Journal of Preventive Medicine and Public Health

Hyun Sul Lim

46 Articles

Epidemiological Investigation for Outbreak of Food Poisoning Caused by Bacillus cereus Among the Workers at a Local Company in 2010.: Kum Bal Choi, Hyun Sul Lim, Kwan Lee, Gyoung Yim Ha, Kwang Hyun Jung, Chang Kyu Sohn; J Prev Med Public Health. 2011;44(2):65-73.; DOI: https://doi.org/10.3961/jpmph.2011.44.2.65

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OBJECTIVES
In July 2 2010, a diarrhea outbreak occurred among the workers in a company in Gyeungju city, Korea. An epidemiological investigation was performed to clarify the cause and transmission route of the outbreak. METHODS: We conducted a questionnaire survey among 193 persons, and we examined 21 rectal swabs and 6 environmental specimens. We also delegated the Daegu Bukgu public health center to examine 3 food service employees and 5 environmental specimens from the P buffet which served a buffet on June 30. The patient case was defined as a worker of L Corporation and who participated in the company meal service and who had diarrhea more than one time. We also collected the underground water filter of the company on July 23. RESULTS: The attack rate of diarrhea among the employees was 20.3%. The epidemic curve showed that a single exposure peaked on July 1. The relative risk of attendance and non-attendance by date was highest for the lunch of June 30 (35.62; 95% CI, 2.25 to 574.79). There was no specific food that was statistically regarded as the source of the outbreak. Bacillus cereus was cultured from two of the rectal swabs, two of the preserved foods and the underground water filter. We thought the exposure date was lunch of June 30 according the latency period of B. cereus. CONCLUSIONS: We concluded the route of transmission was infection of dishes, spoons and chopsticks in the lunch buffet of June 30 by the underground water. At the lunch buffet, 50 dishes, 40 spoons, and chopsticks were served as cleaned and wiped with a dishcloth. We thought the underground water contaminated the dishes, spoons, chopsticks and the dishcloth. Those contaminated materials became the cause of this outbreak.

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Bacillus cereus: A review of “fried rice syndrome” causative agents
Sui Sien Leong, Figen Korel, Jie Hung King
Microbial Pathogenesis.2023; 185: 106418. CrossRef
Outbreaks, Germination, and Inactivation of Bacillus cereus in Food Products: A Review
Won Choi, Sang-Soon Kim
Journal of Food Protection.2020; 83(9): 1480. CrossRef
The Bacillus cereus Food Infection as Multifactorial Process
Nadja Jessberger, Richard Dietrich, Per Einar Granum, Erwin Märtlbauer
Toxins.2020; 12(11): 701. CrossRef
Surveillance of Bacillus cereus Isolates in Korea from 2012 to 2014
Su-Mi Jung, Nan-Ok Kim, Injun Cha, Hae-young Na, Gyung Tae Chung, Hyo Sun Kawk, Sahyun Hong
Osong Public Health and Research Perspectives.2017; 8(1): 71. CrossRef
Analysis of Waterborne Pathogenic Bacteria among Total Coliform Positive Samples in the Groundwater of Chungcheongnam-do Province, Korea
Jungho Yu, Changkeun Wang, Inchul Shin, Donguk Kim, Kwisung Park
Korean Journal of Environmental Health Sciences.2016; 42(3): 189. CrossRef
Cellular responses and proteomic analysis of hemolytic Bacillus cereus MH-2 exposed to epigallocatechin gallate (EGCG)
Dong-Min Kim, Sang-Kook Park, Kye-Heon Oh
The Korean Journal of Microbiology.2016; 52(3): 260. CrossRef
Molecular Typing in Public Health Laboratories: From an Academic Indulgence to an Infection Control Imperative
Franz Allerberger
Journal of Preventive Medicine and Public Health.2012; 45(1): 1. CrossRef

Work-Related Musculoskeletal Symptoms Among Dairy Farmers in Gyeonggi Province, Korea.: Ji Hyuk Park, Hyun Sul Lim, Kwan Lee; J Prev Med Public Health. 2010;43(3):205-212.; DOI: https://doi.org/10.3961/jpmph.2010.43.3.205

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OBJECTIVES
The prevalence of work-related musculoskeletal symptoms (WMS) among Korean dairy farmers has not been investigated. The purpose of this study was to assess the prevalence of WMS and to evaluate the relationship between WMS and risk factors. METHODS: Self-developed questionnaires including the questionnaire developed by the Korean Occupational Safety and Health agency (KOSHA) were used to investigate WMS among dairy farmers in Gyeonggi Province, Korea. We informed selected dairy farmers about the study and sent the questionnaires by registered mail. They visited a public health center nearby or a branch of public health center on the appointed date and skillful researchers identified or conducted the questionnaires by interview. We analyzed 598 (32.8%) of the 1824 dairy farmers. Multiple logistic regression was implemented to estimate the odds ratios of risk factors. RESULTS: The mean age of the respondents was 50.4 +/- 8.7 years and the proportion of males was 63.0%. The prevalence of WMS at any site was 33.3%. The prevalence of neck WMS was 2.2%, shoulders 10.0%, arms/elbows 5.0%, hands/wrists/fingers 4.2%, low back 11.5%, and legs/feet 11.7%. The adjusted odds ratio of low back WMS for milking 4 or more hours per day was 4.231 (95% CI = 1.124 - 15.932) and statistically significant. Low back WMS (2.827, 95% CI = 1.545 - 5.174) was significantly decreased by education. CONCLUSIONS: Low back WMS increased with milking hours and milking 4 or more hours per day was significantly associated with low back WMS. Low back WMS was significantly reduced with education. We hope that there will be increased attention about WMS in dairy farmers and the subject of future investigations.

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Acute Effects of a Warm-Up Intervention on Pain, Productivity, Physical Capacities and Psychological Perceptions Among Vineyard Workers: a Cluster Randomized Trial
Nicolas Larinier, Nicolas Vuillerme, Alexandre Jadaud, Solène Malherbe, Eymeric Giraud, Romain Balaguier
Journal of Occupational Rehabilitation.2024; 34(1): 100. CrossRef
Prevalence of shoulder pain and its correlates in Jeju agricultural population: A retrospective cross-sectional study
Hyun Jung Lee, Jung-Hwan Oh, Jeong Rae Yoo, Seo Young Ko, Jeong Ho Kang, Sung Kgun Lee, Wooseong Jeong, Gil Myeong Seong, Chul-Hoo Kang, Chaemoon Lim, In Seok Son, Hyun Ju Yang, Min-su Oh, Sung Wook Song
Medicine.2024; 103(8): e37043. CrossRef
Evaluation of working conditions, work postures, musculoskeletal disorders and low back pain among sugar production workers
Mehrdad Hassani, Reza Hesampour, Joanna Bartnicka, Nasim Monjezi, Sahebeh Mirzaei Ezbarami
Work.2022; 73(1): 273. CrossRef
Agricultural Risk Factors Related Musculoskeletal Disorders among Older Farmers in Pathum Thani Province, Thailand
Teeraphun Kaewdok, Sanpatchaya Sirisawasd, Sasitorn Taptagaporn
Journal of Agromedicine.2021; 26(2): 185. CrossRef
Investigation of Ergonomic Conditions and the Relationship between the Severity of Discomfort and Working Postures among Date Palm Farmers
Maryam Nourollahi Darabad, Davod Afshari, Javad Nosrati Amirabadi, Gholam abbas Shirali, Ali Sahraneshin Samani
Journal of Occupational Hygiene Engineering.2021; 8(3): 59. CrossRef
Prevalence and Risk-Factors of Musculoskeletal Disorders Among Provincial High School Teachers in the Philippines
Lito M AMIT, Gerald T MALABARBAS
Journal of UOEH.2020; 42(2): 151. CrossRef
Association of knee pain with working position and other factors among dairy farmers: A study in West Java, Indonesia
I M Rachmi, R A Werdhani, I N Murdana
Journal of Physics: Conference Series.2018; 1073: 042011. CrossRef
Prevalence and Characteristics of Musculoskeletal Pain in Korean Farmers
David Min, Sora Baek, Hee-won Park, Sang-Ah Lee, Jiyoung Moon, Jae E. Yang, Ki Sung Kim, Jee Yong Kim, Eun Kyoung Kang
Annals of Rehabilitation Medicine.2016; 40(1): 1. CrossRef
Prevalence of Musculoskeletal Disorders among Farmers
Md Monoarul Haque
MOJ Orthopedics & Rheumatology.2016;[Epub] CrossRef
Musculoskeletal Disorder Symptoms and Its Related Factors among Male Workers in Manufacturing Industries
Seung-Hyun Lee, Young-Chae Cho
Journal of the Korea Academia-Industrial cooperation Society.2015; 16(10): 6627. CrossRef
Patterns of Work-Related Musculoskeletal Disorders Among Workers in Palm Plantation Occupation
Leonard Joseph Henry, Ali Jafarzadeh Esfehani, Ayiesah Ramli, Ismarulyusda Ishak, Maria Justine, Vikram Mohan
Asia Pacific Journal of Public Health.2015; 27(2): NP1785. CrossRef
Musculoskeletal Symptoms and Its Related Factors among Male Workers in a Nonferrous Manufacturing Industry
Yeon-Ok Jeong, Young-Chae Cho
Journal of the Korea Academia-Industrial cooperation Society.2012; 13(8): 3552. CrossRef
Prevalence of musculoskeletal disorders among farmers: A systematic review
Aoife Osborne, Catherine Blake, Brona M. Fullen, David Meredith, James Phelan, John McNamara, Caitriona Cunningham
American Journal of Industrial Medicine.2012; 55(2): 143. CrossRef
Musculoskeletal Disorder Symptoms and Related Factors among Male Workers in Small-scale Manufacturing Industries
Seung-Hyun Lee, Ju-Yeon Lee, Young-Chae Cho
Journal of the Korea Academia-Industrial cooperation Society.2012; 13(9): 4025. CrossRef

Seroprevalence and Risk Factors of Brucellosis among Slaughterhouse Workers in Korea.: Seok Ju Yoo, Young Sill Choi, Hyun Sul Lim, Kwan Lee, Mi Yeoun Park, Chaeshin Chu, Young A Kang; J Prev Med Public Health. 2009;42(4):237-242.; DOI: https://doi.org/10.3961/jpmph.2009.42.4.237

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OBJECTIVES
The incidence of zoonoses in Korea has increased recently. However, the study of high risk groups for zoonoses has not been conducted to date in Korea. Thus, we did this study to obtain data on brucellosis among slaughterhouse workers in Korea. METHODS: We evaluated the structure of slaughterhouses and the process of slaughtering by reviewing the relevant literature and doing field studies. We visited 73 slaughterhouses and 62 residual products handle houses across the country. In addition, we conducted a questionnaire survey of the work activities, and obtained blood samples in order to determine the seroprevalence and risk factors of brucellosis. The titers of brucellosis antibodies were measured using the standard tube agglutination test (SAT). We diagnosed subjects as seropositive for Brucellosis if the titers were more than 1:160. The data collected was evaluated using SPSS ver. 17.0. RESULTS: We included 1,503 subjects and obtained 1,482 blood samples among them: 849 workers involved in slaughtering, 351 handlers of residual products, 190 inspectors and their assistants, and 92 grading testers and their assistants. The seroprevalence of brucellosis among the slaughterhouse workers was 0.8% (95% CI=0.4-1.5). Broken down, the seroprevalence of brucellosis among the workers involved in slaughtering was 0.7% (95% CI=0.3-1.6), the handlers of residual products was 1.7% (95% CI=0.7-3.9) respectively. Risk factors for contracting brucellosis among slaughterhouse workers were being splashed with cattle blood around the mouth, cattle secretions around the body and not putting on protective apron while at work. CONCLUSIONS: An educational program is needed for high risk groups on zoonoses about the prevention of infection. Thus, effective working guidelines for workers who participate in the slaughter of animals must be developed in order to protect them from zoonoses.

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Seroepidemiologic evidence of Q fever and associated factors among workers in veterinary service laboratory in South Korea
Dilaram Acharya, Ji-Hyuk Park, Jeong-Hoon Chun, Mi Yeon Kim, Seok-Ju Yoo, Antoine Lewin, Kwan Lee, José Reck
PLOS Neglected Tropical Diseases.2022; 16(2): e0010054. CrossRef
Occupational exposure to livestock and risk of tuberculosis and brucellosis: A systematic review and meta-analysis
M. Mukthar Mia, Mahamudul Hasan, Faija Sadia Pory
One Health.2022; 15: 100432. CrossRef
The impact of expanded brucellosis surveillance in beef cattle on human brucellosis in Korea: an interrupted time-series analysis
Sukhyun Ryu, Ricardo J. Soares Magalhães, Byung Chul Chun
BMC Infectious Diseases.2019;[Epub] CrossRef
Spatial analysis to assess the relationship between human and bovine brucellosis in South Korea, 2005–2010
Jun-Sik Lim, Kyung-Duk Min, Sukhyun Ryu, Seung-Sik Hwang, Sung-Il Cho
Scientific Reports.2019;[Epub] CrossRef
Obituary: Dr. Hyun-Sul Lim’s (1952-2018) life as an epidemiologist, occupational and environmental medicine researcher, and family physician
Sun Huh
Epidemiology and Health.2018; 40: e2018033. CrossRef
Vaccination of goats with a combinationSalmonellavector expressing fourBrucellaantigens (BLS, PrpA, Omp19, and SOD) confers protection againstBrucella abortusinfection
Mwense Leya, Won Kyong Kim, Jeong Sang Cho, Eun-Chae Yu, Young-Jee Kim, Yoonhwan Yeo, Kwang-Soo Lyoo, Myeon-Sik Yang, Sang-Seop Han, John Hwa Lee, Dongseob Tark, Jin Hur, Bumseok Kim
Journal of Veterinary Science.2018; 19(5): 643. CrossRef
Seroreactivity and Risk Factors Associated with Human Brucellosis among Cattle Slaughterhouse Workers in South Korea
Dilaram Acharya, Seon Hwang, Ji-Hyuk Park
International Journal of Environmental Research and Public Health.2018; 15(11): 2396. CrossRef
Seroprevalence of Brucellosis, Leptospirosis, and Q Fever among Butchers and Slaughterhouse Workers in South-Eastern Iran
Saber Esmaeili, Saied Reza Naddaf, Behzad Pourhossein, Abdolrazagh Hashemi Shahraki, Fahimeh Bagheri Amiri, Mohammad Mehdi Gouya, Ehsan Mostafavi, Jonas Waldenström
PLOS ONE.2016; 11(1): e0144953. CrossRef
Epidemiology of brucellosis among cattle in Korea from 2001 to 2011
Hachung Yoon, Oun-Kyong Moon, Soo-Han Lee, Won-Chang Lee, Moon Her, Wooseog Jeong, Suk-Chan Jung, Do-Soon Kim
Journal of Veterinary Science.2014; 15(4): 537. CrossRef
Awareness on Zoonoses among Pig Farmers in Korea
Seok-Ju Yoo, Hyun-Sul Lim, Kwan Lee
Journal of agricultural medicine and community health.2014; 39(4): 222. CrossRef
Time series analysis of human and bovine brucellosis in South Korea from 2005 to 2010
Hu Suk Lee, Moon Her, Michael Levine, George E. Moore
Preventive Veterinary Medicine.2013; 110(2): 190. CrossRef
Biossegurança no trabalho em frigoríficos: da margem do lucro à margem da segurança
Gabriela Chaves Marra, Luciana Hugue de Souza, Telma Abdalla de Oliveira Cardoso
Ciência & Saúde Coletiva.2013; 18(11): 3259. CrossRef
Occupational exposure assessment using antibody levels: exposure to avian leukosis/sarcoma viruses in the poultry industry
Kyung-Mee Choi, Eric S. Johnson
International Journal of Environmental Health Research.2011; 21(4): 306. CrossRef

Seroprevalence of Brucellosis among Risk Population in Gyeongsangbuk-do, 2006.: Kwan Lee, Hyun Sul Lim, Woo Won Park, Sung Hwan Kim, Do Young Lee, Mi Yeoun Park, Youngju Hur; J Prev Med Public Health. 2007;40(4):285-290.; DOI: https://doi.org/10.3961/jpmph.2007.40.4.285

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OBJECTIVES
Cases of human brucellosis in Korea have recently increased due to the increasing incidence of bovine brucellosis. The authors conducted this study to elucidate the status of brucellosis through seroepidemiologic study. METHODS: We selected our study population from a high risk group. We conducted a questionnaire survey and obtained blood samples to determine the seroprevalence of brucellosis antibodies for 10 days in February, 2005. The titers of brucellosis were measured by the combination of standard tube agglutination test (STA) and enzyme-linked immunosorbent assay (ELISA) test. RESULTS: Our study subjects comprised 1,075 cases: 971 livestock workers, 51 veterinarians, and 53 artificial inseminators. In the STA test, 27 cases (2.5%) had titers of greater than or equal to 1:20. Of 1,068 cases (7 cases were excluded due to previous brucellosis), 7 cases of brucellosis were diagnosed with titers of 1:160, giving a seroprevalence of brucellosis of 0.66%. The seroprevalence in the male group was 0.95%, and that of livestock workers, veterinarians, and artificial inseminators was 0.52%, 4.17%, and 0.00%, respectively. The Spearman's correlation coefficient between the positive rate of bovine brucellosis per capita and household and human brucellosis was 0.806 and 0.744, respectively. The concordance rate between the Korea National Institute of Health and the Gyeongsangbuk-do Institute of Health and Environment by the STA and ELISA tests was 94.7% and 100.0%, respectively. CONCLUSIONS: The study results indicated in higher seroprevalence rate among veterinarians than among livestock workers and artificial inseminators. Because veterinarians may be exposed to this high risk, effective working guidelines for veterinarians to guard against brucellosis must be developed. Moreover, more extensive epidemiologic research for laboratory workers and meat handlers is needed.

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Awareness on Zoonoses among Pig Farmers in Korea
Seok-Ju Yoo, Hyun-Sul Lim, Kwan Lee
Journal of agricultural medicine and community health.2014; 39(4): 222. CrossRef
Evaluation and Selection of Multilocus Variable-Number Tandem-Repeat Analysis Primers for Genotyping Brucella abortus Biovar 1 Isolated from Human Patients
Subok Lee, Kyu-Jam Hwang, Mi-Yeoun Park, Seon-Do Hwang, Hee-Youl Chai, Hyuk Chu, Sang-Hee Park
Osong Public Health and Research Perspectives.2013; 4(5): 265. CrossRef
Application of the Microagglutination Test for Serologic Diagnosis of Human Brucellosis
Sang-Hee Park, Yoo-Hoon Lee, Hyuk Chu, Seon-Do Hwang, Kyu-Jam Hwang, Hee-Yeol Choi, Mi-Yeoun Park
Osong Public Health and Research Perspectives.2012; 3(1): 19. CrossRef
Awareness of Major Zoonoses among Dairy Farmers in Gyeonggi Province
Kum-Bal Choi, Hyun-Sul Lim, Kwan Lee, Young-Sun Min
Journal of agricultural medicine and community health.2010; 35(4): 339. CrossRef
Seroprevalence and Risk Factors of Brucellosis among Slaughterhouse Workers in Korea
Seok-Ju Yoo, Young-Sill Choi, Hyun-Sul Lim, Kwan Lee, Mi Yeoun Park, Chaeshin Chu, Young-A Kang
Journal of Preventive Medicine and Public Health.2009; 42(4): 237. CrossRef
The Relationship between Cerebrovascular Mortality and Community Health Indicators in Gangwon-do
Jeoung-Ha Sim, Mi-A Son
Journal of agricultural medicine and community health.2009; 34(1): 1. CrossRef
Awareness of Zoonoses among Cattle Slaughterhouse Workers in Korea
Hyun-Sul Lim, Seok-Ju Yoo, Kwan Lee
Journal of agricultural medicine and community health.2009; 34(1): 101. CrossRef
A review of published reports regarding zoonotic pathogen infection in veterinarians
Whitney S. Baker, Gregory C. Gray
Journal of the American Veterinary Medical Association.2009; 234(10): 1271. CrossRef

Seasonal Variation of Food Intake in Food Frequency Questionnaire among Workers in a Nuclear Power Plant.: Jae Jeong Yang, Sue Kyung Park, Hyun Sul Lim, Kwang Pil Ko, Younjhin Ahn, Yoon Ok Ahn; J Prev Med Public Health. 2007;40(3):239-248.; DOI: https://doi.org/10.3961/jpmph.2007.40.3.239

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OBJECTIVES
This study was conducted to investigate the systematic error, such as seasonal change or inadequate food items, in a food frequency questionnaire administered to workers in a Nuclear Power Plant, Korea. METHODS: We performed three repeat-tests with 28 subjects on May 13, July 8 and Dec 16, 1992. Our food frequency questionnaire (FFQ) comprised 84 foods organized into 7 food-groups, and was composed of the items of usual intake frequency (8 categories) and the amount per intake (3 or 4 categories) over the previous year. We compared the means of intake frequency and the frequency of the portion-size according to each season using Repeated Measures ANOVA and Pearson's chisquare test with Fisher's exact test. RESULTS: We found the significant seasonal changes of several food items in intake frequency measurement. These items were typical seasonal foods such as mandarin orange, plum and green vegetables, while the single questions consisted of inadequate food items such as thick beef or similar soup and various kimchi products. Significant seasonal changes in portion-size were found in only two items: cooked rice-brown and fresh.frozen fishes. CONCLUSIONS: The systematic errors observed could caused loss of validity in the FFQ. Consideration should be given for seasonal variation in FFQ survey and methodological concerns are needed to improve the quality for measuring usual diet pattern.

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Association between dietary patterns and periodontal disease: The OsteoPerio cohort study
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Seasonality of sodium and potassium consumption in Switzerland. Data from three cross-sectional, population-based studies
H. Marti-Soler, C. Pommier, M. Bochud, I. Guessous, B. Ponte, M. Pruijm, D. Ackermann, V. Forni Ogna, F. Paccaud, M. Burnier, A. Pechère-Bertschi, O. Devuyst, P. Marques-Vidal, I. Binet, D. Conen, P. Erne, L. Gabutti, A. Gallino, D. Hayoz, F. Muggli, P.M.
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Nutrients.2016; 8(11): 749. CrossRef
Vitamin C Deficiency in a Population of Young Canadian Adults
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One Year Follow-up Study of Symptomatic Cases of Ulnar Neuropathy at the Elbow in a Rural Population.: Young Joo Sim, Hyun Sul Lim; J Prev Med Public Health. 2006;39(5):404-410.

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Abstract PDF: OBJECTIVES
This study examined the natural history of symptomatic patients who did or did not display abnormal results on nerve conduction studies (NCS). METHODS: Forty hundred fifty adults were selected among a total of 578 residents who participated in the health examination in a rural Korean district. A symptom questionnaire and NCS were used to diagnose ulnar neuropathy at the elbow (UNE). There were 6.4% of the subjects with UNE, 5.1% of the subjects showed symptoms without a NCS, and 84.2% of the subjects who were asymptomatic. One year later, 20 symptomatic limbs with an abnormality on the ulnar NCS and 22 symptomatic limbs without any abnormality in the ulnar NCS were enrolled in a follow-up study. The natural history of UNE was evaluated by examining the changes in the clinical and electrodiagnostic examinations. RESULTS: The 1-year follow-up of the enrolled limbs found that for the symptomatic limbs with an abnormality on the NCS, the degree of severe of the clinical grade changed from 20% to 10%. In contrast, for the symptomatic limbs that were without any abnormality in the NCS, the change of the severe degree of the clinical grade was from 0% to 18.2%. Also, for the electrodiagnostic change, only symptomatic limbs without NCS abnormalities showed significant changes in motor latency, amplitude and conduction velocity at the 1-year follow-up. CONCLUSIONS: The 1-year follow-up study revealed symptomatic limbs that were without any abnormality on the ulnar NCS were more likely to progress than the symptomatic limbs with an abnormality on the ulnar NCS.; Summary

Future of Scientific Research on Preventive Medicine in Korea.: Hyun Sul Lim; J Prev Med Public Health. 2006;39(2):105-109.

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Abstract PDF: The Korean Society of Preventive Medicine has undergone continuous development, after overcoming the difficult early years, in the 59 years since its establishment in 1947. It has repeatedly upgraded its quality and quantity of research with the first journal edition in 1968 and the continuous increase in publication numbers, scientific articles, joint research projects, intra-field exchanges and participation in various international scientific activities. In the future, we should gather a more extensive collection of opinions regarding the introduction of clinical preventive medicine specialists and prepare for the establishment of a training program for clinical specialists into a preventive medicine residency course. Moreover, we should raise interest in the importance of protecting individual information and maintaining medicine ethics. It's impossible to develop academic activities without cooperation. We need such cooperation with basic medical approaches across a wide range of fields. Furthermore, we should strengthen our cooperation with aspects of clinical and drug epidemiology in many fields including public health, statistics, and dietetics. Finally, we should raise the level of international cooperation with many countries, including North Korea, to prevent diseases and promote health. Preventive medicine is a science in which practice is as important as theory. We must aim to nurture preventive medicine specialists who practice in many areas of society with the goal of preventing diseases, promoting health, improving fertility, and securing healthy elderly life for individuals and the entire population. To this end, we will endeavor to promote both theoretical and practical components of academic development.; Summary

Investigation of a Series of Brucellosis Cases in Gyeongsangbuk-do during 2003-2004.: Hyun Sul Lim, Young Sun Min, Hwan Seok Lee; J Prev Med Public Health. 2005;38(4):482-488.

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Abstract PDF: OBJECTIVES
We conducted an investigation on 14 cases of brucellosis in Gyeongsangbuk-do during 2003-2004 to understand the source of infection and the transmission routes of brucellosis. METHODS: The authors visited the each of the health centers and we examined the patients, their written epidemiologic questionnaire and the occurrence of bovine brucellosis. We visited the patients' living and work areas, and we examined their occupations, the date they developed symptoms, the progress of their symptoms, whether or not they were treated, their current status, whether or not they consumed raw milk and raw meat, and if their work was related to cattle breeding and the related details. We reviewed the results of the blood tests and medical records and we examined the cattle's barn. RESULTS: There were 3 patients in 2003 and 11 patients in 2004. All of their brucella antibody titer exceeded 1: 160. The patients' symptoms were fever, myalgia, malaise, chills and an influenza-like illness, but the clinical signs were absent on the medical records. Brucella abortus were cultured from 3 of the patients' blood samples. CONCLUSIONS: When the authors discovered the transmission routes, they were divided into 4 different sorts. The first route was related to cattle birth such that patients touched the calves or placentas that were infected with the Brucella species. The second route was related to performing artificial insemination on the cattle and the semen that was used for artificial insemination. The third route was due to the ingestion of raw meat and milk. The last route was due to sexual intercourse between the patients.; Summary

Epidemiologic Investigation on an Outbreak of Salmonellosis in Yeongcheon-si, 2004.: Hyun Sul Lim, Young Sun Min, Hwan Seok Lee; J Prev Med Public Health. 2005;38(4):457-464.

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An outbreak of salmonellosis occurred among the students and staff of D primary school in Yeongcheon-si, 2004. This investigation was carried out to prevent any recurrence of this outbreak and to study the infection source and transmission of the salmonellosis. METHODS: The authors conducted a questionnaire survey among 1, 205 students and staff members from D primary school about the ingestion of the school lunch and drinking water, and the manifestation of their symptoms. The author examined rectal swabs, the tap water and microorganism cultures, and we also investigated the dining facility and water supply facility. RESULTS: The diarrheal cases were defined as the confirmed cases or the persons who had diarrhea more than one time with symptoms such as fever, vomiting and tenesmus. The diarrheal attack rate was 28.0%. Ingestion of fried bean curd with egg had a significantly high association with the diarrheal attack rate (p< 0.05), and the relative risk of the fried bean curd with egg was 10.68 (95% CI=3.88-29.41), as was determined by logistic regression analysis. The bacterial counts in the tap water of the food preparation room and toilet (first floor) exceeded the maximum permissible counts. S. Enteritidis bacteria were only cultured from the fried bean curd with egg of all the supplied foods on September 3, 2004. CONCLUSIONS: The major cause of salmonellosis was presumed to be the contaminated bean curd via contaminated tap water due to a water leak of a school water pipe. This contaminated bean curd was under prepared, which allowed the S. Enteritidis to survive and multiply prior to its ingestion.; Summary

Seroprevalence of Measles Antibody and its Attributable Factors in Elementary Students of Routine 2-dose Schedule Era with Vaccination Record.: Geun Ryang Bae, Hyun Sul Lim, Un Yeong Goh, Byung Guk Yang, Young Taek Kim, Jong Koo Lee; J Prev Med Public Health. 2005;38(4):431-436.

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We investigated the seroprevalence of the measles antibody and its attributable factors for the students who underwent routine 2-dose Schedule Era. METHODS: The subjects were 996 students of the national measles seroepidemiologic study in December 2000 who had vaccination records. We conducted a questionnaire survey and we performed serologic testing for the measles specific IgG by using an enzyme linked immunosorbent assay. RESULTS: The coverage for the first dose of the MMR vaccination at 12-15 months of age was 95.1% and the coverage for the second dose of MMR at 4-6 years of age was 35.0%. The proportion of subjects undergoing 2- doses of MMR decreased as the age of the subjects increased. The seropositive rate of the measles antibody was significantly high in the second dose vaccinees (93.5% in the second dose group, 84.7% in the non-second dose group, p< 0.001) and it was 72.0% in the 0-dose group, 85.4% in the 1-dose group and 93.7% in the 2-dose group (p< 0.001). Two point eight percent of the subjects had a past history of measles infection. On the multiple logistic regression analysis, the first and second dose (odds ratio, 8.54; 95% CI.=3.05-23.91), the first dose (odds ratio, 3.06; 95% CI.=1.20-7.81) and the outbreak in the year 2000 (odds ratio, 1.89; 95% CI.=1.24-2.88) were the significant factors for the eropositivity. CONCLUSIONS: Maintaining high coverage with a 2-dose vaccination program would be the decisive factor to prevent an outbreak of measles and to eliminate measles in Korea.; Summary

Epidemiologic Investigation on an Outbreak of Shigellosis in Seongju-gun, Korea, 2003.: Young Sun Min, Hyun Sul Lim, Kwan Lee, Sang Hyuk Lim, Bog Soon Lee; J Prev Med Public Health. 2005;38(2):189-196.

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Abstract PDF: OBJECTIVES
An outbreak of shigellosis occurred among students and staff of S primary and middle school, Seongju-gun, in 2003. This investigation was carried out to institute an effective counterplan, and study the infection source and transmission of the shigellosis. METHODS: The authors conducted a questionnaire survey among 235 students and staff from S preschool, primary and middle school relating to the ingestion of school lunch and the manifestation of symptoms. Also, the author investigated the drinking water, feeding facility and reconstructed cooking process of the food presumed to be the cause of the shigellosis. The diarrhea cases were defined as confirmed cases and those cases who had had diarrhea more than one time, accompanied with symptoms such as fever, vomiting and tenesmus. RESULTS: From rectal swabs 20 people, between June 28 and July 4, 2003, were confirmed with shigellosis. The diarrhea attack rate was 40.0%. Those who had ingested tomatoes and cubed radish kimchi had significantly higher diarrhea attack rates (p< 0.05), with the relative risk of tomatoes being 2.69 (95% CI: 0.98-7.42). The major cause of shigellosis was presumed to be from contaminated tomatoes due to cooking with rubber gloves containing holes. CONCLUSION: The cooks in charge of school lunches must make doubly sure to not only attend to their sanitation, but also to manage the table wear and items used in providing school lunches. The health care authority should introduce higher-leveled criteria for health care among cooks, so that they cannot cook when the have a case of any infectious disease.; Summary

Changing Patterns of Communicable Diseases in Korea.: Hyun Sul Lim; J Prev Med Public Health. 2005;38(2):117-124.

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Abstract PDF: Before twentieth centuries and during early twentieth centuries, communicable diseases were the major cause of morbidity and mortality in Korea. But reliable data are not available. After 1975, the overall morbidity and mortality from communicable diseases, rapidly declined. Recently many new pathogenic microbes were recognized: L. monocytogenes, Hantaan virus, Y. pseudotuberculosis, P. multocida, L. pneumophilia, Human immunodeficiency virus (HIV), G. seoi, H. capsulatum, C. burnetii, V. cholerae O139, C. parvum, F. tularensis, E. coli 0157: H7, B. burgdorferi, S. Typhimurium DT104, Rotavirus, hepatitis C virus and so on. Since the first HIV infection recognized in 1985, the reported cases of infection and deaths from HIV/AIDS have been steady increased each year. Legionnaire's disease, E. coli O157: H7 colitis, listeriosis and crytosporidiasis have been occurring just sporadically among immunocompromized cases. Many re-emerging communicable diseases were occurred in Korea: leptospirosis, malaria, endemic typhus, cholera, tsutsugamushi disease, salmonellosis, hepatitis A, shigellosis, mumps, measles, acute hemorrhagic conjunctivitis, brucellosis and so on. Leptospirosis and tsutsugamushi diseases have been noticed as major public health problems since 1980s. The malaria that had been8 virtually disappeared for a decade has reappeared from 1993 with striking increase of patients in recent 3-4 years. The distributions of salmonella and shigella serotypes have been changed a lot in recent few decades. Furthermore rapid emergence of antibiotic-resistant bacterial strains induces more difficult and complex problems in control of communicable diseases. We must recognize on the importance of environment and ecosystem conservation and careful prescription of anti-microbial agent in order to prevent communicable diseases.; Summary

Epidemiologic Investigation into the Outbreak of Acute Hemorrhagic Conjunctivitis in Gyeongju-City, South Korea, in 2002.: Hong Hwan Kim, Hyun Sul Lim, Young Sun Min; J Prev Med Public Health. 2004;37(4):312-320. Published online November 30, 2004

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Abstract PDF: OBJECTIVES
An outbreak of acute hemorrhagic conjunctivitis (AHC) caused by coxsackie A24 (CA24) virus occurred in South Korea in 2002. CA24 was isolated for the first time from patients with AHC. Therefore, this study was conducted to understand the transmission routes and prevent another AHC outbreaks. METHODS: The authors conducted a questionnaire survey among 1, 730 students from 2 middle schools and 1 technical high school in Gyeongju city. For statistical analysis the chi-square test was used, and chi-square for trend method showing a level of significance less than p< 0.05 was proven to be significant. Variables which were proven to be significant in univariate analysis were analysed by multiple logistic regression. RESULTS: The attack rate was 57.1%. The student groups with rubbing one's own eyes, computer usage, and sharing cellular phone had a significantly higher AHC attack rate (p< 0.05). According to the multiple logistic regression, the odds ratios for male, high school, computer use, sharing cellular phone, and rubbing one's own eyes were significant (p< 0.05). CONCLUSION: The most significant feature of this outbreak was that many students rubbed their own eyes following contact with AHC patients in a deliberate attempt to avoid going to school. Other transmission methods were computer usage and sharing cellular phone. In the future, health and school authorities must plan new strategies for the prevention of AHC.; Summary

Smoking Behaviors and Its Relationships with Other Health Behaviors among Medical Students.: Soon Woo Park, Jung Han Park, Sang Won Lee, Hyun Sul Lim, Jong Tae Lee, Yune Sik Kang; J Prev Med Public Health. 2004;37(3):238-245.

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Abstract PDF: OBJECTIVES
This study was conducted to examine the smoking behaviors and the relationship between smoking and other health behaviors among medical students. METHODS: A self-administrated questionnaire was administered to a sample of 1, 775 students from four medical schools between April and May 2003. Due to the small number of female smokers, the characteristics of smoking behaviors were analyzed only for males. RESULTS: A total of 1, 367 students (920 males and 447 females) completed the questionnaires, with an overall response rate of 77.7%. The smoking rates for males and females were 31.5, and 2.2%, respectively. Among the male smokers, 70.7% smoked daily, and 39.0% smoked one pack or more per day. Male students on medical course were more likely to smoke daily, and one pack or more per day, than those on premedical course. Male daily smokers desired to quit smoking less than occasional smokers, and 65.0% of male daily smokers were not ready to quit compared with 37.8% of the occasional smokers. Among the male daily smokers, 29.6% were severely nicotine dependent. The most common reason for not to quit smoking among male smokers was 'no alternative stress coping method' (44.4%), followed by 'lack of will power' (25.4%), and 'no need to quit' (19.4%). Compared with male non-smokers, male smokers were more likely to drink alcohol more often and in larger amounts, take coffee more often, eat breakfast less regularly, and be overweight or obese. CONCLUSIONS: The results of this study suggest that many male medical students were serious smokers, especially those on medical course. It is necessary to install a smoking prevention program for pre-medical students, provide effective smoking cessation methods for smokers, teach positive stress coping methods, and make the school environment suitable for coping with stress.; Summary

Evaluation of Field Epidemiology Specialist Training Program Based on the Satisfaction and the Changes of Educational Needs.: 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; J Prev Med Public Health. 2004;37(1):80-87.

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Abstract PDF: 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.; Summary

Prevalence and Risk Factors of Green Tobacco Sickness among Korean Tobacco Harvesters.: Hyun Sul Lim, Kwan Lee, Si Hyun Nam; J Prev Med Public Health. 2004;37(1):37-43.

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Abstract PDF: OBJECTIVE
This study was carried out to understand the prevalence and risk factors of green tobacco sickness (GTS) among Korean tobacco harvesters. METHODS: The authors conducted a questionnaire among the tobacco harvesters (1, 064 persons from 555 out of 723 tobacco harvesting households) in Cheongsong-gun for 4 days from May 7 to 10, 2002. RESULTS: The study subjects were 550 males and 514 females. The recognition and experience of GTS up until 2001 were 96.4% and 61.9%, respectively. The prevalence of GTS in 2001 was 42.5%, and was significantly higher in females than in males (59.0% vs. 26.6%, p< 0.01). The incidence density of GTS according to the number of workdays in 2001 was 12.3 spells/100 person' days. The GTS symptoms reported by the tobacco harvesters in 2001 were dizziness in 441 cases (97.6%), nausea in 414 (91.6%), headache in 349 (77.2%) and vomiting in 343 (75.9%). The use of gloves, hat and wristlets, sweating at work and the number of working hours significantly increased the prevalence of GTS (p< 0.05). Multiple logistic regression analysis was used to determine the factors significantly associated with GTS. Odds ratios for smoking, working over 10 hours and sweating at work were 0.26 (95% CI: 0.19-0.35), 1.64 (95% CI: 1.26-2.14) and 1.60 (95% CI: 1.14-2.25), respectively. Of those who reported GTS in 2001, 311 cases (68.8%) underwent treatment from their local medical facilities. CONCLUSION: In Korea, there are many tobaccoharvesting households, and most may be stricken with GTS. More extensive epidemiological studies, including heincidence and associated risk factors, are expected and a surveillance system including measurements of cotinine in urine should be conducted.; Summary

Survey on the Symptoms Related to Hair Dyeing among University Freshmen.: Kwan Lee, Hyun Sul Lim; Korean J Prev Med. 2003;36(3):223-229.

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Abstract PDF: OBJECTIVES
This study was carried out to investigate the prevalence and symptoms related to hair dyeing among university freshmen. METHODS: The authors conducted a questionnaire survey among 1, 499 university freshmen from Mar 11 to 15, 2002. RESULTS: The study group contained 710 females and 789 males. Up until 2002, 62.7% of the subjects had experienced hair dyeing, and this was significantly higher in females (66.2%, p< 0.05). The period of first experience of hair dyeing was in high school for 361 cases (38.4%), after high school for 345 cases (36.7%) and before high school for 234 cases (24.9%). The major reasons of hair dyeing were 'to improve their appearance' in 466 cases (49.6%), and 'to follow the hair dyeing fashion' in 169 cases (18.0%). The prevalence of hair dyeing in 2002 was 47.8%, and again was significantly higher in females (53.7%, p< 0.05). The major symptoms related to hair dyeing were 'cleaved and nonelastic hair' in 498 cases (69.6%), and 'thin and easily breakable hair' in 353 cases (49.3%). Of those, 361 cases (50.4%) appealed to three or more symptoms related to hair dyeing. Through multiple logistic regression, factors significantly associated with symptoms related to hair dyeing were found to be female (OR=2.14, 95% CI; 1.61-2.83), use of hair dryer (OR=1.36, 95% CI; 1.004-1.854), a frequency of hair dyeing of three or more (OR=1.48, 95% CI; 1.04-2.09), and a duration of processing hair dyeing of over 60 minutes (OR=2.18, 95% CI; 1.50-3.18). CONCLUSIONS: The prevalence and experience of hair dyeing were generally high among university freshmen. Therefore, more extensive epidemiological studies on the symptoms related to hair dyeing should be conducted.; Summary

Cause of Enterohemorrhagic Escherichia coli Infection in Ulju County, Korea.: Geun Ryang Bae, Sang Won Lee, Byung Guk Yang, Bok Kwon Lee, Jae Gu Park, Byeong Hun Hwang, Hyun Sul Lim; Korean J Prev Med. 2003;36(1):77-84.

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Abstract PDF: OBJECTIVES
Two related cases of Hemolytic-Uremic Syndrome (HUS) were reported to the Korea National Institute of Health in May, 2001. Shiga toxin 2 genes were detected in both stool samples. We suspected an enterohemorrhagic Escherichia coli (EHEC) infection as the cause of the HUS, and conducted an investigation to find the source of the infection and its route of transmission. METHODS: We performed case investigations on these two related HUS cases, and obtained interviews and rectal swabs form the family members and other close contacts. Additionally, we performed rectal swabs on the cattle raised by the household of the index patient. RESULTS: We found a 20 month old index patient and a 6 year-old cousin had developed HUS, where there had been a 2 day history of contact with the index, and bacteriological examinations for these two patients revealed, indistinguishably, the same E. coli O171. The grandmother of the index patient was found to be asymptomatic, but E. coli O26 was isolated. We also found a probable case in the mother of the cousin. She reported a history of contact with the index, and developed bloody diarrhea of 3 days duration. The test results for the cattle revealed E. coli O26 in one cow, and E. coli O26 and O55 in another. E. coli O26, which was isolated in both cows and the grandmother of the index, were indistinguishably the same. CONCLUSIONS: We found that the E. coli O26 in the grandmother had originated from the cows, and that the E. coli O171 found in the index patient had been transmitted to the cousin through person-to-person contact.; Summary

Epidemiologic Investigation on an Outbreak of Cholera in Gyeongsangbuk-do, Korea, 2001.: Jun Ho Lee, Hyun Sul Lim, Kwan Lee, Jun Chul Kim, Sang Won Lee, Un Yeong Go, Byung Kuk Yang, Jong Koo Lee, Moon Sik Kim; Korean J Prev Med. 2002;35(4):295-304.

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Abstract PDF: OBJECTIVES
This study was carried out to investigate the cause, magnitude and transmission route of the cholera outbreak in 2001. METHODS: The study population were those persons who ingested foods at the restaurant, were confirmed as cholera patients, had symptoms of diarrhea and served as workers at the restaurant. A questionnaire survey and microbiological examinations on the microbes isolated from rectal swabs were conducted. Of the cases, 316 food histories were surveyed by an analysis of the restaurant menu. RESUJLTS: There were 139 confirmed cases of cholera reported in Korea in 2001. Of these, 104 were related to the restaurant. By region, Gyeongsangbuk-do had the highest incidence with 91 cases. Of these 91 cases, 74 had ingested foods at the restaurant, 2 were employees and 3 were secondary infection cases within the families. The results of the odds ratio analysis of the 316 persons having ingested foods at the restaurant were as follows: sandwiches 5.07 (95% CI, 1.85-14.59), soybean curd 2.45 (95% CI, 1.09-5.56), noodles 2.34 (95% CI, 1.24-4.42), steamed squid 2.01 (95% CI, 1.17-3.47) and vinegared rice 1.82 (95% CI, 1.08-3.09). It was certain the restaurant in question was the cause of the 2001 outbreak. CONCLUSIONS: We suspected that more than one restaurant employee contaminated foods served at the restaurant. In addition, eating raw fishes purchased at the Pohang Fisheries infected the employees of the restaurant. There is a possibility that these raw fishes were themselves contaminated by cholera bacilli in the sea.; Summary

Investigation of Health Hazards in the Underground Storage Facilities of Ginger Roots.: Hyun Sul Lim, Geun Ryang Bae; Korean J Prev Med. 2002;35(1):72-75.

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Abstract PDF: OBJECTIVES
To evaluate the health hazards in the underground storage facilities of ginger roots. METHODS: The authors reviewed the emergency rescue records from the Seosan fire department over the period Jan 1, 1996 to Aug 31, 1999. The atmospheres in 3 different underground storage locations were analyzed for O2, CO2, CO, H2S and NH4. RESULTS: From the emergency records, we were able to identify 20 individuals that had been exposed to occupational hazards in the underground storage facilities. Among these 20 cases, 13 were due to asphyxiation (resulting in 7 deaths) and 7 were due to falls. In the first atmospheric tests, performed on Feb 25, 1998, the O2 level inside the underground storage facility, located about 5~6 meters below the surface, was 20.6% and the CO2 level was about 1,000 ppm. CO, H2S and NH4 were not detected. In the second tests on Jul 6, 1999, measurements of the O2 level at 3 meters below the surface in two different storage locations were 15.3 and 15.1%. And the O2 levels inside the storage facilities were 12.2 and 12.1%. The CO2 level was above 5,000 ppm (beyond upper limits of measurement). CO, H2S and NH4 were not detected. CONCLUSIONS: We conclude that asphyxiation in the underground storage facilities for ginger roots was not due to the presence of toxic gases such as CO, H2S and NH4, but rather the exclusion of oxygen by carbon dioxide was responsible for causing casualties. For the development of a hazard free working environment, safety education as well as improvements in storage methods are needed.; Summary

A Study on the Correlation between Categorization of the Individual Exposure Levels to Agent Orange and Serum Dioxin Levels Among the Korean Vietnam Veterans.: Joung Soon Kim, Han K Kang, Hyun Sul Lim, Hae Kwan Cheong, Min Kyung Lim; Korean J Prev Med. 2001;34(1):80-88.

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Abstract PDF: OBJECTIVES
In an epidemiologic study on the health impact of Agent Orange exposure, the valid estimation of exposure level is the most important step. Based on recent studies, we examined the correlation between exposure levels categorized by personal exposure estimates and serum 2,3,7,8-tetrachlorodibenzo-p-dioxin (2,3,7,8-TCDD, Dioxin), exploring the possibility of utilizing the exposure level as a surrogate for the estimate of exposure to agent orange. METHODS: During the study period (Jan 1996-Feb 1996), blood specimens of 745 subjects taken randomly among 1,329 persons and kept frozen, were analyzed for 2,3,7,8-TCDD and six other dioxin congeners. The serum dioxin and congeners were measured in 1998 by CDC ,adjusted for serum lipids. We categorized the total exposure scores into five groups based on Agent Orange exposure data collected by interview and military records. Pearson and Spearman's correlation coefficients & multiple regression analysis were used to identify the relationship of the exposure level categorized with serum concentration of 2,3,7,8-TCDD, and six other dioxin congeners. RESULTS: Dioxin and the other congeners, except 1,2,4,6,7,8-HpCDD, showed significant correlations to exposure categories (p<0.005); 2,3,7,8-TCDD and OCDD showed positive correlations, whereas the other congeners did negative. The values of 2,3,7,8-TCDD differed according to exposure category and proportionally increased from the low exposure group to the high, a dose-response relationship, even after other possible confounding variables were adjusted for. In multiple regression analysis, age(beta=0.033), dioxin(beta=0.433), 1,2,3,7,8-PeCDD(beta=0.998), 1,2,3,4,7,8-HxCDD(beta=0.773), 1,2,3,6,7,8-HxCDD(beta=0.255), 1,2,3,7,8,9-HxCDD(beta=3.468), 1,2,3,4,6,7,8-HpCDD(beta=0.109) were found to be significantly related to the total exposure score(p<0.005). CONCLUSION: This study demonstrated that the use of such categorizations as a surrogate measure of agent orange exposure in identifying exposure degrees in a health impact study is valid.; Summary

Asbestos and Non-Asbestos Fiber Content in Lungs of Autopsied Subjects in Pohang with no Known History of Occupational Asbestos Exposure.: Hyun Sul Lim, Ji Yong Kim, Dong Hoon Kim, Kiyoshi Sakai, Naomi Hisanaga; Korean J Prev Med. 2000;33(4):477-483.

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Abstract PDF: OBJECTIVES
To obtain reference values for the pulmonary asbestos and non-asbestos fiber contents of residents in Korea and to compare them with similar results from Japan. METHODS: The autopsied lung specimens from 22 deceased people (20 males and 2 females) in Pohang, without any known occupational history of asbestos exposure, were analyzed for incidence of asbestos and non-asbestos fibers by transmission electron microscopy with energy dispersive X-ray analysis after using low temperature ashing procedures. RESULTS: Chrysotile fiber (46.2%) was the major fiber type found in the lungs of the subjects. The asbestos fiber concentrations found in males and females were 0.09x106 fibers/(g of dry lungs) and 0.30x106 fibers/(g of dry lungs), respectively, showing a geometric mean concentration 0.09x106 fibers/(g of dry lung tissue), due to the predominance of males in the sample. The non-asbestos fiber contents in males and females were 4.61x106 fibers/(g of dry lungs) and 17.79x106 fibers/(g of dry lungs), respectively, with a geometric mean concentration 5.21x106 fibers/(g of dry lung tissue). CONCLUSIONS: Residents in Pohang had significantly lower levels of both asbestos and non-asbestos fibers than urban residents in Korea. Furthermore, Koreans had significantly lower levels of both asbestos and non-asbestos fibers than Japanese.; Summary

Prevalence and Risk Factors of Myofascial Pain Syndrome on School Boys.: Duck Soo Kim, Hyun Sul Lim, Jong Min Lee; Korean J Prev Med. 2000;33(2):184-192.

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Abstract PDF: OBJECTIVES
To inquire the prevalence and the risk factors for myofascial pain syndrome (MPS) on young boys in order to use these results as the fundamental data for the prevention of their MPS. METHODS: For 7 days in May 1999, this research was taken on 489 male students ranging from 6th to 12th grade. We randomly selected a class for every group and from these classes we operated physical examinations, self-reported questionnaires and from a rehabilitation doctor, MPS test was taken. Thoracic kyphosis and lumbar lordosis were also taken by using the inclinometer. We defined MPS as a regional pain complaint, palpable taut band that is painful on compression. RESULTS: The shoulder MPS prevalence of the subjects were 29.7 persons/100 persons. The statistics revealed that as grades went up, the percentage significantly increased in the MPS prevalence. As of case-control study, 145 students who were tested postive in all aspects were placed as cases, and 176 students who were perfectly normal as controls on risk factors. As a result of comparing the student groups who were satisfied with their chairs to the student groups were not satisfied, the latter showed a significantly higher odds ratio (p<0.01). By the multiple logistic regression test, we concluded that the MPS disease was prevailed far more in the students in the higher grades (Odds ratio: 1.16, 95% C.I.: 1.03-1.31), and also those who were dissatisfied with their chairs than in the ones who were satisfied (Odds ratio: 1.92, 95% C.I.: 1.17-3.17). CONCLUSIONS: Significant correlations showed between the MPS diagnosed group and the students who are dissatisfied with their chairs. As a result, more research and observation has to be made concerning this disease, and the desks and chairs should be adjusted to suit the student? physical standards.; Summary

Epidemiologic Investigation of an Outbreak of Shigella sonnei among Students in Bonghwa, 1999.: Hyun Sul Lim, Geun Ryang Bae; Korean J Prev Med. 2000;33(1):10-16.

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Abstract PDF: OBJECTIVES
This study was carried out to investigate the sources of infection and modes of transmission of an outbreak of shigellosis that occurred among students of B middle and high school in Bonghwa, Korea from May 1 to 21, 1999. METHODS: We conducted questionnaires to 468 students, 38 staffs and 9 food handlers twice times (May 6, May 21) for follow up and secondary attack rate. Personal details and history of illness and exposure to particular foods were sought. And we conducted rectal swab for culture to 243 students, 33 staffs and 9 food handlers. Bacteriological examinations of water in the school were done. Cases were identified as subjects who had diarrhea (two or more loose stools in a 24-hour periods) on or after May 1. RESULTS: A total of 307 cases (attack rate: 59.6%) of 515 subjects were identified, including 50 confirmed (46 students and 4 staffs) by S. sonnei. All 9 food handlers denied illness and were had rectal swab for culture at May 6 that were negative for S. sonnei. 146 of 307 reported fever, 156 had tenesmus, 44 reported vomiting, and only 5 of 307 reported blood in the stool. The median duration of diarrhea was 4 days (range: 1-18 days). The mean incubation period until onset of diarrhea was 63 hours (range: 16-144 hours) and the secondary attack rate was 2.8% (43 cases of 1,561 family members). Risk for illness was higher among students who had eaten watered kimchi at March 30 than among those who did not [301(72.7%) of 417 versus 5(9.6%) of 52; RR=7.51; 95% CI=3.26-17.31]. CONCLUSION: The source of infection was estimated to be contaminated watered kimchi by one or two food handler who is presumed to be carrier.; Summary

Epidemiologic Investigation of an Outbreak of Shigellosis in Kyongju, Korea.: Hyun Sul Lim, Cheol Jung, Geun Ryang Bae, Yeong Joo Hur, Sang Won Lee, Eun Kyeong Jeong; Korean J Prev Med. 2000;33(1):1-9.

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Abstract PDF: OBJECTIVES
This study was carried out to investigate the sources of infection and modes of transmission of an outbreak of shigellosis that occurred among pupils of "M" primary school and residents near the school in Kyongju from Sept. 24 to Oct. 24, 1998. METHODS: The subjects who completed a questionnaire and a rectal swab for microbiologic examinations were 1,534 persons (781 males, 753 females), including 469 pupils of "M" primary school (268 males, 201 females). Bacteriological examinations of underground water and simple piped water were done. RESULTS: The attack rate of diarrhea was 28.7% in the subjects from Sept. 24 to Oct. 24, 1998. There was no difference in attack rate of diarrhea by gender, but it was significantly higher in the pupils of "M" primary school than others (p<0.01). The attack rate of diarrhea by resident areas was no different to the pupils of "M" primary school, but was significantly higher in the residents of Mohwa 2 Ri except pupils that "M" primary school is located in (p<0.01). The distribution of date of onset revealed the exposure date to be Sept, 22 and 23 in consideration of incubation periods and common source outbreak followed propagative spread in the epidemic curve. The major characteristics of diarrhea were watery (89.1%) in nature, 1~3 days (72.5%) in duration, 2~3 times (63.9%) in frequency. The clinical symptoms among the diarrheal cases included abdominal pain (74.1%), fever (56.4%), headache (55.9%), chill (40.4%) and tenesmus (31.4%). CONCLUSIONS: The source of infection was estimated to be contaminated underground water and simple piped water caused by leakage from the cess pool. It is highly necessary that the management of drinking water and cess pools should be done thoroughly.; Summary

Epidemiologic Survey on Outbreak of Dermatosis Associated with Ants, Pachycondyla chinensis.: Geun Ryang Bae, Hyun Sul Lim, Byung Jin Kim; Korean J Prev Med. 1999;32(3):421-426.

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Abstract PDF: OBJECTIVES
An outbreak of dermatosis occurred at a city gas manufacturing factory in Pohang in Aug, 1998. The authors conducted a study to find the cause and prevent the dermatosis. METHODS: We conducted a questionnaire survey of 73 workers in the factory twice, once on Aug. 14th and then Sept. 11th, 1998. Also, a dermatologist examined their skin lesions. We suspected ants as the cause, so we collected them for identification. RESULTS: Twelve cases of dermatosis were identified with an attack rate of 16.4%. The attack rates were not different by age, educational level or tenures. The attack rates were 66.6% among production workers, 2.0% among clerical workers, 16.7% among tank trailer drivers and 0% among guards. The attack rate among production workers was significantly higher than that of the others (p<0.01). There were no histories of the same dermatosis for the past one year. Histories of other skin diseases and allergies were very rare in both cases with skin diseases and control. Multiple, pruritic, rice-grained to bean sized erythematous macules or papules with a central biting point could be found after initial severe itching occurred. Three cases showed signs of dermatosis with an allergic nature. The onset of dermatosis was between July 30 and Aug 12 and the durations varied from 5 days to over a month. The most frequent sites of skin lesions were the chest and abdomen (66.6%), and they were also observed on the neck (33.3%), arms (33.3%), shoulders (16.7%) and back (16.7%). Over 10 ants with their wings were collected in the work place and identified as Pachycondyla chinensis, subfamily Ponerinae. CONCLUSIONS: We thought that the outbreak of dermatosis was brought about by the ants flying into the work place through the open windows. Further studies on the factors contributing to the prosperity of the ants in this area are needed.; Summary

A study on manganese health hazards among experienced welders.: Gyu Hoi Kim, Hyun Sul Lim, Sun Hee Yu; Korean J Prev Med. 1998;31(4):644-665.

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Abstract PDF: This study was conducted to evaluate the health hazards and to develop early diagnostic methods of the manganism in experienced welders and to know the meaning of signal intensities on the brain Magnetic Resonance images. It was carried out from December 1996 to February 1997 with 277 male welders, the duration of welding was at least 5 years or more. The study was consisted of a questionnaire, physical examination and measurements of blood and urine manganese concentrations. Brain Magnetic Resonance imaging was done on 19 study subjects by random sampling. As the duration of welding increases, the positive rates of clinical symptoms, neurological examinations and blood manganese concentrations were also increased. However, physical examinations and urine manganese concentrations were not statistically significant with the duration of welding. Authors couldn't observe any Parkinsonism-like diseases. There were statistically significant correlations between duration of welding and blood manganese concentrations(r=0.16, p<0.01). There were not statistically significant correlations between duration of welding and urine manganese concentrations(r=0.06). There were statistically significant correlations between blood and urine manganese concentrations(r=0.34, p<0.01). By viewing brain Magnetic Resonance images, 13 welders(68.4 %) among 19 welders were found to have signal intensities. The positive rates of clinical symptoms, physical examinations, neurological examinations and blood and urine manganese concentrations were not statistically different between those with signal intensities and those without signal intensities. We would like to suggest that some non-specific clinical symptoms and neurological signs are correlated with the duration of welding but any Parkinsonism-like diseases had not been observed with these welders. Next we suggest that the high signal intensities on T1WI of brain Magnetic Resonance images are not the sign of manganese intoxication but the sign of manganese deposition.; Summary

A Case of Metal Fume Fever Associated with Copper Fume in a Welder.: Hyun Sul Lim, hae Kwan Cheong; Korean J Prev Med. 1998;31(3):414-423.

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Abstract PDF: Metal fume fever has been known as an occupational disease is induced by intense inhalation of fresh metal fume with a particle size smaller than 0.5 nm to 1 nm. The fumes originate from heating metals beyond their boiling point, as happens, for example, in welding operations. Oxidation usually accompanies this process. In most cases, this syndrome is due to exposure to zinc oxide fumes; however, other metals like copper, magnesium, cadmium, manganese, and antimony are also reported to produce such reactions. Authors report a case of metal fume fever suspected to be associated with copper fume inhalation. The patient was a 42-year-old male and was a smoker. He conducted inert gas tungsten arc welding on copper-coated materials without safety precautions such as a protective mask and adequate ventilation. Immediately after work, he felt metallic taste in his mouth. A few hours after welding, he developed headache, chilling sensation, and chest discomfort. He also complained of myalgia, arthralgia, feverish sensation, thirst, and general weakness. Symptoms worsened after repeated copper welding on the next day and subsided gradually following two weeks. Laboratory examination showed a transient increase of neutrophil count, eosinophilia, elevated erythrocyte sedimentation rate, and positive C-reactive proteinemia. Blood and urine copper level was also increased compared to his wife. Before this episode, he experienced above complaints several times after welding with copper materials but welding of other metals did not produce any symptoms. It was suggested that copper fume would have induced metal fume fever in this case. Further investigations are needed to clarify their pathogenic mechanisms.; Summary

A Case Report on the Meniscal Tear due to Repetitive Foot-Switch Stepping.: Sun Hee Yu, Hyun Sul Lim, Doo Hie Kim, Dong Ju Chae, Suk Kang; Korean J Prev Med. 1997;30(4):805-814.

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Abstract PDF: Injuries to the menisci occur in a variety of ways, most commonly with a twist, pivot, squat, or valgus stress to the knee. Tear patterns are classified to longitudinal, horizontal, or transverse features according to the mechanism of injury. Work-related meniscal tear usually occurs with a repetitive usage of the foot, hence it can be classified as a cumulative traumatic disorder. We found a 47 year-old female worker who had been taking charge of repetitive foot-switch stepping for 8 years. She suffered from pain in the right knee since 5 months ago. Tenderness along the medial joint line of the right knee was observed and pain was aggravated with full flexion of the right knee. On magnetic resonance imaging, high signal intensity was observed at the posterior horn of the medial meniscus of the right knee. Degenerative longitudinal and transverse complex tear in the medial meniscus was observed on arthroscopy. Arthroscopic partial meniscectomy was performed. We surveyed the work process and the health status of co-workers. It turned out that the work process was compatible to injure the meniscus and nine out of fourteen co-workers(64.3%) complained pain of the knee. No other factors related to her meniscal tear could be found except for the situation at her work. Therefore, we conclude that meniscal tear is related to the repetitive stepping of foot switch.; Summary

Respiratory symptoms of workers exposed to the fume containing manganese.: Sun Hee Yu, Doo Hie Kim, Hyun Sul Lim, Ji Yong Kim, Byung Soon Choi; Korean J Prev Med. 1997;30(4):752-763.

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Abstract PDF: To evaluate the effect of manganese on the respiratory system, we investigated the respiratory symptoms of 63 male workers exposed to fume containing manganese (Mn), iron (Fe), and silica (Si), and compared them with those of 66 male workers not exposed to the fume in a manganese alloy smelting factory. The prevalence ratios of the seven respiratory symptoms were not different between two groups. The presence of any respiratory symptom was not related with the age, duration of employment, smoking status of workers, and exposure to fume. In furnace workers, it was not related with the airborne Mn, Fe, and Si concentration in the total or respirable fume. Airborne Mn concentrations of all 4 furnaces in the respirable fume were below 1 mg/m(3). There were two suspicious cases of pneumoconiosis among furnace workers and one definite case(1/2) among casting workers who were not exposed to fume. The above results suggest that the exposure to the low airborne Mn concentration is not related with respiratory symptoms and pneumoconiosis. However, it is necessary to study the respiratory effects of Mn using the symptom questionnaire with consideration of the severity and persistence of symptoms and the time interval from exposure.; Summary

Phototoxic Dermatosis among Coal-tar Pitch Workers.: Cheol Jung, Hyun Sul Lim, Doo Hie Kim, Yeol Oh Sung; Korean J Prev Med. 1997;30(1):145-156.

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Abstract PDF: Interview survey and dermatological examination have been performed to investigate the health problems of workers continuously exposed to coal-tar pitch. The phototoxicity of coal-tar pitch was confirmed by the photopatch tests for six healthy adults. The main results are followings; 1. There was no special history of allergic diseases in both the exposed and non-exposed group. 2. The frequency of the phototoxic dermatosis and the coal-tar acne in the exposed group was significantly greater(p<0.05) than that of the control group. In the exposed group, the phototoxic dermatosis and the coal-tar acne were observed in nine workers(90%) and seven workers(70%), respectively. However, those disease were not observed in the control group. 3. Five results(83%) were positive to the photopatch test for coal-tar pitch 48 hours after UVA irradiation. But the lesion was subsiding 72 hours after UVA irradiation. 4. Malignant cancers were not reported among workers ever exposed to coal-tar pitch. In conclusion, it appears that workers exposed to coal-tar pitch have high risks of phototoxic dermatosis and coal-tar acne. A health policy should be provided to prevent phototoxic dermatosis among coal-tar pitch workers. More studies are required to determine malignancy.; Summary

A Study on the Establishment of Management Methods about Occupational Dermatoses.: Hyun Sul Lim, Hae Kwan Cheong, Byung Soon Choi, Ji Yong Kim, Yeol Oh Sung, Yang Ho Kim; Korean J Prev Med. 1996;29(3):617-638.

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Abstract PDF: Occupational dermatosis is one of the most prevalent occupational disorders. However, the extent of the occupational dermatoses including incidences and prevalencies of each disease entity, and etiologic materials are not yet well stated in Korea. Authors reviewed the literatures on the statistic data and reports on the occupational dermatoses, and surveyed on the occupational dermatoses in two factories, and surveyed the physicians responsible to the occupational dermatoses with formed questionnaire. The results are as follows; 1. Among medical journals published since 1964, there were 31 articles on the occupational dermatoses. Of 31 articles, 18 were case reports and all others were review articles. Of 18 case reports, 9 were epidemiologic survey. The Workers' Periodic Health Examinations revealed that prevalence of the occupational dermatoses was highest(4.36 per 10,000 workers) in 1974, but number of the cases reported were decreased sharply since 1978 with some tendency to increase since 1987. There were 2,240 reported cases of occupational dermatoses between 1966 and 1992, which is 1.90% of all the reported occupational diseases. Skin infection and injuries due to chemicals were most frequent and there were 6 cases of skin cancer. 2. In an epidemiological survey on the dermatoses among 995 workers in a metal product manufacturing factory and 225 workers with acne, 130 workers with scar, 123 workers with deformity of toe nails. Scars, photosensitivity dermatitis, deformity of finger and toe nails, and acne were more prevalent in the metal product manufacturing factory(p<0.05). In the metal product manufacturing factory, workers treating organic solvents and oils had more dermatoses than those without treating the materials(p<0.05). On the skin patch performed on 16 workers in the metal product manufacturing factory, there were 8 cases of irritation dermatitis and 5 cases of contact dermatitis. Prevalence of contact dermatitis in the metal product manufacturing factory was 1.3%. 3. On the questionnaire survey, 34 dermatologists, 29 doctors of preventive medicine, and 22 family physician replied. The proportion of occupational etiology among all dermatoses assumed by the physicians were below 9%, and the most important occupational dermatosis in Korea was contact dermatitis. Main etiologic materials related to the occupational dermatosis were organic solvent, acid and alkali, and metals. The reason for the scarcity of report of occupational dermatoses were difficulty in diagnosis and physician's ignorance of the occupational etiology. They replied that to prevent the occupational dermatosis in the workplace, the use of protective devices was most important, and development of diagnostic criteria on the occupational dermatoses is urgent. Above results shows us that there is many workers with occupational dermatoses, but they are mostly unreported. Measures to prevent and manage the occupational dermatoses are not satisfactory at present. Hence, authors suggest measures for the precises diagnosis, report and prevention of the occupational dermatoses. a. Dernatikigustm orevebtuve physician, and industrial hygienist should work as a team to examine the high risk group and establish the preventive measures. b. Disease entities, diagnostic criteria of occupational dermatoses should be listed, criteria for the compensation and job fitting at recruitment should be established, and manual for the proper treatment and effective prevention of each occupational dermatosis should be developed. c. Patch test antigens against each occupational category should be developed and it should be available to any physicians responsible. d. To facilitate the diagnosis of occupational dermatoses by the doctors responsible for the Workers' Periodic Health Examination, development of standardized questionnaire, education on the techniques of the patch test, and cooperation with the dermatologist in diagnosis of occupational dermatoses is essential.; Summary

A Survey on Health Behavior of Male Workers in Steel Industry.: Eun Hee Ha, Hyun Sul Lim, Cha Hyung Wie, Jung Ok Kwak; Korean J Prev Med. 1996;29(1):113-132.

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Abstract PDF: This study was carried out to evaluate the relations among workers' general characteristics, work-related behaviors and health related behaviors in a steel industry with 1,134 workers in Pohang. The results were as follows; 1. The mean age of workers was 50 years old and working duration was 15 years and over. Most of them were married(94 5%) and had studied beyond high school (53.0%). They performed three shift work and most of them(63.0%) had experienced industrial accidents. The frequency of noise and dust exposure was defined by a minimum of 6 hours per day, and workers complained about noise exposure(62.9%) and dust(55.6%). There were current smokers(67.7%), current drinkers(74.3%) and current exercising workers(32.3%) in the industry. The number of cigarette consumption in current drinkers was significantly high (13.6 +/- 8.4 pieces/day) and the alcohol consumption in current smokers was significantly high(l04.5 +/- 113.5 g/wk). And the number of cigarette consumption of exercisers was significantly low and the alcohol consumption of exercisers was higher than non-exercisers. 3. The ratio of current smokers on frequent noise in exposed workers versus non-exposed workers was not significantly high but the current drinkers in frequent noise and dust exposed workers was significantly higher than non--exposed. 4. The normal levels of SGOT workers in non-smokers were significantly higher than in current smokers, and the abnormal levels of LFT(SGOT, SGPT, gamma-GTP workers in nondrinkers were significantly high. The normal levels of SBP and DBP workers in current smokers were not significantly high but were significantly high in non-drinkers. 5. The ratio of current smokers in workers unsatisfied with their job and working condition was higher than non-smokers, but the ratio of current drinkers in workers satisfied with their job and working condition were higher. 6. The significant factors for SGOT and gamma-GTP were age, the drinking amount and BMI. But the only significant factor for r-GTP was BMI. The significant factors for DBP were age, the alcohol consumption and BMI And the significant factors for SBP were age, BMI.; Summary

A Study on Safety Accidents Occurred for 5 Years at a Welding Material Manufacturing Factory.: Hyun Sul Lim; Korean J Prev Med. 1995;28(3):551-562.

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Abstract PDF: To assess the status of safety accidents, authors reviewed and analysed the records of safety accidents of a welding material manufacturing factory at pohang city from January 1989 to December 1993. The results are; 1. The total incidence of safety accidents was 295 spells for five years. 2. Average age of workers with accident was 35.7 years. Average duration of employment was 6.2 years and the duration of employment increased as the year increased. 3. There was no statistical significance on season, month, weekday and time by year in the incidence of safety accidents. The most frequent part of body injured was upper and the most frequent type of injury was abrasion. 4. Mean admission rate of safety accidents was 12.6% and the ratio of treated spells as occupational injury was 7.8%. 5. The most frequent cause of injury was worker's mistake and the most frequent action for the prevention of further accidents was safety education. 6. The incidence rate of safety accidents on 1993 was 116.2 spells per l,000 persons. Above results suggest that to prevent safety accidents, safety education should be done continuously, the environmental and human factors were controlled and more exact reporting system of safety accidents was needed.; Summary

A Study on the Manganese Exposure and Health Hazard among Manganese Manufacturing Woman Workers.: Hyun Sul Lim, Ji Yong Kim, Hae Kwan Cheong, Hoe Kyung Cheong; Korean J Prev Med. 1995;28(2):406-420.

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Abstract PDF: No abstract available.; Summary

An Epidemiologic Study on Occupational Dermatosis Associated with Mites.: Hyun Sul Lim, Ji Yong Kim, Hae Kwan Cheong, Yeol Oh Sung, Han Il Ree; Korean J Prev Med. 1995;28(1):13-26.

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Abstract PDF: An outbreak of dermatosis occurred in a livestock fodder factory at Kyongju in May 1994. Authors conducted a questionnaire survey on 60 workers in the factory and a dermatologist examined their skin lesion. Authors also collected mites and identified them. The obtained results were summarized as follows; 1. Twentyeight cases of dermatosis were identified with attack rate of 46.7%. Attack rate was not different by department, age, sex, educational level and employment duration. Attack rate was 67.5% in productive worker and 5.0% in clerical workers (p<0.01) but was not significantly different between departments among productive workers (p>0.05). 2. Three cases among 28 dermatosis cases and one subject among 32 non-cases had a history of same dermatosis last year. Only one of dermatosis cases had a history of dermatosis among family members. History of other skin lesion and allergy was very rare in both cases and non-cases. 3. Skin lesions of the cases were rice-sized erythematous papules or vesicles with a central biting point. Onset date of dermatosis was between May 1 and June 10. Duration was from one day to more than 30 days. Skin lesion was most frequent at the back(75.0%). and also observed at the arms(64.3%). abdomen(60.7%), legs(57.1%), chest(32.1%) and neck (25.0%). Skin lesion was aggravated while workers are sweeping the floor(35.7%), working at the workplace(21.4%) and in bed at night(28. 6%). 4. Total l,637 mites were collected and identified into 3 suborder, 7 families and 17 species. Dermafophagoides farinae was most frequent Nnd most of the species identified were blood sucking mites. Authors concluded that the outbreak of dermatosis was brought about by mite-bites and grain beetle parasitizing Acarophenax tribolii was the most suspected species. Further studies to identify the specific species causing dermatosis and route of import are needed.; Summary

A Baseline Study on the Choice of Optimal Screening Test Items among Workers with Abnormal Liver Function Tests on Workers' Periodic Health Examination.: Hae Kwan Cheong, Hyun Sul Lim, Gyu Hoi Kim; Korean J Prev Med. 1994;27(4):747-762.

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Abstract PDF: Workers', periodic health examination is the main tools used to manage the health problems of most workers in Korea. The most common health problem found in workers' periodic health examination is liver disorder. Liver disorder is also one of the most common health problems in general population and one of the leading causes of mortality in adult population. Regulation proposed by government(NO. 207, Ministry of Labor, 1992) defines the criteria for selection of workers with the liver dysfunction for further evaluative examination and the examination items used for diagnosis of the workers with liver dysfunction. This study was designed to evaluate the proficiency of each examination items presently defined in Regulation and propose the optimal examination items for detection of the liver disorders found by workers' periodic health examination. Study subjects are 186 workers with abnormal liver function tests in screening examination of workers' periodic health ex amination. Questionnaire survey including past history of liver disorder, drinking history, height and weight was done. Physical examination by physician, routine test items defined by Regulation (SGOT, SGPT, gamma- GTP, protein, albumin, total and direct bilirubin, alkaline phoshatase, alpha-feto protein, HBsAg and anti-HBs), anti-HCV antibody test and liver ultrasonography were done. Results are as follows; 1. Result of evaluative examination utilizing only the items defined in Regulation was; There were 75 workers with suspected liver disorder(40.3%), 63 with no liver dysfunction(33.90%), 13 with suspected hepatitis B(7.0%), 10 workers with hepatitis B(5.4%) 10 workers with hepatitis B carrier state(5.4%), 10 with alcoholic liver disorders(5.4%), 5 with fatty liver(2.7%). When alternative diagnostic criteria applying additional examination items (drinking history, body mass index, anti-HCV antibody and ultrasonography) diagnosability of liver disorder was increased. When all four items were included, final results were; 23 workers (l7.8%) with hepatitis B(10 carriers, 13 suspects and 10 hepatitis B), 10(5.4%) with hepatitis C(4 carriers, 5 suspects and 1 hepatitis C), 13(7.0%) with alcoholic liver disorder, 45 (24.2%) with fatty liver (40 suspects, 5 fatty liver), 41 0%) with suspected liver disorders and 44(23.7%) with normal liver. 2. Of examination items defined by Regulation, only SGOT, SGPT, gamma-GTP and HBsAg were significantly different in abnormal rate and mean value, and all other laboratory findings did not showed significant difference between two groups. Drinking history, body mass index and anti-HCV antibody test which are the items that authors included in this study, also showed significant difference between two groups. Utilization of body mass index(BMI) for abnormal liver function group in diagnosis of fatty liver had high specificity(97.6%) but sensitivity (22.3%) was low. Therefore we suggest that SGOT, SGPT, gamma-GTP, HBsAg, alcohol drinking history, BMI and anti-Hcv Ab were useful for diagnosis of liver disorders among worker's periodic health examination.; Summary

An Epidemiologic Investigation on an Outbreak of Anthrax Occurred in Kyongju by Eating Dead Cow's Meat.: Hyun Sul Lim, Hae Kwan Cheong, Joung Soon Kim, Heechoul Ohr, Dong Mo Rhie, Ho Hoon Kim; Korean J Prev Med. 1994;27(4):693-710.

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Abstract PDF: This epidemiologic study was carried out to investigate cause and magnitude of food-poisoning like epidemic occurred among inhabitants of a village who have eaten dead cow's meat near Kyonng in February of 1994, around lunar new year. The investigation consisted of interview survey on all inhabitants of 77 households (l11 males and 119 females) and their visitors (40 males and 35 females), skin test with anthraxinum(Russian product), study on clinical characteristics for the patients hospitalized, and microbiologic examination on microbes isolated from cow's meat, patient and soils of dead cow's barn. The results obtained are as followings; 1. The proportion of the inhabitants who ingested the dead cow's meat was 36.4%. The incidence rate of the disease was 65.1% for males, 41.7% for females and the cases were distributed evenly for all age groups. The group ingested raw meat showed higher incidence than the group ingested cooked meat. There was no case among people who did not eat the meat. 2. The most clinical symptoms were significantly more frequent among cases than non-cases; sore throat (57%), nausea (51%), fever(47%), indigestion(43%), cough(41%), anorekia(41%), abdominal distention(41%), and abdominal pain(39%) were the major symptoms among cases. 3. Among 29 cases hospitalized out of total 61 cases, three patients, all old and feeble persons, deceased from the disease resulting in 4.9% fatality rate among total patient and 10.3% among hospitalized. Septicemia and meningitis were the causes of the deaths. 4. Three strains isolated from patients, and three strains from dead cow's meat and soil revealed typical microbiologic characteristics of Bacillus Anthracis, which also proved to be fatal to experimentally infected mice.; Summary

A study on occupational hydrofluoric acid burns in a hydrofluoric acid manufacturing factory.: Hyun Sul Lim, Hae Kwan Cheong, Ji Young Kim; Korean J Prev Med. 1993;26(4):587-598.

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Abstract PDF: Hydrofluoric acid is one of the strongest irritating, corrosive and poisonous inorganic chemicals. Hydrofluoric acid burns are occurring with ever-increasing frequency due to the wide use of this acid in industries. Hydrofluoric acid burns are characterized by severe progressive tissue destruction and excruciating pain due to the unique properties of the freely dissolvable fluoride ion. The authors reviewed medical records of 32 cases(36 spells) of hydrofluoric acid burns which occurred in a hydrofluoric acid manufacturing factory from Sep. 1, 1990 to June 30, 1993. The results are as follows; 1. Eleven measurements of air concentrations of hydrofluoric acid by detection tube method from 1990 to 1992 were all below TLV(Department of Labor, R. O. K). 2. There were 19 cases(22 spells) of hydrofluoric acid burns which occurred during the study period among regular employees. The overall incidence density of hydrofluoric acid was 17.8 cases(20.6 spells) per 100 person-year. Incidence density was 19.0 cases(22.0 spells) per 100 person-year among male workers and there were no female cases. Incidence density was 32.9 cases(38.3 spells) per 100 person-year among production workers and 1.9 cases(1.9 spells) per 100 person-years among management workers with the difference being statistically significant(P<0.01). 3. Of 32 cases(36 spells) of hydrofluoric acid burns among workers who were regularly employed or temporarily employed, 26 spells(81.2%) were between age 20 to 39. In 15 spells(41.7%) burns occurred between 12 : 00 and 17 : 59 with 16 spells(44.3%) having arrived at hospital within 2 hours after the accident. 4. Of 36 spells, the main cause of hydrofluoric acid burns were by splashes(8 spells, 22.2 %). The most frequent site of burns were fingers and pain was the most frequent symptom. Thirty spells(83.3%) of the hydrofluoric acid burns were treated with local injection of antidote(calcium gluconate). Complete recovery without scarring were observed in most of the cases(34 out of 36 cases, 94.4%). The study results suggest that to prevent hydrofluoric acid burns, environmental control and the wearing of hydrofluoric acid resistant protective clothes and gloves are important. It is also stressed that establishment of an emergency management and a transfer system for hydrofluoric acid burn victims is necessary.; Summary

Determinants Of Health: Environmental Factors.: Hyun Sul Lim; Korean J Prev Med. 1993;26(4):480-507.

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Abstract PDF: Environmental pollution is common problem of the present world that is intimately related to the future survival of human beings. The problems of environmental pollution originate from the pursuit of benefit by enterprises, insufficient countermeasure of government and ignorant life style of the people. Health hazards due to environmental pollution have characteristics of irreversibility, difficulty in measurement and ineffectiveness of personal prevention. Objects of this article are to review the various aspects of environmental pollution, to outline the present status of environmental pollution and strategy to control environmental pollution in Korea. In the first part of this article, causes of environmental pollution are presented. International relationships, world-wide status of environmental pollution and health hazards due to environmental pollution are briefly reviewed. In the second part, present status of air, water, soil and ocean pollution in Korea is presented. Pollution by radioactive materials, noise, vibrations, odor, wastes and chemicals is reviewed. Climate changes related to environmental poisoning, problems of workplace environment, pesticide and defoliants are also reviewed. Finally, control measures for environmental pollution including the role of government are reviewed.; Summary

A study on diagnostic criteria of noise-induced hearing loss among workers in an iron foundry.: Ji Yong Kim, Hyun Sul Lim, Hae Kwan Cheong, Ok Ryun Moon; Korean J Prev Med. 1993;26(3):371-386.

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Abstract PDF: This study was carried out to evaluate diagnostic criteria of noise-induced hearing loss (NIHL) among workers in an iron foundry. Of 1,093 workers under the observation of noise-specific health examination, 184 workers were selected by way of first and second screening audiometric examination. A questionnaire survey, otological examinations, Rinne test and audiometric test were performed and the results were as follows; The degree of hearing impairment in the left ear was more severe than in the right ear(p<0.05). The difference between hearing threshold of the first and the second hearing test at 1,000 Hz was about 5 dB with a narrow range of deviations while the difference at 4,000 Hz was about -7dB with a wide range. Of the total study workers, 84.8% were tested within 15 hours away from noise exposure, and the rest after 16 hours. This study has identified that mean hearing loss at 4,000 Hz showed a significant statistical difference among the two study groups while mean hearing loss by 4-divided classification did not. The same phenomena were observed between the group with and without tinnitus and between the group with and without difficulty in hearing(p<0.05). Among 184 workers, 10 workers(5.4%) diagnosed as NIHL by old diagnostic criteria in contrast to 150 workers diagnosed as NIHL by the new diagnostic criteria. There was a significant difference between the two groups in the average hearing loss at 4,000 Hz and 4-divided classification(p<0.01), but there were no significant difference in age, the duration of employment, blood pressure and the duration wearing the personal hearing protector(p>0.05). If we apply Early Loss Index(ELI) method, some workers in younger age group diagnosed as NIHL by the new diagnostic criteria were fallen into within the normal range. In the mean time older age group show reverse results in contrast to the above finding. It is too early to confirm the value of the usage of the new diagnostic criteria in hearing examination. Further study is called for to verify the value of this criteria.; Summary

Development Of An On Site Diagnostic Tool To Detect Neuropsychiatric Impairment Due To Chronic Organic Solvent Exposure.: Soo Hun Cho, Sun Min Kim, Ho Jang Kwon, Yong Hyun Yim, Hyun Sul Lim; Korean J Prev Med. 1993;26(1):147-164.

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Abstract PDF: A study has been conducted on developing questionnaire to serve as on site diagnostic tools for the early detection of neuropsychiatric impairment among workers chronically exposed to low-level organic solvents. Two drafts of tentative questionnaire have been developed as follows ; several question items were selected from questionnaires which were administered to workers exposed to organic solvents in previous studies and were grouped into each symptom category based on the presence of its association using Guttman scaling method, then these selected items were reviewed by neuropsychiatry specialists. The final draft of the questionnaire (total symptom score=36) was developed by selecting 33 question items which had more than a 0.88 Guttman coefficient of reproducibility in each symptom category from a pilot study in which these tentative questionnaires were administered to workers manufacturing soles. Three plants using organic solvents and one plant never using organic solvents as a control group were selected to test the reliability and validity of the developed questionnaires. The major organic solvent in the workplace environment detected by a personal air sampler and GC/MSD was toluene. The concentration of toluene in air from the department using organic solvent was statistically different from that of the department never using organic solvent. The concentration of toluene from almost all of the workplace did not exceed the allowable level. There was no statistically significant difference between the concentration of urinary hippuric acid from the workers of the department using organic solvent and that of the department never using it. Total symptom score of the plant never using organic solvents was 9.8 and those of the three plants using organic solvents were 15.6, 14.7, and 13.7 respectively. In order to evaluate the validity of the questionnaires, the workers from two different department of the plant in which usage of organic solvents are totally different were compared. The total symptom score was 17.8 for workers of the department using organic solvent and 13.5 for the department never using organic solvent and scores of each symptom group between exposure and non-exposure group also showed statistically significant difference. The finding that total symptom score of the usefulness of the developed questionnaire to assess the health effects of chronic exposure to organic solvents. The correlation coefficient, which was calculated to evaluate the test-retest reliability, was 0.581(p=0.001). The coefficient of Crohnbach which reflects the internal consistency of the questionnaire was 0.91. In conclusion, the reliability of the questionnaire was well maintained over the time lapse between the two administrations of the questionnaire and despite the seasonal difference.; Summary

A Study on the Status of Seeking Intervention among the Workers with Health Problems Identified by the Workers' Periodic Health Examination.: Hee Kwan Cheong, Joung Soon Kim, Ok Ryun Moon, Hyun Sul Lim; Korean J Prev Med. 1992;25(4):343-356.

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Abstract PDF: Authors studied the workers' knowledge about the health problems detected through the previous workers' periodic health examination, content of follow-up management and actions taken for their health problem detected on previous health examination. From June to September 1992, workers' periodic health examination was performed on workers employed in 10 companies located in 2 middle-sized Korean cities. A questionnaire survey was done for 150 workers who reported to have D2 result of either hypertension or liver disorder at the previous workers' periodic health examination done in 1991. The results are as follows; 1. Of 160 workers who had D2 result of either hypertension or liver disorder in previous examination one year before, only 85 workers(51.3%, 43 workers with hypertension, 38 workers with live disorder) responded that they have such disorders. The other 65 workers responded to questionnaire were all those with C results. Respondents' knowledge about their diagnoses was relatively precise (95.2% in hypertension group, 94.6% in liver disorder group) but knowledge about classification of diseases was poor. 2. The main efforts to solve the health problem was self management (26 spells, 55.3%), visiting clinic or hospital (6 spells, 12.8%), use of herb medicine (2 spells, 4.3%) and use of drug store (2 spells, 4.3%) in hypertension group. In liver disorder group, 30 spells (71.4%) relied on self management, 6 spells (14.3%) on hospital or clinic and 9 spells (21.4%) had no effort to improve the health problem. Content of self management was low salt diet, quit smoking, regular exercise and quit alcohol drinking in order. Avoidance of salt in diet was high in hypertension group and quitting alcohol drinking was high in liver disorder group. In those with self management, 80.7% of hypertension group and 83.3% of liver disorder group continued previous effort. Those, however, who utilized clinic or hospital, only 16.7% and 50.0% were still visiting hospital or clinic. 3. Fifty seven percent of hypertension group and 64.3% of liver disorder group was presently smoking, 8.5% and 11.9% reduced smoking and 21.3% and 14.3% stopped smoking. Forty nine percent of hypertension group and 28.6% of liver disorder group was presently drinking. Reduced alcohol intake was reported in 29.8% and 40.5%, 12.8% and 23.8% stopped alcohol drinking. Sixty six percent of hypertension group and 73.8% of liver disorder group did no regular exercise, but 12.8% and 11.9% of each group increased their physical exercise for last one year. Forty three percent of hypertension group and 38.1% of liver disorder group was overweight (defined by bodymass index greater or equal than 25). Reduced body weight was reported in 17.2% and 16.7% of each group. Reduced dietary salt intake was high in hypertension group (51.5%). The study results suggest that follow-up management after workers' periodic health examination is not satisfactory. In order to improve this situation, adequate information on the result of the workers' periodic health examination should be distributed to each worker group with health education and counselling.; Summary

The Effect Of Gunshot Or Cannonade Training During Military Service On Hearing Threshold Levels.: Heon Kim, Soo Hun Cho, Hyun Sul Lim; Korean J Prev Med. 1991;24(1):86-92.

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Abstract PDF: To test if exposure history to rifle fire or cannonade training during military duty can induce hearing loss, history of personal military service and history of gunshot exposure were asked to 228 male college students with self-administrative questionnaire. Otoscopic examination and Rinne's test were performed if any abnormal finding was detected by pure-tone audiometry. Average hearing threshold levels of 500 Hz, 1,000 Hz, 2,000 Hz, 4,000 Hz and threshold levels at 4,000 Hz were calculated for 112 students who were remained after exclusion of cases with history of ear disease, of ototoxic drug administration, and of neuropsychiatric disease, and mean of those were compared between group of students who have completed military duty (completed group) and group of those who have not (not-completed group), and between group exposed(exposed group) and group unexposed to gunshot sound(unexposed group). Mean of average hearing threshold level and mean of threshold levels at 4,000 Hz of completed group and those of exposed group were higher than those of not-completed group and unexposed group, respectively. Proportion of cases that average threshold level was greater than 40 dB of threshold levels at 4,000 Hz was greater than 50 dB were higher also in completed group and exposed group than in duty not-completed group and unexposed group, respectively. Multiple linear regression analysis including age, duration of military service, degree of gunshot sound exposure as independent variables and average hearing threshold level as dependant variable, was performed in order to estimate the effect of age on hearing, and any considerable effect of age on hearing could not be found. In conclusion, hearing impairment can be induced by rifle fire or cannonade training.; Summary

Formaldehyde exposure in the plywood manufacturing factory.: Myung Wha Ha, Doohie Kim, Hyun Sul Lim, Sang Hu Park; Korean J Prev Med. 1991;24(1):37-44.

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Abstract PDF: In the plywood manufacturing factory established in 1979, female 3 workers who had exposed to adhesives containing formaldehyde for more than 48 months of duration suffered from eye, nasal, oral, throat and skin irritation and dyspnea as chief complaints. The actual level of the exposure to formaldehyde were not estimated when the exposed workers started to have above symptoms. The environmental monitoring of workplace was measured on April 25, 1990, and the concentration of formaldehyde revealed 0.2 ppm, however the exhaustive ventilatory system was already installed at that time. Twenty six subjects from entire factory were examined by questionnaire, physical examination and spirometry, etc. on August 22, 1990. Significant difference was observed in symptoms and signs of nasal, oral and throat irritation between teh exposed group with longer duration and that with short duration. When the exposed group with longer duration was compared to the group of nonexposed, symptoms and signs of nasal, oral, throat and skin irritation, chest tightness and dullness were significantly increased in the former group. The results of the spirometric test showed that the forced vital capacity and the forced expiratory volume at 1 second were decreased amont the exposed group with longer duration but not significant.; Summary

A Survey on the Damage done to the Farmers by Agrochemicals in a Rural Area of Korea.: Hyun Sul Lim; Korean J Prev Med. 1982;15(1):205-212.

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Abstract PDF: This survey was conducted to find out demage done to the farmers by ;Agrochemicals in a rural area of Korea from January to October, 1980. Choon Sung Gun, Kang Won Province was the survey area and the 412 males were surveyed among all those that have sprayed agrochemicals. during 10 Months in 1980. Obtained results and findings from this survey are summarized as follows; 1. The total spray days of 413 males were 3,114 days and avarage spray days per person were 7.54 days. Also avarage spray hours per person were 4.7 hours. 2. The incidence rate per 100 persons of self-recognized skin manifestation was 12.6 persons and incidence rate per spray day was 2.7 percent. The incidence rate per 1Q0 persons of self-recognized intoxication was 23.0 persons and incidence rate per spray day was 3.6 percent. 3. In cases where mask was not used, when it was syrayed in hot weather, when stronger solution was used, the results were higher percentage in self-recognized intoxication (P<0.01). 4. The symptoms of self-recognized intoxication were headache (55.8%), dizziness (46.9%),. nausea (17.7%), fatigue (17.0%), and vomiting (17.0;%). 5. Number of intoxication per 100 used standardized unit by agrochemicals was parathion (93.8 spells), sumithion (91.8 spells) and folithion (66.7 spells). 6. Treatment was done by health facility utilization (27 cases), visits to drug store (13 cases) and visits to health center (7 cases).; Summary

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