표면근전도와 전자각도기를 이용한 자동차 부품 조립작업 위험요인 평가

강동묵,이철호,,신용철,김은아,우지훈,조병만,이수일 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Objectives: As automobile part manufacturing is characterized by high speed and high repetition, observation methods which are usually utilized for static posture are inappropriate to evaluate musculoskeleatal risk factors. This study quantified the risk factors of musculoskeletal disorders on the forearm and suggested exposure limits by estimating the risk factors using surface electromyography (EMG) and electrogoniometer. Methods: Ten percent of the total workers at 3 automobile part manufacturing factories were randomly selected, and 99 male workers were recruited as study subjects. The study was conducted during May 2003 to September 2004. The workers were equipped with electrogoniometers on the wrist and the elbow, surface EMGs on the skin of the flexor digitorum superficialis (FDS) and extensor carpi radialis (ECR) muscles, and the heart beat recorder during work as indicators of joint movement, local muscle tension and physical work load, respectively. Results: After controlling for age, body mass index and job stress, wrist flexion maximum angle, FDS relative activity (RA) and ECR RA were significantly associated with forearm musculoskeletal symptoms. The odds ratios of the forearm were 5.0(95% CI: 1.1-22.7), 14.0(95% CI: 1.5-128.8) and 7.3(95% CI: 1.1-49.4) for wrist flexion maximum angle more than 76˚, FDS RA more than 2.8%, and ECR RA more than 3.5%, respectively. Conclusions: Joint angle and focal muscle activity were associated with forearm musculoskeletal symptoms. To reduce forearm musculoskeletal symptoms among automobile part manufacturers, the wrist flexion angle, and FDS and ECR activity need to be reduced below the guidelines recommended in this study.

용접공들의 망간 폭로와 건강장해에 관한 연구

문덕환,강동묵,손병철 大韓産業醫學會 1999 대한직업환경의학회지 Vol.11 No.4

Objectives : In order to evaluate the degree of manganese exposure and its health hazards effect on welders in manufacturing industry. Methods : The author measured airborne, blood and urine concentrations of manganese and blood chemistry, and also observed clinical symptoms and signs on 60 welders for case and 60 non-welders for control working in manufacturing industry by age maching method. Results : The geometric means of blood and urine concentrations of manganese were 1.13±1.38 ㎍/㎗ and 2.52±1.37㎍/ℓ for Welders group, 1.09±1.68 ㎍/㎗ and 1.86±1.34 ㎍/ℓ for Non-welders group. Airborne concentration of manganese was 0.15±1.66㎎/㎥ for exposured group, and the urinary mean concentration of manganese was statistically significant difference between exposured and non-welders group (P<0.05). Clinical signs in welders group were palmomentle reflex(23.3%), tremor(20.0%) and grabellar sign(5.0%). Symptoms in welders group were fatigue(66.7%), amnesia(66,7%), excessive sweating(51.7%), nervousness(51.7%), general weakness(48.3%) and arthralgia(46.7%) and so on, and there was statistically significant difference compared to non-welders group(P<0.05). Manganese effects on blood chemistry were not observed. There were statistically significant correlation between manganese concent- ration in blood and urine(r=0.269), airborne and urine(r=0.601) and airborne and blood(r=0.268). Conclusion : The author suggest that further studies are followed to evaluate the health status of welders whose blood and urine manganese concentrations were below normal reference level, and to establish the questionnaire and the diagnostic tools for early detecting the chronic manganese poisioning on welders.

한국인 직무 스트레스 측정도구의 개발 및 표준화

장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

피로와 의료이용, 업무상 사고 및 질병결근

장세진,고상백,강동묵,김성아,정진주,이철갑,강명근,현숙정,조정진,차봉석,박종구 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Objectives: This study examined the relationship of fatigue to medical utilization, occupational accident and sickness absence. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project, 2002~2004). A total of 30,146 employees categorized within the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were recruited. A structured-questionnaire was used to assess the participants' sociodemo-graphics, job-related factors, health-related behaviors, personality trait, self=perceived fatigue (MFS) and the frequency of medical utilization, occupational accident and sickness absence. Data on medical utilization and occupational accident were confirmed from company health records. Chi-square test and logistic regression analysis were used to elucidate the relationship of self-perceived fatigue to medical utilization, occupational accident and sickness absence. Results: In logistic regression analyses, self-perceived fatigue was associated with medical utilization (outpatient), occupational accident and sickness absence although the strength of the associations was higher in the blue collar workers except for medical utilization. For medical utilization, the white collar worker's adjusted odds ratios of outpatient utilization for workers scoring in the third quartile and the highest quartile, compared to workers scoring in the lowest quartile were 1.50 (95% CI: 1.20-1.87) and 2.16 (95% CI: 1.69-2.75), respectively. The blue collar workers' adjusted odds ratios of outpatient utilization for workers scoring in the second (OR: 1.23, 95% CI: 1.06-1.43), third (OR: 1.42, 95% CI: 1.22-1.66) and highest quartile (OR:1.83, 95% CI: 1.55-2.17), respectively, compared to workers scoring in the lowest quartile were statistically significant. However, no associations were found between fatigue and inpatient utilization for either the white or blue collar workers. The blue collar workers' adjusted odds ratios of being injured for workers scoring in the second, third and highest quartile were 1.41 (95% CI: 1.00-2.00), 1.57 (95% CI: 1.10-2.22) and 2.41 (95% CI: 1.69-3.44), respectively, compared to those scoring in the lowest quartile, but, those of the white collar workers were not significant. There was more likely to an increased risk of sickness absence in workers scoring in the second, third and highest quartile compared to those scoring in the lowest quartile in both white and blue collar workers, but the magnitudes of risk were higher in the blue collar workers than the white collars workers. Conclusion: This result suggests that fatigue is a determinant predictor of medical utilization, occupational accident and sickness absence, and that the pattern of risks for the three outcomes differs according to the occupational type. Some limitations of this study and considerations for future study were also discussed.

유기용제 폭로가 여성 근로자들의 월경에 미치는 영향

김대환,이채관,김휘동,강동묵,문덕환,김정호,손병철,이창희,이채언 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.1

유기용제는 산업장에서 널리 사용되고 있다. 특히 여성근로자들의 폭로기회가 증가하고 있으며 이로 인한 자연유산, 수태능력 감소, 월경이상 등이 보고되고 있다. 따라서 유기용제 폭로가 여성근로자들의 월경에 미치는 영향을 보기 위해 설문조사와 월경주기별 여성생식 호르몬(progesterone, estrogen) 분석을 하였다. 그 결과 폭로군에서 progeterone의 억제효과가 유기용제에 폭로되는 여성근로자들의 다양한 월경이상을 초래할 가능성이 있는 것으로 생각된다. ■ Objectives This study was conducted to evaluate the effects of menstrual function in female workers exposed to organic solvents. ■ Methods Rates of menstrual disorders were studied in 87 female workers with exposure to organic solvents(Cn/Hn-value 0.713) in a factory manufacturing shoes and compared with 83 general female workers who had no exposure to organic solvents, Detailed menstrual and reproductive histories were obtained by personal interview using structured questionnaire, and plasma concentrations of progesterone and estrogen were assayed by radioimmunoassay(RIA). ■ Results The rates for menstrual irregularity, menstrual duration, blood clot in menstrual flow and dysmenorrhea were not significantly different in both groups. Number of using menstrual pad was significantly higher and the plasma level of progesterone during 6-11th day of menstrual cycle was significantly lower in the exposed group compared with non-exposed group(P<0.05). ■ Conclusions It seemed to be suppression effect of organic solvents on the reproductive hormones(progesterone and estrogen) in female workers. But there was no evidence that menstrual disorder was likely to result from exposure to organic solvents, because other behavioral, psychological and work related factors may also affect menstrual function.

미용업 종사자들의 피부, 호흡기 및 근골격계 자각증상에 관한 유병률

이종태,박봉진,엄상화,김성준,강동묵,손혜숙,정귀원,강민숙,박성희 大韓産業醫學會 1999 대한직업환경의학회지 Vol.11 No.3

Objectives: Present study was conducted to evaluate work-related symptom prevalence among hairdressers. Methods: Exposed group comprised 184 employee employed 73 hair salons in 6 district of Pusan city, and non-exposed group comprised 119 people living recent apartments. A trained interviewer interviewed them with organised questionnaire which included dermatologic, respiratory and musculo-skeletal symptoms. Results : Prevalence of hand eczema was 28.3% in exposed group, and 5.8% in non-exposed group. Adjusted odds ratio for age and atopy history was 4.30(2.34-7.93). Prevalence of respiratory symptom (coughing) in exposed group was 22.1%, and 9.4% for non-exposed group. Adjusted odds ratio for coughing which was adjusted for age, smoking and atopy history was 2.76(1.32∼5.78). Prevalences of musculo-skeletal symptoms among exposed group were neck(59.9%), shoulder(76.6%), upper back(41.2%), lower back(72.2%), arm and elbow(31.3%), wrist(44.2%), finger(35.0%), leg(71.1%). Adjusted Odds Ratios for musculo-skeletal symptoms which was adjusted for age were neck 2.13(1.29∼3.51), shoulder 2.52(1.50∼4.24), upper back 1.71(1.01∼2.88), lower back1.78(1.06∼2.99), arm and elbow 3.10(1.62∼5.94), wrist 2.09(1.23∼3.57), finger 4.83(2.41∼9.68), leg 3.46(2.07∼5.79). Conclusions : These results show that employees in hair salon are likely to have high risk for work-related dermatologic, respiratory and musculo-skeletal symptoms and diseases. Hence, prevention methods from those work-related diseases are required to be developed. Also, the scope of occupational and environmental medicine should be expanded to service area including hairdressers.

반복작업에 의해 발생한 척골관 증후군 1례

김정원,박인선,이영준,김유창,김필자,강동묵,이채언 대한산업의학회 2000 대한직업환경의학회지 Vol.12 No.2

Objectives : To report cubital tunnel syndrome due to repetitive motions. Methods : A worker complaining muscle weakness and atrophy of the right hand intrinsic muscles admitted to a hospital. We evaluated him with blood tests, neurophysio-logic studies (NCV & EMG), plain X-ray and US at the both elbows. We investigated his occupational history, and videotaped his work motions based on the work cycle at his previous work site. Finally, an ergonomics expert analyzed the motions using rapid upper limb assessment (RULA). Results : NCV & EMG studies reveals slow conduction velocity on both ulnar nerve across the elbow, more severely in the right side. US shows us compatible finding with diffuse neuritis of both ulnar nerves at both elbows. RULA score is 7. Conclusion : We confirmed that the worker's symptoms were related to his previous jobs demanding repetitive motions using the elbow joints. It is necessary that we should prepare appropriate measures to evaluate, prevent, rehabilitate, and help injured workers to return to work.

부산지역 강하먼지 중 불용성 중금속 함유량

이용범,황용식,이창희,박명희,이채관,강동묵,김정원,전병일,문덕환 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.1

■ Objectives The purpose of this study was to estimate qualitatively various bulk deposition flux of insoluble heavy metal components by applying regional and seasonal distribution. our institution from January 1980 to December 31th, 2001. ■ Materials and Methods Dustfall particles were collected by the modified American dust jar (wide inlet bottle type) at 6 sampling sites in Pusan area from March, 1999 to February, 2000. Five chemical species (Cd, Cr, Mn, Ni and Pb) were analyzed by AAS(Perkin-Elmer 4100ZL). ■ Results The mean values of each heavy metal concentrations were Cd for 3.947 g/㎢/month, Cr for 0.191 ㎏/㎢/month, Mn for 0.375 ㎏/㎢/month, Ni for 0.176 ㎏/㎢/month, and Pb for 0.823 ㎏/㎢/month. ■ Conclusions Insoluble heavy metal amount of regional variations were found in order of industrial zone, coastal zone, commercial zone, agricultural zone and residential zone.

Environmental health centers for asbestos and their health impact surveys and activities

Dong-Mug Kang,Jong-Eun Kim,Yong-Jin Lee,Hyun-Hee Lee,Chang-yeol Lee,Seong-Jae Moon,Min-Sung Kang 대한직업환경의학회 2016 대한직업환경의학회지 Vol.28 No.-

In 2009, Korea banned the import, transport, and use of asbestos, and the Asbestos Injury Relief Act (AIRA) was promulgated in 2011. Two environmental health centers for asbestos (EHCA), including Pusan National University Yangsan Hospital (PNUYH) and SoonChunHyang University Cheonan Hospital (SCHUCH), were adapted to find environmental asbestos-related diseases (ARDs) and to support the purposes of AIRA. EHCA conducted a health impact survey (HIS) on persons who resided or reside near asbestos factories or mines. A total of 13,433 persons have taken screening examinations in PNUYH EHCA, and 623 persons (4.6%) have had secondary examinations. Of the 21,014 persons who had screening examinations in SCHUCH EHCA, 2490 persons (11.8%) had secondary examinations. Some of those who tested positive for ARDs through HISs filed applications for the asbestos victims’ medical pocketbook (AVMP). Approximately 116 and 612 persons received AVMPs as a result of PNUYH and SCHUCH examinees, respectively. EHCAs have conducted HISs, public relations, and education for asbestos victims, ordinary citizens, and physicians. As HISs are based on voluntary participation, they does not monitor high-risk groups. Active surveillance focusing on high-risk groups has been blocked by the personal information protection act. Although important work has been performed in finding environmental asbestos victims and increasing public awareness on asbestos, it is necessary to improve the current system and registration.

Asbestos and environmental diseases

Kang, Dong-Mug,Kim, Young-Ki,Kim, Jong-Eun Korean Medical Association (KAMJE) 2012 대한의사협회지 Vol.55 No.3