Epidemiology of Work-related infectious disease in Korea

Myong Jun-Pyo(명준표) 대한직업환경의학회 2012 대한직업환경의학회 학술대회 논문집 Vol.2012 No.11

Climate Change and Related Medical Problems

( Jun-pyo Myong ) 대한결핵 및 호흡기학회 2021 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.129 No.-

Since mass fossil fuel combustion has been utilized, Carbon dioxides, Methane, NOx has been released into the air. Those Gases facilitate a global warming and also induce the climate change on earth. The representative findings of it are increasing temperature, numbers of extreme weather event, melting the Permaforst, and rising sea level. Those global climate change influence the precipitation, heat, foods, and storms which causes not only direct influence via flood, storm damage, and heat waves but also indirect effects on change of allergen, diseases vectors, and increasing pollution. Those change in nature would be related with various health issues such as increasing the numbers of illness, injuries and death. A respiratory system is a first line organ which contact ambient air, temperatures, allergens, and biologic agents. Lots of literatures on the increase of air pollution and lung health, in addition, the changing pattern of allergens and respiratory allergic responses supports the evidences of the association between climate change and respiratory health. Respiratory health issues due to climate change are exacerbation of chronic, allergic asthma responses, growth impairment of lung function, decreased lung function due to air pollution or any other infections. Extreme weather events also increase the wildfire activities which may generate large scale particulate matter results in various exacerbation of respiratory diseases and respiratory impairments. Our generation is facing the era of changes due to climate change and reaction of human against it. Therefore, we should aware the expected health impact by climate change and prepare the solutions.

CT interpretation based strategy for asbestos related lung cancer

( Jun-pyo Myong ),( Jungim Jung ),( Hyoungkyu Yoon ) 대한결핵 및 호흡기학회 2018 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.126 No.-

The asbestos can result in various health outcomes such as asbestosis, malignant mesothelioma, lung cancer, and etc. However, the numbers of asbestos related health outcomes may be underestimated in Korea. The aim of this study is to establish a surveillance program for hidden asbestos related lung cancer (ARLC) and evaluate the effect of surveillance program. A total of 7 hospitals joined to find a hidden ARLC in this active surveillance program. The reading sheet of chest CT scan among incident lung cancer in all hospitals were collected for retrospective evaluation (2015.07-2017.06) and a prospective evaluation have been performed for 6 months (2017.07-2017.12). The searching keywords in the reading sheet of chest CT scan for asbestos exposure were ‘plaque’, ‘asbestos’, ‘asbestosis’. A total of 5,389 (No of CT scan=17,503) those who eligible subjects diagnosed as incident lung cancer in retrospective evaluation and 2,030 (No of CT scan=2,976) those diagnosed as incident lung cancer in prospective evaluation were enrolled. The numbers of those subjects with lung cancer who are estimated the exposure of asbestos were 29 cases (7.2 cases per 6 months) in retrospective evaluation and 12 cases per 6 months in prospective evaluation, respectively. Overall increase of finding ARLC (0.54% → 0.98%) after informing process for radiologist was shown. This study result shows that the national statistics of ARLC may be underestimated. In addition, a hospital-based surveillance program focused on radiologists will make the numbers of reporting the ARLC increase.

Impacts of Household Income and Economic Recession on Participation in Colorectal Cancer Screening in Korea

Myong, Jun-Pyo,Kim, Hyoung-Ryoul Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.5

To assess the impact of household income and economic recession on participation in CRC screening, we estimated annual participating proportions from 2007 to 2009 for different CRC screening modalities according to household income levels. A total of 8,042 subjects were derived from the fourth Korean National Health and Nutrition Examination Survey (KNHANES IV). Multivariate logistic regression analysis was used to estimate odds ratios and 95% confidence intervals for CRC screening with household income quartiles by gender in each year. People were less likely to attend a high-cost CRC screening such as a sigmoidoscopy or colonoscopy independent of the income quartile during the economic recession. Income disparities for participating in opportunistic cancer screening appear to have existed among both males and females during the three years (2007-2009), but were most distinctive in 2009. An increase in mortality of CRC can therefore be expected due to late detection in periods of economic crisis. Accordingly, the government should expand the coverage of CRC screening to prevent excess deaths by reducing related direct and indirect costs during the economic recession.

Thematic Poster : TP-69 ; Non-Tuberculosis Mycobacteria Related Liquefactive Necrosis of Progressive Massive Fibrosis in a Coal Briquettes Manufacture Factory Worker

( Jun Pyo Myong ),( Younmo Cho ),( Jong In Lee ),( Hyoung Ryoul Kim ),( Jung Wan Koo ) 대한결핵 및 호흡기학회 2014 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.118 No.-

Background: Pneumoconiosis is common among those who exposured to massive coal dust. The patient with pneumoconiosis are apt to co-morbid with non-tuberculosis mycobacteria infection. We can find prominent process of liquefactive necrosis of progressive massive fibrosis (PMF) from a coal briquettes manufacture factory worker. Methods: 73 years old male worked for a coal briquettes manufacture factory for 20 years, and retired. A ILO classification of his chest X ray graph was (2/3, p/q, 6 lung zone, em, tbi, id B). He has complaint melanoptysis since several months. The serial computed tomograph and sputum analysis were followed. Results: With increased black colored sputum, an air-fluid level was formed at the PMF at right upper lung field from Apr 05 2013. Black colored secretion was drained from whole the bronchus under bronchocsopy at Apr 02 2013. M. Intracellulare was identified at sputum & BAL fluid AFB. Finally, a cavitary lesion remained. Another air-fluid level was shown at the small sized PMF at left middle lung field from Jul 31 2013. We can show those serial radiological and biological findings and while follow up of patients with complicated pneumoconiosis. Conclusions: Aspergilluma is apt to be followed by a cavitary lung lesion. Therefore, those patients with PMF necrosis might have more poor prognosis due to a massive hemoptysis by angiogenesis of lung vasculatures. To prevent fatal events, further evaluation should be followed NTM related liquefactive necrosis of PMF.

Overview of occupational cancer in painters in Korea

Jun-Pyo Myong,Younmo Cho,Min Choi,Hyoung-Ryoul Kim 대한직업환경의학회 2018 대한직업환경의학회지 Vol.30 No.-

Comprehensive consideration is necessary for setting guidelines to evaluate evidence of occupational cancer in painters due to work-related exposure to carcinogens in paint (a phenomenon termed herein as “work-relatedness”). The aim of the present research is to perform a comprehensive review and to suggest criteria for the provision of compensation for occupational neoplasm among painters in Korea. In order to perform a comprehensive review, this study assessed and evaluated scientific reports of carcinogenicities from the International Agency for Research on Cancer (IARC) and the Industrial Injuries Advisory Council (IIAC), as well as reviewed the existing literature about occupational exposure among painters in Korea and the epidemiologic investigations of claimed cases of cancer among painters in Korea. The IARC declares that occupational exposures in commercial painting are classified as Group 1 carcinogens for lung cancer and bladder cancer among painters. The epidemiologic studies show consistent causal relationships between occupational exposure in painters and cancers such as lung cancer [meta relative risk: 1.34 (95% confidence intervals (CIs): 1.23-1.41)] and bladder cancer [meta relative risk: 1.24 (95% CIs: 1.16-1.33)]. In reviewing occupational cancer risks for commercial painters, the Industrial Injuries Advisory Council (IIAC) confirms occupational cancer risks for lung and bladder cancer among commercial painters. According to the IIAC, however, the elevated cancer risks reported in existing literature are not doubled in either lung or bladder cancer in commercial painters relative to the risks of these cancers in the general population. Based on our review of existing Korean articles on the topic, painters are exposed to potential carcinogens including polycyclic aromatic hydrocarbons (PAHs), benzene, hexavalent chrome, crystalized silica, asbestos, and other agents, and relative levels are estimated within commercial painting processes. However, the cancer risks of occupational exposure to Group 1 carcinogens for lung and bladder cancer in painters per se are not fully assessed in existing Korean articles. Total work duration, potential carcinogens in paint, mixed exposure to paints across various industries such as construction and shipbuilding, exposure periods, latent periods, and other factors should be considered on an individual basis in investigating the work-relatedness of certain types of cancer in commercial painters.

미세먼지와 건강 장애

명준표 ( Jun-pyo Myong ) 대한내과학회 2016 대한내과학회지 Vol.91 No.2

Sand dust is a source of particulate matter (PM) in Korea. Recently, an attention has been focused on the health effects of PM and fine PM. Here we examine the possible mechanisms of PM disposition and review the literature on the health effects of PM. PM can enter and accumulate in the respiratory tract via impaction, gravitational settling, diffusion, and electrostatic attractions. PM may cause oxidative stress, inflammation, direct penetration, and increased blood viscosity. This literature review revealed that PM exposure is associated with several health risks, such as mortality and respiratory and cardiovascular diseases. Furthermore, PM exposure may be linked to lung cancer. Thus, a comprehensive approach is needed to manage PM and reduce its environmental exposure and related health effects. (Korean J Med 2016;91:106-113)

규폐증 환자에서 발생한 카플란증후군

명준표,김경연,임 영 大韓産業醫學會 2008 대한직업환경의학회지 Vol.20 No.2

배경: 카플란증후군은 다발성 폐결절(multiple pul monary nodules). 류마티스성 관절염 (rheumatoid arthritis),탄광에서 일하였던 직업력이 있을 때 진단된다. 하지만 국내에서 카플란증후군 증례에 대한 보고는 매우 드물고,특히 규폐증 환자에게서 발생한 카플란증후군이 보고된 바 없어,이에 증례를 보고하고자 한다. 증례: 49세 남자환자는 25년간 석재 공장에서 석공으로 일하였던 직업력과 더불어 흉부방사선 검사 결과를 통해 규폐증 진단 받았으며,류마티스성 관절염 역시 확진되어 카플란증후군으로 진단되었다. 고찰: 국내의 카플란증후군의 보고는 외국에 비해 매우 적은 실정이다. 따라서 진폐증 환자를 치료하는 지방 산재의료원들의 환자에 대한 연구가 필요하다. 또한 카플란증후군 뿐만아니라 진폐증에 대한 완치법이 없으므로 질환 발생의 예방을 위해 사업장에서 분진농도의 허용기준 이하 관리,호흡보호구의 착용,진폐증에 대한 교육,체계적인 건강관리 등을 통하여 환자 발생의 예방 및 환자를 조기 발견하고 작업 전환을 시키는 방안이 필요하다. Background: Caplan originally described a condition, now reffered to as Caplan's syndrome or Caplan's disease, where progressive massive fibrosis was exhibited by coal miners with multiple pulmonary nodules, and rheumatoid arthritis. This syndrome is very rare in Korea. Case report: The patient was a 49-year old male, with occupational history as a stonemason for 25 years. Silicosis was diagnosed by chest X-ray, while rheumatoic arthritis was diagnosed by immunological examination. Caplan's syndrome was confirmed based on these findings, occupational history, and clinical symptoms. Discussion: The authors report on the patient's Caplan's syndrome, with a particular focus on his silicosis.

한 전자제품 연구소 종사자들의 생활습관 행태와 건강상태의 관련성

명준표,김형렬,최원선,조성은,이보람,구정완,이강숙,박정일 大韓産業醫學會 2009 대한직업환경의학회지 Vol.21 No.1

목적 학 전자제품 개발연구소의 근로자들을 대상으로 실시하였던 건강검진 자료를 이용하여 생활습관 상태와 건강상태를 파악하고 이들 사이의 관련성을 조사하고자 하였다 방법 건강검진을 받았던 수검자 3041명을 최종 대상자로 선정하였고 국민건강보험공단에서 제시한 건강검진 문진표 중 식이 음주 몹연 운동 항목을 이용하여 생활습관에 대한 평가를 실시하였다 건강검진결과를 이용하여 비만 혈압 당뇨 간장질환 이상지혈증에 대한 정상/비정상을 평가하였다 건강검진결과와 생활습관에 대한 평가는 다변량 로지스틱 희귀분석을 통하여 실시하였다 결과 조사 대상자의 생활습관 중 과도한 음주의 유병률은 1610명(52.9%) 운동 부족 2662명(86,2%) 흡연 952명(31.3%)이였다 건강검진 결과 비만인 군은 824명(27.1%) 고혈압 군은 198명(6.5%) FBS가 비정상 군은 28명 (0.9%) 간기능 검사 비정상 군은 462명(15.2%) 이상지혈증이 있는 군은 563명(18.5%)의 유병률을 보였다 다별량 로지스틱 희귀분석 결과 육류 위주의 식이는 비만 고혈압 간장질환(ALT r-GTP) 이상지혈증(LDL)과 관련이 유의하게 높았고 과도한 음주는 비만 고혈압 r-GTP 비정상의 위험도와 통계적으로 유의한 관련성이 있었다 운동 부족인 군은 HDL 비정상의 위험도가 높았으며 흡연군은 비만 당뇨 간장질환(ALT r-GTP) 이상지혈증(TG HDL)의 위험도가 통계적으로 유의하게 높았다 결론 전자제품 개발연구소 근로자들의 바르지 않은 생활습관(식이 음주 운동 흡연)은 비만 고혈압 당뇨 간장질환 이상지혈증과 관련이 있다 따라서 연구직 근로자들을 대상으로 한 사업장 건강증진 사업이 필요하다 Background An unhealthy lifestyle is the most important cause of lifestyle-induced illness (diabetes hypertension liver enzyme abnormality dyslipidemia etc) This study was carried out to evaluate that relation between employees lifestyle and their health status in a Korean electronic research and development company Methods We conducted a descriptive cross-sectional survey 3,041 consecutive workers in a Korean R&D company were enrolled in this study A checkup list for the health examination (from the National Health Insurance Coperation) which contained the information on the lifestyle, and the results of the health examination which contained information on the body mass index (BMI) systolic blood pressure (SBP) and diastolic blood pressure (DBP) and liver function tests (LFT AST ALT r-GTP) and Cholesterol profiles (total cholesterol TG, HDL, LDL) were done for all the subjects We evaluated the health profile as normal or abnormal Statistical analysis of the health profiles and the lifestyle of the employees was performing by using multiple logistic regression analysis Results The prevalence of 'excessive alcohol drinking was 52.9% (n=1,610) that for 'lack of exercise' was 86.2% (n=2,662), that for meat eating 12.2% (n=370) and that for current smoker was 31.3% (n=952) According to results of health examination the prevalence of obesity was 27.1%(n=824) hypertension was 7.1% (n=215) diabetes was 1.0% (n=30) abnormal LFT was 15.4% (n=469) and dyslipidemia was 18.7% (n=569) On multiple logistic regression analysis of the health profile and lifestyle 'meat eating' was related to obesity hypertension abnormal LFT (ALT, r-GTP) dyslipidemia (LDL) Excessive alcohol drinking was related to obesity hypertension abnormal LFT (r-GTP) Lack of exercise' was related to dyslipidemia (HDL) Current smoker was related to obesity, diabetes abnormal LFT (ALT r-GTP) and dyslipidemia (TG HDL) with statistically significance Conclusions For workers in the R&D company an unhealthy lifestyle (such as diet alcohol drinking lack of exercise and smoking) were related to obesity hypertension diabetes abnormal LFT and dyslipidemia Therefore health promotion is necessary for the young employees of an Korean R&D company

환경미화원의 작업별 근골격계질환 자각증상 특성과 상지의 인간공학적 평가

명준포,이향기,김형렬,정혜선,정은희,남 웅,구정완 大韓産業醫學會 2008 대한직업환경의학회지 Vol.20 No.2

목적: 본 연구는 서울 및 경기 일부 지역의 환경미화원 을 대상으로 신체부위별 근골격계 질환의 증상 호소율을 파악한 후 작업의 차이에 따른 증상호소의 차이를 확인하고,원인 작업을 평가하여 근골격계질환의 관련요인을 찾고자 한다. 방법: 서울 및 경기 일부 지역에 소재하는 환경미화업체 근로자 중 대상자 543명을 대상으로 분석을 시행하였다. 근골격계 질환의 증상호소율은 NIOSH의 근골격계 질환의 자각증상에 대한 기준을 사용하였다. 환경미화원의 작업에 대한 인간공학적인 평가는 RULA. REBA를 사용하여 분석하였다. 결과: 환경미화원의 72.2%가 근골격계질환의 자각증상 및 통증이 있다고 답하였다. 전체 대상자 중에서 상지의 경우 39.6%,허리는 30.0%, 다리는 27.4%가 경도 이상의 통증을 호소하였다. 거리환경미화원의 자각증상 기준별 양성자 비율이 지역환경미화원보다 허리의 '증상 기준 3’를 제외한 모든 영역에서 높게 나타났다. 그리고 거리환경미화원이 상지의‘증상기준 1’,하지의‘증상기준 2∼3’의 영역에서 지역환경미화원보다 통계적으로 유의하게 (p<0.05) 높은 비율을 나타냈다. NIOSH 기준 1∼3에 양성자로 해당하는 군을 종속변수로 작업 이외에 근골격제 질환에 영향을 미칠 것으로 판단되는 인자의 영향을 확인하고자 다변량 로지스틱 회귀분석을 실시하였다. 그 결과 연령이 증가할수록‘증상기준 1’에 대하여 1.018배(95% CI: O.993∼1.046) 근골격계질환의 자각 증상이 증가하였던 것으로 확인되었다. 10시간 이상 작업 할 경우‘증상기준 1’과 ‘증상기준 2’를 모두 만족시키는 경우가 2.165(95% CI: 1.156∼4.1311,2.187배(95% CI: 1.071∼4.65l) 통계적으로 유의하게 높게 나타났다. 지역환경미화원의 RULA,RULA 접수 중 상지의 subtotal A 접수, REBA,REBA 접수 중 상지 total A 점수는 모두 거리환경미화원의 점수에 비해 높게 나타났다. 결론: 거리환경미화원이 지역환경미화원에 비하여 인간 공학적인 평가점수가 낮음에도,거리환경미화원이 상대적으로 높은 반복 작업의 빈도와 10시간 이상 작업 등에 의해 상지에 대한 근골격계 질환의 자각증상 호소한다고 판단된다. 환경미화원의 근골격계질환에 대한 다양한 대책 들이 필요하다. Objectives: The aim of this study was to estimate musculo-skeletal symtoms of municipal sanitation workers and to evaluate working conditions of municipal sanitation workers to search for the factors related to musculo-skeletal symptoms. Methods: We conducted a descriptive cross-sectional survey. The study subjects were comprised of 543 municipal sanitation workers in some divisions of Seoul and the Gyeonggi province. Musculo-skeletal analysis was done by using the modified criteria of NIOSH musuclo-skeletal symptoms, RULA and, REBA. Statistical analysis was done by using the chi-square test, multiple logistic regression analysis. Results: 72.2% of the subjects complained musculo-skeletal symptoms (39.6% on the upperlimbs, 30.0% on the lumbar region, 27.4% on the legs). For the musculo-skeletal symptoms criteria (1∼3), street cleaners complained of more musculo-skeletal symptoms than the solid waste collectors, after classifying the jobs of sanitation workers. On logistic regression analysis of the musculo-skeletal "symptoms criterial" positive groups, age was related to the criteria positive (Prevalence odds ratio=1.018, 95% CI: 0.993-1.046). The worktime was significantly related to 'criteria positive 1 and, 2' (Prevalence odds ratio=2.165 (95% CI: 1.156-4.131), 2.187 times (95% CI: 1.071-4.651)). The RULA score, the subtotal A score of RULA, the REBA score and , the total AREBA score of the upperlimbs of solid waste collectors were higher than those of the street cleaners. Conclusions: In spite of the lower ergonomic evaluation score of the street cleaner, the street cleaners complained of more musculo-skeletal symptoms than did the solid waste collectors due to more frequent repetitive motions, a longer work time (over 10 hours) etc. It is suggested that the sanitation workers need to use the proper methods to avoid musculo-skeletal disease.