- Evaluation of Field Epidemiology Specialist Training Program Based on the Satisfaction and the Changes of Educational Needs.
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No Rai Park, Ihn Sook Jeong, Jong Gu Lee, Young Taek Kim, Jin Ho Chun, Ki Soon Kim, Sang Soo Bae, Jong Myon Bae, Gyung Jae Oh, Hee Chul Ohrr, Kun Sei Lee, Byung Kook Lee, Hun Jae Lee, Hyun Sul Lim, Young Hwangbo
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J Prev Med Public Health. 2004;37(1):80-87.
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- OBJECTIVE
To evaluate the learning achievement and satisfaction levels for the Field Epidemiology Specialist Training Program (FESTP), on infectious disease control between March 19 and October 31, 2002. METHODS: The FESTP was designed as a set of 84 hours curricula including lectures, discussions, self-studies, and field practicals, and organized both centrally and locally by the Division of Communicable Disease Control of the National Institute of Health and 11 universities. Before and after the program, a questionnaire survey on the educational need (49 items) and satisfaction (15 items) was conducted on 484 trainees, who were responsible for communicable disease control and immunization at 242 regional health centers. The data were analyzed with paired t-tests for comparison of the educational needs between the pre and post scores. RESULTS: The average score for satisfaction was 3.06 out of 5.0; with relatively higher scores for sincerity (4.10) and professionalism (4.01) of the tutors, adequacy (3.54) and clearness (3.51) of the evaluation criteria, usefulness (3.54) and fitness (3.52) of the contents, but with relatively lower satisfaction for schedule (2.96) and self-studies (2.91). The average for requirement for education improved, as shown by the decrease from 2.72 to 2.22 (p< .0001) with the biggest decrease in the outbreak investigation from 2.60 to 2.08. CONCLUSION: The FESTP was evaluated as being effective, the trainees showed moderate satisfaction and decrease educational needs. However, the actual schedules and self-studies should be rearranged to improve the satisfaction level.
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Summary
- Different Effect of Blood Lead on Zinc Protoporphyrin by Gender in Korean Lead Workers.
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Hyun Cheol Ahn, Yong Bae Kim, Gap Soo Lee, Kyu Yoon Hwang, Sung Soo Lee, Kyu Dong Ahn, Byung Kook Lee
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Korean J Prev Med. 1999;32(4):499-504.
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- OBJECTIVES
To evaluate whether a relation between blood lead and zinc proto porphyrin(ZPP) was modified by gender in Korean lead workers. METHODS: A cross-sectional study was conducted with 1,304 male and 101 female subjects in 1997. The relation between blood lead and ZPP were evaluated with linear, exponential, and quadratic models. Then, the different effect of gender on the relation was examined by adding the interaction terms in the each model. RESULTS: Mean+/-SD of blood lead and ZPP level was different between male(27.7+/-10 microgram /dl and 51.3+/-23.4 microgram/dl) and female subjects(22.5+/-9.2 microgram/dl and 78.7+/-38.6 microgram/dl). After adjusting for possible confounders, the effect modification by gender was significant in linear(beta=1.119, p<0.001), exponential(beta=Exp(0.008), p<0.05), and quadratic model(beta= 1.388, p<0.001). In separate analysis, a quadratic relation between blood lead and ZPP was shown in male lead workers(beta=0.036, p<0.001), but an exponential relation in female lead workers(n=Exp(0.029), p<0.001). CONCLUSION: Our data showed that the increasing rate of ZPP in female were always higher than in male lead workers, suggesting that females were more susceptible to occupational lead exposure than males.
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Summary
- The effect of smoking and drinking habit on the health status of lead workers.
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Choong Koo Lee, Yong Bae Kim, Gap Soo Lee, Kyu Yoon Hwang, Hwa Sung Kim, Sung Soo Lee, Kyu Dong Ahn, Byung Kook Lee
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Korean J Prev Med. 1998;31(4):708-718.
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- To investigate the effect of smoking and drinking habit on the health status in lead using industries, 2,785 male workers in lead using industries (7 storage battery industries, 7 secondary smelting and related industries, and 4 primary metal and other manufacturing industries) were selected for this study. This study was carried out as a part of periodic health examination. Selected study variables were zinc protoporphyrin in whole blood (ZPP), SGOT and SGPT for laboratory test. Questionnaire for lead related symptoms and smoking and drinking habit was provided to all the workers and filled up by themselves and reconfirmed by physician. The results obtained were as follows; 1. The overall smoking and drinking rate of study population were 69.8% and 73.6%, respectively. While the smoking and drinking rate of storage battery workers were 68.8% and 72.3%, those of secondary smelting industries and other industries were 66.0% and 66.4% and 74.6 and 80.3% respectively. 2. While the mean values of blood ZPP of lead exposed workers were significantly higher than other group, those of SGOT of storage battery workers were significant higher than other worker. But there were no differences of mean values of other variables. 3. Smoking habit did not affect on the mean value of blood ZPP of workers in special health examination group, but there were significant differences of blood ZPP and SGOT between drinker and non-drinker. 4. Symptom prevalence of lead exposure were higher in drinking and smoking group than non-drinking and non-smoking group. 5. In multiple regression analysis of the total lead related symptoms, blood ZPP, SGOT, and SGPT as dependent variable, respectively, and age, work duration, blood ZPP, pack year and amount of alcohol drinking as independent variables, work duration, pack year, amount of alcohol drinking, age contributed to total symptoms; and age, work duration, pack year contributed to blood ZPP; and age, amount of alcohol drinking, work duration contributed to SGOT; and pack year contributed to SGPT.
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Summary
- The change of validity of blood zinc protoporphyrin test by different cut-off level in level workers.
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Yong Bae Kim, Hyun Cheol Ahn, Young Hwangbo, Gap Soo Lee, Sung Soo Lee, Kyu Dong Ahn, Byung Kook Lee
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Korean J Prev Med. 1997;30(4):741-751.
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- Measurement of blood lead (PbB) and blood zinc protoporphyrin (ZPP) are most common biological indices to identify the individual at risk for excess or the health sequences by lead exposure. Because PbB is known most important and reliable index of lead exposure, PbB is often regarded as a gold standard to detect lead exposure. But in Korea PbB is a secondary test item of detailed health check-up with positive finding of screening test in most occasion. Our lead standard requires all lead workers to take annual heath-check twice a year for investigation of their health effect due to lead exposure. Blood ZPP is one of most important index to detect high lead absorption in lead workers as a screening test. Measurement of blood ZPP is known well to correlate with PbB in steady state of exposure in most lead workers and is often used as a primary screening test to detect high lead absorption of lead workers with the advantage of simplicity, easiness, portability and low cost. The current cut-off criteria of blood ZPP for further detailed health check-up is 100 ng/dl which is supposed to match the level of 40 ng/dl of PbB according to our standard. Authors tried to investigate the validity of current criteria of cut-off level(100 ng/dl) of blood ZPP and possible another better cut-off level of it to detect the lead workers whose PbB level over 40 ng/dl. The subjects in our study were 212 male workers in three small scale storage battery industries. Blood ZPP, PbB and hemoglobin(Hb) were selected as the indices of lead exposure. The results were as follows. 1. The mean of blood ZPP, PbB and Hb in lead workers were 79.5+/-46.7 ng/dl, 38.7+/-15.1 ng/dl, and 14.8+/-1.2 g/dl, respectively. There were significant differences in blood ZPP, PbB and Hb by industry(P<0.01). 2. The percents of lead workers whose blood ZPP were above 100 ng/dl in the group of work duration below 1, 1-4, 5-9 and above 10 years were 8.6%, 17.2%, 47.6%, and 50.0%, respectively. The percents of lead workers whose PbB were above 40 ng/dl in those were 31.4%, 40.4%, 71.4%, and 86.4%, respectively. 3. The percents of lead workers whose PbB were below 40 ng/dl, 40-59 ng/dl and above 60 ng/dl were 54.7%, 34.9% and 10.4%, respectively. Those of lead workers whose blood ZPP were below 100 ng/dl, 100-149 ng/dl and above 150 ng/dl were 79.2%, 13.7% and 7.1%, respectively. 4. Simple linear regression of PbB on blood ZPP was statistically significant(P<0.05) and as PbB was 40 ng/dl, blood ZPP was 82.1 ng/dl. 5. While the highest sensitivity and specificity of blood ZPP test to detect lead workers with PbB over 40 ng/dl were observed in the cut-off level of 50 ng/dl and 100 ng/dl of blood ZPP, respectively, the highest validity(sensitivity+specificity) of blood ZPP to detect lead workers with PbB over 40 ng/dl was observed in the cut-off level of around 70 ng/dl of blood ZPP. But even with optimal cut-off level of around 70 ng/dl of blood ZPP, still 25.0% of false negative and 20.7% false positive lead workers were found. As the result of this study, it was suggested that reconsideration of current blood ZPP cut-off of our lead standard from 100 ng/dl to somewhat lower level such as around 70 ng/dl and the inclusion of PbB measurement as a primary screening test for lead workers was highly recommended for the effective prevention of lead workers.
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Summary
- A Retrospective cohort study on the effect of health counselling through the level of gamma-GTP after screening test.
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Yong Jin Lee, Jae Eog Ahn, Joo Ja Kim, Byung Kook Lee
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Korean J Prev Med. 1997;30(3):518-529.
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- 1,281 male subjects who had been examined more than 3 times for regular check-up in one human dock center of the university hospital were studied between 1990-1995, to evaluate the effect of health counseling with life style and gamma-GTP value between 1054 normal group without intervention and 227 abnormal group with intervention, ages from 30 to 69 years old. Total mean value of gamma-GTP was 45.7+/-40.7 unit with highest gamma-GTP value in age group 50-59 on initial examination. Total abnormal rate was 17.7% with the highest abnormal rate of 18.6% in age group 50-59. Initially, the value of gamma-GTP was significantly different according to the degree of alcohol intake, relative weight and smoking in normal group(p<0.01) not in abnormal group. In conclusion, the value of gamma-GTP were significantly increasing in normal group without intervention and significantly decreasing in abnormal group with intervention(p<0.05), which suggests the effect of health counseling, such as the recommendation to change the health behaviour.
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Summary
- A study on lead exposure indices of male workers exposed to lead less than 1 year in storage battery industries.
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Young Hwangbo, Yong Bae Kim, Gap Soo Lee, Sung Soo Lee, Kyu Dong Ahn, Byung Kook Lee, Joung Soon Kim
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Korean J Prev Med. 1996;29(4):747-764.
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- This study intended to obtain an useful information for health management of lead exposed measuring the lead exposure indices and workers and determine biological monitoring interval in early period of exposure by work duration in all male workers (n=433 persons) exposed less than 1 year in 6 storage battery industries and in 49 males who are not exposed to lead as control. The examined variables were blood lead concentration(PBB), Zinc-protoporphyrin concentration(ZPP), Hemoglobin(HB) and personal history; also measured lead concentration in air(PBA) in the workplace. According to the geometric mean of lead concentration in the air, the factories were grouped into three categories: A; When it is below 0.05mg/m3, B; When it is between 0.05 and 0.10mg/m3, and C; When it is above 0.10mg/m3. The results obtained were as follows: 1. The means of blood lead concentration(PBB), ZPP concentration and hemoglobin(HB) in all male workers exposed to lead less than 1 year in storage battery industries were 29.5+/-12.4 microgram/100ml, 52.9+/-30.0 microgram/100ml and 15.2+/-1.1 gm/100ml. 2. The means of blood lead concentration(PBB), ZPP concentration and hemoglobin(HB) in control group were 5.8+/-1.6 microgram/100ml, 30.8+/-12.7 microgram/100ml and 15.7+/-1.6 microgram/100ml, being much lower than that of study group exposed to lead. 3. The means of blood lead concentration and Zpp concentration among group A were 21.9+/-7.6 microgram/100ml, 41.4+/-12.6 microgram/100ml; those of group B were 29.8+/-11.6 microgram/100ml, 52.6+/-27.9 microgram/100ml; those of group C were 37.2+/-13.5 microgram/100ml, 66.3+/-40.7 microgram/100ml. Significant differences were found among three factory group(P<0.01) that was classified by the geometric mean of lead concentration in the air, group A being the lowest. 4. The mean of blood lead concentration of workers who have different work duration(month) was as follows; when the work duration was 1-2 month, it was 24.1+/-12.4 microgram/100ml,; When the work duration was 3-4 month, it was 29.2+/-13.4 microgram/100ml; and it was 28.9+/-34.5 microgram/100ml for the workers who had longer work duration than other. Significant differences were found among work duration group(P<0.05). 5. The mean of ZPP concentration of workers who have different work duration(month) was as follows; When the work duration was 1 2 month, it was 40.6 18.0 g/100ml, When the work duration was 3-4 month, it was 53.4+/-38.4 microgram/100ml; and it was 51.5+/-60.4 microgram/100ml for the workers who had longer work duration than other. Significant differences were found among work duration group(P<0.05). 6. Among total workers(433 person), 18.2% had PBB concentration higher than 40 microgram/100ml and 7.1% had ZPP concentration higher than 100 microgram/100ml; In workers of factory group A, those were 0.9% and 0.0%; In workers of factory group B, those were 17.1% and 6.9%; In workers of factory group C, those were 39.4% and 15.4%. 7. The proportions of total workers(433 person) with blood lead concentration lower than 25 microgram/100ml and ZPP concentration lower than 50 microgram/100ml were 39.7% and 61.9%, respectively; In workers of factory group A, those were 65.5% and 82.3%; In workers of factory group B, those were 36.1% and 60.2%; In workers of factory group C, those were 19.2% and 43.3%. 8. Blood lead concentration (r=0.177, P<0.01), ZPP concentration (r=0.135, P<0.01), log ZPP (r=0.170, P<0.01) and hemoglobin (r=0.096, P<0.05) showed statistically significant correlation with work duration (month). ZPP concentration (r=0.612, P<0.01) and log ZPP(r=0.614, P<0.01) showed statistically significant correlation with blood lead concentration. 9. The slopes of simple linear regression between work duration(month, independent variable) and blood lead concentration(dependent variable) in workplace with low air concentration of lead was less steeper than that of poor working condition with high geometric mean air concentration of lead. The study result indicates that new employees should be provided with biological monitoring including blood lead concentration test and education about personal hygiene and work place management within 3~4 month.
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Summary
- Follow-up Management State of Lead Battery Workers in Periodic Health Examination.
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Gap Soo Lee, Young Hwangbo, Yong Bae Kim, Hwa Sung Kim, Jung Oh Ham, Sung Soo Lee, Kyu Dong Ahn, Byung Kook Lee, Jung Hur
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Korean J Prev Med. 1996;29(4):733-746.
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- To evaluate the follow-up management state and related factor of lead battery workers in periodic health examination as part of program of group occupational health service, author studied 293 workers with questionnaire on knowledge of results and follow-up management state and related factors, and compared the responses to their periodic health examination result charts. The results were as follows: 1. 252(86%) workers responsed that they had received the health examination result chart, but only 116(39.6%) workers responsed that they had been educated or explained about the result of health examination, and 11(57.9%) workers among 19 workers with non-occupational disease D, 101(44.3%) workers among 228 workers with non-occupational disease C, and 19(28.4%) workers among 67 workers with occupational disease C knew accurately their health examination results. 2. 78(24.8%) of the workers responsed that they had follow-up management, and contents of follow-up management were follow-up(36.6%), out-patient treatment(31%), change worksite(8.5%), temporary retirement(7.0%) and others(16.9%). 3. Most of the workers responsed that the health examination were necessary, but three-fourths of the workers responsed that the health examination had been superficial or that they didn't know. 4. In this study, follow-up management show significant association with only explanation or education about health examination result chart.
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Summary
- Study on the lead exposure of workers in a litharge making industry.
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Sang Bok Lim, Jung Kyu Lim, Sung Soo Lee, Kyu Dong Ahn, Byung Kook Lee
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Korean J Prev Med. 1995;28(4):875-884.
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- In order to investigate the level of lead exposure of workers in litharge making industry and to evaluate how lead exposure, personal habit such as smoking and drinking affect the prevalence of lead related symptoms and other study variables, we investigate 114 workers(24 office workers and 90 lead exposed workers) in a litharge making industry. Study variables chosen were blood lead(PbB), zinc protoporphyrin in whole blood(ZPP), Hemoglobin(Hb), hematocrit (Hct), SGOT and SGPT. symptom questionnaires which had 15 lead exposure related symptoms were provided to all workers and filled up by themselves and reconfirmed by physician. The results obtained were as follows; 1. The mean value of PbB, ZPP and SGOT in lead exposed group were higher than those of non-exposed group, and there were no differences of means in other study variables. 2. The smoking and drinking rate of study subjects were 65.8% and 71.0% as a whole. Smoking rates were lower in non-exposed group than exposed group, but drinking rate were not. 3. There were no differences of mean values of study variables between smoker and non-smoker in non-exposed and exposed group, but there was a difference of mean value of SGOT between drinker and non-drinker in lead exposed group. 4. while the symptom prevalence of lead exposed group were higher in neuromuscular category than non-exposed group, those of non-exposed group were higher or same with exposed group in gastrointestinal and general symptom category. 5. The symptom prevalence of smoker were higher than non-smoker regardless of exposure. 6. The symptom prevalence of drinker were only higher in gastrointestinal symptom category than non-drinker. 7. In multiple stepwise regression analysis of lead related symptoms as dependent variable and blood lead, smoking habit, drinking habit and work duration as independent variables, drinking habit contributed to the gastrointestinal symptom category, whereas blood lead and smoking contributed to the neuromuscular symptom category. For the total symptoms work duration and smoking habit contributed significantly.
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Summary
- An analysis of liver function test of preemployment screening for office workers.
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Yeon Gyo Shin, Yong Jin Lee, Jae Eog Ahn, Kuck Hyeun Woo, Joo Ja Kim, Byung Kook Lee
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Korean J Prev Med. 1995;28(3):706-714.
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- This is to analyze and compare the distribution of the liver function test and its abnormal rates of the preemployment screening for office workers in asymptomatic young age groups between female and male. Liver function test(SGPT and SGOT) of 8,184 young adults(2,633 in female and 5,551 in male) were examined during the period from Jan.1,1994 to Dec. 31, 1994. The results were as follows; 1. Mean level of SGPT was 9.l+/-7.6(IU/L) in female, 21.0+/-27.9(IU/L) in male, and that of SGOT was 15.1+/-6.0(IU/L) in female, 20.5+/-26.5(IU/L) in male. There were significant differences(p<0.01) between female and male in both SPT and SGOT. And also there was significant increasing trend(p<0.05) by age groups in male for SGPT, decreasing trend(p<0.01) in female for SGOT. 2. In the abnormal rates of liver function test by the level of cut-off value, there were significant differences up to twice between the lowest and the highest cut-off value in both female(0.4% vs 0.7%) and male(6.5% vs 12.4%) 3. Abnormal rate of SGPT was 0.4% in female and 6.3% in male, and that of SGOT was 0.2% in female and 1.2% in male with significant differences between female and male in both tests.
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Summary
- A study on renal function indices in lead exposed male workers.
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Sung Soo Lee, Young Hwangbo, Kyu Dong Ahn, Byung Kook Lee, Joung Soon Kim
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Korean J Prev Med. 1995;28(2):421-432.
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- The influence of lead exposure on renal function was studied. Eighty nine lead exposed workers who worked in 2 storage battery factories, and seventy one control workers were chosen for this study. Blood lead(pbB) and zinc protoporphyrin in whole blood(ZPP) were selected as indicators of lead exposure. As indicators of renal function, urinary N-acetyl-beta-D-glucosaminidase(NAG), blood urea nitrogen(BUN), serum creatinine(S-Cr), total protein in urine(U-Tp),and serum uric acid(S-Ua) were selected. The results obtained were as follows: 1. while the mean values of lead exposure indicators of lead workers were significantly different from non-exposed ones, the mean values of NAG, U-TP, BUN and S-Cr of renal function indicators of exposed were also significantly different from non-exposed but their mean values were all within normal limits. 2. BUN, logarithmic U-TP, logarithmic NAG and S-Cr showed statistically significant correlation with pbB. 3. The proportion of workers whose values of renal function indicators were over the normal limits(NAG7.5 U/g cr; U-TP 10.9mg/dl; BuN20 mg/dl; S-Cr1.2 mg/dl; S-Ua7.0 mg/dl) by the level of lead absorption in terms of pbB and ZPP were calculated. The proportion of workers with over the normal limits of U-TP among total workers showed the dose-response relationship. when age is adjusted, U-TP showed significantly strong dose-response relationship with the level of pbB and ZPP.
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Summary
- A Study on Urinary N-acetyl-beta-D-glucosaminidase Activities of Office Workers in a Certain Industrial Complex Area.
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Hwa Sung Kim, Gap Soo Lee, Sung Soo Lee, Kyu Dong Ahn, Byung Kook Lee
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Korean J Prev Med. 1994;27(3):547-556.
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- In order to identify the necessary information of biochemical indices for renal effect of lead for the early detection in medical surveillance of lead worker, the reference values of urinary N-acetyl-beta-D-glucosaminidase(NAG) activities were studied with 205 office workers in one industrial complex area who were not exposed to lead occupationally. While study variables selected for lead exposure were blood lead (pbB), blood zinc protoporphyrin(ZPP) and delta-aminolevulinic acid (DALA) in urine, those for renal effect were urinary N-acetyl-beta-D-glucosaminidase(NAG), blood urea nitrogen(BUN), serum creatinine(cr), serum uric acid (Ua), and urinary total protein (U-Tp). The results obtained were as follows: 1. The mean values of blood lead, ZPP and DALA in all subjects were 14.39+/-4.02 microgram/dl, 21.61+/-8.00 microgram/dl, and 2.73+/-0.90 microgram/l respectively. 2. The mean value of urinary NAG activities in all subjects was 3.51+/-2.01 U/l. The mean value of urinary NAG activities, which calculated from NAG activities divided by urinary creatinine concentration (CNAG), was 5.42+/-5.53 U/g creatinine and logarithmic normal distributed. 3. The reference value of urinary NAG activity was 12.06 U/g creatinine (95% CI=10.57-14.76U/g creatinine). 4. Logarithmic CNAG(r=0.781 P<0.01), U-TP(r=0.670 p<0.01) and ZPP (r=0.172 p<0.05)showed statistically significant correlation with CNAG.
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Summary
- A Study on the Incidence of Diabetes and Its Risk Factors in the Impaired Glucose Tolerence.
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Joo Hee Park, Yeon Gyo Shin, Joo Ja Kim, Taik Sung Nam, Byung Kook Lee
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Korean J Prev Med. 1994;27(3):425-437.
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- This is to study the incidence of Diabetes and its risk factors in the impaired glucose tolerance group. 1084 subjects who had been examined 3 times for regular check-up in one human dock center under the university hospital were studied between 1986~1993. The results are as follows; Prevalence rate of diabetes was 3.56%, and that of impaired glucose tolerance was 30.90% as of initial examination. The rate of diabetes was increasing with the age where 1.2% at age group 30~39, 3.21% at age group 40~49, 5.84% at age group 50~59, 14.28% at age group 60 and over. And also the rate of impaired glucose tolerance was increasing with the age where 21.29% at age group 30~39, 31.42% at age group 40~49, 38.91% at age group 50~59, 33.33% at age group 60 and over. Of the examinees who were initially examined, total incidence rate of diabetes who developed to obvious diabetes at the 3rd follow-up examination from the initially impaired glucose tolerance group was 4.63% and it was 11.3 times higher than from the normal group (0.41%). After controlling for the effects of both age and obesity, the risk of subsequent diabetes for subjects with impaired glucose tolerance remained significantly higher than for normal subjects (Relative Risk, 10.48). Test for trends for developing to diabetes by the increasing level of fasting blood sugar and 1 hr blood sugar at the initial examination were statistically significant in either normal and impaired glucose tolerance group. To determine the risk factor for developing to diabetes, logistic regression test was applied. Only fasting blood sugar and 1 hr blood sugar were predictors for developing diabetes from the impaired glucose tolerance group at initial examination.
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Summary
- Prevalence rate of lead related subjective symptoms in lead workers.
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Du Shin Jeong, Hwa Sung Kim, Kyu Dong Ahn, Byung Kook Lee
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Korean J Prev Med. 1993;26(2):251-267.
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- The relationship between lead related subject symptoms and lead exposure indices was studied in 435 male lead workers in thirteen lead using industries. 212 male office workers who were not exposed to lead occupationally were also studied as a control group. Fourteen lead related symptoms were selected. They were further subdivided into 4 sub-symptom groups such as 1) gastrointestinal, 2) neuromuscular and joint 3) constitutional, and 4) psychological symptoms. Symptom questionnaires were provided to the workers and filled up by themselves and reconfirmed by interviewer(doctor). The test used for the evaluation of lead exposure were blood lead (PbB), zinc protoporphyrin in whole blood(ZPP), hemoglobin(Hb), hematocrit(Hct), delta-aminolevulinic acid in urine(DALA). The results obtained were as follows; 1. The higher prevalence rate in the sub-group of neuromuscular and joint symptoms was observed in occupationally lead exposed subjects than non-exposed subjects. Among the sub-groups, the most frequent symptom was "numbness of finger, hands of feet", and the prevalence of the symptom of "arthralgia", "weakness of fingers, hands or feet" and "myalgia" were higher in order. 2. While the symptom which showed the biggest difference of prevalence rate among the 14 symptoms between exposed and non-exposed subjects was "numbness of fingers, hands or feet" , the symptom which showed the highest prevalence rate was "feeling tired generally" in exposed and non-exposed subjects, but no statistical difference of symptom prevalence were observed. 3. In total study population, PbB and ZPP had dose-response relationship with 4 symptoms of neuromuscular and joint symptoms ("numbness of finger, hands or feet", "arthralgia", "weakness of fingers, hands or feet" and "myalgia") and one symptom of gastrointestinal group("intermittent pains in lower abdomen"). 4. In lead exposed workers, only neuromuscular and joint symptoms group showed dose-response relationship with PbB and ZPP. 5. In lead exposed workers, the prevalence rate of overall symptoms of lead workers with age below 39 years was higher than that of lead workers with age above 40. While neuromuscular and joint symptoms group had a dose-response relationship with PbB in former group, it had a dose-response relationship with ZPP in latter group. 6. Age adjusted odds ratios of symptoms of non-exposed with exposed and odds ratios of low exposed with high exposed workers showed the dose-response relationship of lead exposure with neuromuscular and joint symptoms group("numbness of fingers, hands or feet", "arthralgia", "weakness of fingers, hands or feet" and "myalgia") and gastrointestinal symptoms group("intermittent pains in lower abdoman").
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Summary
- A cross-sectional study on prevalence rate and contributing factors of fatty liver diagnosed by ultrasonography.
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Jae Eog Ahn, Jung Oh Ham, Kyu Yoon Hwang, Joo Ja Kim, Byung Kook Lee, Tack Sung Nam, Joung Soon Kim, Hun Kim
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Korean J Prev Med. 1991;24(2):195-210.
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- Fatty liver is caused by derangement of fat metabolism and can be reversed by removal of contributing factors. The contributing factors of fatty liver is known to be overweight, chronic alcoholism, diabetes mellitus, malnutrition, and drug abuse such as tetracycline. This study was carried out on 1335 persons who visited 'Soon Chun Hyang Human Dock Center' from March to June 1990. In analysis of the data, prevalence of fatty liver diagnosed by ultrasonogram by age and sex, laboratory finding between fatty liver group and normal group, and odds ratio of known contributing factors, were compared. The results obtained are as following; 1) The prevalence rate of fatty liver diagnosed by ultrasonogram is 29.6% in male and 11.5% in female. 2) Age groups with high prevalences are 40~50's in male (32.0%) and 50's in female (24.5%). 3) The fatty liver shows significant association with style (p<0.05), whereas not with hepatitis B-virus surface antigen (p>0.05). 4) All laboratory values except alkaline phosphatase and bilirubin are elevated significantly in accordance with the degree of fatty liver (p<0.01). 5) Fatty liver diagnosed by ultrasonogram showed so strong associations with body index, triglycerides and gamma-glutamyl transferase for males, and body index and fasting blood sugar for females that these factors may be used as supplementary data in establishing diagnosis of fatty liver. 6) Odds ratio of contributing factors are as follows; If the odds ratio of below 29 year of age is 1.0 then that of 30~39 is 1.74 (p=0.33), 40~49 is 2.47 (p=0.10), 50~59 is 2.86 (p=0.0570), over 60 is 1.81 (p=0.34). If the odds ratio of female is 1.0 then that of male is 5.67 (p<0.01). If the odds ratio of body index below zero is 1.0 then that of 0~9 is 5.08 (p<0.01), 10~19 is 12.37 (p<0.01), 20~29 is 29.19 (p<0.01), 30 above is 154.02 (p<0.01). If the odds ratio of below 99 mg/dl FBS is 1.0 then that of 100~120 is 106 (p=0.76), over 120 is 1.91 (p=0.02). If the odds ratio of below 29 micron/1 gamma-GT is 1.0 then that of 30~s59 is 2.11 (p<0.01), 60~90 is 1.87 (p<0.05), 90 above is 1.69 (p=0.15). If the odds ratio of below 149 mg/dl TG is 1.0 then 150~199 is 1.49 (p=0.05), 200~250 is 1.09 (p=0.77), 250 above is 2.53 (p<0.01). In summary, early diagnosis of fatty liver could be made by ultrasonogram supplemented with body index and serum triglyceride. The fatty liver could be preventive by avoiding contributing factors such as obesity, alcohol intake, high blood sugar appropriately.
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Summary
- Relationship of between blood lead level and lead related symptoms in low level lead exposure.
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Kyu Yoon Hwang, Jae Eog Ahn, Kyu Dong Ahn, Byung Kook Lee, Joung Soon Kim
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Korean J Prev Med. 1991;24(2):181-194.
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Abstract
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- This study intended to obtain an useful information on the prevalence of subjective symptoms, and to clarify the interrelationships between blood lead and lead related symptoms in low level lead exposure. The 93 male workers exposed to lead and 56 male nonexposed workers were examined for their blood lead (PBB), Zinc-protoporphy (ZPP), hemoglobin (HB) and personal history, and completed 15 questionnaires related to symptoms of lead absorption; also measured lead concentration in air (PBA) in the workplace. The results obtained were as follow; 1. The means of blood lead (PBB), blood ZPP and hemoglobin (HB) among workers exposed to lead were 26.1+/-8.8 microgram/dl, 28.3+/-26.0 microgram/dl and 16.2+/-1.2g/dl; whereas those of nonexposed workers were 18.7+/-5.1 microgram/dl, 20.6+/-8.7 microgram/dl and 17.3+/-1.1g/dl. The means of above three indicies between two groups showed significant difference statistically (p<0.05). 2. The means of blood lead (PBB), blood ZPP and hemoglobin of workers exposed to different lead concentration in air were as follows; When it was below 25 microgram/m3 , the indices were 24.7+/-79, 26.1+/-26.8 microgram/dl and 16.4+/-1.1 g/dl respectively; These indices were 27.1+/-8.5, 23.9+/-10.92 /dl and 16.2+/-1.3 g/dl when the lead concentration in air was 25~50 microgram/m3; and they were 3.4+/-9.3, 42.3+/-31.3 microgram/dl and 15.5+/-1.2 g/dl when the concentration of lead was above 50 microgram/m3. Although there were statistical difference in blood lead and hemoglobin among three different lead concentration in air, there was no statistical difference of blood ZPP among the three groups with different exposure levels (p>0.05). 3. The most frequently by complained symptom was "Generalized weakness and fatigue", and fewest symptom was "Intermittent pains in abdomen". 4. Only two symptoms out of fifteen symptoms checked by themselves revealed significant difference between exposed and nonexposed groups. These were "Intermittent pains of abdomen" and "Joint pain or arthralgia" (p<0.05). No positive correlation was found between the levels of blood lead and symptom groups categorized as gastrointestinal, neuromuscular and constitutional symptoms. 5. Blood lead (r=0.3995) and ZPP (r=0.2837) showed statistically significant correlation with mean lead concentration in air, whereas correlations were not demonstrated between blood lead and lead related symptoms or blood ZPP and lead related symptoms. 6. Blood lead (PBB) and ZPP showed association (r=0.2466) and the equation PBB=23.75+0.0842 ZPP was derived. 7. On stepwise multiple regression, using blood lead level as a dependent variable and ZPP, hemoglobin (HB), age, work duration (WD) and symptom prevalence as a independent variables, only ZPP significantly contributed a lot to blood lead level. 8. While the ZPP measurement was found to be a good indicator in evaluating health effect of lead absorption in low level lead exposure, lead related symptoms were not sensitive enough to evaluate of lead absorption in low level exposure.
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Summary
- A study on the status of working environment control and health management of workers in a manufacturing industries.
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Jung O Ham, Kyu Yoon Hwang, Kyu Dong Ahn, Byung Kook Lee, Tack Sung Nam
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Korean J Prev Med. 1990;23(3):275-284.
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- To obtain the useful information for the status of working environment and health management of workers in manufacturing industries, comparision of results on the status of working environmental and health management of workers for 32 manufacturing industries in Chunam area from 1988 to 1989 was carried out. The results were as follows: 1. The rate of over-PEL(Permissible Exposure Limit) to for hazardous factors decreased significantly 23.5% in 1988, 18.3% in 1989 (p<0.05) and, the highest rate of over-PEL was the stone and sand handling industry, the highest rate of over-PEL was the dusty worplace as 38.5% in 1988, 35.2% in 1989. 2. The rate of workers exposed to hazardous factors in 1988 and in 1989 was 22.4% respectively, the rate of workers checked up special health examination was 40.1% in 1988, 75.3% in 1989. In stone and sand handling an dmedicochemical industries, none of workers exposed to hazardous factors was subjected to special health examination in 1988, but 75% of workers exposed to hazardous factors had checked up in 1989. 3. The 6 industries appointed as part-time factory physician among 17 industries which were supposed to have factory physician according to the Safety and Healthy Act of Korea, 6 out of 24 industries only appointed industrial hygienist, furthermore 4 out of 6 hygienists had another duty in addition to occupational hygiene itself.
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Summary
- Alterations of Blood Cholinesterase Activity and Urinary Para-nitrophenol Excretion After Exposure to Organophorus Insecticides.
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Byung Kook Lee, Kyou Chull Chung
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Korean J Prev Med. 1974;7(1):115-121.
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Abstract
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- In order to evaluate the health hazard due to organ orphosphorus insecticides, we measured the blood cholinesterase activity and urinary para-nitrophenol among 56 exposed subjects. They are orchard workers, rice plant workers and smithion factory workers. The clinical symptoms were also checked by physicians. We also measured the blood cholinesterase activity and urinary para-nitrophenol excretion of 20 urban people and 15 rural people who had never been exposed to organophosphorus insecticides in order to compare them according to age, sex and geographical differences. And these results were also compared with those of exposed groups. The results obtained were as follows. 1. The normal plasma cholinesterase activity and cell cholinesterase activity were 0.861+/-0.148 delta pH/hr and 0.822+/-0.154 delta pH/hr. And normal para-nitrophenol in urine was 1.21+/-0.52 mg/liter. 2. No significant difference was existed in blood cholinesterase activities and urinary para-nitrophenol excretion according to sex, age and geographical difference. 3. The plasma cholinesterase activity and cell cholinesterase activity of orchard workers, rice plant workers and smithion factory workers were 0.682+/-0.189 delta pH/hr, 0.775+/-0.160 delta pH/hr, 0.754+/-0.123 delta pH/hr and 0.691+/-0.082 delta pH/hr, 0.756+/-0.117delta pH/hr. And significant decreases in blood cholinesterase activities were existed among orchard workers and smithion factory workers compared with control group. 4. The urinary para-nitrophenol excretions of orchard workers, rice plant workers and smithion factory workers were 1.33+/-0.66 mg/liter, 1.19+/-0.88mg/liter and 1.37+/-0.67mg/liter and there were no significant difference between exposed groups and control group. 5. The clinical symptoms complained during and after organophosphorus insecticides exposure were frequently ranked by headache (67.7%) and vertigo (64.5%) and muscular ataxia and weakness (51.6%).
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