인천지역 한 대학병원에서 진단된 기관지천식 중 직업관련성 천식

채창호,진영우,김은아,최승원,강성규,최용휴 大韓産業醫學會 1999 대한직업환경의학회지 Vol.11 No.2

Bronchial Asthma could be developed by occupational origin. 4-16% of bronchial asthmas are known to be related to occupational exposure. However, occupational asthma has not been reported from the periodic occupational health examination, but reported through case report from clinicians. The authors analysed hospital records to find out work-related bronchial asthma and their occupational characteristics at a university hospital in Inchon. All records which were confirmed as bronchial asthma in adult by an allegist from June, 1996 to May, 1998 were selected. Through record reviewing, any suspected work related asthma was selected and the inteview was done by phone or at the out-patient clinic. The possible cases were confirmed by additional tests including specific bronchial provocation test. Sixteen(3.9%) out of 411 bronchial asthma were confirmed as work-related asthma. Eight cases out of 16 worked at furniture industry, three worked at dye manufacturing and two worked at musical instrument manufacturing industry. Others worked at farm and machinary industry. The confirmed asthmogen were toluene diisocyante(8), reactive dye(3), and grain dust(1). None of the cases was detected as work-related asthma in the periodic health examination. Twelve out of sixteen occupational asthma patients discontinued their work. The results suggested that many patients with occupational asthma were not reported and the periodic health examination was not an effective system for detecting the workrelated asthma. Thus setting up the surveillance system involving allergist or pulmonologist would be important to detect and prevent occupational asthma.

인천지역 한 대학병원에서 진단된 수근관 증후군환자의 직업 관련성

최용휴,박정일,임종한,강성규,채창호 大韓産業醫學會 1999 대한직업환경의학회지 Vol.11 No.3

Objectives: The study was carried out to evaluate the work-relatedness and the occupational distribution in 147 carpal tunnel syndrome(CTS) cases diagnosed at a university hospital from May 1996 to May 1998. Methods: We obtained the information on disease appearance, occupational history including job content and other life style by medical records and telephone interviews. Results: Of the 147 patients with carpal tunnel syndrome, 51 patients(34.7%) were shown to be work-related. Work-related CTS were most frequent in elementary workers (21 case, 41.2%). The other cases were 15(29.4%) workers in service and shop and market sales, 9(17.6%) workers in craft and related trades, 4(7.8%) workers in skilled agriculture and fishery. Only two workers had claimed to the Industrial Accident Compensation Insurance, but no one has been admitted as an occupational CTS yet. Conclusions: It is suggested that arrangements of surveillance system for adequate control of occupational CTD is neccessity.

작업관련성 근골격계질환으로 요양승인된 사례 분석

안연순,최용휴,강성규,정호근 大韓産業醫學會 2002 대한직업환경의학회지 Vol.14 No.2

목 적 : 이 연구는 1999년 근로복지공단에서 업무상질병으로 인정한 근골격계질환을 정밀분석하여 질병의 종류와 특성을 밝힘으로서 직업성 근골격계질환 예방사업이나 업무상질병 판정의 기초자료로 제공하고자 실시하였다. 방 법 : 근로복지공단 주전산망을 통하여 재해일자가 1999년 1월 1일부터 12월 31일까지인 근로자중 2000년 6월 30일까지 요양이 승인된 업무상 질병자 2,333명을 파악하고 이 중 뇌심혈관계질환자 1,348명과 직업병자 575명을 제외한 근골격계질환자 410명을 연구대상으로 하였다. 소속 사업장 또는 연구대상 근로자에 대하여 우편 또는 전화 면담조사를 실시하여 업무상 질병자의 성, 연령, 질병 관련 작업기간, 질병 발생원인, 업종, 직종, 질병종류, 사업장규모 등에 대한 조사를 실시 후 기술분석을 시행하였다. 결 과 : 근골격계질환자 410명 중 남성이 310명(75.6 %), 여성이 100명(24.4 %)이었다. 연령별로는 30-39세가 143명(34.9 %)을로 가장 많았고, 질병관련 근무기간은 1년 이상 5년 미만 근무자의 비율이 36.0 %로 가장 높았다. 소속 사업장 규모는 5인 이상 50인 미만 사업장이 38.0 %로 가장 높았다. 종사업종은 제조업이 235명(57.3 %)을로 가장 많았고 다음으로 운수업 46명(11.2 %), 건설업 25명(6.1 %) 순 이었다. 제조업 중에는 자동차 밑 트레일러 제조업과 운송장비제조업이 각각 58명, 35명으로 가장 많았다. 직종별로는 장치, 기계조작 및 조립 종사자가 129명(36.5 %)을로 가장 많았고 다음으로 단순 노무 종사자 90명(25,5 %), 기능원 및 관련기능종사자 63명(17.8 %), 서비스 종사자 28명(7.9 %) 순 이었다. 질병별로는 전체 424건 중 요부질환이 232건(54.7 %)이었고, 경부 및 상지질환이 183건(43.2 %), 하지질환이 9건(2.1 %)이었다. 요부질환자의 평균 연령은 36.5세, 평균작업기간은 4.7년이었고, 질병 종료는 요추간판탈출증이 134건(57.5 %)을로 가장 많았다. 질병 발생원인은 반복작업에 의한 경우가 54건, 비반복성 원인에 의한 경우가 89건이었는데 반복작업은 부적절한 작업자세로 인한 요통이 23건으로 가장 많았고, 비반복성 원인은 들기작업에 의한 요통이 27건으로 가장 많았다. 결 론 : 이 연구는 재해발생 시점과 조사시점이 많은 차이가 있어 근골격계질환과 관련하여 중요한 많은 항목들을 제대로 조사하지 못하였고, 특히 발생 원인은 약 70%만 조사가 가능하여 결과가 선택치우침에 의해 도출되었을 가능성을 배제할 수 없다. 그러나, 이 연구를 통하여 우리나라에서 업무상질병으로 인정받은 근골격계질환을 분석함으로써 연령, 성, 작업기간 등 질병 발생 근로자의 특성과 고위험업종 및 직종, 발생 원인 등을 전체적으로 파악할 수 있었던 것은 나름대로 의의가 있다. Objectives : The purpose of this study was to analyze the characteristics of work-related musculoskeletal diseases, as listed by the Korea Labor Welfare Corperation(KLWC) Methods : Using the database of the KLWC, we collected information from 410 approved occupational musculoskeletal disease cases, which occurred between 1 January and 31 December 1999 and were approved by 30 June in 2000. We investigated the characteristics of the disease using a mail survey and telephone interviews. The characteristics we investigated included : sex, age, disease-related working duration, process of disease occurrence, type of enterprises, etc. Results : Men accounted for 75.6 % (310 workers) of the approved cases. The most common age group was 30-39 years (n=143, 34,9 %). The mean disease-related working duration was 5.7 years, and the most commonly had a work-duration of 1-5 years (n=108, 36.0 %). The major industrial types of enterprise were manufacturing (235 workers, 57.3 %), transportation (46 workers, 11.2 %), and construction (25 workers, 6.1 %). Within the manufacturing industry, the most common was motor vehicles and trailers manufacturing. Within the group, the most common jobs were plant or machine operators and assemblers (129 workers, 36.5 %), elementary occupations (90 workers, 25.5 %), and craft and related trades workers (63 workers, 17.8 %). The majority of the diseases involved lumbar problems (232 cases, 54,7 %), neck and upper extremity diseases (183 cases, 43.2 %) and lower extremity diseases (9 cases, 2.1 %). In the cases of lumbar disease, the mean age and working duration was 36.5 years and 4.7 years, respectively. Fifty-four cases of lumbar diseases were due to repetitive work and 89 due to non-repetitive work. Bad posture at work was the most common cause for those doing repetitive woek(23 cases), and lifting the most common cause of problems in the non-repetitive work cases (27). Conclusions : We were able to elucidate the characteristics of workers with approvd occupational musculoskeletal disease through this study. Many approved cases occurred in women, and workers performing repetitive work, of these herniated nucleus pulposus occurred in many workers performing simple repetitive works without serious external forces. This suggests that a prevention policy for occupational musculoskeletal disease must be established, to focusing on the above-mentioned high-risk groups.

상지 단순반복 작업자의 수근관증후군에 대한 연구

진미령,최용휴,이세휘,김규상 大韓産業醫學會 1998 대한직업환경의학회지 Vol.10 No.4

The objectives of this study were to investigate the prevalence and risk factors of occupationally related carpal tunnel syndrome(CTS) among workers employed in services and manufacturing industries analysing the sensitivity and specificity of clinical symptoms and signs. Three surveys were made for this study. The first survey was done for 1,447 workers employed by 25 companies. The jobs of the employees were repetitive works at VDT and assembly lines. Therefore, employees could be divided to two groups, doing repetitive works and non repetitive works. The second survey was made for 189 workers who were randomly selected from 517 workers complained some symptoms at their hands and wrists. We examined their symptoms and carried out neurological examinations for CTS(Tinel's sign, Phalen's sign, pin prick test, carpal compressive test, toniquet compression test). The third survey was made for nerve conduction study(NGS) for 57 workers who had shown positive signs for CTS. The main results of this study were as follow: 1. From the first survey, we have found that there were significant statistical differences in getting uncomfortable neuromuscular symptoms by sex, job type, total working hours during a week, duration of current work, and kinds of work. Odds ratio in male vs female, repetitive vs non repetitive, service vs manufacturing companies, total working hours during a week, and duration of current work were 1.867(95% CI=1.467-2.377), 1,680(95% CI=1.121-2.279), 1.663(95% CI=1.123-2.279), 1.016(95% CI=1.006-1.027) and 1.283(95% CI=1.097-1.501) respectively. 2. From the second survey, we have found that 46 peoples (25.0%) were positive for one or more than one signs in neurological examination of NIOSH criteria. Positive findings from neurological examinations were high among workers of low level of education(p-value=0.008), manufacturing jobs(p-value=0.00), long hours a week(p-value=0.028), and long duration of current work(p-value=0.00). 3. From the third survey, we diagnosed 35 peoples (61.4%) had CTS by NCS. They had abnormally delayed latent period or velocity in median nerve conduction velocity.

모 제약회사 근로자들의 직업성 천식 유병률과 약제 분말 노출수준

오성수,최용휴,김은아,이영목,장재길,유장진,박승현,김태균,정수영,김규상,강성규 大韓産業醫學會 2006 대한직업환경의학회지 Vol.18 No.2

목적: 제약회사에서 직업상 천식의 유병 규모를 파악하고 작업공정에 대한 작업환경 측정을 통해 제약회사의 약제 분말에 대한 노출수준을 평가하고자 하였다. 방법: 제약회사에서 약제 분말에 노출되는 근로자를 대상으로 천식을 선별하기 위하여 설문조사 및 진찰, 혈액검사, 폐기능 검사 그리고 피부단자시험을 실시하였고, 각 부서별 공정에 따라서 총분진과 항생제 또는 효소제 분말에 대한 작업환경 측정을 실시하였다. 직업상 천식이 의심되는 근로자에 대하여 기관지과민성에 대한 검사(메타콜린을 이용한 비특이 기관지유발시험)와 약제 분말 기관지유발시험을 실시하여 확진하였다. 결과: 설문조사 및 진찰에서 작업 관련 천식 증상이 있는 근로자는 11명(34.4%)이었고, 약제 분말을 이용한 피부단자시험에서 1+ 이상 반응을 보인 근로자 10명(31.2%)이었다. 비특이 기관지유발시험 결과 8명(25.0%)이 양성(PC20 ≤16 mg/ml)이었다. 약제 분말 기관지유발시험을 통해 직업상 천식으로 확진된 근로자는 5명(15.6%)이었다. 작업환경 측정에서 원료를 충진하거나 투입하는 작업 그리고 정립작업에서 약제 분말에 대한 노출이 많았다. 결론: 제약회사에서 직업상 천식은 주로 제조공정 중 약제 분말에 노출된 근로자에서 발생하여, 증상 및 직업성 천식의 유병률이 높았다. 따라서 원료를 충진 또는 투입하는 작업과 정립작업 등 제조과적에서 약제 분말 노출을 줄이기 위한 세심한 주의가 필요하여, 약제 분말을 취급하는 근로자에 대해서는 천식 증상 조사뿐 아니라 정기적으로 피부단자시험, 비특이 기관지유발시험 등을 실시하여야 할 것이다. Objectives: After the investigation of one worker with occupational asthma, we surveyed the preva- lence of occupational asthma and the exposure level of pharmaceutical dust of 32 workers in a pharmaceutical company. Methods: Thirty-two of the 90 employees participated in the survey which consisted of questionnaire, blood sampling, spirometry and skin prick tests with 8 common allergens as well as 9 antibiotics and 2 enzymes. Various indices of the working environment were also measured. Subjects who had a symptom suggestive of work-related asthma or positive skin prick test were further investigated by PC20 methacholine. Nine subjects who had a PC20 result of 16 mg/ml or less (n=7) or had work-related symptoms and positive skin prick test (n=2) were referred to undergo a specific bronchial provocation test to phar- maceutical dust in an academic allergic disease center. Results: Eleven of 32 workers (34.4%) had a work-related symptom suggestive of occupational asthma. Ten (31.2%) showed positive skin prick test. 8 (25.0%) had a PC20 result of 16 mg/ml or less (indicative of significant bronchial hyperresponsiveness), and 5 (15.6%) had a positive result on the specific bronchial provocation test. Exposure levels of stuffing, input of raw materials and screening process were relatively high. Conclusions: This survey showed that pharmaceutical workers have an increased risk of occupational asthma. Although pharmaceutical factories maintain a relatively good working environment, careful control of respiratory tract exposures, especially during stuffing, input or raw materials and screening process, is important to prevent occupational asthma. Pharmaceutical workers need to undergo regular skin prick and methacholine bronchial provocation tests, as well as asthmatic symptom survey, to ensure the early detection and prevention of occupational asthma.

수부 및 수지의 누적외상성질환 실태 및 작업관련성

김규상,최용휴,강성규 대한인간공학회 1999 대한인간공학회 학술대회논문집 Vol.1999-2 No.-

전기ㆍ전자제조업체 근로자의 작업위험성과 직업성 근골격계질환

김규상,이동경,최용휴,정병용,정호근 대한산업의학회 2002 대한직업환경의학회 학술대회 논문집 Vol.- No.-

포스터발표 / P-24 : 톨루엔 노출근로자의 내부흡수량 평가를 위한 생물학적 모니터링

양정선,이미영,최용휴,김대성,강성규 한국분석과학회 1999 학술대회논문집 Vol.- No.-

특수건강진단기관 청력 검사실의 배경소음

김규상(Kyoo Sang Kim),최용휴(Yong-Hyu Choi),원용림(Yong Lim Won),강성규(Seong-Kyu Kang) 대한직업환경의학회 2004 대한직업환경의학회지 Vol.16 No.3

VDT작업이 안 조절반응과 동공 대광반사에 미치는 영향

김은아,김양호,진영우,채창호,최용휴,문영한,Kim, Eun-A,Kim, Yang-Ho,Jin, Young-Woo,Chai, Chang-Ho,Choi, Yong-Hyu,Moon, Young-Hahan 대한예방의학회 1997 예방의학회지 Vol.30 No.3

6명의 20대 여성을 대상으로 VDT작업으로 인한 조절반응 및 동공대광반사의 작업부과에 따른 변화와 다른 사무작업을 부과할 때와의 차이를 보았다. 그 결과 다음과 같은 결과를 얻었다. 1. VDT작업에서 작업부과 시간이 증가함에 따라 조절 수축속도가 감소했으며 1시간의 휴식시간 후에는 현저하게 증가했고 다시 작업을 부과함에 따라 감소하는 경향을 보였다. 조절 수축속도의 변화보다는 뚜렷하지 않지만 이완속도도 VDT작업부과에 따라 감소되고 휴식에 의한 회복되는 경향을 보였다. 2. 일반 사무작업과 근거리 사무작업에서는 조절 수축속도에서 VDT작업부과때와 같은 반응은 보이지 않았으며, 근거리 사무작업에서 이완속도가 작업부과에 따라 감소하였으나 휴식 후 회복되지 않았다. 3. 동공대광반사에서 최초동공직경, 최초동공면적은 VDT작업에서만 작업시간의 증가에 따라 유의한 감소를 보였는데 휴식 후 회복되지 않았다. 이러한 결과는 조절 수축속도의 변화, 조절 이완속도, 동공직경과 면적의 변화가 VDT작업의 특성을 연구하는데 사용될 가능성을 보여주며, 이를 위해서 연구대상이 개인차, 생체리듬, 감정적 자극 등을 보정한 연구가 필요하다고 생각된다. We studied on change of lens accommodation and pupil light reflex caused by VDT work in six women and compared them with those of other office works. The results were as follows. 1. In VDT work the accommodation contraction velocity decreased during the first 2-hr VDT task, then recovered markedly by the end of the one-hour lunch break, and decreased again by the end of the 2nd 2-hr VDT task. Changes of relaxation velocity showed similar pattern although it was less typical than that of contraction velocity 2. There was no marked change in accommodation contraction velocity and amplitude of accommodation in general office work and near-distance office work, and in the near-distance office work accommodation relaxation velocity decreased according to work load without recovery after lunch break. 3. Initial pupil diameter, initial pupil area of light reflex decreased significantly during VDT task only in VDT work and didn't recover after lunch break. These results suggest possibility that changes of accommodation contraction velocity, accommodation relaxation velocity, near point distance, and pupil diameter and area are useful in evaluating characteristics of VDT work. For this, more research adjusted individual differences, circadian rhythm, emotional stress needs.