북한 환경보건 현황 추론

정해관 한국환경보건학회 2018 한국환경보건학회 학술대회 자료집 Vol.2018 No.2

일부 지역 도로관리 종사자에서 발견된 흉부 X선상 소음영 소견에 관한 조사

정해관,임현술,최익한,이원재,이현경 동국대학교 경주대학 1993 東國論集 Vol.12 No.-

Authors examined 135 workers(133 males and 2 females) employed in a local road construction and maintenance office lacated in the Pohang area to investigate the presence of pneumoconiosis cases among them. Examination consisted of questionnaire survey, physical examination and chest radiograph. Results are as follows ; 1. Of 135 workers, 8 cases(5.9%) were found to have small opacities of category 0/1 or more on chest radiogtaph. These cases were all males and prevalence was highest in group with age 50 or more(11.1% 3 out of 27 workers) and in froup with 5 to 9 years of employment(9.5%, 4 out of 42 workers). Small Opacities were found only in field workers(8.9%, 8 out of 90 workers) and prevalence of small opacities by job title was 8.8% in overload watchmen(3 out of 34 workers), 8.2% in road sweepers, road repair and maintenance workers(5 out of 56 workers). 2. Prevalence of small opacities on chest radiograph was higher in dusty, outdoor jobs than non-dusty jobs and the difference was statistically significant(P<0.05) 3. There was no statistically significant difference between those with radiological appearance of small opacities and normal subjects in age, educational level, duration of employment, previous dust exposure, past history of respiratory illness and clinical symptoms(P>0.05). 4. Of 8 cases with small opacities on chest radiograph, 1 case had small opacity of category 1/0(s/s) and the other 7 cases had small opacities of category 0/1. Two cases had past history of pulmonary tuberculosis, but radiologic findings were not consistent with tuberculosis. Two cases with less than 5 years of employment had previous history of dust exposure. Although specific etiologic factors were not clear with this study alone, authors suspected that specific geological factors in the Pohang area(soils rich in diatomaceous earth, bentonite and fullers' earth etc.) may have some role in development of small opacities. Above results suggests that follow up investigation for further development and progression of pneumoconiosis and effective measures to prevent dust exposure of road workers are needed.

일개 연탄공장 주변 지역주민들의 건강실태에 관한 조사

정해관,임현술 동국대학교 경주대학 1992 東國論集 Vol.11 No.-

Authors studied the effect of environmental coal dust contamination on the health status of inhabitants around a briquet factory and attempted to find out new cases of pneumoconiosis in this area. questionnaire survey was done on 2,002 persons of 497 households in Sangbong 1, 2-dong area within 1km distance from the briquet factory. On the basis of questionnaire survey, physical examination was done and chest X-ray was taken on 87 persons with risk of pneumoconiosis. Results are as follows : 1. questionnaire survey a. Respiratoy symptoms complained were coal dust expectoration(22.3%), sorethroat(21.1%), chest pain(15.7%), rhinorrhea(13.3%), cough(13.0%) and dyspnea(11.7%). Other symptoms complained were musculoskeletal, ophthalmological, cardiovascular, gastrointestinal, neuropsychiatric and dermatological in order. b. Inhabitants living within 500 meters distance from the factory complained more respiratory symptoms than those living outside this area. complaints of coal dust expectoration and frequent URI were more frequent in those living within 500 meters from the factory than those living outside(P<0.05). c. In surveyed population, incidence of acute illness was 108.6 spells and incidence of respiratory illness was 80.7 spells per 1,000 persons. But distance from factory and duration of residency in this area were not related to the incidence of acute illness. Admission rate was 40.6 spells per 1,000 persons in a year and there were 23 deaths during 3 years. 2. Mass examination. a. On chest X-ray, 3 cases of pneumoconiosis and 3 cases of suspected pneumoconiosis were found among 87 persons examined. b. Among them, a case of pneumoconiosis and a case of suspected pneumoconiosis had had occupational exposure history to coal dust. It was assumed that in the other 4 cases, their pneumoconiosis was related to their environmental coal dust exposure. c. 6 cases lived from 6 to 33 years in that area and away from 200 to 700 meters' distance from the factory.

근로자 건강진단시 간기능 이상자의 정밀검사항목 개선을 위한 조사연구

정해관,임현술,김규회,Cheong, Hae-Kwan,Lim, Hyun-Sul,Kim, Gyu-Hoi 대한예방의학회 1994 Journal of Preventive Medicine and Public Health Vol.27 No.4

Workers' periodic health examination is the main tools used to manage the health problems of most workers in Korea. The most common health problem found in workers' periodic health examination is liver disorder. Liver disorder is also one of the most common health problems in general population and one of the leading causes of mortality in adult population. Regulation proposed by government (No. 207, Ministry of Labor, 1992) defines the criteria for selection of workers with the liver dysfunction for further evaluative examination and the examination items used for diagnosis of the workers with liver dysfunction. This study was designed to evaluate the proficiency of each examination items presently defined in Regulation and propose the optimal examination items for detection of the liver disorders found by workers' periodic health examination. Study subjects are 186 workers with abnormal liver function tests in screening examination of workers' periodic health examination. Questionnaire survey including past history of liver disorder, drinking history, height and weight was done. Physical examination by physician, routine test items defined by Regulation (SGOT, SGPT, $\gamma$-GTP, protein, albumin, total and direct bilirubin, alkaline phosphatase, $\alpha$-feto protein, HBsAg and anti-HBs), anti-HCV antibody test and liver ultrasonography were done. Results are as follows; 1. Result of evaluative examination utilizing only the items defined in Regulation was; There were 75 workers with suspected live. disorder(40.3%), 63 with no liver dysfunction (33.9%), 13 with suspected hepatitis B(7.0%), 10 workers with hepatitis B(5.4%), 10 workers with hepatitis B carrier state(5.4%), 10 with alcoholic liver disorders(5.4%), 5 with fatty liver(2.7%). When alternative diagnostic criteria applying additional examination items (drinking history, body mass index, anti-HCV antibody and ultrasonography) diagnosability of liver disorder was increased. When all four items were included, final results were; 23 workers (17.8%) with hepatitis B (10 carriers, 13 suspects and 10 hepatitis B), 10 (5.4%) with hepatitis C(4 carriers, 5 suspects and 1 hepatitis C), 13(7.0%) with alcoholic liver disorder, 45(24.2%) with fatty liver (40 suspects, 5 fatty liver), 410%) with suspected liver disorders and 44 (23.7%) with normal liver. 2. Of examination items defined by Regulation, only SGOT, SGPT, $\gamma$-GTP and HBsAg were significantly different in abnormal rate and mean value, and all other laboratory findings did not showed significant difference between two groups. Drinking history, body mass index and anti-HCV antibody test which are the items that authors included in this study, also showed significant difference between two groups. Utilization of body mass index (BMI) for abnormal liver function group in diagnosis of fatty liver had high specificity (97.6%) but sensitivity (22.3%) was low. Therefore we suggest that SGOT, SGPT, $\gamma$-GTP, HBsAg, alcohol drinking history, BMI and anti-HCV Ab were useful for diagnosis of liver disorders among worker's periodic health examination.

환경독성보건학회의 새로운 출발에 즈음하여

정해관,정규혁 환경독성보건학회 2010 환경독성보건학회지 Vol.25 No.2

망간노출로 인한 신경장해의 임상적 양상

정해관,마샤 라트너,로버트 펠드만 東國大學校醫學硏究所 2002 東國醫學 Vol.9 No.1

망간의 신경독성은 19세기 초 이래 널리 알려져 왔다. 고전적 망간중독은 파킨스증후 군을 유발하나 그 임상적 양상이 파킨슨병과는 명확하게 구별된다는 점이 인정되고 있다. 그러나 최근 들어 망간 노출 농도가 낮아지는 반면 노출인구는 증가하면서 저농도 노출에 의한 신경장해의 범위에 대해서 논란이 있어왔다. 특히 인구 노령화에 따른 각종 신경퇴행성 질환과는 구별도 필요하게 되었다. 저자들은 최근까지 보고된 직업적, 비직업적 망간 노출인구에서의 건강장해에 대한 임상적, 역학적 연구들을 비교 분석하여 망간 노출에 따른 신경장해를 다음과 같은 5가지 범주로 구분하였는데, 이들은 만성 망간중독, 파킨슨병, 추체외로증후군, 임상전 단계 및 변형증후군 등이다. 이와 같은 임상적 구분은 망간 독성의 병태생리를 이해하는데 도움을 줄뿐 아니라 직업적 및 비직업적 망간노출을 평가하는데도 유용한 도구로 사용될 수 있을 것이다. Neurotoxicity of manganese is known since the report of manganism in early 19th century. However, there are controversies on the range of the clinical manifestation of manganese exposure, especially after the introduction of magnetic resonance imaging on the exposure assessment of manganese exposure. The authors categorized various clinical syndromes of neurologic disorders, which are suggested to be related to occupational or non-occupational manganese exposure, into five stages; chronic manganism, Parkinson's disease, extrapyramidal syndrome, subclinical stage, and variant cases. This categorization will be useful in understanding the pathophysiology of the manganese toxicity and could be utilized in assessment of occupational and non-occupational manganese exposure.

有機게르마늄에 대한 올바른 知識

鄭海觀 약업신문사 1996 의약정보 Vol.1996 No.8

직업적 망간 폭로에 있어서 뇌자기공명영상의 의의

정해관 대한자기공명의과학회 1998 Investigative Magnetic Resonance Imaging Vol.2 No.1

망간은 체내 필수원소의 하나이며 주로 간과 뇌의 기저핵게 축적되며 간을 통하여 배설된다. 망간은 체내 대사가 매우 빠르기 때문에 직업적 망간 폭로를 측정하는데 어려움이 있다. 특히 용접공과 같이 망간 폭로가 간헐적이거나 불규칙한 경우에는 혈중 및 요중 망간과 같은 기존 생체폭로지표로는 장기간에 걸친 폭로량을 정확하게 반영하기 힘들다. 뇌자기공명영상이 대두됨에 따랄 뇌내에 축적된 망간을 영상으로 확인하는 것이 가능하게 되었다. 초기에는 만성간부전 및 장기간에 걸친 정맥영양주입환자 등에서 뇌기저부의 고신호간도 소견이 보고되었다. 망간은 상자성 물질로 뇌자기공명영상에서 T1 이완시간을 단축시켜 T1 강조영상에서 고신호강도를 나타난다. 망간축적에 따른 고신호강도는 주로 담창구, 흑질, 피간 및 뇌하수체 등에서 나타난다. 저자들은 최근까지 국내 및 국외에서 직업적 및 비직업적으로 망간에 폭로된 사람에서 보고된 뇌자기공명영상소견을 수집하여 분석하였다. 우선 T1강조영상에서 관찰되는 고신호 강도와 연령, 성별, 직업적 망간 폭로 및 신경학적 이상 유무간의 관계를 분석하였다. 생물학적 폭로지표와 고신호강도간의 관계도 분석하였다. 고신호강도와 뇌내 망간축적, 신경세포손상 및 신경학적 이상간의 관계에 대한 문헌들을 분석하였다. T1강조영상에서 나타나는 고신호강도는 뇌내 망간축적 정도를 반영한다. 이러한 관계를 이용하여 신호강도를 분석하므로써 뇌내 망간축적 정도를 추정할수 있다. 뇌내 망간축적은 기저핵의 신경세포손상을 초래한다. 그러나 신경학적 이상은 비교적 단기간에 걸친 망간 축적과는 무관하게 보인다. 이는 신경학적 이상소견은 마간의 누적축적량과 관련되어 있기 때문인것으로 추정된다. 뇌자기 공명영사에서 관찰되는 고신호강도 소견은 표적 장기의 망간적 축적량을 반영하는데는 충분하지 못한 것으로 보인다. 따라서이러한 놔자기공명영상의 특성 및 비용-효과적인 측면을 고려할 대 망간폭로집안에서의 망간폭로정도를 추정하기 위하여 놔자기공명영상을 사용하는 것은 바람직하지 않다고 보인다. 그러나 망간과 관련된 건강장해가 의심되는 파킨슨증 환자에서 망간폭로를 확인 및 추정하는 데에는 매우 유용하게 활용할 수 있다. Manganese is an essential element in the body. It is mainly deposited in the liver and to a lesser degree in the basal ganglia of the brain and eliminated through the bile duct. Rapid turnover of managanese in the body makes it difficult to evaluate the manganese exposure in workers, esecially in those with irregular or intermittent exposure, like welders. Therefore, conventional biomarkers, including blood and urine manganese can provide only a limited information about the long-tern or cumulative exposure to manganese. Introduction of magnetic resonance imaging (MRI) made a progress in the assessment of manganese exposure in the medical conditions related to manganese accumulation, e. g. hepatic failure and long-term total parenteral nutrition. Manganese shortens spin-lattice(T1) relaxation time on MRI due to its paramagnetic property, resulting in high signal intensity (HSI) on T1-weighted image(T1W1) of MRI. Manganese deposition in the brain, therefore, can be visualizedas an HSI in the globus pallidus, the substantia nigra, the putamen and the pituitary. clinical and epidemiologic studies regarding the MRI findings in the cases of occupational and non-occupational manganese exposure were reviewed. relationships between HSI on T1W1 of MRI and age, gender, occupational manganese exposure, and neurological dysfunction were analysed. Relationships betwen biological exposure indices and HSI on MRE werealso reviewed. Literatures were reviewed to establish the relationships between HSI, Manganese deposition in the brain, pathologic findings, and neurological dysfunction. HSI on T1W1 of MRI reflects regional manganese deposition in the brain. This relationship enables an estimation of regional manganese deposition in the brain by analysing MR signal intensity. Manganese deposition in the brain can induce a neuronal loss in the basal ganglia but functional abnormality is supposed to be related to the cumulative exposure of manganese in the brain, use of brain MRI for the assessment of exposure in a group of workers seems to be hardly rationalized, while ti can be a useful adjunct for the evaluation of manganese exposure int he cases with suspected manganese-related health problems.

1995년 포항시에서 발생한 콜레라 유행에 관한 역학 조사

정해관,최병순,김익중,임현술 東國大學校 嶺南地域發展硏究所 1996 地域發展硏究 Vol.2 No.1

Unrecognized Bomb Hidden in the Babies’ Room: Fatal Pulmonary Damage Related with Use of Biocide in Humidifiers

정해관,하미나,이종현 환경독성보건학회 2012 환경독성보건학회지 Vol.27 No.-