납 노출자에 ALAD 및 VDR 유전자의 다형성이 혈중 납과 혈압과의 관련성에 미치는 영향

리갑수,황보영,김용배,김화성,이성수,안규동,이병국 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.1

To evaluate the effect of ALAD and VDR polymorphism on the relationship of blood lead with blood pressure in lead exposed workers, 801 lead exposed workers were selected. Blood lead was selected as parameters of lead dose and systolic and diastolic blood pressure using Random Zero Sphygmomanometer were chosen as blood pressure. ALAD and VDR genotype of each subject was assayed. Demographic information such as sex, age, education, past and family history, and personal habit of smoking and drinking were collected. Job duration of lead exposed workers was also obtained. The means of age and work duration of the subjects were 40.4±10.1 years and 8.2±6.5 years. The means of systolic blood pressure and diastolic blood pressure of the subjects were 123.2±16.3 mmHg and 75.8±11.9 mmHg. The overall prevalence of hypertension was 9.7%. ALAD2, the variant allele, in lead exposed workers was 10% and ALAD1 was 90%. For VDR genotype, the Bb or BB genotypes were 11.2%, while the bb genotype was 88.8%. The mean blood lead of subjects was 25.4±10.9 ㎍/㎗ (range 8.0-65.6). In the multiple regression analysis, blood lead was the significant positive predictor of systolic blood pressure and not the significant negative predictor of diastolic blood pressure after adjusting for possible confounders (age, sex, body mass index, use of anti-hypertensive drugs, drinking and smoking habits, VDR and ALAD genotypes. Also the subjects with the VDR Bx had 2.9 mmHg higher than those with the VDR bb (p=0.09). There was no interaction of VDR and ALAD genotypes between blood lead and systolic blood pressure. In multiple logistic regression analysis, the Odd's ratio of VDR genotype(BB or Bb vs. bb) for hypertension was 1.7 (95% confidence interval: 0.8-3.2). This study suggests that blood lead increases systolic blood pressure controlling covariates.

연 축전지 사업장의 질환 요주의자 및 유소견자의 사후관리 실태 연구

리갑수,황보영,김용배,김화성,함정오,이성수,안규동,이병국,허정,Lee, Gap-Soo,HwangBo, Young,Kim, Yong-Bae,Kim, Hwa-Sung,Ham, Jung-Oh,Lee, Sung-Soo,Ahn, Kyu-Dong,Lee, Byung-Kook,Hur, Jung 대한예방의학회 1996 예방의학회지 Vol.29 No.4

연 업종별 보건관리 대행기관에 의해 근로자의 보건 관리를 하고 있는 5개 연 축전지 회사의 전체 근로자들 중 1995년에 일반 건강진단 및 특수 건강진단을 동시에 시행한 전체 1,919명의 근로자 중에서 C(건강관리 상 계속 관찰이 필요한자)와 D(유소견자)의 판정을 받은 365명의 근로자들을 대상으로 하여 이들 중 퇴직자 35명, 조사 기간중 출장, 휴직 및 야간 근무자 8명, 그리고 조사에 응하지 않은 근로자 29명 등 총 72명을 제외한 293명을 대상으로 설문 및 1995년도 일반 및 특수 건강진단 결과표를 통하여 건강진단 결과에 따른 사후관리 조치실태 및 관련 요인들을 조사하였다. 결과를 요약하면 다음과 같다. 1. 요주의자 이상근로자의 86%가 건강진단결과표를 받았으나 이에 대한 교육설명이 제대로 이루어지지 않았고, 자신의 건강진단 결과를 잘 알고 있지 못하였다. 2. 사후관리 조치가 있었던 근로자는 23%로 낮았으며, 사후관리조치의 내용은 단순한 추적관찰이 가장 많았다. 3. 조사대상 근로자들은 현재의 건강진단은 필요하지만 형식적이라고 하였다. 4.사후관리 조치의 유무를 피설명변수로 한 로지스틱 회귀분석에서 유의한 설명 변수는 건강진단 결과에 대한 설명의 유무뿐이었다. To evaluate the follow-up management state and related factor of lead battery workers in periodic health examination as part of program of group occupational health service, author studied 293 workers with questionnaire on knowledge of results and follow-up management state and related factors, and compared the responses to their periodic health examination result charts. The results were as follows: 1. 252(86%) workers responsed that they had received the health examination result chart, but only 116(39.6%) workers responsed that they had been educated or explained about the results of health examination, and 11(57.9%) workers among 19 workers with non-occupational disease D, 101(44.3%) workers among 228 workers with non-occupational disease C, and 19(28.4%) workers among 67 workers with occupational disease C knew accurately their health examination results. 2. 78(24.8%) of the workers responsed that they had follow-up management, and contents of follow-up management were follow-up(36.6%), out-patient treatment (31%), change worksite(8.5%), temporary retirement(7.0%) and others(16.9%). 3. Most of the workers responsed that the health examination were necessary, but three-fourths of the workers responsed that the health examination had been superficial or that they didn't know. 4. In this study, follow-up management show significant association with only explanation or education about health examination result chart.

연폭로 근로자들의 연폭로 수준에 따른 혈압변화에 관한 연구

리갑수,안현철,김용배,이성수,안규동,이병국 순천향대학교 산업의학연구소 1997 순천향산업의학 Vol.3 No.1

To evaluate the blood pressure change of lead workers by lead exposure level, authors analyzed 1,009 lead workers. Study variables were systolic and diastolic blood pressure, smoking and drinking habit, age, work duration, blood lead concentration(PbB), ZPP, hemoglobin, BMI and cholesterol. The results were obtained as follow; 1. Means of systolic and diastolic blood pressure were 126.93mmHg and 74.08mmHg. Systolic pressures were significantly higher in males and drinkers than in females and non-drinkers. Blood pressure was increased as age and work duration were increased. 2. Means of PbB and ZPP were 26.79㎍/㎗, 61.38㎍/㎗ respectively. Male workers' PbB was higher than female workers', and ZPP was contrary. PbB and ZPP were increased as age and work duration were increased. Smokers' and drinkers' PbB were not different from nonsmokers' and nondrinkers' but ZPP were lower. 3. As PbB was increased, systolic pressure was increased, but diastolic pressure was not increased. 4. There were no significant increase in both systolic and diastolic pressure by increase of ZPP. 5. In pearson's correlation analysis, systolic pressure was correlate with BMI(R^(2)=0.2618), hemoglobin (R^(2)=0.1794), cholesterol(R^(2)=0.14334), PbB(R^(2)=0.12616) and alcohol consumption per week(R^(2)=0.10925). 6. In pearson's correlation analysis, diastolic pressure was correlate with BMI(r-square : 0.25037), age, hemoglobin, cholesterol and work duration, but not correlate with PbB. 7. Forward multiple regression analysis using systolic pressure as dependent variable revealed that BMI, PbB hemoglobin and cholesterol in order were significantly contributed to dependent variable. 8. Forward multiple regression analysis using diastolic pressure as dependent variable revealed that BMI, age, hemoglobin, smoking and cholesterol in order were significantly contributed to dependent variable.

일부 지역 제조업체 안전·보건관계자들의 지식 및 태도에 관한 연구

송영표,리갑수,이성수,안규동,이병국 순천향대학교 산업의학연구소 1996 순천향산업의학 Vol.2 No.1

The useful preventive measure for industrial accidents in manufacturing industries could be achieved through automation, education of workers on safety, proper work practice and etc. The success of prevention of industrial accident could be haevily relied on the awareness of accident prevention of workers and management personnel in each industries. In order to obtain general awareness of industrial accident in terms of knowledge and attitude and to provide useful information for the proper preventive measure of industrial accident, questionnaire survey was done with manufacturing industries in Chunan area which has 5 and more workers. Questionnaire with 50 question items were sent to 570 relevant personnels in 471 manufacturing industries. Out of 560, 460 relevant personnel replied to the questionnaire. The results obtained were as follow; 1. While most manufacturing industries(391 industries, 86.7%) under study reported that they had full time occupational safety and health personnel, only 30 manufacturing industries(6.5%) with legal requirement of such personnel did not have relevant ones. 2. Most popular position for the personnel of safety and health duty were section chief(33.2%), and 46.8% of safety and health personnel were in the age group of 30-39. Whereas 66.9% of them were titled as production chief and management chief. 3. Most safety and health personnel(98.5%) reported that disseminated information from professional organization of occupational safety and health were very useful to carry out their safety and health duties. 4. Eight one percent respondent received safety education from governmental organization or affiliated institute and most of them (97.3%) reported that such education was very effective. 5. While 61.8% of respondent reported the necessity of field inspection by inspector for routine and consultation, 30.0% of respondent wanted document inspection without real field inspection. But most respondent replied that such inspections were useful for conducting safety and health prevention. 6. While 93.7% of respondent thought that accident prevention were helpful for production, 88.8% and 86.0 of them replied that accident prevention could influence the cost of production and quality of products, respectively which eventually influenced the competitiveness of each industries. 7. Eighty five percent of respondent replied that accident could be prevented with educational, personal and material resources. 8. While 96.5% of respondent replied that their industries provided safety education, out of them 26.2% industries thought that their safety education were superficial. The most popular frequency of safety education was once per month(56.0%) and 31.0% industries provided once a week. On the other hand 13.1% of industries provided every day safety education on regular basis. 9. While 45.2% of respondent replied that employer had strong commitment for safety and health, 41.3% of respondent replied that there were some changes and progression of employer's attitude for safety and health issues. 10. While 49.2% of respondent replied the necessity of legal requirement of safety personnel, 45.8% of respondent replied that voluntary requirement for safety personnel were more practical and helpful for accident prevention. 11. The necessity of periodic health examination were replied from most respondent(90.0%) and 73.0% of respondent thought that periodic health examination were helpful for the promotion of worker's health, but 56.4% of respondent criticized that periodic health examination were superficial and needed revision of content and method of periodic health examination. 12. Most respondent(92.7%) agreed the necessity of environmental measurement and 64.4% of respondent had their confidence on the result of environmental measurement, whereas 56.7% of respondent replied that their industries were repaired and improved according to the recommendation of environmental measurement and 85.6% of respondent replied that some kind of countermeasure for the recommendation such as supplies of personal protective equipments were done.

이차 제련 및 리사지 업종 근로자들의 연폭로에 관한 연구

채제명,리갑수,이성수,안규동,이병국 大韓産業醫學會 1997 대한직업환경의학회지 Vol.9 No.1

Two hundred and six male lead workers (86 lead workers from secondary smelting industries and 120 lead workers from litharge making industries) and 212 office workers who were not exposed to lead occupationally were studied to investigate the effect of lead on the health of lead workers in high risk operation to lead. Blood lead (PbB), zinc protoporphyrin in whole blood (ZPP), -aminolevulinic acid in urin (ALAU), Hematocrit (Hct) and hemoglobin (Hb) were selected as and index of lead exposure. Questionnaires of 15 lead related symptoms were provided to all study subject and filled up by themselves and reconfirmed the symptom answers by interviewing medical doctor. While the mean value of PbB, ZPP and ALAU of lead workers in secondary smelting industries were 62.7±14.6㎍/㎗, 103.1±60.5㎍/㎗ and 7.4±10.3mg/liter, those of lead workers in litharge making industries were 58.5±14.1㎍/㎗, 74.2±45.2㎍/㎗ and 5.3±7.9mg/liter respectively, and there were statistically significant difference of mean values between two groups. Simple linear regression analysis of PBB and ZPP and ALAU showed the steeper slope in secondary smelting industries than litharge making industries. Higher symptom prevalence rates of lead exposed group were observed in lead colic related symptom (S4) and neuromuscular symptoms compared with non-exposed workers. The prevalence of neuromuscular symptoms only showed dose-response relationship by the increase of PbB and ZPP. But more statistical significances were observed in neuromuscular symptoms by the increase of PbB than ZPP. On stepwise multiple regression using total symptom score as a dependent variable and PbB, ZPP, ALAU, Hct, Hb, age and work duration as a independent variables only ZPP and age contributed to the lead related symptoms.

우리나라 연노출 근로자들의 체내 총 연부담과 건강영향에 대한 단면연구

황보영,리갑수,김용배,이성수,안규동,이병국 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.1

목적 : 직업적 연노출 근로자들과 대조군을 대상으로 총 체내 연부담량 (혈중연량, 경골연량, 착화연량 등)과 이들이 인체에 미치는 건강영향의 관련성을 규명. 방법 : 조사 변수는 체내 총연부담 (혈중 연량, XRF를 이용한 경골연량, DMSA 착화연량)과 이들의 인체에 대한 영향(ALAU, creatinine 청소율, 혈색소, 혈압, 연관련 증상)들이었다. 조사대상은 연노출자 775명과 대조군 135명이었다. 결과 : 연노출 근로자들의 혈중 연량은 대조군보다 높았고 (31.7 ㎍/㎗ vs 5.3 ㎍/㎗), 경골연량도 높았다 (36.4 ㎍/g bone mineral vs. 5.8 ㎍/g bone mineral). 4시간 DMSA착화연량은 연노출군에서 186.2 ㎍이었고, 대조군은 조사되지 않았다. 혈색소와 적혈구용적치는 대조군이 높았으며 (14.2 g/㎗ vs. 15.3 g/㎗과 42.4% vs. 44.7%), 소변 ALA, ZPP와 BUN은 노출군에서 높았다 (각각 2.1 ㎎/ℓ vs. 1.6 ㎎/ℓ, 79.7 ㎍/㎗ vs. 38.5 ㎍/㎗, 14.4 vs. 13.1). 크레아티닌 청소율은 노출군에서 114.3 ㎖/min였다. 근육신경계 증상과 일반적인 연관련 증상은 노출군에서 높았다. 경골연량, 흡연량, 음주횟수, 신장, 연령들이 혈중 연량에 영향을 주는 변수로 확인되었다. 경골연량에 영향을 미치는 변수는 혈중 연량, 직력, 혈구용적치, 키 등이었다. DMSA 착화연량에 영향을 주는 요소는 혈중 연량, 크레아티닌 청소율, 연령, 경골연량이었다. 뇨중 ALA와 관련있는 변수는 DMSA착화연량, ZPP, 경골연량, 연령, 체중 등이었다. 크레아티닌 청소율에 영향을 주는 것은 DMSA 착화연량과 소변의 ALA량이었다. DMSA착화연량은 수축기 혈압에 영향을 미치는 것으로 나타났으며, 일반적인 연중독증상과 부의 관련성이 있는 것으로 나타났다. 결론 : DMSA 착화연량은 뇨중 ALA농도, 크레아티닌 청소율, 수축기 혈압, 일반적인 연중독 증상에 영향을 미치는 것으로 나타나 DMSA 착화연량이 생물학적 활성을 갖는 지표임이 확인되었다.

연 폭로시 성별에 따른 혈중 Zinc Protoporphyrin의 양-반응 관계

김용배,리갑수,황규윤,이성수,안규동,이병국,안현철,Kim, Yong-Bae,Lee, Gap-Soo,Hwang, Kyu-Yoon,Lee, Sung-Soo,Ahn, Kyu-Dong,Lee, Byung-Kook,Ahn, Hyun-Cheol 대한예방의학회 1999 Journal of Preventive Medicine and Public Health Vol.32 No.4

Objectives : To evaluate whether a relation between blood lead and zinc proto porphyrin(ZPP) was modified by gender in Korean lead workers. Methods : A cross-sectional study was conducted with 1,304 male and 101 female subjects in 1997. The relation between blood lead and ZPP were evaluated with linear, exponential, and quadratic models. Then, the different effect of gender on the relation was examined by adding the interaction terms in the each model. Results : $Mean{\pm}SD$ of blood lead and ZPP level was different between male$(27.7{\pm}10{\mu}g/dl\;and\;51.3{\pm}23.4{\mu}g/dl)$ and female subjects$(22.5{\pm}9.2{\mu}g/dl\;and\;78.7{\pm}38.6{\mu}g/dl)$. After adjusting for possible confounders, the effect modification by gender was significant in linear$(\beta=1.119,\;p<0.001)$, exponential$(\beta=Exp(0.008),\;p<0.05)$, and quadratic model$(\beta=1.388,\;p<0.001)$. In separate analysis, a quadratic relation between blood lead and ZPP was shown in male lead workers$(\beta=0.036,\;p<0.001)$, but an exponential relation in female lead workers$(\beta=Exp(0.029), p<0.001)$. Conclusion : Our data showed that the increasing rate of ZPP in female were always higher than in male lead workers, suggesting that females were more susceptible to occupational lead exposure than males.

모 공단지역 사무직 근로자들의 요중 N-acetyl-$\beta$-D-glucosaminidase 역가에 관한 연구

김화성,리갑수,이성수,안규동,이병국,Kim, Hwa-Sung,Lee, Gap-Soo,Lee, Sung-Soo,Ahn, Kyu-Dong,Lee, Byung-Kook 대한예방의학회 1994 Journal of Preventive Medicine and Public Health Vol.27 No.3

In order to identify the necessary information of biochemical Indices for renal effect of lead for the early detection in medical surveillance of lead worker, the reference values of urinary N-acetyl-$\beta$-D-glucosaminidase (NAG) activities were studied with 205 office workers in one industrial complex area who were not exposed to lead occupationally. While study variables selected for lead exposure were blood lead (PbB), blood zinc protoporphyrin(ZPP) and $\delta$-aminolevulinic acid (DALA) in urine, those for renal effect were urinary N-acetyl-$\beta$-D-glucosaminidase (NAG), blood urea nitrogen (BUN), serum creatinine(Cr), serum uric acid (Ua), and urinary total protein(U-TP). The results obtained were as follows: 1. The mean values of blood lead, ZPP and DALA in all subjects were $14.39{\pm}4.02{\mu}g/dl,\;21.61{\pm}8.00{\mu}g/dl,\;and\;2.73{\pm}0.90mg/l$ respectively. 2. The mean value of urinary NAG activities in all subjects was $3.51{\pm}2.01U/l$. The mean value of urinary NAG activities, which calculated from NAG activities divided by urinary creatinine concentration (CNAG), was $5.42{\pm}5.53U/g$ creatinine and log-arithmic normal distributed. 3. The reference value of urinary NAG activity was 12.06 U/g creatinine(95% CU=10.57-14.76 U/g creatinine). 4. Logarithmic CNAG(r=0.781 p<0.0l), U-TP(r=0.670 p<0.01) and ZPP(r=0.172 p<0.05) showed statistically significant correlation with CNAG.

의료기사의 누적 외상성 증후군 증상에 관한 조사

박찬호,리갑수,이성수,안규동,이병국 순천향대학교 산업의학연구소 2001 순천향산업의학 Vol.7 No.1

The cumulative trauma disorder is a disease group of musculoskeletal systems developed by repeated work, which became greate concern in occupational health problem in Korea recently. Many paramedicals working in the department of Laboratory, Radiology, and Rehabilitation of the hospital have been engaged in the simple repetitive hard works causing cumulative trauma disorder. This is the study on the cumulative trauma disorder in those medical technicians. Total 285 (180 male, 105 female) medical technicians and office workers working in the hospital were surveyed with the self-administered questionnaires. They included the questions such as age, sex, marital status, education, height, weight, smoking and drinking history as a general characteristics and work department, kind of work, work duration, work conditions as a work characteristics. And also subjective symptoms related with the work in each region of body area were questioned. Among the work conditions, there were significant differences between medical technicians and office workers (e.g., high in medical technicians) in daily works lifting patients or heavy equipments, works moving continuously and rapidly, works with uncomfortable position, works keeping neck and upper arms in uneasy position. Complained rate of subjective symptoms was significantly higher in physical therapist and in the group of work duration over 10 years. The significant symptoms were pain, abnormal sensation, burning sensation. The significant factors affecting the subjective symptoms were female and work duration over 10 years for wrist area, female and current smoking for knee or ankle area, physical therapist, work duration between 6 and 9 years for lumbar area, female and radiologic technicians and work duration over 6 years for shoulder area. None was significant for neck area.

우리나라 연 작업자들의 연폭로 수준에 관한 연구

조인숙,김용배,리갑수,김화성,황규윤,장봉기,이성수,안규동,이병국 순천향대학교 산업의학연구소 1999 순천향산업의학 Vol.5 No.1

To assess lead exposure in Korean lead workers, 2047 male lead workers in 17 lead using industries were studied. Study population were divided into 4 occupation categories such as storage battery industry(type 1), secondary smelting and litharge making industries(type 2), PVC stabilizer making industries(type 3) and primary smelting and related industries (type 4). Blood lead and zinc protoporphyrin in whole blood (ZPP) were selected as an index of lead exposure. Hemoglobin and hematocrit were also checked. Fifteen questionnaires of lead related symptoms were provided to all lead workers and filled up by themselves and confirmed by medical doctors. Personal variables such as age, work duration, smoking and drinking habits were also collected. the results were as follows. 1) The mean blood lead, ZPP and hemoglobin of all lead workers were 29.7+12.6㎍/100㎖, 56.5+38.6㎍/100㎖ and 14.6+1.3 gm/100㎖ respectively. 2) While the mean blood lead of lead workers in type 1, 2, 3 and 4 were 28.6+11.6㎍/100㎖, 46.2+15.3 ㎍/100㎖, 46.8+12.1 ㎍/100㎖ and 26.2+10.2 ㎍/100㎖, the mean value of blood ZPP of those workers were 53.6+32.6 ㎍/100㎖, 108.1+87.1 ㎍/100㎖, 98.9 +54.9 ㎍/100㎖ and 45.8+19.5 ㎍/100㎖ respectively. 3) The percents of lead workers whose blood lead were 40-59.9 ㎍/100㎖ and over 60.0 ㎍/100㎖ were 17.6% and 2.1% respectively. Those whose blood lead were 40-59.9 ㎍/100㎖ and over 60.0 ㎍/100㎖ were 15.18% and 0.96% for type 1, 43.59% and 21.79% for type 2, 58.89% and 12.22% for type 3 and 11.82% and 0% for type 4 respectively. 4) The percents of lead workers whose blood ZPP were 100-149 ㎍/100㎖ and over 150 ㎍/100㎖ were 5.17% and 3.17% respectively. Those whose blood ZPP were 100-149 ㎍/100㎖ and over 150 ㎍/100㎖ were 4.66% and 2.04% for type 1, 10.26% and 25.64% for type 2, 23.33 and 13.33% for type 3 and 1.28% and 0.32% for type 4 respectively. 5) The prevalence rate of smoking and drinking of male lead workers in all lead industries were 70.8% and 71.0% respectively. While the mean blood lead of smoker, non-smoker, drinker and non-drinker were 30.24+12.58 ㎍/100㎖, 28.35+12.7 ㎍/100㎖, 30.24 ㎍/100㎖ and 28.74 ㎍/100㎖ respectively, the mean blood ZPP of those were 55.7+37.1 ㎍/100㎖, 58.4+41.9 ㎍/100㎖, 55.7+36.5 ㎍/100㎖ and 58.4+43.3 ㎍/100㎖ respectively. 6) While the correlation of hematocrit corrected blood lead with other lead exposure variables were higher than non-corrected blood lead, the correlation of log-transformed ZPP with other lead exposure variables were higher than non-corrected blood ZPP. 7) The most frequent symptom among 15 lead related symptom questionnaires was 'general fatigue' and the next one was 'feeling irritated with disturbance' and least one was 'acute abdominal pain around the umbilicus' in all lead workers. The overall prevalence of lead workers in storage battery industry and primary lead smelting industry were higher than secondary lead smelting and PVC stabilizer making industries. 8) The prevalence of lead related symptoms was a little higher in 13 symptoms in smokers than non-smokers and in 14 symptoms in drinker than non-drinkers, but they were not statistically significant. 9) Stepwise multiple regression analysis, using overall symptom prevalence as a dependent variable blood lead, blood ZPP, hemoglobin, age, work duration, drinking and smoking habits as independent variables, indicated that smoking habit, drinking habit and age were significantly contributed to the dependent variable. 10) The slopes of simple linear regression of blood lead (independent variable) with blood ZPP and log-transformed ZPP as dependent variable were different among 4 types of lead industries. The slope of lead industries with low mean blood lead were less steeper than those with high mean blood lead.