• Safety and Health at Work
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• v.1 no.2
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• pp.183-191
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• 2010

Objectives: The objective of this study is to investigate the distribution patterns and exposure concentrations of bioaerosols in industries suspected to have high levels of bioaerosol exposure. Methods: We selected 11 plants including 3 livestock feed plants (LF industry), 3 metal working fluids handling plants (MWFs industry), and 5 sawmills and measured total airborne bacteria, fungi, endotoxins, as well as dust. Airborne bacteria and fungi were measured with one stage impactor, six stage cascade impactor, and gelatin filters. Endotoxins were measured with polycarbonate filters. Results: The geometric means (GM) of the airborne concentrations of bacteria, fungi, and endotoxins were 1,864, $2,252\;CFU/m^3$, and $31.5\;EU/m^3$, respectively at the sawmills, followed by the LF industry (535, $585\;CFU/m^3$, and $22.0\;EU/m^3$) and MWFs industry (258, $331\;CFU/m^3$, and $8.7\;EU/m^3$). These concentrations by industry type were significantly statistically different (p < 0.01). The ratio of indoor to outdoor concentration was 6.2, 1.9, 3.2, and 3.2 for bacteria, fungi, endotoxins, and dust in the LF industry, 5.0, 0.9, 2.3, and 12.5 in the MWFs industry, and 3.7, 4.1, 3.3, and 9.7 in sawmills. The respiratory fractions of bioaerosols were differentiated by bioaerosol types and industry types: the respiratory fraction of bacteria in the LF industry, MWF industry, and sawmills was 59.4%, 72.0%, and 57.7%, respectively, and that of fungi was 77.3%, 89.5%, and 83.7% in the same order. Conclusion: We found that bioaerosol concentration was the highest in sawmills, followed by LF industry facilities and MWFs industry facilities. The indoor/outdoor ratio of microorganisms was larger than 1 and respiratory fraction of microorganisms was more than 50% of the total microorganism concentrations which might penetrate respiratory tract easily. All these findings suggest that bioaerosol in the surveyed industries should be controlled to prevent worker respiratory diseases.

• Tuberculosis and Respiratory Diseases
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• v.87 no.1
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• pp.65-79
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• 2024

Background: Exhaled condensates contain inflammatory biomarkers; however, their roles in the clinical field have been under-investigated. Methods: We prospectively enrolled subjects admitted to pulmonology clinics. We collected exhaled breath condensates (EBC) and analysed the levels of six and 12 biomarkers using conventional and multiplex enzyme-linked immunosorbent assay, respectively. Results: Among the 123 subjects, healthy controls constituted the largest group (81 participants; 65.9%), followed by the preserved ratio impaired spirometry group (21 patients; 17.1%) and the chronic obstructive pulmonary disease (COPD) group (21 patients; 17.1%). In COPD patients, platelet derived growth factor-AA exhibited strong positive correlations with COPD assessment test (ρ=0.5926, p=0.0423) and COPD-specific version of St. George's Respiratory Questionnaire (SGRQ-C) score (total, ρ=0.6725, p=0.0166; activity, ρ=0.7176, p=0.0086; and impacts, ρ=0.6151, p=0.0333). Granzyme B showed strong positive correlations with SGRQ-C score (symptoms, ρ=0.6078, p=0.0360; and impacts, ρ=0.6007, p=0.0389). Interleukin 6 exhibited a strong positive correlation with SGRQ-C score (activity, ρ=0.4671, p=0.0378). The absolute serum eosinophil and basophil counts showed positive correlations with pro-collagen I alpha 1 (ρ=0.6735, p=0.0164 and ρ=0.6295, p=0.0283, respectively). In healthy subjects, forced expiratory volume in 1 second (FEV₁)/forced vital capacity demonstrated significant correlation with CC chemokine ligand 3 (CCL3)/macrophage inflammatory protein 1 alpha (ρ=0.3897 and p=0.0068). FEV₁ exhibited significant correlation with CCL11/eotaxin (ρ=0.4445 and p=0.0017). Conclusion: Inflammatory biomarkers in EBC might be useful to predict quality of life concerning respiratory symptoms and serologic markers. Further studies are needed.

• Health Policy and Management
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• v.19 no.3
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• pp.1-26
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• 2009

Objectives : To identify target areas and set priorities among those areas identified for national quality evaluation. Methods : Target areas were identified from: i) analysis of the national health insurance claims data, mortality and prevalence data ii) various group surveys, including representatives from 22 medical specialty associations, 19 physician associations, QI staffs in hospital, civil organizations, and commissioners of Health Insurance Review and Assessment Service(HIRA) ⅲ) literature reviews and RAM(RAND/UCLA appropriateness method). The priority areas for national quality evaluation represented the full spectrum of health care and the entire life span. The criteria for selecting the priority areas were impact, improvability, and measurability. The priority areas were divided into three categories : short-term, mid-term, long-term. Results: Based on the group surveys and the data analysis, 46 candidates were selected as quality evaluation priority areas. 13 areas were selected as having a short-term priority areas: tuberculosis, community acquired pneumonia, stroke, ischaemic heart disease, diabetes, hypertension, chronic lower respiratory disease(asthma, chronic obstructive pulmonary disease), intensive care unit, emergency room, nosocomial infection, use of antibiotics, multiple medication and renal failure. This results suggested that we need to enlarge the target priority areas to the chronic diseases in short-term. Conclusions: The priority areas identified from the study will assist healthcare quality associated institutions as well as HIRA in selecting quality evaluation areas. It is required to develope and implement strategies for improving the quality of care within the next 5 years.

• The Korean Journal of Emergency Medical Services
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• v.8 no.1
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• pp.33-45
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• 2004

The study is designed to develop an educational CD-Title for Basic Life Support. The study is conducted from July to December, 2002, Based on the course of program development suggested by Dick and Cray. the study followed the planning, development, education and evaluation of a program. The developed CD-Title consists of 8 parts. 1. Intro include Introduction, Adult CPR, Child CPR, Infant CPR, Adult Foreign-Body Airway Obstruction, Infant Foreign-Body Airway Obstruction, and Exercise in Menu at Right of screen. 2. Introduction consist of death process at cardiac arresst, chain of survival, introduction of CPR, respiratory & ciculatory anatomy and physiology. 3. Adult CPR consist of assessment responsiveness, activating EMS system, position victim, opening a airway, checking for breathing, rescue breathing, checking for sign of circulation, chest compression, 1 person & 2 persion adult CPR video. 4. Child & Infant CPR consist of, causes, assessment responsiveness, position victim, opening the airway, checking for breathing, rescue breathing, checking for sign of circulation, chest compression, activating EMS system, child & infant CPR video. 5. Adult Foreign-Body Airway Obstruction include assessment responsiveness, activating EMS system, position victim, opening a airway, checking for breathing, 2 rescue breathing, reopening the airway, 2 rescue breathing, finger sweep, 5 abdominal thrusts, unresponsiveness adult Foreign-Body Airway Obstruction video. 6. Infant Foreign-Body Airway Obstruction consist of, causes, assessment responsiveness, position victim, opening the airway, checking for breathing, 2 rescue breathing, reopening the airway, 2 rescue breathing, checking foreign-body object in oral cavity of victim, 5 back blow, 5 chest thsusts, activating EMS system, video. 7. 32 exercise consist of 8 Adult CPR, 12 Child & Infant CPR, 5 Adult Foreign-Body Airway Obstruction, 7 Infant Foreign-Body Airway Obstruction. Every part consist of animations to trigger students interests. This CD-Title will be useful education for first responders and lay rescuers.

• Korean Medical Education Review
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• v.18 no.2
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• pp.65-82
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• 2016

This study aimed to identify curriculum gaps and a pilot study to provide the programs for selection during clerkship. Over the course of a clerkship, students analyze the current level and the needs level of TLO (terminal learning objectives) based on the book "Learning outcome of basic medical education: Scientific concept and principle-centered." We conducted a needs assessment utilizing a t-test, Borich Needs Assessment, and the Locus for Focus model. In the investigation of the needs level, the levels of the musculoskeletal and respiratory systems were relatively high and in the investigation of the current level, the levels of the digestive and musculoskeletal systems were relatively high. This study is expected to contribute to reasonable decision-making by utilizing various methods of analysis and providing in-depth results of needs analysis in designing clerkship curriculum.

• Tuberculosis and Respiratory Diseases
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• v.73 no.3
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• pp.151-161
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• 2012

Background: Adequate assessment and control of sedation play crucial roles in the proper performance of mechanical ventilation. Methods: A total of 30 patients with various pulmonary diseases were prospectively enrolled. The study population was randomized into two groups. The sedation assessment group (SAG) received active protocol-based control of sedation, and in the empiric control group (ECG), the sedation levels were empirically adjusted. Subsequently, daily interruption of sedation (DIS) was conducted in the SAG. Results: In the SAG, the dose of midazolam was significantly reduced by control of sedation (day 1, $1.3{\pm}0.5{\mu}g/kg/min$; day 2, $0.9{\pm}0.4{\mu}g/kg/min$; p<0.01), and was significantly lower than the ECG on day 2 (p<0.01). Likewise, on day 2, sedation levels were significantly lower in the SAG than in the ECG. Significant relationship was found between Ramsay sedation scale and Richmond agitation-sedation scale (RASS; $r_s$=-0.57), Ramsay Sedation Scale and Bispectral Index (BIS; $r_s$=0.77), and RASS and BIS ($r_s$=-0.79). In 10 patients, who didn't require re-sedation after DIS, BIS showed the earliest and most significant changes among the sedation scales. Ventilatory parameters showed significant but less prominent changes, and hemodynamic parameters didn't show significant changes. No seriously adverse events ensued after the implementation of DIS. Conclusion: Active assessment and control of sedation significantly reduced the dosage of sedatives in patients receiving mechanical ventilation. DIS, conducted in limited cases, suggested its potential efficacy and tolerability.

• Journal of Environmental Health Sciences
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• v.44 no.5
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• pp.460-467
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• 2018

Objectives: The objectives of this study are to estimate the inhalation exposure level of benzene for workers using Tier 1 exposure models ECETOC TRA (European Center for Ecotoxicology and Toxicology of Chemicals Target Risk Assessment) and Stoffenmanager, and to investigate their reliability for exposure assessment in K-REACH. Methods: Two exposure scenarios, 'manufacture of benzene' and 'use as solvents,' were developed for assessment of workers' exposure to benzene. The Process Category (PROC) for ECETOC TRA was collected from the European Chemical Agency (ECHA) registration dossier, and the Activity for Stoffenmanager was converted from PROC using translation of exposure models (TREXMO). The information related to exposure, such as working duration, Respiratory Protective Equipment (RPE), Local Exhaust Ventilation (LEV), and Risk Management Measure (RMM) were classified into high, medium, and low exposure conditions. The risk was determined by the ratio of the estimated exposure and occupational exposure limits of benzene. Results: Under high exposure conditions, the worker exposure level calculated from all PROCs and Activities exceeded the risk level, with the exception of PROC 1 and Activity 1. In the medium exposure condition, PROC 8a, 8b, and 9 and Activity 3, 7, and 8 all exceeded the risk, whereas in the low condition, all PROCs and Activities were determined to be safe. As a result, action corresponding with the low exposure condition is required to reduce the risk of exposure among workers in workplaces where benzene is manufactured or used as a solvent. In addition, the predicted exposure levels derived from the exposure models were lower than measured levels. The exposure levels estimated from Stoffenmanager were more conservative than those from ECETOC TRA. Conclusions: This study demonstrates the feasibility of exposure models for exposure assessment through the example of occupational inhalation exposure assessment for benzene. For more active utilization of exposure models in K-REACH, the exact application of collected information and accurate interpretation of obtained results are necessary.

• Journal of Korean Academy of Nursing
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• v.32 no.2
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• pp.176-185
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• 2002

Knowing the accurate GA is critical in nursing care of high-risk newborns. A descriptive study was performed to examine the reliability and clinical applicability of the new Ballard examination (NBE) in high-risk infants. Method: A NBE was performed to measure GA by assessing the neuromuscular and physical maturity in the course of physical examination of a convenient sample of 50 high-risk infants. Results: 1) There was a highly correlation between both the GA by LMP (GA-LMP) and GA by NBE (GA-NBE) (r = .894, p = .000) 2) There was a greater positive relationship in neuromuscular maturity than physical maturity in the GA-NBE of the high-risk newborn (r = .657 versus r = .915, p <. 05). 3) The high-risk infants were thoes with congenital anomalies, prematurity, and RDS(Respiratory Distress Syndrome). Male infants showed a higher neuromuscular maturity, compared to female infants. 4) There was a positive correlation between neuromuscular, physical, total maturity, GA-LMP and GA-NBE in the birth weight, 1 minute Apgar score. Conclusion: The study supports the reliability an clinical relevance of NBE in assessment of the accurate GA in high-risk infants.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.17
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• pp.7029-7035
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• 2014

Certain types of human papillomaviruses (HPVs) are undoubtedly involved in genesis of human malignancies. HPV plays an etiological role in cervical cancer, but also in many vaginal, vulvar, anal and penile cancers, as well as head and neck cancers. In addition, a number of non-malignant diseases such as genital warts and recurrent respiratory papillomatosis are attributable to HPV. Moreover, HPV forms have detected in several other cancers including esophageal squamous cell carcinoma, lung, prostate, ovarian, breast, skin, colorectal and urinary tract cancers, but associations with etiology in these cases is controversial. The aim of this systematic assessment was to estimate the prevalence of HPV infection and HPV types in HPV-associated cancers, HPV-related non-malignant diseases and in cancers that may be associated with HPV in Iran. The present investiagtion covered 61 studies on a variety of cancers in Iranian populations. HPV prevalence was 77.5 % and 32.4% in cervical cancer and head and neck cancers, respectively. HPV was detected in 23.1%, 22.2%, 10.4%, 30.9%, 14% and 25.2% of esophageal squamous cell, lung, prostate, urinary tract cancers, breast and skin cancers, respectively. HPV16 and 18 were the most frequent HPV types in all cancers. The findings of present study imply that current HPV vaccines for cervical cancer may decrease the burden of other cancers if they are really related to HPV.

• Journal of Environmental Health Sciences
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• v.28 no.2
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• pp.173-182
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• 2002

Exposure to environmental tobacco smoke(ETS) increases the risk of lung cancer and other diverse health effect for nonsmokers. Health risk assessment of nonsmokers related to ETS exposure requires large and exact data of ETS exposure to nonsmokers. This study presented the data of ETS exposure to workers at three category of restaurants(Korean restaurant, coffee shop, wine shop) in Seoul. Markers of ETS exposure measured in this study were area and personal NO$_2$, area and urine nicotine, area respiratory suspended particulate(RSP) and urine cotinine. The mean concentration of RSP and nicotine of all restaurant indoor samples was 177.8$\mu\textrm{g}$/㎥(range:75.3~317.0$\mu\textrm{g}$/㎥) and 7.8$\mu\textrm{g}$/㎥(range:0~57.3$\mu\textrm{g}$/㎥). The mean concentration of urine cotinine measured for the biomarker of ETS exposure was 77.3ng/mL(range:17.3~174.6ng/mL). In all measurements, the concentration of ETS markers at the wine shop was higher than those at other restaurants. The correlation coefficient among the ETS markers measured in the study was significant between area RSP and nicotine concentration and between area NO$_2$and nicotine concentration.