
  • Background: A number of different weaning techniques can be employed such as spontaneous breathing trial, Intermittent mandatory ventilation(IMV) or Pressure support ventilation(PSV). However, the conclusive data indicating the superiority of one technique over another have not been published. Usually, a conventional spontaneous breathing trial is undertaken by supplying humidified $O_2$ through T-shaped adaptor connected to endotracheal tube or tracheostomy tube. In Korea, T-tube trial is not popular because the high-flow oxygen system is not always available. Also, the timing of extubation is not conclusive and depends on clinical experiences. It is known that to withdraw the endotracheal tube after weaning is far better than to go through any period. The tube produces varying degrees of resistance depending on its internal diameter and the flow rates encountered. The purpose of present study is to evaluate the effectiveness of weaning and extubation following a 60 minutes spontaneous breathing trial with simple oxygen supply through the endotracheal tube. Methods: We analyzed the result of weaning and extubation following a 60 minutes spontaneous breathing trial with simple oxygen supply through the endotracheal tube in 18 subjects from June, 1993 to June, 1994. They consisted of 9 males and 9 females. The duration of mechanical ventilation was from 38 hours to 341 hours(mean: $105.9{\pm}83.4$ hours). In all cases, the cause of ventilator dependency should be identified and precipitating factors should be corrected. The weaning trial was done when the patient became alert and arterial $O_2$ tension was adequate($PaO_2$ > 55mmHg) with an inspired oxygen fraction of 40%. We conducted a careful physical examination when the patient was breathing spontaneously through the endotracheal tube. Failure of weaning trial was signaled by cyanosis, sweating, paradoxical respiration, intercostal recession. Weaning failure was defined as the need for mechanical ventilation within 48 hours. Results: In 19 weaning trials of 18 patients, successful weaning and extubation was possible in 16/19(84.2 %). During the trial of spontaneous breathing for 60 minutes through the endotracheal tube, the patients who could wean developed slight increase in respiratory rates but significant changes of arterial blood gas values were not noted. But, the patients who failed weaning trial showed the marked increase in respiratory rates without significant changes of arterial blood gas values. Conclusion: The result of present study indicates that weaning from mechanical ventilation following a 60 minutes spontaneous breathing with $O_2$ supply through the endotracheal tube is a simple and effective method. Extubation can be done at the same time of successful weaning except for endobronchial toilet or airway protection.

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