한국인의 연, 망간, 알루미늄 및 실리콘의 혈중 농도

김정만,안정모,김원술,김정일,신해림,정갑열,김준연 동아대학교 산업의학연구소 2000 산업의학연구소 논총 Vol.- No.5

Blood Lead, Manganese, Aluminium and Silicon Concentrations in Korean Adults Jung Man Kim, Jung Mo Ahn, Won Sul Kim1), Jung Il Kim2), Hai Rim Shin, Kap Yeol Jung2), Joon Youn Kim Department of Preventive Medicine, College of Medicine and Industrial Medicine Research Institute. Dong-A University Department of Health Care, Handong University Sunlin Presbyterian Hotpital1) Department of Occupational Medicine, College of Medicine, Dong-A University2) 0bjectives : This study was performed to determine the reference values of blood lead, manganese, aluminium, and silicon in healthy adults. Methods : The subjects were 132 (67 male and 65 female), and classified to three age groups (≤39,40∼49, and 50≤). Hood lead, manganese and aluminium were analyzed by atomic absorption spectrophotometer, and blood silicon was analyzed by direct current plasma optical omission spectrometer. Results : Blood lead levels(geometric mean, S.D) were (3.49, 1.70) ㎍/dL in male auld (3.04, 1.65) ㎍/dL in female, but the difference is not significant, and there was no significant difference between age groups. Mean blood manganese level was 0.99±0.41㎍/dL, and there was no significant difference between sex or age groups. Mean blood aluminium level was 0.59±0.35㎍/dL and there was no significant difference between sex or age groups. Mean blood silicon level was 54.41±27.64㎍/dL in male and 43.34±23.51㎍/dL in female, and the level in male was significantly higher than that in female (p〈0.05). There was significant difference between age groups, and the oldest showed the highest level in male (p〈0.05), but no significant difference between age groups in female. Conclusions : Authors hope that this study would provide basic data for determininig reference values and evaluating health effects.

음식물 섭취에 따른 요중 마뇨산 배설량의 변화

김정일,박태혁,정갑열,신해림,김준연 동아대학교 산업의학연구소 2000 산업의학연구소 논총 Vol.- No.5

Objectives ; Urinary hippuric acid levels have been usually determined to evaluate workers exposes to toluene. Food and drink intake could affect urinary hippuric acid excretion and chi study was carried out to investigate what kinds of food and drink would affect urinary hippuric acid excretion. Methods ; The subjects were 136 medical school students. Authors measured urinary hippuric acid levels three times from 10 a. m. to noon; before, one hour after and two hours after food or drink-intake, and they were asked not to eat from the previous night(9 p. m) of testing. We selected six diets(bread and coffee, brown sauce noodle, Korean style meal, noodle, pork-galbi and rice and soybean stew and rice) , six fruits(apple, grape, orange, pear, persimmon and plum) and five beverages(Alps-D□, Demisoda□, Orange juice□, Pear juice□ and Pocari sweat□). Analysis of urinary hippuric acid was performed by high performance liquid chromatography. Results ; Intake of popular Korean diets, fruits and some drinks didn't affect urinary hippuric acid excretion. But intake of sodium benzoate-contained Alpa-D□ increased urinary hippuric acid excretion. Conclusions ; For the health examination on workers exposed to toluene, the history of diet and fruit intake can be negligible, but that of beverage intake should be included.

연 착화제 효능에 관한 동물실험적 연구

김정만,김병권,김성환,서병성,김인식,김용규,정갑열,김준연 동아대학교의과대학 1997 동아의대학술지 Vol.9 No.1

농산물 소독과정에서 브롬화메틸에 노출된 근로자에게 발생한 신경병 2례

박태혁,김정일,손지언,김종국,김형수,정갑열,김준연 大韓産業醫學會 2000 대한직업환경의학회지 Vol.12 No.4

목적 : 농산물 소독과정에서 브롬화메틸에 노출된 근로자에게 발생한 신경병 2례 보고. 방법 : 피로감, 전신무력감, 어지럼증, 보행장애 등의 증상을 주소로 내원한 브롬화메틸을 사용하여 방역작업에 종사하는 건강한 20세와 18세의 근로자를 대상으로 혈액검사, 신경정도 및 근전도검사, 뇌자기공명영상 등의 임상검사와 작업력조사를 시행하였다. 결과 : 1례에서 뇌자기공명영상에서 연수와 소뇌의 양측 측충부의 고신호강도가 관찰되었고 11일 후의 추적조사에서 동일 부위의 고신호강토가 감소된 소견이 관찰되었으며 뇌병증으로 최종 진단되었다. 다른 1례는 신경전도검사에서 다발성 신경병 소견과 뇌유발전위검사에서 우측 하부 뇌간부위 병소가 관찰되었고 뇌병증 및 말초신경 병으로 최종 진단되었다. 결론 : 근로자들의 증상은 소독과정에서 브롬화메틸 노출로 인한 신경 병으로 판단되며 훈증소독과방역작업에 종사하는 근로자들의 실태조사와 안전에 대한 대책이 시급하다고 하겠다. Objectives : To report two cases of neuropathy due to methyl bromide intoxication. Methods : Workers, engaged in the fumigating process, complained fatigue, general weakness, ataxia, and hypersomnia. We evaluated them with blood tests, neurophysiologic studies and MRI and investigated their occupational history. Results : Increased signal intensities were found in the medulla oblongata and paraver mian of cerebellum in MRI and after 11 days, high signal intensities were reduced in the following MRI. In the other case, polyneuropathy and rlght lower brainstem lesion were observed In the NCV and BAEP studies. Conclusions : We confirmed that worker's symptoms were related to methyl bromide exposure in the fumigation. It is necessary that we should evaluate present condition of fumigating process and prepare appropriate methods to protect workers engaged in the fumigation.

석면에 장기간 노출된 퇴직한 수리조선업 근로자의 폐영상 : 단순흉부촬영 및 고해상전산화단층촬영 소견과 그 유병률 Lung and Pleural Diseases Prevalence on Chest Radiograph and HRCT

김기남,김정일,,이기남,정갑열,김준연 大韓産業醫學會 2006 대한직업환경의학회지 Vol.18 No.2

목적: 장기간 석면에 노출되었던 퇴직한 조선소 근로자에서 단순흉부촬영과 고해상 CT소견 및 그 유병률을 알아보고자 하였다. 대상 및 방법: 수리조선소에서 배관공 또는 영선반에서 근무한 후 퇴직한 근로자 18명을 대상으로 하여 후전면 및 측면 단순흉부촬영과 고해상 CT를 시행하였다. 이들은 모두 조선소에서 사용하는 단열재 사용 작업 중에 석면에 노출되었다. 결과: 단순흉부촬영에서 총 18례 중 12례(66.7%)에서 흉막병변이 관찰되었다. 흉막플라크의 위치는 횡경막 단독으로 비후된 경우가 5례로 가장 많았으며, 외측흉벽 흉막플라크의 두계는 a가 3례, b가 1례에서 보였고, 길이는 1이 4례, 2가 1례에서 보였다. 흉막플라크를 가진 12례 중 2례는 미만성 흉막비후를 동시에 보였다. 흉막플라크의 석회화는 횡경막에서만 4례 관찰되었다. 석면과 관련된 폐실질병변이 의심되는 소견은 관찰되지 않았다. 고해상 CT에서는 16례(88.9%)에서 흉막비후가 관찰되었으며, 위치는 척추 주위 13례, 횡경막 11례 등이었다. 동반된 석회화는 7례에서 보였다. 두께는 1 mm부터 1cm까지 이었고, 길이는 2cm부터 47cm이상까지 매우 다양하였다. 3명(16.7%)에서 흉막비후 근처의 하폐 기저부에 흉막하 곡선이 나타나는 석면폐증의 초기 소견이 보였다. 결론: 장기간 석면에 노출된 근로자의 석면 관련 흉막병변의 유병률이 매우 높아 장기적인 추적검사가 필요하다고 사료된다. Purpose: To determine imaging findings among retired workers who were long-term exposed to asbestos. Lung and pleural diseases prevalence were studied on chest radiograph and HRCT. Materials and Methods: Eighteen workers who were long-term exposedto asbestos occupationally in shipyards were examined by chest radiographs (PA and lateral view) and HRCT (high-resolution computed tomography). Results: In 12of 18 subjects (66.7%), asbestos-related pleural abnormalities were evident in diaphragmatic, lateral chest wall and costophrenic angle of the pleura on chest radiographs. The thickness of pleural plaques at the lateral chest wall varied. Diffuse pleural thickening was evident in 2 workers. Parenchymal abnormalities were not found on chest radiographs. On HRCT, pleural thickening wasobserved in 16 of 18 subjects (88.9%), in the areas of juxtavertebral, diaphragmatic, anterior, lateral, mediastinal and fissural pleura. Curvilinear subpleural lines representing early parenchymal asbestosis were found in the lower posterior lung in three of 18 subjects (16.7%). Conclusions: In long term asbestos-exposed workers, the asbestos-related pleural disease was 66.7% on chest radiographs and 88.9% on HRCT. The authors suggest that this group should be followed up periodically

혈중 및 호기 일산화탄소를 이용한 일산화탄소 헤모글로빈 농도간의 관련성 연구

김형수,박태혁,손지언,정갑열,김정만,김준연 동아대학교 2001 大學院論文集 Vol.26 No.-

This study was conducted to find a correlation between blood COHb and calculated COHb with expiratory air and related variables such as occupational and smoking factors. Author selected 69 healthy workers in 8 workplaces suspected CO exposure. Basic informations were collected by self-reported questionnaire and medical history taking. Author measured Indirect COHb concentration with expiratory air using Micro II-Smokerlyzer and blood COHb concentration using Oxymeter. The results of the study were summarized as follows : 1. In the smoker, mean blood COHb and calculated COHb with expiratory air were 2.21±0.98% and 2.27±0.97 %, and there was not a statistically significant difference. In the non-smoker, mean blood COHb and calculated COHb with expiratory air were 0.42±0.43 % and 0,65±0.30 %, and there was also not a statistically significant difference. 2. There were positive correlations between blood COHb and calculated COHb with expiratory air in both the smoker (r=0.91, p=0.0001) and non-smoker (r=0.73, p=0.0001). 3. In the smoker, the factors affected COHb were total smoking index (Pack × years) and passed time after the last smoking. 4. In the nonsmoker, the parking and driving groups had higher COHb concentration than others (p<0.05). In conclusion, there was no significant difference between indirect COHb concentration with expiratory air using Smokerlyzer and blood COHb concentration and there was a highly significant correlation between indirect and blood COHb concentrations. Therefore indirect COHb concentration with expiratory air is a useful screening method for CO exposure. Author suggest the resection of smoking during at least 90 minutes before measuring COHb concentration in order to exclude smoking effects.

연 착화제 효능에 관한 동물실험적 연구

서병성,김준연,김정만,김용규,정갑열,김성환,김인식,김병권 동아대학교 부설 산업의학연구소 1997 산업의학연구소 논총 Vol.- No.3

This experiment was carried out to compare the efficacy of 2,3-dimercaptosuccinic acid(DMSA) and calcium ethylenediamine tetraacetate(CaEDTA) as chelating agents for lead poisoning. The rats had been fed water containing 0.5% lead acetate for 3 months and randomly divided into three groups. We administered DMSA only for group I(n=5), CaEDTA only for group II(n=5), and both DMSA and CaEDTA for group III(n=10), for 4 days. We evaluated urinary lead(PbU) level, blood lead(PbB) level and blood zinc protoporphyrin(ZPP) level before and after administration of the chelating agents. The results obtained were as follows; 1. After administration of chelating agents, the mean PbU levels, which were 248.2㎍/dl, 252.6㎍/dl and 270.0㎍/dl in group I, II and III before administration, were increased to 484.6㎍/dl, 479.9㎍/dl and 1,792.1㎍/dl in group I, II and III, respectively(p<0.05). 2. After administration of chelating agents, the mean PbB levels, which were 67.4㎍/dl, 59.9㎍/dl and 62.5㎍/dl in group I, II and III before administration, were decreased to 38.1㎍/dl, 36.3㎍/dl and 31.3㎍/dl in group I, II and III, respectively(p<0.05), but there were no different changes of ZPP level among groups. 3. The blood lead clearances, which were calculated by PbB level before and after administration of chelating agents, were 49.8%, 43.5% and 39.5% in group III, I and II, respectively.

우리나라 도시와 농촌 지역 주민의 혈중 연 및 혈중 Zinc Protoporphyrin농도 비교 연구

김준연,김병권,홍영습,이용언,정갑열 동아대학교 부설 산업의학연구소 1997 산업의학연구소 논총 Vol.- No.3

The study was carried out on healthy population in urban and rural area, in order to compare the level of blood lead (PbB) and blood zinc protoporphyrin (ZPP) between the population living in each area from July 1 1994 to December 31 1994. We stratificated the results with sex, age and area. The results obtained were as follows; 1. In urban area, overall mean of the PbB level was 7.08±1.61㎍/dl and both men and women had the highest level of PbB, which were 8.15±0.85㎍/dl, 6.90±1.48㎍/dl, in less than 39 years old group. In rural area, overall mean of the PbB level was 6.75±1.61㎍/dl and both men and women had the highest levels of PbB, which were 7.25±2.29㎍/dl, 7.00±2.92㎍/dl in 40∼49 years old group. And there was statistically significant difference between mean of the men's PbB level in urban area and that in rural area (p<0.05). 2. In urban area, overall mean of the ZPP level was 32.08±8.28㎍/dl and men had the highest level of ZPP, which was 29.59±5.13㎍/dl, in 40∼49 years old group, and women had that, which was 36.83±7.95㎍/dl, in less than 39 years old group. In rural area, overall mean of the ZPP level was 34.54±11.31㎍/dl and men had the highest level of ZPP, which was 32.10±5.45㎍/dl, in less than 39 years old group and women had that, which was 40.17±14.02㎍/dl, in 40∼49 years old group. And there was statistically significant difference between mean of the men's ZPP level in urban area and that in rural area (p<0.05). 3. There was statistically significant difference in PbB and ZPP between men and women group in both area (p<0.05) but not significant among age group in both area (p>0.05).

상지 단순반복작업 근로자의 수근관 증후군 유병률에 관한 조사

손지언,장태원,김윤규,홍영습,정갑열,김동일,이강진,하남진,김상범,김준연 대한산업의학회 2001 대한직업환경의학회지 Vol.13 No.3

목적 : 본 연구는 수근관 증후군의 발생위험이 높은 작업형태에 종사하는 상지 단순반복작업근로자로서 육류 및 어류 가공 사업장과 목재소 근로자에서 근전도검사를 이용하여 수근관 증후군의 유병률을 조사하고자 하였다. 방법 : 상지 단순반복작업근로자로서 육류 및 어류 가공 사업장 근로자 69명과 목재소 근로자 17명을 실험군으로, 관리직, 경리, 경비등 상지의 단순반복작업이 없는 근로자 28명을 대조군으로 선정하여, 작업적 및 병력조사, 이학적 검사와 근전도검사를 통해 수근관 증후군의 유병률을 조사하였다. 결과 : 수근관 증후군의 유병률은 육류 및 어류 가공 사업장과 목재소에서 각각 26.09 % (18명)와 29.41 %(5명)로 조사되었으며, 육류 및 어류가공사업장과 목재소 근로자를 '7년 이상과 미만의 작업기간'으로 층화하여 비교한 결과 '상지부위의 통증 호소 유무', 'Visual Analogue Scale(VAS: 총 10점) 4점 이상 여부', 'Tinel teat 양성 유무', 'Phalen test 양성 유무'는 모두 단기 작업근로자군에서 양성의 빈도가 증가되었고 '수근관 증후군 유무'는 장기작업근로자군에서 양성의 빈도가 증가되었다. 결론 : 육류 및 어류 가공 사업장과 목재소의 수근관 증후군 유병률은 각각 26.09 %와 29.41 %로 육류 및 어류 가공 사업장과 목재소는 1996년 OSHA가 지정한 바와 같이 위험한 작업요인이 있는 작업장으로 분류하여 관리되어야 할 것으로 생각된다. Objectives : This study was carried out to survey on the prevalence of Carpal Tunnel Syndrome(CTS) in high risk jobs(meat and fish processing plant and wood plant), by application of Nerve Conduction Study(NCS), a confirmatory diagnostic method. Methods : Experimental group was 69 workers sampled from meat and fish processing plants and 17 workers sampled from wood plants, who were simple, repetitive workers using upper extremities and control group was 28 workers sampled from managers, secretaries and keepers. All employees were examined through work history, physical examination and NCS. Results : 18 workers(26.09%) in meat and fish processing plants, and 5 workers(29.41%) in wood plants had compatible findings to NIOSH diagnostic criteria for CTS. The experimental group had more symptoms (complaint of upper extremities, Visual Analogue Scale ≥4(VAS: total 10 point)), signs(Tinel and Phalen test) and prevalence of CTS than control group(p<0.05). The prevalence of symptoms and signs were higher in short term workers(<7 years), but the prevalence of CTS was higher in long term workers(≥7 years). Conclusions : The prevalence of CTS in meat and fish processing plant and wood plant were 26.09% and 29.41% respectively. Authors propose that meat and fish processing and wood plants should be managed as a risk job category which were designated by OSHA in 1996

Renal Dysfunction Indicators, Lead Exposure, Urine - microglobulin Blood urea Nitrogen, Urine N-acetyl-β-D-glucosaminidase

김준연,김성률,홍영습,김동일,정갑열,이상주 동아대학교 부설 산업의학연구소 1997 산업의학연구소 논총 Vol.- No.3

A range of indicators is available to assess renal dysfunction in lead exposure. This study was undertaken to find out which indicators were most valuable as makers of renal dysfunction. We selected 75 male workers from the secondary lead smelter, plastic stabilizer and radiator manufacturing industries (the "exposed" group) and 64 male office workers (the "control" group). Blood lead; blood zinc protoporphyrin; urine lead; urine coproprphyrin; δ-aminolevulinic acid dehydratase activity; and urine δ-aminolevulinic acid were chosen as indicators of lead exposure. Blood urea nitrogen; serum creatinine; serum uric acid; urine N-acetyl-β-D-glucosaminidase; urine albumin; urine α₁-microglobulin; and urine β₂-microglobulin were used as indicators of renal dysfunction. Urine α₁-microglobulin level was significantly associated with the lead exposure level. Blood urea nitrogen, urine N-acetyl-β-D-glucosaminidase and urine α₁-microglobulin levels were highly correlated with indicators of lead exposure. Urine α₁-microglobulin had the highest correlation with other indicators of renal function. In addition, the proportion of subjects with high urine α₁-microglobulin levels showed a gradient with lead exposure. Conclusively, Blood urea nitrogen, urine N-acetyl-β-D-glucosaminidase and urine α1-microglobulin are useful indicators, but urine α₁-microglobulin is the early and the most valuable indicator of renal dysfunction related to lead exposure.