용접공진폐증 집단검진을 위한 단순 흉부방사선 촬영과 고해상 흉부전산화 단층촬영의 진단적 의의

강정학,전진호,구혜원,고광수,유병철,손혜숙,이종태,이채언,김건일,최석진,Kang, J.H.,Chun, J.H.,Gu, H.W.,Ko, K.S.,Yu, B.C.,Sohn, H.S.,Lee, J.T.,Lee, C.U.,Kim, K.I.,Choi, S.J. 대한예방의학회 1996 예방의학회지 Vol.29 No.4

Pneumoconiosis is one of the major problem in the field of occupational health at Korea. Therefore, the efficient diagnosis of pneumoconiosis is a hot issue on the occupational health program. The author executed this study to estimate the diagnostic value of high resolution computed tomography(HRCT) compared with chest radiography for screening of welder's lung. HRCT was introduced very recently for the diagnosis of pneumoconiosis, however, the diagnostic value for screening of welder's lung - principally nonfibrogenic and reversible - has not been evaluated. The subjects were fifty cases of welder's lung or suspected cases who had been collected between 1989 and 1994 from one shipyard and continuously followed-up on the basis of in-plant periodic health check program. We applied both chest radiography and HRCT on the same subjects from May 1 to 30, 1996. The images were evaluated by two careered radiologists independently. The findings of chest radiography were classified into four category by ILO classification, and the findings of HRCT according to the criteria of Bergin et al. The concordance between two radiologists expressed with Kendall's tau-b was 0.72 by chest radiography and 0.44 by HRCT- that is, interobserver variation of HRCT was bigger than that of chest radiography. The concordance between the two different methods was highly variable as 0.44 by radiologist A and 0.06 by radiologist B - that is, interobserver variation was very big. However, HRCT looked more detectable for the minor parenchymal change. These findings suggested that it is not appropriate to use HRCT routinely for screening of welder's lung due to lack of diagnostic criteria, and feasibility, acceptability and economic aspects. Nevertheless, HRCT might be recommendable in the case of equivocal parenchymal features on the chest radiography, unexplained respiratory symptoms, and/or lung function abnormalities suggestive of interstitial fibrosis.

트리클로로에틸렌이 흰쥐의 태반 기능과 발생에 미치는 영향

강정학 ( Jeong Hak Kang ),이채관 ( Chae Kwan Lee ),문덕환 ( Deog Hwan Moon ),손병철 ( Byung Chul Son ),김대환 ( Dae Hwan Kim ),이창희 ( Chang Hee Lee ),김휘동 ( Hwi Dong Kim ),김정원 ( Jung Won Kim ),김종은 ( Jong Eun Kim ),이채언 한국산업위생학회 2004 한국산업보건학회지 Vol.14 No.3

This study aimed at investigating the toxic effects of trichloroethylene (TCE) on the placental function and reproduction in rat. For these study placental prolactingrowth hormone (PRL-GH) family gene expression, placental trophoblast cell frequency and reproductive data were analyzed. Pregnancy of the Sprague-Dawley rats were checked by the presence of the copulatory plug or sperm in the vaginal smear and defined as the pregnant day (PD) 0. The pregnant rats were divided into the three groups. The control group was intraperitoneally injected with sesame oil. The remaining groups were injected with 100 or 500mg/kg B.W/day of TCE resuspended with sesame oil from PD 7-11 or 16-20. Rats were sacrificed at PD 11 and 20. mRNA levels of PRL-GH family and Pit-1a, b isotype genes were analyzed by Northern blot hybridization and Reverse transcription-polymerase chain reaction. Hormone concentration was analyzed by radioimmunoassay. Frequency of placental trophoblast cells were observed by histochemical study. Reproductive data such as placental and fetal weights pregnancy period, and litter size were surveyed at PD 20 and after birth. Statistical analysis was carried out by the SAS program (version 8.1). mRNA levels of PRL-GH family genes such as placental lactogens and placental prolactin like proteins were reduced by TCE administration. mRNA level of Pit-1a, b isotype genes that induce the expression of PRL-GH family genes were also reduced by TCE administration. Placental lactogen II concentration in the placenta, fetus and maternal blood were decreased by TCE administration. Exposure to a high dose of TCE reduced the frequency of the spongiotrophoblast cell in junction zone. Reproductive data such as placental and fetal weights, litter size were reduced, and pregnancy period was extended in the TCE exposed group than control. These data suggested that TCE disrupts the ordered functions of placenta and these effects lead to the reproductive disorder in rat.

경남지역 일부 산업간호사의 업무수행에 관한 연구

김영숙,손혜숙,강정학,이창희,이채언,Kim, Young-Sook,Shon, Hae-Sook,Kang, Jeong-Hak,Lee, Chang-Hee,Lee, Chae-Un 대한예방의학회 1995 Journal of Preventive Medicine and Public Health Vol.28 No.3

Authors purposed to observe activities of occupational health nurses and it's related factors, and to suggest the way that induct better occupational health nurses' activities with questionaire to 87 occupational health nurses who individually work as health manager in the plant. The questionaire included type of plant and number of workers, general characteristics, work conditions, activities, etc. Major findings are as follows. 1. 82.8% of occupational health nurses were third decade. 93.1% graduated junior college or college. And 82.8% were not married. 2. General work conditions: 40.2% were belonged to safety-health section, 98.85% were mere clerks. 60.9% worked less than weekly 44 hours, and an annual salary of 50.6 % was between 10 million and 14 million won. 3. Work condition related to health manager work: there was separated health care room in 94.3%, working period as health manager(occupational health nurse) was less than 5 years in 70.1%, 49.4% had the out-of-health manager work. In 87.4%, occupational physician was appointed, only 6.9% of them were full time, 52.9% of them worked little in the plants. The problems related to workers' health were discussed with industrial nurses in 88.5%. 4. Attitude for their work: 88.5% were thought that their work is important for workers' health care, 57.5% satisfied to work as health manager. In 51.7%, motive to being industrial nurse were the appropriate aptitude. 5. Activities: General medical care in 100% were carried out, in 97.7% works related to general health examination, in 100% works related to special health examination were carried. But works related to use of protective apparatus were carried out in 20.8%. 6. Factors related to level of activities: In cases who solved the health related problems by themselves, the level of activites was significantly higher than in others. In cases there were full time occupational physician, the level of activities was significantly lower. 7. Occupational health nurse's needs: 100% wanted regular education, 89.7% wanted the qualifying examination. As the results, author suggests that the right of self-control is given to occupational health nurses and the work of occupational physician is clearly defined for the induction of the better activities of occupational health nurses.

용접 근로자의 혈액상 변화

유철인,이지호,강정학,이헌,이충렬,Yoo, Cheol-In,Lee, Ji-Ho,Kang, Jeong-Hak,Lee, Hun,Lee, Choong-Ryeol 대한예방의학회 1999 Journal of Preventive Medicine and Public Health Vol.32 No.2

Objectives: To ascertain whether some result of hematological examination could be as reference data for health management of welders. Method: The authors conducted the hematological examination of 1,018 welders and 531 control workers of a shipbuilding industry in Ulsan using automatic blood analyzer. Results: The WBC count of welders was lower than that of control on controlling the age and the duration of employment, but changes of other blood cells were not observed. Conclusion: We could use the results of hematological examination such as WBC counts as an indicator for subtle changes of health status of welders.

부산지역의 대기 중 중금속 농도

송인혁,조규일,문덕환,이창희,강정학,김종갑,한용수,이채언,Song, In-Hyeok,Cho, Gyu-Il,Moon, Deog-Hwan,Lee, Chang-Hee,Kang, Jung-Hak,Kim, Jong-Gab,Han, Yong-Soo,Lee, Chae-Un 대한예방의학회 1995 Journal of Preventive Medicine and Public Health Vol.28 No.3

This study was carried out to assess the present level of atmospheric metals. Five metals - lead, cadmium, chromium, manganese, vanadium - were checked on the industrial(Sasang) and residental area(Daeshindong) in the city of Pusan. Sampling period was the year of 1986, 1990 and 1994, and the sampling time was 2 days of each site. As the result of comparison with the atmospheric standard of ASHRAE(1980), the average concentrations of lead was above the standard, the average concentrations of chromium was around the standard, and the average concentrations of cadmium and vanadium was below the standard. The average concentrations of manganese was above the standard of industrial environment. And the average concentrations of five metals was higher in the industrial area than the residental area. The average concentrations of lead, cadmium and chromium showed the increase tendency by the year, and the average concentrations of vanadium showed no change, and the average concentrations of manganese showed the decrease tendency. As a result of correlation analysis, lead and cadmium(r=0.31), vanadium and manganese(r=0.24), vanadium and chromium(r=0.19) showed significance.

용접근로자의 비중격천공 증례

이충렬,류철인,이지호,강정학,강성규,양정선,신용철 大韓産業醫學會 1998 대한직업환경의학회지 Vol.10 No.3

Six cases of nasal septum perforation were found among welders during periodic physical checkup in 1997. Considering the size, shape and margin, the perforations were assumed to have been occurred several years before of which the diameter were 8∼15mm. To investigate the cause of perforation, we reviewed the past history of preemployment, the results of annual working environment survey and the material safety data sheets of welding rods and steels with which they have dealt, and analyzed the concentration of several metals of welding fume and the concentration of blood and urinary chromium. In the result, we presupposed that the nasal septum perforations of welders were due to chronic exposure to low level hexavalent chromium and/or nickel, and report these cases with literatures review.

유기용제노출이 직업적 청력손실에 미치는 영향

이지호,고영주,이헌,강정학,유철인,이충렬,김양호 大韓産業醫學會 2000 대한직업환경의학회지 Vol.12 No.4

목적 : 산업 장에서 노출되는 유기용제가 청력역치에 어떠한 영향을 미치는가를 5년 동안의 추적조사를 통하여 파악하고자 하였다. 방 법 : 유기용제와 소음에 동시에 노출된 근로자 43명과 소음노출수준, 연령, 근무경력을 짝짓기 한소음노출군을 대상으로 문진과 이경검사, 소음노출 수준, 유기용제노출수준을 조사하였다. 결과 : 1. 전체 근로자의 각 주파수별 청력역치 변화양상에서 500Hz∼2000Hz에서는 추적기간 동 소음동안 현저한 변화가 없었고, 4000Hz 및 8000Hz에서는 역치가 증가하는 경향을 나타내었다. 2.유기용제와 소음에 동시에 노출된군에서 소음 노출군에 비해 4000Hz 이상에서 청력역치가 높게 나타났으나, 통계적인 유의성은 없었다(p(0.05). 3.반복측정 분산분석 법으로 각 주파수별 평균청력 역치의 연차적 변화에 미치는 영향을 분석한 결과 유기용제 노출은 통계적으로 유의한 영향이 없었으나(p)0.05), 소음노출수준은 250Hz, 2000Hz 및 4000Hz에서, 연령은 250Hz와 500Hz에서 통계학적으로 유의한 영향을 미치는 것으로 나타났다(p(0.05). 4.소음노출군파 동시노출군 각각에서의 청력역치 변화량을 paired t-test로 비교한 결과 250Hz∼4000Hz에서는 통계학적 유의성이 없었으며(p(0.1), 8000Hz에서만 경계치 (p=0.0884)의 유의성을 나타내었다. 5.요인들의 영향을 보정한 상태에서 관찰하기 위해 관찰기간동안의 청력역치변화량을 종속변수로 두고 일반선형모형을 이용하여 주파수별로 관찰한 결과 8000Hz에서만 모델에 통계학적 유의성이 있었으며 (p(0.05), 여기서 소음노출수준이 통계학적으로 유의한 영향을 미치는 것으로 나타났고(p(0.05), 유기용제노출은 경 계수준이 었다(p=0.087). 결론 : 청력에 대한 유기용제의 영향이 소음과 연령에 비해 상대적으로 미미하여 명확한 결론에 이르지는 못하였으나, 다소 영향이 있는 것으로 생각되어 유기용제의 영향에 대한 추가연구가 필요할 것으로 판단된다. 또한 보다 효과적인 근로자들의 청력관리를 위해서는 소음 외 산업 장에서 동시에 노출되는 여러 유해물질들을 고려하여야 할 것이다. Objectives : This study was to evaluate the impacts of simultaneous exposure to noise and mixed solvents on workers'hearing threshold level (HTL) over five-year period. Methods : The study was conducted by interview and annual audiometric test on workers in ship building industry from 1994 to 1998. The cases(workers who exposed to noise and mixed solvent simultaneously) were 43 male workers and controls (workers who exposed to nolle) were selected by matching method with regard to age, sex, carrier, and noise exposure level. To assess the impacts of solvent exposure on hearing threshold level, with considering other factors, general liner model was used. Results : 1. The audiogram of all subjects showed typical sensorineural hearing loss pattern. The mean HTLe were increased at high frequency (4000HB and 8000Hz) for study period. 2. The HTLs of cases were more increased than those of controls at high frequencies (4000Hz and 8000Hz), but there was not statlstical significance. 3. The impact of age on the HTL was statistically significant at 250Hz and 500Hz (p(0.05), and the impact of noise on the HTL was statistically significant at 250Hz, 2000Hz and 4000Hz (p(0.05), but the impact solvent exposure on the HTL was not significant. 4. The changes in HTLs of cases were higher than those of controls at high frequency, there were not statistical significance at 4000Hz, but only at 8000Hz (p=0.087). 5. Statistical analysis of the general linear model implicated that the changes in HTL was impacted by noise exposure bevel significantly (p=0.031) and Impacted by solvent exposure weakly (p=0.087) at 8000Hz. Conclusions : The results of this study suggest that workers who simultaneously exposed to noise and mixed solvent were at risk for more affected HTL than those exposed to noise exposure only, but we could not find definitive evidence. Further detailed studies must be made in large number of workers.

톨루엔을 포함한 유기용제의 직업적 폭로로 인한 신경내분비계 영향

이채언,이종태,정의화,손혜숙,문덕환,전진호,강정학,이창희,김휘동,김종한,정귀옥 大韓産業醫學會 1995 대한직업환경의학회지 Vol.7 No.2

Long term occupational exposure to solvent mixtures may cause adverse effects to the central nervous system with neurobehavioral symptoms. And some organic slovents have been suggested to cause impairment of tuberoinfundibular dopaminergic activity and neurochemical mechanisms controlling pituitary secretion. For the purpose of assessing neuroendocrine effects in occupational solvents exposure, hormonal study settings (shoes-manufacturing industry & fishing products industry) and compared with nonexposed controls(33 men, 85 women). Male workers exposed to solvent mixtures had significantly lower plasma level of follicle-stimulating hormone(FSH) than nonexposed male controls. While female workers exposed to solvent mixtures had significantly lower plasma levels of growth hormone(GH), and thyroid-stimulating hormone(TSH) than nonexposed female controls. The results of significant decrease in plasma concentrations of pituitary hormones(FSH, GH, and TSH) in workers exposed solvent mixtures indicate that occupational exposure to solvent mixtures may induce neuroendocrine effects through an effect on hypothalamic pituitary axis.