Screening of Workers with Presumed Occupational Methanol Poisoning: The Applicablility of a National Active Occupational Disease Surveillance System

Eom, Huisu,Lee, Jihye,Kim, Eun-A Occupational Safety and Health Research Institute 2019 Safety and health at work Vol.10 No.3

Background: Methyl alcohol poisoning in mobile phone-manufacturing factories during 2015-2016 was caused by methyl alcohol use for cleaning in computerized numerical control (CNC) processes. To determine whether there were health complications in other workers involved in similar processes, the Occupational Safety and Health Research Institute conducted a survey. Methods: We established a national active surveillance system by collaborating with the Ministry of Employment and Labor and National Health Insurance Service. Employment and national health insurance data were used. Overall, 12,048 employees of major domestic mobile phone companies and CNC process dispatch workers were surveyed from 2016 to 2017. We investigated methyl alcohol poisoning by using the national health insurance data. Questionnaires were used to investigate diseases due to methyl alcohol poisoning. Results: Overall, 24.9% of dispatched workers were employed in at least five companies, and 23.9% of dispatched workers had missing employment insurance history data. The prevalence of blindness including visual impairment, optic neuritis, visual disturbances, and alcohol toxicity in the study participants was higher than that reported in the national health insurance database (0.02%, 0.07%, 0.23%, and 0.03% versus 0.01%, 0.07%, 0.13%, and 0.01%, respectively, in 2015). Moreover, 430 suspicious workers were identified; 415 of these provided an address and phone number, of whom 48 responded (response rate, 11.6%). Among the 48 workers, 10 had diseases at the time of the survey, of whom 3 workers were believed to have diseases related to methyl alcohol exposure. Conclusion: This study revealed that active surveillance data can be used to assess health problems related to methyl alcohol poisoning in CNC processes and dispatch workers.

Effectiveness of workers’ general health examination in Korea by health examination period and compliance

Huisu Eom,Jun-Pyo Myong,Eun-A Kim,Bohwa Choi,Soon Woo Park,Young Joong Kang 대한직업환경의학회 2017 대한직업환경의학회지 Vol.29 No.-

Background: Our study evaluated the effectiveness of the Workers’ General Health Examination by health examination period and compliance. Methods: A retrospective cohort of the health examination participants in 2006 (baseline year: N = 6,527,045) was used. We identified newly occurring cardio-cerebrovascular disease over 7 years (from 2007 to 2013). After stratification by age, sex, and national health insurance type, we identified 7 years’ cumulative incidence of cardio-cerebrovascular disease by health examination compliance and estimated its relative risk by health examination period and compliance. Results: The compliant group presented a lower cumulative incidence of cardio-cerebrovascular disease than the noncompliant group; this result was consistent across sex, working age (40s and 50s), and workplace policyholder. Relative risk of cardio-cerebrovascular disease by health examination period (1 and 2 years) showed statistically significant results in ischemic heart disease for male participants. Of men in their 40s, office workers (over a 2-year period) presented statistically higher relative risk of ischemic heart disease than non-office workers (over a 1-year period: 1.03; 95% confidence interval, 1.02–1.03). However, there were no consistent results in ischemic cerebrovascular disease and hemorrhagic cerebrovascular disease for men or cardio-cerebrovascular disease for women. Conclusion: A 1-year period of Workers’ General Health Examinations in non-office workers had a more significant prevention effect on ischemic heart disease than a 2-year period in office workers among working age (40s–50s) men. It is, however, necessary to consider that prevention of cardio-cerebrovascular disease can be partially explained by their occupational characteristics rather than by health examination period.

A case of azoospermia in a non-destructive testing worker exposed to radiation

Jaechan Park,Sanggil Lee,Chulyong Park,Huisu Eom 대한직업환경의학회 2017 대한직업환경의학회지 Vol.29 No.-

Background: Interest in radiation-related health problems has been growing with the increase in the number of workers in radiation-related jobs. Although an occupational level of radiation exposure would not likely cause azoospermia, several studies have reported the relation between radiation exposure and azoospermia after accidental or therapeutic radiation exposure. We describe a case of azoospermia in a non-destructive testing (NDT) worker exposed to radiation and discuss the problems of the related monitoring system. Case presentation: A 39-year-old man who was childless after 8 years of marriage was diagnosed with azoospermia through medical evaluations, including testicular biopsy. He did not have any abnormal findings on biochemical evaluations, other risk factors, or evidence of congenital azoospermia. He had been working in an NDT facility from 2005 to 2013, attaching and arranging gamma-ray films on the structures and inner spaces of ships. The patient’s thermoluminescent dosimeter (TLD) badge recorded an exposure level of 0.01781 Gy for 80 months, whereas results of his florescence in situ hybridization (FISH) translocation assay showed an exposure level of up to 1.926 Gy of cumulative radiation, which was sufficient to cause azoospermia. Thus, we concluded that his azoospermia was caused by occupational radiation exposure. Conclusion: The difference between the exposure dose records measured through TLD badge and the actual exposure dose implies that the monitor used by the NDT worker did not work properly, and such a difference could threaten the health and safety of workers. Thus, to protect the safety and health of NDT workers, education of workers and strengthening of law enforcement are required to ensure that regulations are strictly followed, and if necessary, random sampling of NDT workers using a cytogenetic dosimeter, such as FISH, should be considered.

Work-related olfactory disorder

Soon Woo Park,Young Joong Kang,Huisu Eom,Hyun-Jin Cho,Jungho Ahn,Sang-Gil Lee 대한직업환경의학회 2018 대한직업환경의학회지 Vol.30 No.-

Background: The olfactory bulb is anatomically exposed and thus can be directly damaged by external stimulation. This can occur as an occupational injury owing to contact with organic solvents or other causes. We present cases of eight patients who sustained occupation-related exposure to potentially toxic substances and later presented with signs and symptoms of anosmia. We examined the occupational and medical characteristics of the patients and evaluated their work-relatedness. Case presentation: Case 1: A 50-year-old man performed high-frequency heat treatments for approximately 11 years. He experienced decreased senses for olfaction and taste during the later years culminating in the diagnosis of anosmia after 3 years (high work-relatedness). Case 2: A 54-year-old man whose work involved exposure to various organic solvents, such as spray painting and application of paint and thinners for approximately 4 years, was subsequently diagnosed with anosmia based on rhinorrhea, headache, and loss of olfaction (high work-relatedness). Case 3: A 44-year-old-man who performed spray painting for approximately 17 years developed anosmia (high work-relatedness). Case 4: A 44-year-old man was involved in ship engine cleaning once a month, for approximately 7 h per cleaning session; he was diagnosed with anosmia based on loss of olfaction (low workrelatedness). Case 5: A 41-year-old man worked in ship building block construction for approximately 13 years; anosmia diagnosis was based on loss of olfaction (low work-relatedness). Case 6: A 47-year-old woman performed product inspection and labeling at a plant manufacturing automobile parts; anosmia diagnosis was based on decreased olfaction and taste (low work-relatedness). Case 7: A 50-year-old woman performed epoxy coating in a plant manufacturing automobile parts; anosmia diagnosis was based on diminishing olfaction (low workrelatedness). Case 8: A 57-year-old woman performed cleaning of the area where mobile phone parts were manufactured; anosmia diagnosis was based on diminishing olfaction (low work-relatedness). Conclusion: The study results confirmed work-relatedness when the subject was young, and the duration of exposure was long without any other cause of anosmia. Regarding compensation for occupational diseases, work-relatedness can be recognized as a relative concept.

Ovarian cancer in a former asbestos textile factory worker

Sunwook Park,Jaechan Park,Eunsoo Lee,Huisu Eom,Mu Young Shin,Jungwon Kim,Dongmug Kang,Sanggil Lee 대한직업환경의학회 2018 대한직업환경의학회지 Vol.30 No.-

Background: The International Agency for Research on Cancer (IARC) defined that asbestos is a group 1 substance that causes lung cancer, mesothelioma (pleura and peritoneum), laryngeal cancer, and ovarian cancer in humans. Many studies on lung cancer, and mesothelioma caused by asbestos exposure have been conducted, but there was no case report of ovarian cancer due to asbestos exposure in Korea. We describe a case of ovarian cancer caused by asbestos exposure in a worker who worked at an asbestos textile factory for 3 years and 7 months in the late 1970s. Case presentation: A 57-year-old woman visited the hospital because she had difficulty urinating. Ovarian cancer was suspected in radiologic examination, and exploratory laparotomy was performed. She was diagnosed with epithelial ovarian cancer. The patient did not undergo postoperative chemotherapy and recovered. She joined the asbestos factory in March 1976 and engaged in asbestos textile twisting and spinning for 1 year, 2 years and 7 months respectively. In addition, she lived near the asbestos factory for more than 20 years. There was no other specificity or family history. Conclusion: Considering the patient’s occupational and environmental history, it is estimated that she had been exposed to asbestos significantly, so we determined that ovarian cancer in the patient is highly correlated with the occupational exposure of asbestos and environmental exposure is a possible cause as well. Social devices are needed to prevent further exposure to asbestos. It is also necessary to recognize that ovarian cancer can occur in workers who have previously been exposed to asbestos, and the education and social compensation for those workers are needed.

Participation inequality in the National General Health Examination based on enterprise size

Young Joong Kang,Jong Heun Park,Huisu Eom,Bohwa Choi,Seyoung Lee,Ji-Won Lee,Jun-Pyo Myong 대한직업환경의학회 2017 대한직업환경의학회지 Vol.29 No.-

Background: Health examinations are performed so that diseases can be identified and treated earlier. Several studies have evaluated the determinants of participation in health examinations including cancer screening, but few have evaluated the relationship between the size of the enterprise and their participation in Workers’ General Health Examinations (WGHE). The aim of the present study was to estimate the association of WGHE participation with the size of the enterprise and the type of policyholder. Methods: The eligible population from 2006 through 2013 was extracted from the National Health Insurance Service (NHIS) database. The population size ranged from 14–17 million. After adjustment for age and gender, multiple logistic regression analysis was performed to estimate the odds ratios of participating in the WGHE (by age group) based on the type of policyholder (reference: public officers) and the size of the enterprise (reference: enterprise size ≥300 employees), respectively. Results: Workers employed at enterprises with <50 persons were less likely to participate in WGHEs than those employed at enterprises with ≥300 persons. After policyholders were stratified by type (non-office workers vs. public officers), a disparity in the WGHE participation rate was found between the different types of policyholders at enterprises with <50 employees (reference: those employed at enterprises with ≥300 employees); the odds ratios for subjects in their 40s and 50s were 0.2–0.3 for non-office workers vs. 0.8–2.0 for public officers. Conclusion: Workplace policyholders at small enterprises comprised a vulnerable group less likely to participate in WGHEs. Efforts should be made to raise the WGHE participation rate among the vulnerable employees belonging to small enterprises, as well as among their dependents.

The current condition of the workers’ general health examination in South Korea

Young Joong Kang,Jun-Pyo Myong,Huisu Eom,Bowha Choi,Jong Heon Park,Eun-A L Kim 대한직업환경의학회 2017 대한직업환경의학회지 Vol.29 No.-

Background: Business owners in the Republic of Korea must take part in the workers’ general health examination. However, there have been few formal analyses of the uptake of this examination by employees. In the present study, we examined the rates of participation in medical examinations according to age group, health insurance type, and enterprise size, and then compared these results with those of the national general health screening. Furthermore, we determined the distribution of patients with abnormal results for diabetes and hypertension, and outlined the significance and history of domestic health examinations. Methods: We started by comparing participation rates extracted from the among health examination data of the National Health Insurance Service from 2006–2013 by sex, age, insurance type, and enterprise size of workplace health insurance beneficiaries (i.e., those whose insurance is provided by their workplace). In addition, we analyzed the prevalence rates of abnormal results for hypertension and diabetes, and explored the history and significance of health examinations in the Republic of Korea. Results: The overall participation rate in the primary health examination in 2006 was 56%, and this increased to 72% in 2013. However, the rates of the secondary screening did not increase much. Among workplace policyholders (i.e., those whose insurance is provided by their workplace), the participation rates of workers in enterprises with less than 50 employees were lower than were those in enterprises with 50 or more employees. Notably, the rates and odds ratios of patients with abnormal results for diabetes and hypertension were relatively high, particularly among those working in smaller enterprises. Conclusions: Although the workers’ general health examination has been replaced with the national general health screening, it remains necessary to ensure uniform health management services among all workers in the Republic of Korea. This can, in turn, promote occupational health and improve working conditions throughout the Republic of Korea.

Practice status of specialized agencies for occupational health management of small-to medium-size enterprises and the factors improving their performance

Saerom Lee,Jun-Pyo Myong,Eun-A Kim,Huisu Eom,Bowha Choi,Young Joong Kang 대한직업환경의학회 2017 대한직업환경의학회지 Vol.29 No.-

Background: We examined the current status of specialized agencies for occupational health management (SAs) and their workforce. Furthermore, we aimed to clarify the current practice status of SA healthcare professionals and factors that influence their performance. Methods: To examine the current SA workforce, we analyzed data from the 2014 Survey of Current Status of SA and their Workforce from the Ministry of Employment and Labor (MOEL). Furthermore, we mailed out an original questionnaire to SA professionals to determine their current health management status and factors that affect their performance. Data from the respondents (N = 384) were analyzed. Results: In 2014, the workforce performing health management in SAs comprised 232 physicians, 507 nurses, and 312 occupational hygienists, with no significant regional differences in the distribution of physicians and nurses. According to the findings of the questionnaire, the average daily number of worker consultations by physicians and nurses was 22.8, while the average time taken for health management ranged from 74.3 to 104.3 min, depending on the size of the firm. Most of the respondents (41.5%) answered that they were following-up on more than 80% of individuals with illnesses. Among health management tasks, performance scores of “consultations for general diseases” and “consultations for lifestyle habits” were relatively high, whereas health promotion activities at workplaces were relatively low. There was a significant correlation between the utilization of general and special health examination results and task performance. Conclusion: Among health management tasks, follow-up management of individuals with illnesses and consultations for disease/lifestyle habits were relatively well performed, whereas health promotion activities at workplaces were not performed well. Among factors that positively influenced SA performance at workplaces, only the utilization of health examination results had significant effects. Therefore, to accomplish health management goals and perform effective health management at workplaces, there is a need to establish a comprehensive system of occupational health service outsourcing integrating health examinations and health management services. Furthermore, the current task system, which focuses on follow-up management, should be expanded to incorporate preventive and health promotion functions—the fundamental functions of occupational health services (OHS).

Erratum to: Practice status of specialized agencies for occupational health management of small- to medium-size enterprises and the factors improving their performance : a cross-sectional survey study

Saerom Lee,Jun-Pyo Myong,Eun-A Kim,Huisu Eom,Bowha Choi,Young Joong Kang 대한직업환경의학회 2017 대한직업환경의학회지 Vol.29 No.-

가습기 살균제 제조 공정 근로자 건강영향 조사

강영중(Young Joong Kang),박순우(Soon Woo Park),엄희수(Huisu Eom),김은아(Eun-A Kim) 한국환경보건학회 2018 한국환경보건학회지 Vol.44 No.5

Objectives: An outbreak of humidifier disinfectant-related respiratory disease has not only been a massive disaster for end users, but it is also a concern for the workers of the manufacturers. This study presents the results of a questionnaire survey on the health effects among workers involved in the manufacture of humidifier disinfectants. Methods: Seven sites where humidifier disinfectants were manufactured were identified. A questionnaire survey was conducted to assess the physical symptoms experienced by workers related to humidifier disinfectants. Among a total of 177 workers, 42 subjects were available for the survey. Results: Twenty-one of the 42 respondents reported that they experienced respiratory or skin and mucosal irritation symptoms during work. Of the respondents who experienced symptoms, 14 believed that their symptoms were related to the work process and reported that the symptoms were experienced while working. However, no respondents reported ongoing symptoms or sequelae during the investigation period, and this result could not minimize selection bias due to low response rates. We then compared the characteristics of the group who experienced suspicious symptoms with those of the group without any symptoms. There was no statistically significant difference between two groups. Conclusions: We could not find significant health effects related to the humidifier disinfectant manufacturing process, although 21 respondents experienced stimulant symptoms and 14 respondents believed that the symptoms were related to the work process. Due to the long period of time after occupational exposure and the lack of data, there were many limitations to this study. However, this is one of the few follow-up investigations of workers related to this large-scale disaster in South Korea and the limitations of this study highlight the need to follow up with a nationwide database rather than an occasional survey.