불산 누출사고에 따른 지역사회 구성원들의 노출평가

김순신,우극현,윤성용,임현술,김근배,유승도,조용성,이석용,이현수,양원호,Kim, Sunshin,Woo, Kuck-Hyeun,Yoon, Seong-Yong,Lim, Hyun-Sul,Kim, Geun-Bae,Yu, Seung-Do,Cho, Yong-Sung,Lee, Seokyong,Lee, Hyunsu,Yang, Wonho 한국환경보건학회 2015 한국환경보건학회지 Vol.41 No.1

Objectives: The purpose of this study was to propose an indirect exposure assessment method using a questionnaire survey at a time when direct exposure assessment would be impossible after a chemical accident. Methods: About two weeks after an accident, a questionnaire survey was performed with 1,264 persons from the local community. Variables related to exposure were extracted from the survey contents, weighted and then graded for comparison with subjective symptoms in order to evaluate the extent of exposure. Survey items suitable for reflecting the previous exposure level during the accident were extracted, weighted and divided into quartile ranges. Subjective symptoms showed an increasing tendency with higher exposure level when compared with final exposure level (p<0.01). Results: For the relationship between the final exposure grade and subjective symptoms, as the exposure grade was increasing the rates complaining of symptom also showed an increasing tendency. However, when adjusted for demographic characteristics, there was a tendency for the eye irritation symptom to appear higher in women, and respiratory organ irritation appeared higher in smokers. Conclusions: When the problem of recall bias is considered, this study may not have completely unraveled exposure and the characteristics of the participants can affect subjective symptoms. Nevertheless, the exposure rating method of using a questionnaire showed a significant relationship with symptom level. It can be deemed that assessment of past exposure may be successfully evaluated by questionnaire in cases such as chemical accidents.

벤젠노출 지표로써 요중 뮤콘산과 혈소판 수치의 연관성

민영선(Young-Sun Min),우극현(Kuck-Hyun Woo),김진석(Jin-Seok Kim),유재영(Jay-Young Yoo),이관(Kwan Lee),임현술(Hyun-Sul Lim),김헌(Heon Kim) 대한직업환경의학회 2010 대한직업환경의학회지 Vol.22 No.2

전자부품 사업장에서 발생한 급성 오존 노출에 의한 호흡기 증상 7례

권용준(Yong-Jun Kwon),우극현(Kuck-Hyun Woo),김진석(Jin-Seok Kim),윤석용(Seong-Yong Yoon),송인웅(In-Ung Song),유재영(Jay-Young Yu),조성용(Seong-Yong Cho) 대한직업환경의학회 2012 대한직업환경의학회지 Vol.24 No.4

합성섬유제조업체 Dimethylacetamide 노출 근로자들의 독성 간손상 발생률

장용석(Yong-Seok Jang),윤성용(Seong-Yong Yoon),조성용(Seong-Yong Jo),최태성(Tae-Sung Choi),유재영(Jay-Young Yoo),우극현(Kuck-Hyun Woo),하봉구(Bong-Goo Ha),정상재(Sang-Jae Jung),천병렬(Byung-Yeol Chun),김진석(Jin-Seok Kim) 대한직업환경의학회 2006 대한직업환경의학회지 Vol.18 No.3

20-30대 무증상 성인에 있어서 채용신검시 나타난 간기능 및 바이러스 간염검사 결과 분석

김주자,신연교,우극현 순천향의학연구소 1995 Journal of Soonchunhyang Medical Science Vol.1 No.2

To determine the distribution of results of liver function test and viral markers for preemployment screening in asymptomatic young adults(twenties and thirties in age group), and also to evaluate the cutoff level of liver function test in deciding repeat follow-up examination. the data from which the first and second repeated examinations for preemployment screening performed during the period from Jan, 1, 1994 to Dec. 31 1994 were analized. The results were as follows: 1. Among 7,855 asymptomatic young adults who were examined, 814 (10.4%) had the abnormal liver function test (10.4% (814/7,855) in male, 0.8% (14/1,707) in female. 2. In 397 male who had repeated follow-up test, 27.2%(108/397) were turned out normal liver function test and 72.8%(289/397) remained abnormal. According to the interval of repeated follow-up test, the longer the interval the higher conversion rate to normal. This can be explained by the effect of treatment of health care, or was dropped from 87.5%(7/8) to 44.2%(23/52) at 401U/dl and that of SGOT was dropped from 80.7%(25/31) to 67.9%(19.28) at 451U/dl which suggest cutoff level to decide repeated follow-up test. This suggest that we can adjust the cutoff level in deciding follow-up examination. 3. Overall positive rates for HBsAg were 5.8%(80/1,561), and 5.9%(80/1,347) in age group 20-29, 4.7%(10/214) in age group 30-39, 6.0%(73/1,214) in male, 4.9%(17/347) in female. Positive rate for HBsAg according to the liver function test was significantly higer in abnormal liver function group than in normal liver function grup (12.7% vs 4.8%). 4. Positive rate for anti-HBs was 32.7% and there were no significant difference between age groups or between liver function groups. 5. Positive rate for anti-HCV was 1.3%(5 in 397 male), actually all 5 were in age group 20-29, among them, 3 had normal liver function test and 2 had abnormal liver function test.

건강질단 질병 유소견자들의 순천향구미병원 외래이용에 영향을 미치는 요인

김진석,우극현,함정오,유재영,최태성,하봉구,윤성용 순천향의학연구소 2002 Journal of Soonchunhyang Medical Science Vol.8 No.1

Background ; The purpose of routine health screening of employee is not only to detect worker's disease at early stage but also to provide early appropriate health service. But, majority of patients who diagnosed by routine health screening haven't underwent health service utilization. Soonchunhyang Kumi Hospital had been provide total occupational health service in kumi industrial estate including health screening, worker interview at workplace by occupational nurses and doctors. Object ; We want to know how much proportion of patient who are diagnosed by routine health screening had visited Soonchunhyang Kumi hospital out-patient clinic and factors influencing such health care service utilization. Method ; Initial study subject were 189 workers who had proved to have hypertension, diabetes mellitus, hyperlipidemia in routine health screening which performed during year of 2000. Among those, 160 workers who had finished questionnaire were selected for final study subject. We investigate whether they had visited health services or not, if they had, what kind of health care facility they visited, and other factors which influencing their health service utilization. Result ; Among 160 workers, 59(36.9%) had visited Soonchunhyang Kumi hospital, 47(29.4%) had visited other health care facility, and 54(33.8%) had not went to any health care facility. Factors which influencing Soonchunhyang Kumi hospital utilization is sex, job, staff's support to hospital visit during worktime, history of medical consultation about health screening result.

2.5-헥산디온에 노출된 근로자에게서 발생한 말초 신경병증

조성용,장용석,최은경,김진석,유재영,우극현,최태성 대한산업의학회 2007 대한직업환경의학회지 Vol.19 No.1

목적: 영상음향장비 제조업체에서 2,5-헥산디온을 취급한 근로자에게서 발생한 다발성 말초 신경병증 환례를 보고하고, 동일 공정근로자들의 말초 신경기능을 조사하고 자 한다. 방법: 환례에 대해 방사선학적 검사, 소변 및 혈액 검사, 신경전달속도 검사, 작업환경 측정을 하였으며, 2,5-헥산디온의 노출을 중단시킨 후 5개월 후에 다시 신경전달속도 검사를 하였다. 동일공정 근로자들의 영향평가에서는 2,5-헥산디온에 노출된 13명의 남자 근로자를 노출 군으로, 해당 물질에 노출된 적이 없는 5명의 남자 근로자를 비노출군으로 선정하여 검사를 하였다. 결과: 환례의 신경전도 검사결과 양측 척골신경과 정중 신경에 이상소견을 보였으며, 호전여부를 관찰하기 위하여 5개월 후 추적검사를 실시한 결과 증상 및 신경전달속도 검사결과가 호전되었다. 동일공정 근로자들의 영향평가에서 노출군의 정중 신경과 척골신경이 비노출군에 비하여 유의하게 감소되어 있었다. 감각 신경의 진폭의 경우, 노출군의 정중 신경과 비복 신경이 감소되었으며, 운동 신경 전도속도에서는 노출군의 비골신경이 유의하게 감소되어 있었다. 말단 잠복기에서는 노출군의 정중신경, 척골신경, 비골신경, 경골신경이 비노출군에 비해서 유의하게 연장되어 있었다. 결론: 환례의 증상과 신경전달속도 검사의 이상소견은 2,5-헥산디온에 의한 말초신경병증에 부합되었다. 동일공정 근로자 건강영향평가에서 신경전달속도 검사결과 노출 군과 비노출군간의 유의한 차이가 있었는데, 이를 통해 2,5-헥산디온이 근로자들의 신경독성에 영향을 줄 수 있다는 것을 확인할 수가 있었다. Objectives: This study is a case report of 2,5-hexanedione induced occupational peripheral polyneuropathy. We also investigated the peripheral nerve function of all workers who had been exposed to 2,5-hexanedione in the same process. Methods: In June, 2006, a 2,5-hexanedione exposed worker complained of both hand numbness. He received neurologic, radiologic, laboratorial and electrophysiologic evaluation, including measurements of workplace environment. Five months after cessation of exposure to 2,5-hexanedione, a follow-up electrophysiologic examination was done. We evaluated the peripheral nerve function of 2,5-hexanedione exposed workers by comparing 13 male 2,5-hexanedione exposed workers who were in same company with the patient and 5 male workers who had not been exposed to 2,5-hexanedione. Results: Under electrophysiologic examination, there were abnormalities in sensory and motor nerve velocity, terminal latency, and F-latency of both median nerve and ulnar nerve. After 5 months, the patient symptoms and the results of follow-up electrophysiologic examinations were improved. Comparing the 2,5-hexanedione exposed group with the unexposed group, the sensory nerve velocity of the median and ulnar nerves in the exposed group was decreased. The motor nerve velocity of the peroneal nerve, and sensory nerve velocity of the median and sural nerves were decreased. Terminal latency of median, ulnar, peroneal, and tibial nerves in the exposed group were increased compared with the unexposed group(<0.05). Conclusions: 2.5-hexandione can induce peripheral polyneuropathy in male workers.

구미지역 직업성질환 감시체계

김성아,김진석,전혜리,정상재,김상우,이채용,함정오,유재영,최태성,하봉구,조민환,우극현 大韓産業醫學會 2003 대한직업환경의학회지 Vol.15 No.1

목적: 구미지역 내 대학병원이자 특수건강진단·보건관리대행기관의 산업의학전문의, 보건관리대행 간호사, 사업장 간호사를 중심으로 직업성질환감시체계를 구축하여 주요 직업성질환들의 발생현황과 규모를 파악하고자 하였다. 또한 연차적으로 산업, 직업, 업무내용 등에 따른 분포나 원인을 기존 자료원(특수건강진단의 직업병 유소견자와 산재요양승인 되는 직업병자)과 비교하여 분석·기술하고 예방 및 관리를 포함한 보건의료기술개발까지을 포함하는 종합적인 감시체계를 구축하고 운용하고자 하였다. 방법: 구미지역의 산업적 특성에 맞는 직업성질환감시체계를 구축하고 지역 감시체계의 모델을 제시하였다. 6대 감시대상 직업성질환(독성 간염, 직업성천식, 직업성 근골격계질환, 직업성 피부질환, 직업성 암, 수지진동증후군)의 실행적 환례정의, 보고양식 및 보고체계 개발, 분석양식 및 결과 배포 형식을 개발하였으며, 그 유병규모를 파악하고, 감시질환의 분포 및 특성, 관련인자 등을 분석·기술하고자 하였다. 이때, 1년간의 환례분석시 직업병 유소견자 및 직업병 요양자에 대한 자료와 함께 비교 분석하였으며, 노동통계자료를 이용하여 년간 발생률을 추정하였다. 결과: 2001. 1. 1일부터 2002.4.30일까지 총 287건이 보고되었으며, 직업성 근골격계질환 132건(46.0%), 직업성 피부질환 100건(34.8%), 독성간염 34건 (11.8%), 직업성천식 16건 (5.6%), 수지진동증후군 5건 (1.7%) 이었으며 직업성 암은 한건도 보고되지 않았다. 보고경로별로는 보건관리대행에서 33건 (11.5%), 해당 유해인자별로 실시되는 특수검진 외의 각종 건강진단업무 수행 중 발견된 환례에 대한 보고가 206건(71.7%)이었다. 직종별 분류의 결과는 섬유업종사자, 단순노무종사자, 음식업종사자 등이 다수를 차지하였다. 근골격계질환의 경우, 수근관증후군이 42건(33%), 외상과염/내상과염이 39건(30%)로 가장 많았다. 직업성 피부질환은 97건이 접촉성 피부염으로 유기용제류가 59건(59%)으로 가장 많고, 니켈 및 에폭시수지에 의한 알레르기성 접촉성 피부염이 각각 6건과 5건이었다. 독성 간염은 모두 DMF 나 DMAc에 의한 것으로, 근무시작 후부터 간기능이상이 발견되기까지의 근무기간은 대부분이 3개월 이하이며, 1개월 이하인 경우도 10건이나 되었다. 동 기간 중 감시환례에 대해 산재요양 자료와 중복여부를 확인한 결과, 중복되는 것은 하나도 없었다. 특수건강진단에서 직업병유소견자로 판정된 경우는 독성간염에서 3건이 있었으며, 나머지 질환은 중복되는 것은 없었다. 2001도 구미지역의 근로자수와 보고환례건수를 이용하여 연간 발생률을 추정하였다. 근로자 10만 명당 연간 발생률은 상지 근골격계질환은 63.6명, 피부질환 48.2명, 독성 간염 17.9명, 천식 7.7명, 수진진동증후군 2.4명이었다. 참여예상인원은 총 46명이었으며, 실제 참여자수는 21명, 평균참여율은 46%, 실제 참여 1이당 평균 보고건수는 산업의학전문의가 28건으로 가장 많았고, 대행간호사는 45,건, 사업장 간호사는 3.3건이었다. 결론: 지역 감시체계는 기존 통계자료들에서 발견되지 않았던 직업성질환의 발견에 유용한 통계원이며, 특히 지역의 특성과 여건을 고려하여 체계화된 시스템을 구축하여 운용한다면 더 성과가 클 것이다. Objectives: Area-based occupational disease surveillance in Kumi (KODS) was used to collect data on occupational diseases. The data was used to estimate the magnitude of the diseases, to analyze for their characteristics and to find links for their intervention and prevention. Methods: Since January 2001, occupational physicians and nurses in Occupational Health Service (OHS) have reported six major occupational diseases; occuaptional musculoskeletal disorders of the upper extremities (MSDUE), occupational dermatoses, toxic hepatitis, occupational asthma (OA), hand-arm vibration syndrome (HAVS), and occupational cancer. For the respective diseases, a reporting sheet and operational diagnostic criteria were developed by the KODS. An analysis of the KODS data, collected over a certain period, was compared with data from the Korea Labor Workers Corporation (KLWC) and the Specific Health Examination (SHE), and the incidence rates of the diseases estimated. Results: Between Jan 2001 and Apr 2002, 287 cases of the six major occupational disease were reported. Of these, there were 132 (46.0%), 100 (34.8%), 34 (11.8%), 16 (5.6%), and 5 (1.7%), cases of MSDUE, occupational dermatoses, toxic hepatitis, OA, and HAVS, repectively. But, there were no cases of occupational cancer. 33 (11.5%) of the incidence were reported via the OHS, 206 (71.7%) from health checkups, and the other 48(16.8%) from other routes. The synthetic fibers and electronic components manufacturing industries accounted for the greatest number of reported cases. With resport to occupation, the greatest numbers of incidence were reported from the elementary occupations, textile workers, assemblers, and cooks and food services worker, in that order. Of the MSDUE cases, carpal tunnel syndrome and epicondylitis were the two most common diseases. Most of the occupational dermatoses were due to contact dermatitis, with organic solvents (59%), nickel (6%), and epoxy resin (5%) accounting for the majority of these cases. All cases of toxic hepatitis were induced by dimethylformamide or dimethylacetamide, which were reported by a unique monitoring system. During same period, there were no cases claimed by workers to the KLWC, and only three cases from SHE, were identified. Using data from workers' number and surveillance, the annual incidence of MSDUE, dermatoses, hepatitis, OA, and HAVS, per 100,000 workers were 63.6, 48.2, 17.9, 7.7, and 2.4, respectively. Conclusions: These results show that an area-based surveillance system can be very effective for the collection of data on work-related diseases, at least in Kumi.

남자 근로자들의 3년간 추척조사를 통한 지방간 발생률 및 관련요인

김진석,이종영,우극현,유재영 大韓産業醫學會 2003 대한직업환경의학회지 Vol.15 No.3

목적: 지방간 발생률 및 이에 관여하는 위험인자를 추적연구를 통해서 규명하고, 각 위험인자의 수준별 발생률 및 발생밀도비를 조사하고자 본 연구를 수행하였다. 방법: 1996년 1월에서 1997년 7월까지 모 대학병원 종합건강진단센터에서 건강진단을 수검한 2,595명 중 199년 1월1일에서 2000년 12월 31일 사이에 재수검한 남성근로자 617명의 자료를 수집하여, 이들 중 초회 건강진단에서 간초음파상 정상소견을 보인 430명을 연구대상으로 하였다. 이들의 2회 건강진단 간초음파 소견을 추적조사하여 정상군(307명, 71.4%)과 지방간 발생군(123명, 28.6%)으로 분류하고, 지방간 발생률을 발생밀도법을 이용한 100인년당 발생자수로 계산하였다. 결과: 남성근로자들의 지방간 발생률은 9.73/100인년이었으며, 연령대별로는 30∼39세가 최저 8.91, 50대이상이 최고 14.12의 발생률을 보였으나, 연령별 차이의 통계적 유의성은 없었다. 직종별로는 사무직이 10.66의 발생률을 보여 생산직의 8.14보다 1.31배 높았다(p<0.05). 정상군과 지방간 발생군의 초회 건강진단시의 생활습관을 비교한 결과, 음주군은 비음주군에 비하여 지방간 발생이 1.41배 많았으며, 채식을 선호하지 않는 군은 채식선호군에 비하여 1.63배 지방간 발생이 많았다. 비만군별 지방간 발생밀도비는 100% 미만군에 비하여 100∼109% 군이 1.78, 110∼119%군이 2.83 그리고 120% 이상군이 4.25이었다. 흡연습관, 규칙적 운동여부, 짠음식 선호도, 하루 한잔의 초과 커피섭취여부, 건강보조식품 섭취여부는 유의한 영향이 없었다. 정상군과 지방간 발생군에서 초회 건강진단시에 조사된 임상검사지표를 비교한 결과, 비만도, 수축기 및 이완기 협압, GPT, γGTP, 공복시혈당, 당화혈색소, 요산, 총콜레스트테롤 그리고 중성지방이 정상군보다 지방간 발생군에서 높았다. 정상군과 지방간 발생군에서 각각 비만도는 101.4±10.9%, 109.6±11.6%, 수축기 혈압은 120.1±14.1 mmHg, 123.6±13.3 mmHg, 이완기 혈압은 79.4±10.3 mmHg, 82.5±10.8 mmHg, GPT는 20.3±9.3 IU/L, 24.2±10.0 IU/L, γGTP는 20.9±16.0 IU/L, 26.5±16.6 IU/L, 공복시혈당은 89.4±12.0 mg/dL, 95.3±17.0 mg/dL, 당화 혈색소는 4.9±0.5%, 5.1±0.6%, 요산은 5.2±1.0 mg/dL, 5.6±1.1 mg/dL, 총콜레스테롤은 180.4±30.8 mg/dL, 194.2±33.6 mg/dL, 그리고 중성지방은 127.2±78.5 mg/dL, 166.9±94.1 mg/dL이었다. GOT HDL-콜레스테롤 그리고 LDL-콜레스테롤은 두 군산에 유의한 차이가 없었다. 다중 로지스틱 회귀분석 결과에서는 비만도 100% 미만군에 비하여 110-119% 군의 교차비가 2.257 (1.138∼4.477) 120% 이상군이 8.174 (3.150∼21.210_이었으며, 혈중중성지방 150 mg/dL이상이 2.759 (1.612∼4.722)의 유의한 교차비를 가졌다. 결론: 남성근로자들을 3년간 추적관찰한 결과 지방간 발생률은 9.73/100 인년이었으며, 생산직 보다 사무직에서 지방간 발생률이 높았다. 비만할수록 음주를 하는 군이, 채식을 선호하지 않는 군이 지방간 발생이 많았으며, 수축기 및 이완기 혈압 GPT, γGTP, 공복시혈당, 당화혈색소, 요산, 총콜레스테롤 그리고 중성지방이 높은 군이 자방간 발생이 많았다. Objects: This study was conducted to investigate the incidence rate of fatty liver and it's related factors based on a three year follow up of multiphasic health screening participants. Methods: 671 male workers who had participated in both initial and second multiphasic health screening were selected. Initial screening was performed during the year of 1996 to 1997 and second screening was performed during the year of 1999 to 2000. Among them, four hundred and thirty workers who didn't initially have a fatty liver were selected as the final study subjects. They were classified into 2 categories according to the initial and second hepatic ultrasonographic findings; stationary normal (307, 71.4%), and fatty liver incident (123, 28.6%). The incidence rate was calculated using the incidence density method. Results: The incidence rate of fatty liver among the male workers was 9.73 per 100 personyears. The white collar workers had a higher incidence rate (10.66) than the blue collar workers (8.14). The incidence density ration of alcohol drinking to fatty liver incidence was 1.41, and the incidence density ratio of low vegetable diet was 1.63. The incidence density ratio of obesity was 1.78 for the 100-109% obesity index group, 2.83 for the 110-119% obesity index group, 4.25 for the ≥120% obesity index group over <100%. Smoking, regular exercise, salty food preference, and taking food supplement had no significant effect on the incidence of fatty liver. The fatty liver incident group had higher initial blood pressure, GPT, γGTP, fasting blood sugar, HbAlc, uric acid, total cholesterol and triglyceride levels than the stationary normal group. However, there were no differences in the GOT, HDL-cholesterol or LDL-cholesterol levels. In the multiple logistic regression in the GOT, HDL-cholesterol or LDL-cholesterol levels. In the multiple logistic regression analysis, obesity index and serum triglyceride were found to be major factors in the incidence of fatty liver after controlling age, alcohol drinking, vegetable diet, daily coffee intake, blood pressure, HbAlc, total cholesterol, and uric acid levels. Conclusions: The incidence rate of fatty liver among the male workers was 9.73 per 100 person-years. The lifestyles which gave rise to an increasing incidence of fatty liver were those vascular disorder related health indices such as blood pressure, and the blood sugar, blood lipid and uric acid levels, were related to the incidence of fatty liver.

주성분이 염화메틸렌(Methylene Chloride)인 재생 세척제를 취급하는 근로자에서 발생한 독성간염 1예

하봉구,김진석,유재영,우극현,함정오,윤성용,장용석,정상재 大韓産業醫學會 2004 대한직업환경의학회지 Vol.16 No.2

목적 : 주성분이 염화메틸렌(Methylene chloride)인 재생 세척제를 취급하는 근로자에서 발생한 독성간염 1례를 보고한다. 방법 : 열감, 오한, 근육통 등의 증상을 주소로 내원한 염화메틸렌을 사용하여 세척한 반도체 부품을 검사, 포장하는 작업에 종사한 27세 여성 근로자를 대상으로 혈액검사, 간 초음파 검사, 복부 전산화단층촬영 등의 임상검사와 작업장 조사를 실시하였다. 결과 : 환자는 입원 후 시행한 검사실 검사와 방사선학적 검사상 급성 간염의 소견을 보였다. A, B 및 C형 간염 표지자 검사 및 자가면역성질환 검사 등은 모두 음성이었다. 문진 상 알코올성 간염을 일으킬 정도의 음주력이나 관련 약물의 복용 및 약물 알러지의 병력이 없었다. 입원 후 보존적인 치료로 증상 및 검사실 소견이 급속히 호전되었다. 퇴원 후 작업장에 복귀하여 염화메틸렌에 재 노출되었을 때 이전의 증상이 재발되어 작업 2일 후 재입원 하였다. 재 입원 후 시행한 검사실 검사에서도 급성 간염의 소견을 보였고, 전회와 동일한 치료로 증상이 호전되고 간효소 수치가 정상화되어 입원 12일째 퇴원하였다. 결론 : 환자의 임상증상, 검사결과, 노출력 및 과거력상 본 증례에서의 간손상이 염화메틸렌과 관련이 있을 것으로 추정된다. Objectives: To report a case of toxic hepatitis in a worker exposed to a cleansing agent mainly composed of methylene chloride. Methods: A 27-yea-old female worker who had worked in an inspection and p a h g position of semiconductor parts in a factory using methylene chloride as a metal cleansing solvent was hospitalized due to fever, chill and generalized aches. We evaluated her with blood tests, abdominal ultrasonographic scan and abdominal CT scan and also took h a occupational history. Results: The patient showed acute hepatitis in blood and radiologic tests after admission. The serologic tests for viral hepatitis A, B, C and autoimmune hepatitis were negative. She had no history of significant alcohol use, recent medication or drug allergy. After admission, her symptoms were improved and liver enzyme levels(AST and ALT) were markedly reduced. She returned to her workplace after discharge. Thereafter, however, her previous symptoms were recurred and she was hospitalized again 2 days after reaming to her workplace. After this second admission, she showed acute hepatitis in blood tests and her symptoms were improved and liver enzyme levels were markedly reduced with the same pattern as those of the first admission. On the 11th day of the second admission, liver enzyme levels were normalized and she was discharged from hospital. Conclusions: We presume that this patient's fiver injury was related to the methylene chloride presence at her workplace due to her clinical symptoms, blood bests, radiologic tests and occupational history.