업무상질병 발생 근로자의 특성 : 1999년 업무상질병으로 요양승인된 사례분석

안연순,강성규,권현길,정호근 大韓産業醫學會 2001 대한직업환경의학회지 Vol.13 No.4

목적 : 이 연구는 1999년 근로복지공단에서 업무상질병으로 인정한 사례를 정밀분석하여 직업병의 종류와 특성을 밝힘으로써 직업병 예방사업이나 산업보건연구의 우선순위를 결정하는데 기초자료로 제공하기 위하여 실시하였다. 방법 : 근로복지공단 주전산망을 통하여 재해일자가 1999년 1월 1일부터 12월 31일까지인 근로자 중2000년 6월 30일까지 요양이 승인된 업무상 질병자2,333명을 파악하고 이 중 뇌심혈관계질환자 1,348명과 근골격계질환자 410명을 제외한 575명을 연구대상으로 하였다. 소속 사업장 또는 연구대상 근로자에 대하여 우편 또는 전화 면담조사를 실시하여 업무상 질병자의 성, 연령, 질병 관련 작업기간, 질병 인지경위, 업종, 직종, 질병종류, 사업장규모 등에 대한 조사를 실시 후 기술분석을 시행하였다. 결과 : 업무상 질병자 575명 중 남성이 511명(88.9%), 여성이 64명 (11.1%)이었다. 사망유무는 조사당시에 사망자가 56명(9.7%)이었고, 사망하지 않은 자가 519명 (90.3%)이었다. 연령별로는50~59세가 217명(37.7%)으로 가장 많았고, 질병관련 근무기간은 10년 이상 근무자의 비율이 49.0%로 가장 높았다. 질병인지경위는 소음성 난청, 진폐증, 이황화탄소 중독으로 인한 업무상 질병자를 제외하고 건강진단을 통하여 질병을 발견한 경우가 조 사자의 12.7%fl 불과하였다. 소속 사업장 규모는5인 미만 사업장이 26.1%로 1999년 당시 산재보험 임의가입 대상인 5인 미만 사업장에 소속된 근로자의 비율이 가장 높았다.질병별로는 호흡기질환이 211명(36.7%)으로 가장 많았고, 다음으로 소음성 난청(이명 1명 포함)149명 (25.9%), 감염성질환 69명(12.0%), 유기용제, 중금속, 가스 등에 의한 중독성질환 60명(10.4%) 순이었다. 기타 피부질환 29명, 암 17명,양성종양(성대결절) 8명, 간장질환 9명, 일사병 및열사병 6명, 신경정신질환 5명, 신경계질환 4명, 안질환 3명, 혈액 ·골수질환 2명, 신장질환 1명, 기타2명이었다. 유해인자별로 분류하였을 때, 분진 209건(36.3%), 물리적인자 157건(27.3%), 화학적인자 89건(16.3%), 생물학적인자 82건(14.3%),작업판련성인자 34건(5.9%), 분류불능 4건으로 분진에 의한 업무상질병의 비율이 가장 높았다.종사업종은 제조업이 262명(45.6%)으로 가장 많았고 다음으로 광업 174명(30.3%), 기타 각종 행정기관 일용직 종사업이 42명 (7.3%), 의료업이 28명 (4.9%)이었다. 직종별로는 기능원 및 관련기능종사자가 285명 (49.6%)으로 가장 많았고 다음으로 장치, 기계조작 및 조립종사자 139명 (24.2%), 단순노무종사자 72명 (12.5%), 전문가 28명 (4.9%), 사무종사자 IS명(2.6%), 기술공 및 준전문가14명(2.4%), 행정 및 경영관리자 8명(1.4%), 판매 및 서비스종사자 8명(1.4%), 미상 6명이었다. 결론 : 이 연구를 통하여 우리나라에서 업무상질병으로 인정받고 있는 사례들을 분석함으로써 기존 통계에서 알 수 없었던 내용을 전체적으로 파악할 수있었고, 인첫받는 사례의 상당부분이 산업의학적 관리의 주요 대상인 팡업이나 제조업 이외의 업종에서 발생하고, 근무조건이 열악한 일용직 근로자에서 발생한다는 사실을 파악하였다. 또, 소음성 난청과 진폐증을 제외하고 업무상질병 승인자의 약 90% 가산업안전보건법상의 건강진단을 통하여 질병을 발견하기보다는 개인적인 병원방문을 통하여 발견한다는 사실을 확인하였다 이것은 작업병을 발견하기 위한특수건강진단 목적중 하나가 제대로 기능을 할 수 없다는 사실을 입증한 것으로 특수건강진단제도이 대한대상자 확대, 검사 항목 확대 등 제도보완이 필요함을 시사하는 결과로 판단된다. 또, 병원근로자, 일용직 근로자 등 업무상질병 위험직종에 대한 업무상질병 예방대책도 조속히 수립되어야 할 것이다. Objectives : The purpose of this study is to analyze the characteristics of occupational diseases listed by Korea Labor Welfare Corporation (KLWC). Methods : Using the database of the KLWC, we collected 575 approved occupational disease cases occurring between 1 January and 31 December 1999 and approved by the thirtieth June in 2000. We investigated the characteristics (sex, age, occupational history, kinds of occupational disease, exposure material, type of enterprises, etc.) of occupational disease using a mail survey and telephone interviews. Results : Men accounted for 88.9 %(511 workers) of the approved cases. 56 cases(9.7 %) died of occupational disease. The most common age group was 50∼59 years of age(n=217, 37.7 %). The proportion of workers with grater than ten years disease related working condition exposure were 195 (49.0 %). The majority of diseases were respiratory problems(211 workers, 22.4%), occupational healing loss(149 workers, 25.9%), infectious disease(69 workers, 12.0%), intoxication(60 workers, 10.4%), skin disease(29 workers, 5.0%) and cancer(17 workers, 3.0%). The causal hazardous agents were dusts(209 cases, 36.3%), physical agents(157 cases, 27.3 %), chemical agents(89 cases, 16.3 %), biological agents(82 cases, 14.3 %) and work-related agents (34 cases, 5.9 %). The major types of enterprise were manufacturing(262 workers, 45.6 %), mining and quarrying(174 workers, 30.3 %), public administration(42 workers, 7.3 %) and the health care Industry(28 workers, 4.9 %). The kinds of job included craft and related trades workers(285 workers, 49.6 %), plant or machine operators and assemblers(139 workers, 24.2 %), elementary occupations(72 workers, 12.5 %) and professionals(28 workers, 4.9 %). Conclusions : We were able to elucidate the kinds of occupational disease and the characteristics of workers through this study. Many approved cases occurred among non-manufacturing and non-mining workers and the kinds of disease were varied. This suggests that management policy must be established to prevent occupational disease occurring among workers in the above type of industries.

최근 3년간(2001년∼2003년) 직업병으로 요양승인된 질병의 특성

안연순,강성규,김광종 大韓産業醫學會 2004 대한직업환경의학회지 Vol.16 No.2

목적 : 이 연구는 2001년부터 2003년까지 최근 3년 동안 근로복지공단에서 업무상질병으로 인정한 사례를 정밀분석하여 직업병의 종류와 특성을 밝힘으로써 직업병 예방사업이나 산업보건연구의 우선순위를 결정하는데 기초자료로 제공하기 위하여 실시하였다. 방법 : 근로복지공단 주전산망을 통하여 요양 승인일자가 2001년 1월 1일부터 2003년 12월 31일까지인 근로자 중 요양이 승인된(요양급여 또는 유족급여 수령자) 업무상 질병자를 파악하고 이 중 작업관련성 질병(뇌심혈관질환, 신체부담작업, 요통 및 기타 등으로 분류)을 제외한 4,240건을 연구대상으로 하였다. 연구대상자에 대한 조사는 근로복지공단의 전산자료를 검토하여 성, 연령, 업종, 직종, 질병종류, 노출 유해인자 종류, 사업장규모 등에 대한 기술 분석을 시행하였고 정보가 불확실한 경우 한국산업안전공단 산업안전보건연구원의 직업병진단 심의결과 보고서를 검토하여 내용을 보충하였다. 결과 : 직업병자 4,240건 중 남성이 3,925건(92.6%), 여성이 315건(7.4%)이었다. 이 중 사망자가 1,199건(28.3%)이었고, 사망하지 않은 자가 3,041건(71.7%)이었다. 연령별로는 50-59세가 1,433건(33.8%)으로 가장 많았고, 소속 사업장 규모는 50인 이상 300인 미만 사업장이 26.3%로 가장 높았다. 질병별로는 호흡기질환이 2,906건(68.5%)으로 가장 많았고, 다음으로 소음성 난청(고막손상 1건 및 돌발성난청 14건 포함) 687건(16.2%), 감염성질환 238건(5.6%), 유기용제, 중금속, 가스 등에 의한 중독성질환 117건(2.8%), 피부질환 111건(2.6%) 순이었다. 기타 진동장애 58건, 암 41건, 비질환 22건, 일사병 및 한랭손상 16건, 신경계질환 12건, 간장질환 10건, 안질환 6건, 혈액질환 5건, 심장질환 4건, 감압병 3건이었고, 정신행동질환 및 신장질환이 각각 2건이었다. 유해인자별로 분류하였을 때, 분진 2,870건(67.7%), 물리적인자 770건(18.2%), 생물학적인자 301건(7.1%), 화학적인자 242건(5.7%), 중금속 51건(1.2%)으로 분진에 의한 업무상질병의 비율이 가장 높았다. 종사업종은 광업이 2,708건(63.9%)으로 가장 많았고 다음으로 제조업 1,112건(26.2%), 보건 및 사회복지사업 159건(3.8%), 건설업 63건(1.5%)순이었다. 직종별로는 기능원 및 관련기능종사자가 2,622건(61.8%)으로 가장 많았고 다음으로 단순노무종사자 730건(17.2%), 고위임직원 및 관리자 327건(7.7%), 장치, 기계조작 및 조립종사자 225건(5.3%), 전문가 138건(3.3%) 순이었다. 결론 : 이 연구를 통하여 우리나라에서 업무상질병 중 직업병으로 인정받고 있는 사례들을 분석함으로써 기존 공식 통계에서 광범위하게 제시되었던 유해인자 및 질병명을 구체적으로 파악할 수 있었다. 진폐증과 직업성난청을 제외하고는 인정받은 사례의 상당부분이 산업의학적 관리의 주요 대상인 광업이나 제조업 이외의 업종에서 발생하고, 특히 병원종사자나 공공근로 종사자에서 감염성질환이나 피부질환과 같은 질병이 많이 발생한다는 사실을 파악하였다. 진폐증과 직업성난청 예방을 위한 지속적인 노력과 함께 직업병 예방 연구 및 사업의 우선순위와 표적집단을 결정하는데 있어 이 연구에서 밝혀진 새로운 위험집단에 대한 대책이 수립되어져야 할 것이다. Aims: The purpose of this study is to analyze the characteristics of the occupational diseases compensated with the Industrial Accident Compensation Insurance that is operated by the Korea Labor Welfare Corporation (KLWC). Methods: Using the KLWC database, we collected 4,240 cases of compensated occupational disease occurring between I January 2001 and 31 December 2003. We analyzed the characteristics (sex. age, type of occupational disease, exposure material, type of industry and occupation, etc.) of occupational diseases using the KLWC electronic data and compensated with the data of claimed cases investigated by the Korea Occupational Safety and Health Agency (KOSHA), Results: KLWC approved 4,240 cases, including 1,199 deaths (28.3%). Men accounted for 92.6% (3,925 cases) of the approved cases. The most common age group was 50-59 years of age (n=l,433,33.8%). The majority of diseases were respiratory diseases (2,906 cases, 68.5%), occupational hearing loss (687 cases, 16.2%), infectious disease (238 cases, 5.6%), intoxication (117 cases, 2.8%), skin diseases (111 cases, 2.6%) and cancer (41 cases, 1.0%). The causal hazardous agents were dust (2,870 cases, 67.7%), physical agents (770 cases, 18.2%), biological agents (301 cases, 7.1%), chemical agents (242 cases, 5.7%), and heavy metals (51 cases, 1.2%). The major types of industry were mining and quarrying (2,708 cases, 63.9%), manufacturing (1,112 cases, 26.2%), health and social work (159 cases, 3.8%) and construction (63 cases, 1.5%). The type of occupation included craft and related trades workers (2,622 cases, 61.8%), elementary occupations (730 cases, 17.2%), senior officials and managers (327 cases, 7.7%) and plant and machine operators and assemblers (225 cases, 5.3%). Conclusions: We were able to elucidate the kinds of occupational disease and the characteristics of workers through this study. Many compensation cases occurred among non-manufacturing and non-mining workers, especially health care workers, and there were various kinds of disease. This suggests that a management policy must be established to prevent occupational diseases occurring among workers in the above types of industry.

8년간(1992~1999) 산업안전보건연구원에 의뢰된 직업병 심의 사례 분석

강성규,김규상,김양호,최정근,안연순,진영우,최병순,양정선,김은아,채창호,최용휴,김대성,박정선,정호근 대한산업의학회 2000 대한직업환경의학회지 Vol.12 No.2

Objectives : Pneumoconisis and noise-induced hearing loss (NIHL) have been reported as main occupational diseases by the Special Health Examination. The Industrial Accident Compensation Insurance has reported various work-related diseases, however, these two diseases occupied almost a half of compensated cases. Therefore, it was not well known about the status of occupational diseases other than pneumoconiosis, NIHL, and cardio-cerebrovascular accident (CVA). This study was conducted to analyze claimed cases as an occupational disease, that was requested to the Korea Industrial Safety and Health Agency (KOSHA). Methods : The local office of the Korea Labor Welfare Corporation (KLWC) has asked the KOSHA for confirmation of claimed cases as an occupational disease. We analyzed 379 cases requested from KLWC, the Ministry of Labor, employers, unions and occupational health agencies from 1992 to 1999. Results : Male was 80.7 % of the requested cases. Their mean age was 42 years old and 75.5 % of them were more than 35 years old. The requested cases were increased rapidly from 25 cases in 1992 to 108 cases in 1999 and the accept rate was 50.7 %. The majority of requested cases were respiratory diseases(22.4%), cancers(18.5%), Neuropsychiatric problems(14.5%), and musculoskeletal problems(13.5%). The accept rate was high in reproductive, respiratory, musculoskeletal and digestive disorders and low in neuropsychiatric, renal and otologic problems and occupational cancers. 73.6% of them were caused by chemical agents, especially 28.5 % were by organic solvents. 67% of them were clinically confirmed at university hospitals. A half of the cases were from KyongIn area, even the request came from the whole country. Conclusions : A claim was common in workers whose age was over 35 years old and exposure history was over 10 years. The respiratory diseases and neuropsychiatric disorders were still main problems in occupational health and occupational cancers was increasing even though its accept rate was not high yet.

1990년대 한국의 직업성암

강성규,안연순,정호근 大韓産業醫學會 2001 대한직업환경의학회지 Vol.13 No.4

The proportion of cancer as a cause of dearth in Korean has been continuously increas-ing. In 2000, 24 % (59,020 of 247,346) of deaths were caused by cancer. Occupational exposure would have contributed to the deevelopment of some cancers. It would have accounted for more than 2,000 cancers in a year if 4% of all cancer or 10% of lung cancer was regarded as arising from the work environment. However, occupational cancer has not been reported as much as expected. The first case of occupational cancer reported officially was mesothelioma caused by asbestos exposure at an asbestos textile industry in 1992. Following the report, many cases of occupational cancers have been reported such as lung cancer due to exposure to asbestos, chromium, exhaust gases, coke oven emissions, and silica, as well as leukemia due to exposure to benzene or other solvent and bladder cancer arising from exposure to benzidine salts. The Health Examination for retirees has been conducted since 1992 in order to detect occupational cancer early in workers who have been exposed to 11 carcinogenic sub-stances. However, to date no occupational cancer has been detected through the Retirees' Health Examination. The Korea Labor Welfare Corporation (KLWC) has referred 108 claims for occupational cancer to the Korea Occupational Safety and Health Agency (KOSHA) between 1992 and 2000. Thirty-three cases were accepted, including 14 cases of lung cancer, eight cases of hematopoietic cancer and six cases of mesothelioma. KLWC has accepted the claim for primary lung cancer developed with pneumoconiosis as an occupational cancer, of which there were 31 cases in 1999 and 61 cases in 2000. In conclusion, special attention is required to detect occupational cancer due to their long latency period and the fact they are usually found after retirement.

전국 단위 감시체계의 현황과 전망

강성규,안연순,지영구,김형옥,하미나,권호장,백남종,김성아,홍윤철,김재용,강대희,정혜선,하은희 대한산업의학회 2001 대한직업환경의학회지 Vol.13 No.2

蜂毒(Apitoxin)이 흰 쥐의 Adjuvant 關節炎에 미치는 影響

朴亨奎,安圭錫,河智容 대한동의병리학회 1993 동의생리병리학회지 Vol.8 No.-

연구배경 : 봉독요법은 아직 보편화되지 못했으나 실제 임상에서 만성 관절염이나 염증질환에 많이 이용하고 있으며, 수천년전부터 민간요법으로 사용되어 왔다. 이에 봉독의 치료효과를 과학적으로 검증하고 치료기전을 밝혀 봉독요법의 활용에 도움이 되고자 한다. 방법 : 실험용 흰쥐에 Freun's complete adjuvant 액을 피하주사하여 관절염을 유발시키면서, apitoxin을 피하주사하여 부종률, 진통효과 및 소염작용을 측정한다. 결과 : 치료군에서 부종률이 억제되었고 WBC 및 혈청 cholinestrase의 활성도가 감소되었으며, 동통역치는 증가하였다. 결론 : 봉독요법은 소염, 진통에 뛰어난 효능을 가지고 있어 비증, 역절풍 및 통풍 등에 응용할 수 있을 것으로 사려된다. In order to study the effect of Apitoxin therapy on the Anti-inflammatary and Analgesic Action, Apitoxin therapy was administered on the Arthritis induced by Freund's complete adjuvant in rats. The obtainded results were summarized as follows. 1. Anti-inflammatory effect of Apitoxin therapy on the Anti-inflammatory action was showed statistical significance. The Sample A was more excellent on the decrease of edema and the number of WBC. 2. Analgesic Effect was showed with significance in sample A and B. Sample A was more excellemt in pain threshold, and B was more excellent in decrease of cholinestrase. According to the above result, it can be concluded Bee Vemom therapy showed the Anti-inflamentory and Analgenic Effect, and is suggest that the more interest, study in the secuity for the clinical use were neded.

대학생들의 氣에 대한 의식 조사 연구

홍성균,이성수,안규동,이병국 순천향대학교 산업의학연구소 2001 순천향산업의학 Vol.7 No.1

Ki is emerging and getting popular as a new alternative therapy in new millenium. The purpose of this study was to investigate the understanding and experience of the Ki therapy for college students. 320(Male=138, Female=182) students were participate in this study. Study subjects were answered with prepared 8 questions for their personal opinion and experience about Ki therapy. Study variables about personal information such as sex, blood type, religion, health status, personality, parent's religion, parent' occupation and parent educational level were also collected. The results of this study were as follows; 1 Among all study students (n=320), 89% of students answered positively in the existence of Ki, whereas only 11% answered negatively. 2. Among all study students (n=320), 13% (n=41) of students had a chance to have a Ki therapy and among 41 students 93% of them had experienced real Ki in any kind of form. 3. Among 41 Ki experienced students, 32% of students felt a feeling of floating and flying, 25% of students felt a feeling of pulling from the back and 21% of students felt a feeling of warming and comfortable, 10% of students felt refreshment and 5% of students felt a feeling of dizziness, whereas only 7% of students did not feel anything from Ki therapy. 4. While 53% of students among 41 Ki experienced students experienced their Ki in Ki training center, 31% and 6% of students experienced in college or university and other place, respectively. 5. Among all study students, 89% of students thought that Ki therapy was useful and wanted to have Ki therapy in case of medical attention, whereas only 11 % of students did not want Ki therapy. 6. Among study students with positive thinking about Ki therapy, 24% and 23% of students thought Ki therapy useful for (endocrine and skin diseases) and chronic adult diseases such as hypertension, cardiac disease, diabetes and obesity, respectively, whereas 21% and 18% of study students thought Ki therapy useful for neuropsychiatric disease and digestive diseases, respectively. 7. Regarding to the reason of attraction of Ki therapy compared with other treatment methods, 51% of students answered that Ki therapy gave comfortable and easiness to mind and 42% of students answered that it did not need any kind of injection or medicine.

한국어 판 구조화 임상면담도구 개발 : 신뢰도 연구

한오수,안준호,송선희,조맹제,김장규,배재남,조성진,정범수,서동우,함봉진,이동우,박종익,홍진표 대한신경정신의학회 2000 신경정신의학 Vol.39 No.2

연구목적: 정신장애의 정확한 진단과 평가는 임상에서뿐만 아니라 신뢰성 있는 연구를 위해서도 매우 중요하다. Structured Clinical Interview for DSM-IV(SCID)는 임상전문가들이 사용하는 진단도구로서, 비교적 짧은 시간에 정확한 진단을 내릴 수 있다. 본 연구는 한국어판SCID를 개발하고 그 신뢰도를 평가하기 위해 수행되었다. 방법: 국문학자가 포함된 번역위원회를 통하여 연구용판 SCID를 번역한 후, 정신과 의사 2인과 임상심리학자 1인에게 한국어판SCID 실시방법을 교육시킨 뒤 한국어판SCID를 이용한 면담의 평가자간 신뢰도 (interrater reliability)를 검증하였다. 면담 대상은 1999년 2월에서 3월까지 2개 병원 정신과에 치료중인 환자 90명(남:41명, 여:29명)이었다. 결과: 현재 장애(current disorder) 평가에서 주요 우울장애, 기분부전장애, 정신분열병, 알코올 남용 및 의존, 기타 물질 남용 또는 의존, 여러 불안장애들 및 섭식장애 등과 같은 대부분 장애의 kappa값은 .70이상으로 매우 높았다. 그 이외의 양극성 장애, 망상장애, 광장공포증, 감별 불능 신체화 장애 및 건강염려증의 kappa값도 .69에서 .40사이로 수용할 수 있는 정도였다. 평생 장애(lifetime disorder)에서는 양극성 장애(k=.69)와 감별 불능 신체화장애(k=.59)를 제외한 다른 모든 장애의 kappa값이 .70이상이었다. K-SCID 면담시 Ⅰ축 질환에 대하여 흔하게 다중 진단이 내려졌으며, 평균 진단 수는 1.5∼1.7개로 나타났다. 결론: 한국어판 SCID는 신뢰도가 높은 진단도구로 생각되며, 향후 정신질환의 정확한 진단과 임상연구에 유용하게 사용될 수 있다. Objectives: Accurate diagnosis and assessment for psychiatric disorders is crucial for research, as well as for clinical practice. Structured Clinical Interview for DSM-Ⅳ(SCID-RV) is a less time-consumimg and more accurate structured diagnostic interview form. It can be used by clinical professions and is known for a reliable diagnostic tool. Present study was conducted to develop Korean version of SCID-RV and to test the inter-rater reliability. Methods: The authors have translated original SCID-RV into Korean, and revised in parallel with sociocultural background of Korea. Ninety patients from two psychiatric hospitals, both outpatient and inpatient, were interviewed and rated independently by three raters. Results: The kappa coefficients for most of illnesses, such as major depressive disorder, dysthymia, schizophrenia, alcohol abuse and dependency, anxiety disorder and eating disorder were excellent(>0.70) in the evaluation of current disorders. And the kappa coefficients for bipolar disorder, delusional disorder, agoraphobia, undifferentiated somatoform disorder, and hypochondriasis were acceptable(>0.40) in the evaluation of current disorders. In the evalua-tion of lifetime disorders, the concordant rates of all the diagnoses except bipolar disorder and undifferentiated somatoform disorder were excellent. Lack of hierarchy in DSM-Ⅳ allows for multiple Axis I diagnoses. Mean numbers of Axis I diagnoses per subject assigned by the three raters were 1.5-1.7. Conclusions: Our findings confirm that SCID-RV yields highly reliable diagnoses. SCID-RV is recommended for accurate diagnosis in clinical practice and research on psychiatric disorders.

폐결핵 환자 혈청에서 수용성 Interleukin 2 수용체 및 Adenosine Deaminase 활성도에 관한 연구

고정희,박성규,백상현,박찬권,박병수,안진영,최우석,박정규 충남대학교 의과대학 지역사회의학연구소 1993 충남의대잡지 Vol.20 No.1

Interleukin-2 (IL-2) induces T cell proliferation in an autocrine manner and provides a means by which antigen triggered T cells can be clonally expanded in vitro. During the following activation, the activity of IL-2 is mediated by specific high affinity IL-2 binding membrane receptors which are expressed shortly after activation. In this process, a 42 KD-fragment (soluble IL-2R) is continuously cleaved off and circulates as a soluble marker of T lymphocyte activation. Elevated level of soluble IL-2R has been identified in the serum of patients with malignant autoimmune and allergic disorders, systemic parasitic infection, undergoing graft versus host disease, acute or chronic lymphocytic leukemia and HIV-infection. ADA (adenosine deaminase) completes the process of differentiation of T cell and is essential for progression of T cell maturation. Therefore level of ADA is to correlated with magnitude of T cell immune response. The fact that expression of sIL-2R and ADA activity increases in peripheral blood T-lymphocytes of patients with active pulmonary tuberculosis suggests that T cell activation might have a major role in the pathogenesis of pulmonary tuberculosis. In order to evaluate the T cell immune response in pulmonary tuberculosis, we measured the serum concentration of sIL-2R and ADA activity in 17 patients with current pulmonary tuberculosis, 10 chronic inactive pulmonary tuberculosis, 10 as normal controls. (1) Current pulmonary tuberculosis had significantly higher levels of sIL-2R (237.24±95.47)when compared with those of inactive tuberculosis (78.6±11.06). and the control (68.17±15.4) group. (2) ADA activity in current pulmonary tuberculosis was significantly increased (34.41±20.63) when compared with those of inactive tuberculosis (24.7±14.36) and control (17.65± 5.94) group. (3) There was good correlation between sIL-2R concentration and ADA activity in serum in current pulmonary tuberculosis group. (4) sIL-2R concentration and ADA activity was decreased significantly 6 months after anti-tuberculosis drug medication. In conclusion, sIL-2R concentration and ADA activity in serum in current pulmonary tuberculosis group was increased when compared with those of inactive pulmonary tuberculosis and the control group. By the way, T cell mediated immune response was enhanced in current pulmonary tuberculosis, but in inactive chronic pulmonary tuberculosis who had treated by antituberculosis drug medication, the concentration of sIL-2R and ADA activity was nearly normal.

연취급 근로자들의 사회 심리적 스트레스가 연노출 수준에 미치는 영향

김용배,황보영,김화성,이성수,안규동,이병국 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.1

Objectives : This study was carried out to assess psychosocial distress of lead workers and to examine the effect of psychosocial distress on lead exposure indices. Methods : The study design was cross-sectional and research subjects were 246 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(Psycosocial 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 : The crude odds ratio of group whose PbB was 20-39 ㎍/㎗ was 3.475(95% CI : 1.243-6.404) and that of group whose PbB was above 40 ㎍/㎗ was 7.586(95% CI : 1.487-15.611). The odds ratio of each group adjusted age, wages, job characteristics, social support, smoking and alcohol drinking habit were still significant. Conclusions : Our results supported the association between lead exposure and psychosocial distress. The inclusion of psychosocial distress measurement as a special health examination for lead workers is highly recommended for the effective prevention of stress in lead workers.