Journal of Preventive Medicine and Public Health

Original Articles

Health Care Utilization of Workers with Skin Disease in Inchon.: Yeon Soon Ahn, Jae Seok Song, Jong Uk Won, Jaehoon Roh; Korean J Prev Med. 1999;32(2):206-214.

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Abstract PDF: OBJECTIVES
This study was carried out to identify relation of health care utilization due to skin disease(ICD-10, L00-L99) and characteristics(sex, age, exposure status, type of industry, size of enterprise) of workers. METHODS: We made new database composed of 30,536 workers' health examination results in one specific health examination institute in Inchon and data of medical insurance utilization due to skin disease in 4 medical insurance associations for enterprise from January, 1995 to December, 1997. And we analyzed determinants of health care utilization due to skin disease of workers. RESULTS: Among 30,536 study subjects, 8,837(28.9%) workers and 4,181(13.7%) workers utilized medical insurance due to total skin disease(ICD-10, L00-L99) and contact dermatitis(ICD-10, L23-L25), respectively. Female workers(p<.001), workers exposed to organic solvents(p<.05), workers in manufacturing industries(p<.05, p<.01, respectively) and in large scale enterprises(p<.001) utilized more medical insurance due to total skin disease and contact dermatitis than male workers, workers not exposed to organic solvents, workers in non-manufacturing industries and small scale enterprises. With multiple logistic regression analysis, significant explanatory variables affecting workers' medical utilization due to total skin disease and dermatitis and eczema(ICD-10, L20-L30) in total workers were sex, age, specific chemicals and size of enterprises. And age, type of industries, organic solvents, specific chemicals and size of enterprises were significant explanatory variables related to medical insurance utilization due to dermatitis and eczema and contact dermatitis in male workers. CONCLUSION: From the above results, we found that workers exposed to organic solvents utilized more medical insurance due to skin disease than workers not exposed to. And, comparing to workers in large scale enterprises, workers in small scale enterprises may have unmet medical care utilization due to skin disease. Therefore we have to establish counterplan to manage occupational skin disease of high risk group(organic solvent exposure group) and to satisfy unmet medical care utilization of workers in small scale enterprises.; Summary

Study on the Exposure Levels of Organic Solvents and Subjective Symptoms of Dry-cleaning Workers.: Soo Young Kim, Jeong Yun Kim, Yeon Kyeng Lee, Sok Goo Lee, Young Soo Lee, Young Chae Cho, Tae Young Lee, Dong Bae Lee; Korean J Prev Med. 1998;31(4):628-643.

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Abstract PDF: To investigate the exposure levels of organic solvents and subjective symptoms of dry-cleaning workers, 77 male and 52 female dry-cleaning workers who had been worked in a small city of Chungnam province, and a large city, Taejon were selected for the study group. Air concentrations of organic solvents in the working environment were analyzed, and subjective symptoms of dry-cleaning workers were surveyed, from July to August 1996. The results obtained were as follows: 1. The concentrations of organic solvents in the working environment were within permissible TLV-TWA limits. 2. For the 13 symptom clusters, the most frequently complained symptom clusters were fatigue as 71.3%, and followed by depression and urinary disturbances as 53.5% and 51.9%. Other symptom clusters complained were below 50%. 3. Positive response rates of subjective symptoms were significantly higher in worker groups such as lived in a large city, female, higher education level, more frequently alcohol drinking, higher concentration of organic solvent in working environment, work in alone. 4. Workers who had used solvent B showed 2.3 point higher scores of subjective symptoms than those of solvent A. Of the subjective symptoms scores, amnesia and nervousness were higher in solvent B user group than solvent B user group. 5. As a result of factor analysis, 3 factors such as depression, urinary disturbance and neurologic disturbance were selected. 6. As a result of the logistic regression analysis, sex, the number of fellow workers, working time, region, job tenure, smoking, alcohol drinking, ventilating system, concentration of organic solvent in working environment and place of residence were selected for the related variables For the conclusion, even though the concentrations of organic solvents in the working environments of dry-cleaning workers were within permissible limit of TLV-TWA, many dry-cleaning workers complained symptoms, such as fatigue, depression, urinary disturbances and so on. And the factors affecting to the symptoms of dry-cleaning workers were the number of fellow workers, work hours, region, job tenure, smoking and alcohol drinking.; Summary

Skin diseases of male workers in painting workplace.: Jae Beom Park, Kyung Jong Lee, Jae Yeon Jang, Ho Keun Chung; Korean J Prev Med. 1997;30(4):830-839.

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Abstract PDF: Painting is risky work to occupational skin disease. This research was carried out to investigate the prevalence of occupational skin disease in painting department of a shipyard company in June 1996. Dermatological examination, self-administered questionnaire survey, compositional analysis of solvents used in painting and cleaning were conducted. Exposed group(n=379) was selected randomly in painting department and control group(n=151) was selected in those who had not exposed to paints or solvents. Exposed group was divided into two groups by substance to contact ; painters contact to paints and organic solvents and workers contact to cleaners mainly composed of organic solvents. The prevalence of contact dermatitis(11.9%) is significantly elevated compared with control group(2.6%), and age adjusted odds ratio(OR) is 4.95 (95% confidence interval[CI]: 1.75-14.03). The prevalence of Tinea pedis, the most common skin disease, in exposure group is 48.0%, and its age-adjusted odds ratio(OR) is significantly elevated compared with control group (OR:3.17, 95% CI:2.06-4.88). Pompholyx is also significantly elevated in prevalence(11.9%) and age-adjusted OR(OR:6.69, 95% CI:2.05-21.87). There were no difference in the prevalence of contact dermatitis, Tinea pedis, and pompholyx by use of protector, work type, and duration of employment in painting department. In exposure group, 71.1% suffer from contact dermatitis improved in vacation or holiday and 68.9% of them had lesion in exposed area, it suggest that contact dermatitis in exposed group is related to their work. In conclusion, workers in painting department have high risks of contact dermatitis, Tinea pedis, and pompholyx. A health policy should be provided to prevent skin disease among painting department.; Summary

A study on Performing Time of Neurobehavioral Test in Workers exposed to Organic Solvents.: Kang Won Park, In Geun Park, Jin Ha Kim, Kang Woo Bae, Duk Hee Lee, Yong Hawn Lee; Korean J Prev Med. 1997;30(1):171-180.

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Abstract PDF: This study was performed to see whether neurobehavioral tests was affected by the exposure-free time in the workers chronically exposed to organic solvents. Thirty-four female workers were participated and four items among neurobehavioral core test battery of World Health Organization, including digit span, Santa Ana Dexterity, digit symbol, Benton Visual Retention, were administered to the workers. Test was conducted three times-preshift on Monday, preshift on Weekday and during shift on Weekday-per person and the interval of tests was 2 weeks. Digit span forward, Santa Ana Dexterity, digit symbol, and Benton Visual Retention showed significant decrements by performing time, especially during shift on Weekday versus preshift on Monday and preshift on Weekday. In addition, the score at preshift on Weekday was significantly lower than preshift on Monday, in preferred Santa Ana Dexterity and digit symbol. Generally, those who were exposed to high concentration, over 50 years and under 6 years of education showed marked decrease of score at during shift. So, it would be desirable that neurobehavioral test is conducted at preshift on Monday and items related to short term memory could be considerable to be done at preshift on Weekday.; Summary

Effects of Organic Solvents on Hearing in Video Tape Manufacturing Workers.: Hae Ryeon Shin, Jong Young Lee, Kuk Hyeun Woo, Jin Seok Kim; Korean J Prev Med. 1997;30(1):61-68.

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Abstract PDF: This study was performed to evaluate the effects on hearing of video tape manufacturing workers exposed to organic solvents. The experimental groups included solvents exposed group 51 and unexposed group 57 workers. All workers was examined air and bone conduction sensitivity by pure tone audiometer. The mean age of solvents exposed group was 34.1 and nonexposed group was 35.8. The mean duration of solvents exposed group was 7.3years. High frequency hearing loss prevalence of both groups was 23.5% in the group exposed to organic solvents and 17.5% in nonexposed group. There is no statistical significants in the prevalence of high frequency hearing loss. According to comparison of mean auditory threshold value by frequencies, on the air conduction test, right was statistically significant in the 250, 500, 1000, 2000, 4000Hz, except 8000Hz. Left 250, 500, 1000Hz was statistically significant. On the bone conduction test, left250, both 500, 1000, 2000, 4000Hz, except right 250Hz, was statistically significant difference. Generally, auditory sensitivity threshold of the exposed group was higher than the nonexposed group.; Summary

The Assessment of Acquired Dyschromatopsia among Organic-Solvents Exposed Workers.: Mi Jung Kang, Su Hee Kang, Suk Kwon Suh, Dong Hoon Shin, Jong Young Lee; Korean J Prev Med. 1996;29(3):529-538.

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Abstract PDF: We investigated the occurrence of color vision loss in 70 organic solvent mixtures exposed workers and in 47 controls. Color Vision was assessed with a color arrangement test designed to identify the defective color sense, the Han Double 15-Hue Test. The results of the test were no significant difference between exposed workers and controls in the proportion of subjects who committed one or two errors. Quantitative analysis, using color confusion index(CCI), showed no signifiant difference between exposed workers and controls. A significant linear correlation was present between age and CCI in both exposed workers(CCi=0.0056age + 0.94; r=0.23; p<0.05) and controls(CCI=0.0066age + 0.86; r=0.33; p<0.05). Qualitative analysis of the patterns on the hue circle showed that the prevalence of acquired dyschromatopsia was 21% in both and no significant difference. Multiple regression analyses showed that age was significantly related to color vision loss. These results did not provide evidence of a relationship between organic solvents exposure and incidence of color vision loss. In field studies for monitor the people at risk of the acquired color vision loss involving low-dose organic solvents exposed workers, both quantitative and qualitative information should be considered.; Summary

Neurobehavioral Changes according to Cumulative Exposure of Complex Organic Solvents.: Duk Hee Lee, In Geun Park, Jin Ha Kim, Young Hawn Lee, Sung Gye Kang, Doo Hie Kim; Korean J Prev Med. 1995;28(2):386-397.

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Abstract PDF: A cross sectional study was performed to evaluate the neurobehavioral effects of chronic exposure of complex organic solvents, using NCTB(Neurobehavioral Core Test Battery) recommended by WHO(World Health organization). Forty female shoe factory workers and twenty-two controls matched with age were participated. The tests were performed in the morning before start of work, to exclude the effects of acute exposure. Workers were exposed mainly to toluene, methyl ethyl ketone, n-hexane, cyclo-hexane, dichloroethylene, trichloroethylene, benzene, xylenes etc. The ranges of present solvent exposure of hygienic effect were 0.46~0.71 in the process using adhesives indirectly, and 1.83-2.39 in the process using it directly. We reclassified the subjects, according to cumulative exposure. It showed significantly poorer performances in high exposed group on Santa Ana Dexterity and Benton visual Retention, compared with control group. After controlling confounder, the significances were still remained. But, further cohort studies, having the information of personal exposure dose from entering a factory, are required to clarify the effects of chronic exposure of complex organic solvents in relation to dose and duration of exposure.; 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 of succiny trialanine p-nitroanilide hydrolytic activity in workers exposed to organic solvents.: Hae Ju Oh, Jae Hoon Roh; Korean J Prev Med. 1993;26(1):74-85.

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Abstract PDF: To measure the serum succinyl trialanine p-nitroanilide hydrolytic activity as new index of liver function in workers exposed to organic solvents, this study conducted 114 workers in department of shoe-making of shoes factories. The results obtained from this study were as follows: 1. The mean values of serum GOT, GPT, gamma GT in whole workers were 22+/-12.32, 20+/-9.65, 28+/-21.35IU/l, respectively and the mean value of serum STN hydrolytic activity was 0.08 0.05. 2. The serum STN hydrolytic activity was significantly higher for male(p<0.05) and there was no difference among the groups of age. 3. There was no difference in the groups by working hours but significant difference in persons who worked over 3 years or were exposed to toluene over 100ppm(p<0.05). 4. The correlation of the exposed dose of toluene and serum GOT, GPT, gamma GT and serum STN hydrolytic activity were statistically significant(r=0.027-0.518). 5. The exposed dose of toluene was most explainable variable and statistically significant among the factors affecting serum STN hydrolytic activity(p<0.05).; Summary

The Type of Anemia in Organic Solvent Workers by MCV and RDW.: S J Kim, S H Ohm, D H Kim, C U Lee, J H Chun, S C Kim, K T Pae; Korean J Prev Med. 1992;25(2):162-171.

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Abstract PDF: The hematologic effect by low-concentration and repeated exposure to mixed organic solvent remains obscure. This study was performed to evaluate the hematologic effect by mixed organic solvent exposure, especially on the type of anemia by mean corpuscular volume(MCV) and red blood cell distribution width(RDW). The subject were 64 organic solvent workers(male 4, female 60) and 78 general workers(male 18, female 60) who showed anemic tendency in worker's health examination which carried out by Pusan Paik Hospital from January to December, 1988. The author gained some hematologic findings (hemoglobin, hematocrit, RBC, WBC, MCV, MCHC, platelet count, ESR, RDW) from auto-analysis method by coulter counter S plus IV, and compared the type of anemia by MCV and RDW. In the pilot study for estimating the prevalence of anemia according to the type of job, the prevalence rate was higher in organic solvent workers than in public officials as 10.9% and 4.1% respectively. There were statistical significance in the value of hemoglobin, hematocrit, MCV, MCHC, platelet count, ESR, RDW between the two study groups with more severe anemic tendency in organic solvent workers. The type of anemia in organic solvent workers was microcytic and anisocytic with the mean value of 68.28+/-8.3fL of MCV and 19.1+/-4.0% of RDW.; Summary

Hematologic Findings and Urinarysis of Workers Exposed to Mixed Organic Solvents.: K W Jeong, D H Kim, S H Ohm, S J Kim, J H Kim, S S Moon, J H Chun, Y W Kim; Korean J Prev Med. 1991;24(3):314-337.

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Abstract PDF: To evaluate the effects on health by exposure to mixed organic solvents, the author analyzed some labortory findings of blood(hemoglobin, hematocrit, RBC, WBC, SGOT, SGPT) and urine(protein, blood, sugar) that were obtained from 722 workers (male: 446, female: 276) who worked in plywood, painting and shoes factories in Pusan area from January to December, 1990. The result were as follows; 1. The mean values of each hematologic finding were all within normal limit but there were significant differences at hematocrit, RBC, WBC, SGOT, in male and at WBC, SGPT in female at the comparison of the mean values and the distribution according to the normal criteria by type of work. 2. There were no differences in urinalysis (protein, blood, sugar) by type of work. 3. In stepwise multiple regression, analysis of hematologic findings on age, working duration and type of work, regression coefficients on age and type of work were relatively high in male and female subject, respectively. As a result of this study, it is considered that the measurement of WBC with morphology is significant in hematologic findings and instead of spot urine and urinstix, 24 hours urine and quantitative analysis is required in urinalysis in screening test for healthy status of workers who deal with the organic solvents.; Summary

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