건강질단 질병 유소견자들의 순천향구미병원 외래이용에 영향을 미치는 요인

김진석,우극현,함정오,유재영,최태성,하봉구,윤성용 순천향의학연구소 2002 Journal of Soonchunhyang Medical Science Vol.8 No.1

Background ; The purpose of routine health screening of employee is not only to detect worker's disease at early stage but also to provide early appropriate health service. But, majority of patients who diagnosed by routine health screening haven't underwent health service utilization. Soonchunhyang Kumi Hospital had been provide total occupational health service in kumi industrial estate including health screening, worker interview at workplace by occupational nurses and doctors. Object ; We want to know how much proportion of patient who are diagnosed by routine health screening had visited Soonchunhyang Kumi hospital out-patient clinic and factors influencing such health care service utilization. Method ; Initial study subject were 189 workers who had proved to have hypertension, diabetes mellitus, hyperlipidemia in routine health screening which performed during year of 2000. Among those, 160 workers who had finished questionnaire were selected for final study subject. We investigate whether they had visited health services or not, if they had, what kind of health care facility they visited, and other factors which influencing their health service utilization. Result ; Among 160 workers, 59(36.9%) had visited Soonchunhyang Kumi hospital, 47(29.4%) had visited other health care facility, and 54(33.8%) had not went to any health care facility. Factors which influencing Soonchunhyang Kumi hospital utilization is sex, job, staff's support to hospital visit during worktime, history of medical consultation about health screening result.

20-30대 무증상 성인에 있어서 채용신검시 나타난 간기능 및 바이러스 간염검사 결과 분석

김주자,신연교,우극현 순천향의학연구소 1995 Journal of Soonchunhyang Medical Science Vol.1 No.2

To determine the distribution of results of liver function test and viral markers for preemployment screening in asymptomatic young adults(twenties and thirties in age group), and also to evaluate the cutoff level of liver function test in deciding repeat follow-up examination. the data from which the first and second repeated examinations for preemployment screening performed during the period from Jan, 1, 1994 to Dec. 31 1994 were analized. The results were as follows: 1. Among 7,855 asymptomatic young adults who were examined, 814 (10.4%) had the abnormal liver function test (10.4% (814/7,855) in male, 0.8% (14/1,707) in female. 2. In 397 male who had repeated follow-up test, 27.2%(108/397) were turned out normal liver function test and 72.8%(289/397) remained abnormal. According to the interval of repeated follow-up test, the longer the interval the higher conversion rate to normal. This can be explained by the effect of treatment of health care, or was dropped from 87.5%(7/8) to 44.2%(23/52) at 401U/dl and that of SGOT was dropped from 80.7%(25/31) to 67.9%(19.28) at 451U/dl which suggest cutoff level to decide repeated follow-up test. This suggest that we can adjust the cutoff level in deciding follow-up examination. 3. Overall positive rates for HBsAg were 5.8%(80/1,561), and 5.9%(80/1,347) in age group 20-29, 4.7%(10/214) in age group 30-39, 6.0%(73/1,214) in male, 4.9%(17/347) in female. Positive rate for HBsAg according to the liver function test was significantly higer in abnormal liver function group than in normal liver function grup (12.7% vs 4.8%). 4. Positive rate for anti-HBs was 32.7% and there were no significant difference between age groups or between liver function groups. 5. Positive rate for anti-HCV was 1.3%(5 in 397 male), actually all 5 were in age group 20-29, among them, 3 had normal liver function test and 2 had abnormal liver function test.

구미지역 직업성질환 감시체계

김성아,김진석,전혜리,정상재,김상우,이채용,함정오,유재영,최태성,하봉구,조민환,우극현 大韓産業醫學會 2003 대한직업환경의학회지 Vol.15 No.1

목적: 구미지역 내 대학병원이자 특수건강진단·보건관리대행기관의 산업의학전문의, 보건관리대행 간호사, 사업장 간호사를 중심으로 직업성질환감시체계를 구축하여 주요 직업성질환들의 발생현황과 규모를 파악하고자 하였다. 또한 연차적으로 산업, 직업, 업무내용 등에 따른 분포나 원인을 기존 자료원(특수건강진단의 직업병 유소견자와 산재요양승인 되는 직업병자)과 비교하여 분석·기술하고 예방 및 관리를 포함한 보건의료기술개발까지을 포함하는 종합적인 감시체계를 구축하고 운용하고자 하였다. 방법: 구미지역의 산업적 특성에 맞는 직업성질환감시체계를 구축하고 지역 감시체계의 모델을 제시하였다. 6대 감시대상 직업성질환(독성 간염, 직업성천식, 직업성 근골격계질환, 직업성 피부질환, 직업성 암, 수지진동증후군)의 실행적 환례정의, 보고양식 및 보고체계 개발, 분석양식 및 결과 배포 형식을 개발하였으며, 그 유병규모를 파악하고, 감시질환의 분포 및 특성, 관련인자 등을 분석·기술하고자 하였다. 이때, 1년간의 환례분석시 직업병 유소견자 및 직업병 요양자에 대한 자료와 함께 비교 분석하였으며, 노동통계자료를 이용하여 년간 발생률을 추정하였다. 결과: 2001. 1. 1일부터 2002.4.30일까지 총 287건이 보고되었으며, 직업성 근골격계질환 132건(46.0%), 직업성 피부질환 100건(34.8%), 독성간염 34건 (11.8%), 직업성천식 16건 (5.6%), 수지진동증후군 5건 (1.7%) 이었으며 직업성 암은 한건도 보고되지 않았다. 보고경로별로는 보건관리대행에서 33건 (11.5%), 해당 유해인자별로 실시되는 특수검진 외의 각종 건강진단업무 수행 중 발견된 환례에 대한 보고가 206건(71.7%)이었다. 직종별 분류의 결과는 섬유업종사자, 단순노무종사자, 음식업종사자 등이 다수를 차지하였다. 근골격계질환의 경우, 수근관증후군이 42건(33%), 외상과염/내상과염이 39건(30%)로 가장 많았다. 직업성 피부질환은 97건이 접촉성 피부염으로 유기용제류가 59건(59%)으로 가장 많고, 니켈 및 에폭시수지에 의한 알레르기성 접촉성 피부염이 각각 6건과 5건이었다. 독성 간염은 모두 DMF 나 DMAc에 의한 것으로, 근무시작 후부터 간기능이상이 발견되기까지의 근무기간은 대부분이 3개월 이하이며, 1개월 이하인 경우도 10건이나 되었다. 동 기간 중 감시환례에 대해 산재요양 자료와 중복여부를 확인한 결과, 중복되는 것은 하나도 없었다. 특수건강진단에서 직업병유소견자로 판정된 경우는 독성간염에서 3건이 있었으며, 나머지 질환은 중복되는 것은 없었다. 2001도 구미지역의 근로자수와 보고환례건수를 이용하여 연간 발생률을 추정하였다. 근로자 10만 명당 연간 발생률은 상지 근골격계질환은 63.6명, 피부질환 48.2명, 독성 간염 17.9명, 천식 7.7명, 수진진동증후군 2.4명이었다. 참여예상인원은 총 46명이었으며, 실제 참여자수는 21명, 평균참여율은 46%, 실제 참여 1이당 평균 보고건수는 산업의학전문의가 28건으로 가장 많았고, 대행간호사는 45,건, 사업장 간호사는 3.3건이었다. 결론: 지역 감시체계는 기존 통계자료들에서 발견되지 않았던 직업성질환의 발견에 유용한 통계원이며, 특히 지역의 특성과 여건을 고려하여 체계화된 시스템을 구축하여 운용한다면 더 성과가 클 것이다. Objectives: Area-based occupational disease surveillance in Kumi (KODS) was used to collect data on occupational diseases. The data was used to estimate the magnitude of the diseases, to analyze for their characteristics and to find links for their intervention and prevention. Methods: Since January 2001, occupational physicians and nurses in Occupational Health Service (OHS) have reported six major occupational diseases; occuaptional musculoskeletal disorders of the upper extremities (MSDUE), occupational dermatoses, toxic hepatitis, occupational asthma (OA), hand-arm vibration syndrome (HAVS), and occupational cancer. For the respective diseases, a reporting sheet and operational diagnostic criteria were developed by the KODS. An analysis of the KODS data, collected over a certain period, was compared with data from the Korea Labor Workers Corporation (KLWC) and the Specific Health Examination (SHE), and the incidence rates of the diseases estimated. Results: Between Jan 2001 and Apr 2002, 287 cases of the six major occupational disease were reported. Of these, there were 132 (46.0%), 100 (34.8%), 34 (11.8%), 16 (5.6%), and 5 (1.7%), cases of MSDUE, occupational dermatoses, toxic hepatitis, OA, and HAVS, repectively. But, there were no cases of occupational cancer. 33 (11.5%) of the incidence were reported via the OHS, 206 (71.7%) from health checkups, and the other 48(16.8%) from other routes. The synthetic fibers and electronic components manufacturing industries accounted for the greatest number of reported cases. With resport to occupation, the greatest numbers of incidence were reported from the elementary occupations, textile workers, assemblers, and cooks and food services worker, in that order. Of the MSDUE cases, carpal tunnel syndrome and epicondylitis were the two most common diseases. Most of the occupational dermatoses were due to contact dermatitis, with organic solvents (59%), nickel (6%), and epoxy resin (5%) accounting for the majority of these cases. All cases of toxic hepatitis were induced by dimethylformamide or dimethylacetamide, which were reported by a unique monitoring system. During same period, there were no cases claimed by workers to the KLWC, and only three cases from SHE, were identified. Using data from workers' number and surveillance, the annual incidence of MSDUE, dermatoses, hepatitis, OA, and HAVS, per 100,000 workers were 63.6, 48.2, 17.9, 7.7, and 2.4, respectively. Conclusions: These results show that an area-based surveillance system can be very effective for the collection of data on work-related diseases, at least in Kumi.

2.5-헥산디온에 노출된 근로자에게서 발생한 말초 신경병증

조성용,장용석,최은경,김진석,유재영,우극현,최태성 대한산업의학회 2007 대한직업환경의학회지 Vol.19 No.1

목적: 영상음향장비 제조업체에서 2,5-헥산디온을 취급한 근로자에게서 발생한 다발성 말초 신경병증 환례를 보고하고, 동일 공정근로자들의 말초 신경기능을 조사하고 자 한다. 방법: 환례에 대해 방사선학적 검사, 소변 및 혈액 검사, 신경전달속도 검사, 작업환경 측정을 하였으며, 2,5-헥산디온의 노출을 중단시킨 후 5개월 후에 다시 신경전달속도 검사를 하였다. 동일공정 근로자들의 영향평가에서는 2,5-헥산디온에 노출된 13명의 남자 근로자를 노출 군으로, 해당 물질에 노출된 적이 없는 5명의 남자 근로자를 비노출군으로 선정하여 검사를 하였다. 결과: 환례의 신경전도 검사결과 양측 척골신경과 정중 신경에 이상소견을 보였으며, 호전여부를 관찰하기 위하여 5개월 후 추적검사를 실시한 결과 증상 및 신경전달속도 검사결과가 호전되었다. 동일공정 근로자들의 영향평가에서 노출군의 정중 신경과 척골신경이 비노출군에 비하여 유의하게 감소되어 있었다. 감각 신경의 진폭의 경우, 노출군의 정중 신경과 비복 신경이 감소되었으며, 운동 신경 전도속도에서는 노출군의 비골신경이 유의하게 감소되어 있었다. 말단 잠복기에서는 노출군의 정중신경, 척골신경, 비골신경, 경골신경이 비노출군에 비해서 유의하게 연장되어 있었다. 결론: 환례의 증상과 신경전달속도 검사의 이상소견은 2,5-헥산디온에 의한 말초신경병증에 부합되었다. 동일공정 근로자 건강영향평가에서 신경전달속도 검사결과 노출 군과 비노출군간의 유의한 차이가 있었는데, 이를 통해 2,5-헥산디온이 근로자들의 신경독성에 영향을 줄 수 있다는 것을 확인할 수가 있었다. Objectives: This study is a case report of 2,5-hexanedione induced occupational peripheral polyneuropathy. We also investigated the peripheral nerve function of all workers who had been exposed to 2,5-hexanedione in the same process. Methods: In June, 2006, a 2,5-hexanedione exposed worker complained of both hand numbness. He received neurologic, radiologic, laboratorial and electrophysiologic evaluation, including measurements of workplace environment. Five months after cessation of exposure to 2,5-hexanedione, a follow-up electrophysiologic examination was done. We evaluated the peripheral nerve function of 2,5-hexanedione exposed workers by comparing 13 male 2,5-hexanedione exposed workers who were in same company with the patient and 5 male workers who had not been exposed to 2,5-hexanedione. Results: Under electrophysiologic examination, there were abnormalities in sensory and motor nerve velocity, terminal latency, and F-latency of both median nerve and ulnar nerve. After 5 months, the patient symptoms and the results of follow-up electrophysiologic examinations were improved. Comparing the 2,5-hexanedione exposed group with the unexposed group, the sensory nerve velocity of the median and ulnar nerves in the exposed group was decreased. The motor nerve velocity of the peroneal nerve, and sensory nerve velocity of the median and sural nerves were decreased. Terminal latency of median, ulnar, peroneal, and tibial nerves in the exposed group were increased compared with the unexposed group(<0.05). Conclusions: 2.5-hexandione can induce peripheral polyneuropathy in male workers.

Psychological effects of a disastrous hydrogen fluoride spillage on the local community

Seung-Hyun Yoo,Seong-Yong Yoon,Kuck-Hyun Woo,Jin-Seok Kim,Seong-Yong Cho,Sung-Soo Lee,Hyun-Sul Lim,Yeon-Soon Ahn,Won-Ho Yang 대한직업환경의학회 2017 대한직업환경의학회지 Vol.29 No.-

Background: On September 27, 2012, at 3:43 pm, a hydrogen fluoride spill occurred in a manufacturing plant located at the 4th complex of the Gumi National Industrial Complex in Gumi City, South Korea. The present study aimed to evaluate the psychological effects of the hydrogen fluoride spill on the members of the community and to investigate their relationships with physical symptoms and changes in psychological effects occurring as time passed after the accident. Methods: The 1st phase involved a survey of 1359 individuals that was conducted 1 month after the spill, and the 2nd phase involved a survey of 711 individuals that was conducted 7 months after the accident. The questionnaires included items for assessing demographic characteristics, hydrogen fluoride exposure level, physical symptoms, and psychological status. Physical symptoms were assessed to determine the persistence of irritations. Psychological status was assessed to investigate the impact of event level using the Impact of Event Scale – Revised Korean version (IES-R-K), and the anxiety level was assessed using the Beck Anxiety Inventory (BAI). Results: As the hydrogen fluoride exposure level increased, the impact of event and anxiety levels increased significantly both 1 and 7 months after the accident (p < 0.05). The mean score of the impact of event levels decreased significantly from 33.33 ± 14.64 at 1 month after the accident to 28.68 ± 11.80 at 7 months after the accident (p < 0.05). The mean score of the anxiety levels increased significantly from 5.16 ± 6.59 at 1 month after the accident to 6.79 ± 8.41 at 7 months after the accident (p < 0.05). The risk of persistent physical symptoms at 7 months after the accident was significantly higher in females. The risk of persistent physical symptoms also increased significantly, with increasing age, hydrogen fluoride exposure, and impact of event levels (p < 0.05). Conclusions: The present study found that the impact of event level and anxiety level increased with increasing hydrogen fluoride exposure. Anxiety levels persisted even after time passed. The risk of persistent physical symptoms at 7 months after the accident was higher in females, and it increased with increasing age, hydrogen fluoride exposure level, and impact of event levels.

기립성 진전 4례

김대현,김재우,이동국 대한신경과학회 1999 대한신경과학회지 Vol.17 No.4

Guidelines for recognition of occupational cancers in Korea

Jaechul Song,Kuck-Hyun Woo,Yang Ho Kim 대한직업환경의학회 2018 대한직업환경의학회지 Vol.30 No.-

Acute Symptoms after a Community Hydrogen Fluoride Spill

Joo-Yong Na,Kuck-Hyun Woo,Seong-Yong Yoon,Seong-Yong Cho,In-Ung Song,Joo-An Kim,Jin-Seok Kim 대한직업환경의학회 2013 대한직업환경의학회지 Vol.25 No.-

Objectives: This study was conducted to describe the demographic characteristics, and clinical signs and symptoms of patients who visited a general hospital because of the release of chemically hazardous hydrogen fluoride that occurred on September 27, 2012 in Gumi City, Korea. Methods: The medical records at 1 general hospital 9 km from the accident site were reviewed using a standardized survey format. There were 1,890 non-hospitalized and 12 hospitalized patients exposed to hydrogen fluoride between September 27 and October 13 2012. Results: Among the 12 hospitalized patients, 11 were discharged within 1 week and the other was hospitalized for 10 days. The chief complaints were respiratory symptoms such as hemoptysis and shortness of breath, gastrointestinal symptoms, neurologic symptoms, sore throat, and lip burn. The number of non-hospitalized patients exhibited a bimodal distribution, peaking on the first and twelfth days after the accident. Their chief complaints were sore throat (24.1%), headache (19.1%), cough (13.1%), and eye irritation (9.2%); some patients were asymptomatic (6.2%). Patients who visited the hospital within 3 days (early patients) of the spill more often had shortness of breath (27.0%) and nausea (6.3%) as the chief complaints than patients who visited after 3 days (late patients) (3.5% and 2.6%, respectively). However, cough and rhinorrhea were more common in the late patients (14.0% and 3.3%, respectively) than in the early patients (5.0% and 0.0%, respectively). Patients who were closer to the accident site more often had shortness of breath and sputum as the chief complaints than patients who were farther away. The mean serum calcium concentration was 9.37 mg/dL (range: 8.4?11.0 mg/dL); none of the patients had a decreased serum calcium level. Among 48 pulmonary function test results, 4 showed decreased lung function. None of the patients had abnormal urine fluoride levels on the eighth day after exposure. Conclusions: Patients hospitalized due to chemical hazard release of hydrogen fluoride had acute respiratory, gastrointestinal, and neurologic health problems. Non-hospitalized patients have acute symptoms mainly related to upper respiratory irritation.

Acute Symptoms in Firefighters who Participated in Collection Work after the Community Hydrogen Fluoride Spill Accident

Seong-Yong Cho,Kuck-Hyun Woo,Jin-Seok Kim,Seong-Yong Yoon,Joo-Yong Na,Jin-Hyun Yu,Yong-Bae Kim 대한직업환경의학회 2013 대한직업환경의학회지 Vol.25 No.-

Objectives: This study aimed to analyze the relationship between clinical status and work characteristics of firefighters and other public officers who engaged on collection duties in the site of the hydrogen fluoride spill that occurred on September 27, 2012, in Gumi City, South Korea. Methods: We investigated the clinical status, personal history, and work characteristics of the study subjects and performed physical examination and several clinical examinations, including chest radiography, echocardiography, pulmonary function test, and blood testing in 348 firefighters, police officers, volunteer firefighters, and special warfare reserved force who worked at the hydrogen fluoride spill area. Results: The subjects who worked near the accident site more frequently experienced eye symptoms (p = 0.026), cough (p = 0.017), and headache (p = 0.003) than the subjects who worked farther from the accident site. The longer the working hours at the accident area, the more frequently the subjects experienced pulmonary (p = 0.027), sputum (p = 0.043), and vomiting symptoms (p = 0.003). The subjects who did not wear respiratory protective devices more frequently experienced dyspnea than those who wore respiratory protective devices (p = 0.013). In the pulmonary function test, the subjects who worked near the accident site had a higher decease in forced vital capacity than the subjects who worked farther from the site (p = 0.019); however, no statistical association was found between serum calcium/phosphate level, echocardiography result, chest radiographic result, and probation work characteristics. Conclusions: The subjects who worked near the site of the hydrogen fluoride spill, worked for an extended period, or worked without wearing respiratory protective devices more frequently experienced upper/lower respiratory, gastrointestinal, and neurological symptoms. Further follow-up examination is needed for the workers who were exposed to hydrogen fluoride during their collection duties in the chemical plant in Gumi City.

Occupational Factors Associated with Changes in the Body Mass Index of Korean Male Manual Workers

In-Woong Song,Kuck-Hyun Woo,Jin-Seok Kim,Seong-Yong Yoon,Joo-Yong Na,Jin-Hyun Yu,Seong-Yong Cho 대한직업환경의학회 2013 대한직업환경의학회지 Vol.25 No.-

Objectives: This study was carried out to analyze and compare the occupational factors that could influence changes in body mass index (BMI) in male manual workers stratified into short-term and long-term work experience groups. Methods: The subjects were 299 male manual workers (sampled systematically) from 27 workplaces, who had undergone travelling medical examinations at a university hospital between March 28 and May 10, 2013, and had also undergone medical examinations at the same hospital in 2012. Their general and occupational characteristics were investigated through a structured, self-administered questionnaire. The BMI at each point in time was calculated based on the anthropometric results of the medical examinations. Multiple regression analyses were conducted on outcomes of the BMI change and predictors composed of the general and occupational characteristics, with the subjects stratified into groups with 5 years or less (short-term) versus more than 5 years (long-term) of work experience at the present post. Results: In the short-term work experience group, the BMI increases of 3-shift workers and groups reporting disagreement with feeling “insufficient job control” and “lack of reward” at work, two of the subscales of job stress, were significantly higher than those of daytime workers and high-stress groups, respectively. In the long-term work experience group, However, although the BMI increase for 3-shift workers was also significantly higher than that of daytime workers, none of the job stress factors were significantly associated with a BMI increase, whereas the social factors of education and marital status were significant, and some lifestyle factors (such as smoking and regular exercise) were also significant. Conclusion: This study showed that, except for 3-shift work, the factors associated with BMI increase could differ depending on the length of job experience. Consequently, different strategies may be needed for workers with short-term versus long-term job experience when designing interventions for preventing their obesity.