업종에 따른 연 취급 사업장의 기중 연 농도 및 연 노출 수준 평가

이병국,김용배,리갑수,안현철,김화성,이용진,황규윤,장봉기,이성수,안규동 순천향대학교 산업의학연구소 1999 순천향산업의학 Vol.5 No.1

In order to obtain an useful information for health management and biological monitoring of lead exposed workers, Authors tried to investigate air lead level and the lead exposed level of workers in lead industry according to occupational category. The subjects in our study were 2074 workers in 7 lead-using industries, and study subjects were divided into 4 occupational categories such as storage battery industry (type 1), primary smelting industry (type 2), secondary smelting industry (type 3) and litharge making industry (type 4). Blood zincprotoporphyrin concentration (ZPP), blood lead concentration (PbB) and urinary δ -aminolevulinic acid (ALAU), hemoglobin (Hb), hematocrit (Hct) were selected as the indices of lead exposure. Personal variables such as age, work duration were also collected. The results were as follows. 1. The geometric mean air lead in 9 lead-using industry was 0.1133±4.3120 ㎎/㎥, and that in type 1, 2, 3 and 4 was 0.1038±3.4952 ㎎/㎥, 0.0429±3.4329 ㎎/㎥, 0.1877±2.5123 ㎎/㎥ and 0.9961±5.2910 ㎎/㎥, respectively. 2. The mean ZPP in 9 lead-using industry was 53.1±28.0 ㎍/㎗, and that in type 1, 2, 3 and 4 was 52.0±24.8 ㎍/㎗, 48.0±16.4 ㎍/㎗, 109.8±85.6 ㎍/㎗ and 74.3±37.8 ㎍/㎗, respectively. There was significant difference in ZPP according to occupational category (P<0.01). The percents of lead workers whose ZPP were above 100 ㎍/㎗ in type 1, 2, 3 and 4 were 4.0%, 1.7%, 34.3% and 21.6%, respectively. 3. The mean PbB in lead-using industry was 26.0±11.2 ㎍/㎗, and that in type 1, 2, 3 and 4 was 25.3±11.1 ㎍/㎗, 26.7±8.8 ㎍/㎗, 50.3±15.2 ㎍/㎗ and 36.4±11.0 ㎍/㎗, respectively. There was significant difference in PbB according to occupational category (P<0.01). The percents of lead workers whose PbB were above 40 ㎍/㎗ in type 1, 2, 3 and 4 were 10.4%, 7.7% 71.9% and 43.2%, respectively. 4. While the correlation of Hb corrected PbB with ZPP was higher than non corrected PbB, the correlation of log-transformed ZPP with PbB was higher than non corrected ZPP. 5. Simple linear regressions of PbB and corrected PbB as independent variable with ZPP, log-transformed ZPP and ALAU as dependent variable were statistically significant (P0.01). Coefficient of determination of corrected PbB with other variables was higher than non corrected PbB. As the result of this study, it was suggested that reconsideration of environmental and biological monitoring program was highly recommended for secondary smelting and litharge making industry.

연폭로 근로자들의 연폭로 수준에 따른 혈압변화에 관한 연구

리갑수,안현철,김용배,이성수,안규동,이병국 순천향대학교 산업의학연구소 1997 순천향산업의학 Vol.3 No.1

To evaluate the blood pressure change of lead workers by lead exposure level, authors analyzed 1,009 lead workers. Study variables were systolic and diastolic blood pressure, smoking and drinking habit, age, work duration, blood lead concentration(PbB), ZPP, hemoglobin, BMI and cholesterol. The results were obtained as follow; 1. Means of systolic and diastolic blood pressure were 126.93mmHg and 74.08mmHg. Systolic pressures were significantly higher in males and drinkers than in females and non-drinkers. Blood pressure was increased as age and work duration were increased. 2. Means of PbB and ZPP were 26.79㎍/㎗, 61.38㎍/㎗ respectively. Male workers' PbB was higher than female workers', and ZPP was contrary. PbB and ZPP were increased as age and work duration were increased. Smokers' and drinkers' PbB were not different from nonsmokers' and nondrinkers' but ZPP were lower. 3. As PbB was increased, systolic pressure was increased, but diastolic pressure was not increased. 4. There were no significant increase in both systolic and diastolic pressure by increase of ZPP. 5. In pearson's correlation analysis, systolic pressure was correlate with BMI(R^(2)=0.2618), hemoglobin (R^(2)=0.1794), cholesterol(R^(2)=0.14334), PbB(R^(2)=0.12616) and alcohol consumption per week(R^(2)=0.10925). 6. In pearson's correlation analysis, diastolic pressure was correlate with BMI(r-square : 0.25037), age, hemoglobin, cholesterol and work duration, but not correlate with PbB. 7. Forward multiple regression analysis using systolic pressure as dependent variable revealed that BMI, PbB hemoglobin and cholesterol in order were significantly contributed to dependent variable. 8. Forward multiple regression analysis using diastolic pressure as dependent variable revealed that BMI, age, hemoglobin, smoking and cholesterol in order were significantly contributed to dependent variable.

심혈관계 질환으로 관상질환 집중치료실에 입원한 환자들의 혜후 측정을 위한 APACHEⅢ점수 체계의 임상적 유용성

이공섭,이창선,최현주,홍종서,강지향,김도형,이민영,오인균,김병엽,김상억,김학찬,한승혜,이재용,지영우,안경주 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.8

납 폭로 근로자에서 δ-aminolevulinic acid dehydratase 유전형질이 zinc protoporphyrin 및 δ-aminolevulinic acid에 미치는 영향

이병국,황규윤,장봉기,김용배,리갑수,안현철,김화성,이성수,안규동,박종범 순천향대학교 산업의학연구소 1999 순천향산업의학 Vol.5 No.1

The inhibition of δ-aminolevulinic acid dehydratase (ALAD) in the heme synthetic pathway results in increased protophoryphyrin (ZPP) and δ-aminolevulinic acid (ALA) and is responsible for some of toxicological effects of lead. This enzyme is coded by the ALAD gene containing 2 co-dominant alleles. The polymorphisms of ALAD gene may be related to differential effects of lead on ZPP and ALA, ALAD genotype was measured in 975 Korean male lead workers, of whom 897 were homozygous for ALAD1 (ALAD 1-1 genotype) and 96 were heterozygous for ALAD2 (ALAD 1-2 genotype). Blood lead in subjects with ALAD1 was significantly higher than those with ALAD2 (p = 0.01). No difference between ALAD genotypes was found for age, exposure duration, ZPP, ALA, hemoglobin, hematocrit, body mass index, tobacco and alcohol use. After adjustment for possible confounders, ALA and ZPP became significantly elevated in ALAD1 subjects (p = 0.004 and 0.055, respectively). This result suggests that ALAD1 subjects may be more susceptible to the hematotoxicologic effects of lead than ALAD2 subjects.

연골외막세포가 포함된 alginate beads를 이용한 토끼에서의 골연골결손 치료

안현정,김은미,정미현,조현철,이인범,성상철,이명철 대한정형외과연구학회 2003 대한정형외과연구학회지 Vol.6 No.2

가토 외고정 모델을 이용한 치밀체형 세라믹스의 골결합능 평가

이재협,이동호,이재학,공현식,안영준,류현승,서준혁,홍국선,김환,장봉순,이춘기 대한정형외과연구학회 2003 대한정형외과연구학회지 Vol.6 No.2

노화로 인한 신체적 기능 쇠퇴와 고령자를 위한 욕실 디자인 가이드라인 관계 연구

이연숙(Lee, Yeun-Sook),임현진(Lim, Hyun-Jin),이지혜(Lee, Ji-Hye),안창헌(Ahn, Chang-Houn) 한국실내디자인학회 2013 한국실내디자인학회논문집 Vol.22 No.5

Advancement toward aging society has presented the importance of house planning in consideration of the elderly, increasing the necessity of such planning. Therefore the importance of indoor design guideline for elderly houses has been stressed and the understanding of the aging in regard to this trend will create more mature spaces. In line with this trend the purpose of this study is to study the medical factors related with bathroom interior design guidelines of the existing elderly houses from the viewpoint of deteriorating physical functions due to aging process. In order to research the deterioration of physical functions due to aging literatures of medical and exercise physiology were used and concerning the existing bathroom design guidelines for the aged people, the guideline items of behavior facilitation, physiological maintenance and perceptual maintenance aspects out of Murtha & Lee’s user benefit criteria(1976) related with physical functions were selected to research in relation with the knowledge about the deterioration phenomena of physical functions. Physical aging and deterioration aspects were classified from the viewpoint of musculoskeletal disorder, cardiovascular disorder, respiratory disorder, gastronomy disorder, urology disorder, somatosensory disorder, endocrine disorder, immune disorder, nervous disorder and skin diseases and these were utilized in interpreting total 100 items of bathroom design guideline. Because bathroom is the space where many physical movements are done, it had the closest relationship with the deterioration of musculoskeletal health in general and as bathroom is the space where people use water and feel the difference in temperature and moisture more than other spaces, deterioration of skin and somatosensory health had the next closest relationship. The result of this study revealed that regarding the deterioration of physical functions of the elderly people in aspect of their perceptibility as designers will design creatively and sincerely based on its relationship with nervous system in future, the result of this study will be used to develop better spatial designs efficiently to meet for the aging society.

직업적 연폭로에서 혈중 연량 수준에 따른 선별검사로서의 혈중 ZPP 검사의 타당도

한구석,안현철,김용배,리갑수,김화성,황규윤,장봉기,이성수,안규동,이병국 순천향대학교 산업의학연구소 1999 순천향산업의학 Vol.5 No.1

In order to evaluate the validity of current screening criteria of lead exposure and to provide effective information for the better health management of lead workers, author investigated the interrelationship between blood lead and blood zinc protoporphyrin(ZPP) and evaluate the validity of blood zinc protoporphyrin as the screening test and blood lead as gold standard of diagnostic test. The total of 2245 lead workers (male workers: 1982, female workers : 263) from 12 lead using industries were studied. Blood lead, ZPP, hemoglobin and hematocrit were selected as lead exposure variables. Personal information on sex, age and work duration were also checked. Blood lead was measured with flameless atomic absorption spectrometry (model: Hitachi 8100) using standard addition method. Blood ZPP was measured with portable hematoflurometer (model: Aviv 206). The results obtained were as follows: 1. The mean blood lead of all lead workers were 0.7±14.3㎍/㎗(Male: 31.0±14.4㎍/㎗, Female: 28.2±12.9㎍/㎗), whereas the mean blood ZPP of those were 68.1±47.5㎍/㎗(Male: 63.9±43.7㎍/㎗, Female: 100.1±61.0㎍/㎗). The mean value of hemoglobin and hematocrit of all lead workers were 14.5±1.5g/㎗(Male: 14.7±1.3g/㎗, Female: 12.3±1.2g/㎗) and 45.4±3.6(Male: 46.2±2.8, Female: 39.5±3.1) respectively. 2. Validity of test using blood zinc protoporphyrin as screening test for blood lead levels of 30㎍/㎗ as gold standard of diagnostic test revealed that the highest validity value for male and female lead workers were 50 and 90 ㎍/㎗ of ZPP respectively, showing 50 and 60 ㎍/㎗ of ZPP for all lead workers. While those test for blood lead levels of 40㎍/㎗ as gold standard of diagnostic test revealed that the highest validity value for male and female lead workers were 60 and 90 ㎍/㎗ of ZPP respectively, showing 60 ㎍/㎗ of ZPP for all lead workers, those test for blood lead levels of 50 and 60㎍/㎗ as gold standard of diagnostic test revealed that the highest validity value for male and female lead workers were 60 or 70 and 100 ㎍/㎗ ZPP respectively, showing 60and 70 or 80 ㎍/㎗ of ZPP for all lead workers. 3. Predictive value of test using blood zinc protoporphyrin as the screening test for different blood lead levels of 30, 40, 50 and 60㎍/㎗ as gold standard of diagnostic test revealed that positive predictive value of screening test were decreased by the increase of blood lead level regardless of csreening criteria value ZPP and negative predictive value of screening test were increased accordingly regardless of screening criteria value of ZPP. On the other hand, within same blood lead level as a gold standard positive predictive values were inceased by the increase of screening criteria value of ZPP, whereas the negative predictive value were decreased accordingly by the the increase of screening criteria value of ZPP. 4. The correlation analysis of all lead workers among study variables revealed that CPbB and natural log transformation ZPP(LZPP) were better correlated with other variables and found to be better estimate than PbB and ZPP themselves. The age was correlated with all other variables, but the work duration was not. The correlation analysis of male and female workers among study variables revealed the same results with all lead workers. 5. The slope of simple linear regression of CPbB (independent variable) with ZPP in female workers(3.223)was steeper than in male workers(2.144). That of lead workers with work duration of less than 1 year was steeper than that of lead workers whose work duration was more than 1 year. But there was no slope difference between two groups divided by their work duration of 2 years less and more. The slope of simple linear regression of CPbB lead (independent variable)with ZPP in lead workers whose blood lead were higher than 30㎍/㎗and 40㎍/㎗ were steeper than those whose blood lead were less than 30㎍/㎗ and 40㎍/㎗. 6. The slope of simple linear regression of CPbB (independent variable) with ZPP in lead industries with low mean blood lead were less steeper than those with high mean blood lead. 7. The slope of simple linear regression of CPbB (independent variable) with LZPP in female workers(0.0308was steeper than in male workers(0.0253). That of lead workers with work duration of less than 1 year was steeper than that of lead workers whose work duration was more than 1 year. But where was no slope difference between two groups divided by their work duration of 2 years less and more. While the slope of simple linear regression of CPbB lead (independent variable) with LZPP in lead workers whose blood lead were hogher than 30㎍/㎗ was not steeper than those whose blood lead were less than 30㎍/㎗, there was no slope difference between two groups whose blood lead were less than 40㎍/㎗ and more than 40㎍/㎗. 8. The slope of simple linear regression of CPbB (independent variable) with LZPP in lead industries with low mean blood lead were less steeper than those with high mean blood lead, but the difference was not significant then that of CPbB and ZPP. With above results, it is recommended that the screening criteria value of ZPP should be down to 60-70㎍/㎗ from 100㎍/㎗ for male lead workers and screening criteria of ZPP for female lead workers was all right with current value of 100㎍/㎗. So it is recommended to make different screening criteria of ZPP for male and female workers like the hemoglobin and hematocrit screening criteria. It is also preferable to use CPbB and LZPP rather than uncorrected PbB and ZPP in the evaluation of lead exposure for lead workers.

연취급 근로자들의 사회 심리적 스트레스와 연노출 지표들간의 관련성

김용배,안현철,황보영,리갑수,황규윤,이성수,안규동,이병국 大韓産業醫學會 2000 대한직업환경의학회지 Vol.12 No.1

목 적 : 연취급 근로자를 대상으로 사회 심리적 스트레스 수준을 알아보고 이를 기초자료로 활용하며 사회 심리적 스트레스와 연노출 지표들간의 관련성을 알아보고자 시도하였다. 방 법 ' 1차 연제련업종의 근로자 234명을 대상으로 일반적 특성, 사회 심리적 스트레스, 직업적 특성과 사회적 지지를 문진과 설문지를 통해 확인했으며 연노출 수준을 알기 위해 혈중 ZPP 농도, 혈중연농도, 요중 δ-ALA 배설량, 혈색소, 혈구용적치등을 측정했다. 결 과 : 단일변량 분석결과 혈중 연농도 수준과 직업적 특성에 따른 사회 심리적 스트레스는 유의한 차이가 있었으며 혈중 연농도가 증가함에 따라 스트레스 수준도 증가되는 경향을 나타냈다. 사회 심리적 스트레스와 연노출 지표 및 다른 변수들간의 관련성을 파악하기 위하여 상관분석을 실시한 결과 혈중 연농도만이 사회 심리적 스트레스와 양의 상관관계를 나타냈으며 유의했다. 결 론 : 고농도 연노출의 가능성이 있는 직종인 경우 기존의 연관련 자각증상에 대한 설문조사와 함께 사회 심리적 스트레스 측정도 병행하여 실시하는 것이 연에 의한 건강장해를 조기에 발견하고 예방하는데 필요하다. Objectives : This study was carried out to assess psychosocial distress of lead workers and to examine the relationship between lead exposure indices and psychosocial distress. Methods The study design was cross-sectional and research subjects were 234 lead workers in primary smelting industry. General characteristics, job characteristics and social support were obtained by self-administered questionnaire and history taking. Psychosocial distress was measured using PWI(Psychosocial Well-being Index), a 45-item self-administered instrument. Blood lead(PbB), zinc protoporphyrin(ZPP), δ-aminolevulinic acid in urine (ALAU) were selected as indicators of lead exposure. Results : There was significant difference in PWI according to lead exposure level and job characteristics. The results of correlation analysis showed that PWI was significantly correlated with PbB (r=0.203, p=0.002). Conclusions : Our results supported the association between lead exposure and psy-chosocial distress. The inclusion of psychosoclal distress measurement as a special health examination for lead workers was highly recommended for the effective health manage-ment.

납노출지표와 적혈구내 protein kinase C 활성도의 연관성

황규윤,황보영,안현철,김용배,리갑수,이성수,안규동,이병국 大韓産業醫學會 2001 대한직업환경의학회지 Vol.13 No.4

목적 : Protein kinase C는 칼슘-인지질 의존형인산화 효소로 'H VJ'tfO에서 납에 의하여 활성화되지만, 납에 노출된 인체내에서 그 영향을 평가한 경우는 얼다. 본 연구의 목적은 납에 직업적으로 노출되는 근로자를 대상으로 납 노출이 적혈구막의 단백질내에서 PKC 활성에 의한 인산화 수준에 영향을 주는지 알아보고자 하였다. 방법 : 1998년부터 국내 납 근로자를 대상으로 납에 의한 건강 영향조사가 4년간의 코호트 연구로 실행하였다. 1차년도에 630명의 납 근로자와 135명의대조군이 조사되었고 이들중 본 연구에서는 직업적노출이 되는 사업장에 근무하는 212명의 근로자를대상하였다. 156명의 남자와 56명의 여자 근로자를 대상으로 인구학적, 과거병력, 직업력 등을 구조화된 설문과 면접으로 조사되었고 납 노출 평가는 혈중 납농도 및 ZPP, 경골중 납농도를 측정하였다. PKC의 활성도는 적혈구막 단백질내 PKC 의존형인산화 수준으로 평가하였다. 적혈구막 단백질인spectrin과 band 4.9의 후인산화수준을 측정하여각 납 노출지표(혈중 납, ZPP, 경골중 납. 노출기간)와의 관련성은 다중회귀분석을 이용하였다. 결과 : 조사대상자의 평균(SD) 연령은39.1(10.0)세, 근무기간은 8.1(6.5)년 이었으며, 경골중 납농도는 범위가 0.8에서 290.8 trg Pb/gbone mineral로 평근(SD) 34.4(35.2) rig Pb/gbone mineral이었다. 적혈구막 단백질의 후인산화수준은 개인간 변이가 매우 컸으며, spectrin은 평균(SD) 540 7(304.1), band 4.9 SfkDa는198.6(78.2), 48 kDa는 247.7(83.3) PSL이었다.경골중 납농도와 노출 기간은 이들 후인산화 수준과역상관성을 보였으나(p(0.05), 혈중 납 농도와 ZPP는 상관성이 없었다(p)0.05). 가능성 있는 혼란변수를 통제한 상태에서도 경골중 납 농도와 노출기간은 이들 후인산화수준과 유의한 회귀계수를 나타내었다. 결론 : 만성적 납 노출에 의하여 적혈구내 PKC활성도는 영향을 받아 증가되어있는 것으로 평가되어 적혈구막 단백질의 인산화수준은 납의 노출지표로 이용될 수 있을 것이다. 납의 신경독성은 부분적으로 PKC의 활성도왁 관련되어 있을 기전을 배제하기 어렵기 때문에 PfC 활성도와 신경행동학적 기능과의 관련성 평가가 진행되어야 할 것이다. Objectives : Protein kinase C(PKC) , a calcium and phospholipid dependent enzyme, is activated by lead in vitro at picomolar concentrations. However, the effect of lead on PKC has never been studied in a human population. The purpose of the study was to evaluate whether lead exposure was associated with PKC mediated-phosphorylation in erythrocytes among lead workers. Methods : Two hundred and twelve lead workers were studied. To determine the levels of phosphorylation ir vivo, an in vivo back phosphorylation technique was used by adding PKC and γ-32P to preparations of erythrocyte membranes. We measured back phosphorylations of erythrocyte membrane proteins, spectrin, and 52 kDa and 48 kDa, as an indirect measure of PKC activation if vivo. Results : The mean(SD) age and exposure duration was 39.1(10.0) years and 8.1(6.5) years, respectively. Tibial lead ranged from 0.8 to 290.8 μg Pb/g bone mineral with a mean (SD) of 34.4(35.2) μg Pb/g bone mineral. The means(SD) of back phosphorylation levels of the three proteins were 540.7(304.1), 198.6(78.2), and 247.7(83.3) photostimulated luminescence units (PSL), respectively, by phosphoimager. After adjustment for potential confounding factors, tibial lead and exposure duration were significantly and inversely associated with back phosphorylation levels. One unit of increase in tibial lead (1 μg Pb/g bone mineral) is associated with a decline in spectrin, band 4.9 52 kDa, and band 4.9 48 kDa back phosphorylation levels by 1.4(p〈0.05), 0.34(p〈0.05), and 0.47(p〈0.01), respectively However, there were no associations between the back phosphorylation levels and either blood lead or ZPP levels. Conclusions : These findings suggest that the PKC activity in erythrocytes is increased by chronic lead exposure and that erythrocyte membrane protein phosphorylation may be a biomarker of lead exposure.