• Korean Journal of Occupational Health Nursing
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• v.6 no.1
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• pp.53-71
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• 1997

Across sectional study was performed to evaluate the chronic effects on central nerve system(CNS) of cumulative exposure of complex organic solvents, using neurobehavioral test. Subjects were 66 (male) dock yard painters of some large ship industry which is located in Ulsan. The neurobehavioral test battery used in this study was NCTB (Neurabehavioral Core Test Battery recommended by WHO(World Health Organization), which consisted of 7 items-Profile of mood states (POMS), Simple reaction time, Santa Ana dexterity test. Digit span, Digit symbol, Benton visual retention test and Pursuit aiming. The subjects were classified by 3 groups according to duration of employment(group 1 ; less than 9 years, group 2 ; 10-14 years, group 3 ; more than 15 years). The results of performance were analyzed considering of work duration, age, educational level, alcohol drinking, smoking and testing time as confounding factors. Benton visual retention test, pursuit aiming correct dot and sum of dot showed significant differences among the groups, and decreased with increasing work duration. It indicated that the mean scores of performance ability were lowering according to work duration. Besides, the tests that didn't show statistical significances but showed linear trends were depression-dejection, vigor, fatigue of POMS, slowest time of simple reaction time and digit span forward. Most of the neurobehavioral test items were correlated with age and educational level. After controlling of confounding factors-age and educational level, the results followed ; digit span backward was different significantly. Tension-anxiety, depression-dejection, anger-hostility of POMS, SD and slowest time of simple reaction time, Santa Ana dexterity test non-preferred hand, digit span forward, Benton visual retention test and pursuit aiming correct dot decreased with increasing of work duration. The correlation analysis was done in order to find out the relationship between subjective symptom and the scores of neurobehavioral core test battery. According to the results of analysis there were no items that had statistical significant relationship(p<0.05).

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.20 no.3
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• pp.156-167
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• 2010

To evaluate the effect of lead biomarkers including bone lead on neurobehavioral test in retired lead workers, 131 retired lead workers without any occupational exposure to organic solvent, mercury and arsenic were agreed to participate this study. For the control subjects 56 non-occupationally lead exposed subjects were recruited from same area of retired lead workers with consideration of demographic characteristics. The mean levels of blood and bone lead of retired lead workers were significantly higher than control group and there were significant correlation among other lead biomarkers. Compared with controls without occupational lead exposure, lead exposured subjects had worse performance on 10 tests out of 12 neurobehavioral tests, but only two tests(Purdue pegboard nondominant and both hand) showed statistical significance of differences. In multiple linear regression analysis of neurobehavioral tests with lead biomarkers and demographic and lifestyle variables, age was associated negatively with 11 neurobehavioral tests, whereas log-transformed ZPP was associated with Purdue pegboard(both hand) and Santa Ana manual dexterity(non-dominant hand). On the other hand, tibia lead was associated Pursuit aiming test(correct) and Purdue pegboard(dominant hand) and calcaneal lead was associated with Purdue pegboard(dominant hand). This study confirmed that among all relevant variables age was most significantly associated with the poor performance of neurobehavioral tests. The blood lead did not have any significant association with neurobehavioral tests, but tibia and calcaneal bone lead and blood ZPP showed significant association with a few tests even after more than mean 9 years from their retirements.

• Journal of Preventive Medicine and Public Health
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• v.26 no.2 s.42
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• pp.210-221
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• 1993

In order to evaluate the confounding factors of neurobehavioral tests and the neurobehavioral effects in the workers exposed to organic solvents, NCTB was carried out on 100 workers. 46 workers had never been exposed to neurotoxic substances, and the others were being exposed to the solvents, mainly toluene. Simple reaction time, digit symbol, Santa Ana dexterity test and persuit aiming were different with age in non exposure group. Simple reaction time was carried out well in males, and digit symbol and persuit aiming were in females. There was no difference at educational level when the subject was educated over 12 years. Santa Ana dexterity and Benton visual test differed according to exposure level to toluene, however simple reaction time didn't. The acute neurotoxic effect was not excluded in this study. But, NCTB could be used to evaluate and prevent neurobehavioral changes in workers exposed to neurotoxic solvents in Korea.

• Safety and Health at Work
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• v.9 no.4
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• pp.381-387
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• 2018

Background: Physician behaviors that undermine a culture of safety have gained increasing attention as health-care organizations strive to create a culture of safety and reduce medical errors. We developed, implemented, and assessed a course to teach physicians skills regarding effective coping and interpersonal communication skills and present our results regarding outcomes. Methods: We examined a professional development program specifically designed to address unprofessional or distressed behaviors of physicians, and we evaluated the impact on burnout, quality of life, and emotional flooding scores of the physicians. Assessments of burnout, quality of life, and emotional flooding were assessed preintervention and postintervention. Results: Results demonstrated statistically significant reductions over time in physicians' emotional flooding and emotional exhaustion (EE). Specifically, using a Wilcoxon Signed-Rank test, results revealed that flooding scores at follow-up were statistically significantly lower than at baseline, V = 590, p < 0.05, and EE and personal accomplishment distributions were found to significantly deviate from normal as indicated by Shapiroe-Wilks tests (p < 0.05). A Wilcoxon signed-rank test indicated that EE scores were significantly higher at baseline compared to follow-up 1, V = 285, p < 0.05. Conclusion: We conclude that the physician participants who enrolled in the educational skills training program improved scores on emotional flooding and EE and that this may be indicative of improved skills related to their experiences and learning in the program. These improved skills in physicians may have a positive impact on the overall culture of safety in the health system setting.

• Journal of Environmental Health Sciences
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• v.33 no.5
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• pp.345-352
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• 2007

As mercury absorbed into body can cross the blood-brain barrier and react with DNA and RNA. Central nervous system has been known to be affected especially in children. But it was very difficult to know the influences of chronic low-does Hg exposure on the health. Although many studies investigated the affect, most of results were still disparate. In order to investigate the health effects of mercury exposure, several test were conducted for some Korean school children. The general health effects were investigated using blood test, Posturography and computer-based neurobehavioral test was done to examine the affect of Hg into neural responses. About 400 children were chosen for blood test whose blood Hg level were upper and lower 10% of population participated in the nationwide Hg exposure survey. The concentration of calcium and creatine, the number of white and red blood cell showed statistical significance with Hg exposure in blood test. Another 36 children were selected from the same participants for the posturography and neurobehavioral test. The intensity and center frequency of hand tremor which were related to unconsciousness also showed distinct significances. Any general relations with Hg exposure were not found in all test including computer-based neurobehavioral test.

• Journal of Preventive Medicine and Public Health
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• v.31 no.4 s.63
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• pp.692-707
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• 1998

Aim. A neurobehavioral test for workers exposed to organic solvents in the workplace can be affected by many factors : age, education, motivation, ethnicity, etc. To apply more suitable neurobehavioral test for Korean workers, we evaluated the validity of several items of computerized and traditional neurobehavioral tests. Methods. We have applied eleven tests : four items of computerized neurobehavioral test(Swedish Performance Evaluation System) including Addition, Symbol-Digit, Dig-it Span, and Finger tapping speed, and seven items of traditional neurobehavioral test consisting of Addition, Digit-Symbol, Digit Span, Benton visual retention test, Pursuit aiming, Pegboard, and Tapping. These tests were performed on 96 workers exposed to solvents, and 100 reference workers. The concurrent and construct validities were evaluated by group difference, correlation with age, educational level, hippuric acid level, neurotoxic symptom, current exposure level, multitrait-multimethod matrix, fator analysis, and discriminant analysis. Results. Statistically significant differences were observed between the workers exposed to solvents and referents in computerized Symbol-Digit, Finger tapping speed, traditional Digit-Symbol and Pegboard. The computerized Symbol-Digit, traditional Digit-Symbol, Addition, Benton visual retention test, and Pegboard were found to be related to the age. The performance of computerized Symbol-Digit, Addition, and traditional Digit-Symbol were found to be related to the educational level significantly. The computerized Symbol-Digit, Finger tapping speed, and traditional Digit-Symbol were found to be related to hippuric acid, and neurotoxic symptom. The discriminability of Finger tapping speed, and Pegboard was better than the other tests. In discriminant analysis, the model with two variables, the computerized Symbol-Digit and Pegboard, classified almost 70 percent of the workers correctly. Conclusions. These results suggest that the computerized Symbol-Digit, Finger tapping speed, and Pegboard are more satisfactory for our purpose, and the Addition, Tapping, Benton visual retention test, and Pursuit aiming are less valid than other items. These may allow the reasonable selection of core neurobehavioral tests for workers exposed to solvents in Korea.

• Journal of Yeungnam Medical Science
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• v.33 no.2
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• pp.85-89
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• 2016

Background: Formaldehyde is used to preserve cadaver in medical schools, and students are exposed to formaldehyde during cadaver dissection classes. When humans are exposed to formaldehyde, it induces mucosal inflammation, skin inflammation, and declining of neurobehavioral function including attention and memory executive functions. The purpose of this study is to identify the effects of formaldehyde exposure on student's neurobehavioral performance during cadaver dissection classes. Methods: The level of formaldehyde was measured in a cadaver dissection class. A total of 16 students were randomly divided into two groups. One group wore respiratory protection masks, while the other group did not. Among many subtests in Korean Computerized Neurobehavioral test, backward digit span was tested on all subjects before and after the class. Results: The length of memorized digit span between the two groups was not significant; however there was a greater decrease in neurobehavioral function after formaldehyde exposure in the non-mask group than the mask group. Conclusion: Formaldehyde exposure during cadaver dissection may likely decrease neurobehavioral performance of students. Therefore, proper ventilation system and respiratory protective equipment are necessary to protect medical school students from adverse effects of formaldehyde exposure.

• Journal of Preventive Medicine and Public Health
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• v.28 no.4 s.51
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• pp.911-923
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• 1995

With increased use of neurotoxic agents in manufacturing industries, hazardous effects of neurotoxic agents pose significant problems in protecting health of workers who work in these industries. A normal range of neurobehavioral performance is required to study hazardous effects of neurotoxic agents among workers. However, such reference for Korean population is not available yet. The objective of this study is to estimate a normal range of neurobehavioral test performance of female workers in Korea. Data for neurobehavioral test performance developed by the World Health Organization were obtained from 165 female workers. Study subjects, 140 production workers and 25 clerks, who voluntarily participated in this study were not occupationally exposed to neurotoxic agents. The mean age and the mean education years of them were 32 years and 10.9 years, respectively Santa Ana dexterity, pursuit aiming, digit symbol, simple reaction time, and Benton visual retention tests among the Neurobehavioral Core Test Battery(NCTB) were included in the evaluation. Subjects were interviewed by a trained interviewer for their detailed occupational history $Mean({\pm}SD)$ performance of the participants were: $45.7{\pm}7.1\;and\;41.9{\pm}6.4$ in the Santa Ana dexterity test of the preferred and non-preferred hands; $45.7{\pm}7.1\;and\;41.9{\pm}6.4$ in correct dot of the pursuit aiming test; $57.7{\pm}16.0$ in the digit symbol test; $274.8{\pm}44.6$ msec in the mean simple reaction time and $70.5{\pm}69.0$ msec in the mean standard deviation of it; and $7.8{\pm}1.7$ in the Benton visual retention test. Most neurobehavioral performance scores were correlated significantly with age and educational level. Educational level was found to be a significant independent variable which was associated with all test scores. Age was significantly associated with scores of pursuit aiming and digit symbol tests.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.15 no.2
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• pp.144-152
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• 2005

To evaluate the effect of lead biomarkers including bone lead on neurobehavioral test in lead workers, 652 lead workers without any occupational exposure to organic solvent, mercury and arsenic were agreed to participate this study. For the control subjects 102 non-occupationally lead exposed blue collar workers in general manufacturing industries were also joined this study. All study subjects joined this study with written informed consent. The study variables of lead exposure were blood and patella lead. For the general characteristics of study subjects, standardized questionnaire regarding age, sex, past disease history, job duration, body mass index (BMI), drinking and smoking habit were provided. For the past history of neurotoxicity related diseases, all study subjects were interviewed by qualified occupational health physician. The results obtained were as follows: 1. Compared with controls without occupational lead exposure, lead exposed subjects had worse performance on all tests(p<0.05). 2. After adjustment for covariates (age, sex, job duration, education level, BMI, smoking and drinking status), the signs of the regression coefficients for blood lead were negative for 13 of the 14 tests. Blood lead was a significant predictor of poorer scores on 8 tests (simple reaction time(ms & root MSD), Trail-Making Test B, Digit Symbol Substitution, Purdue Pegboard assembly, Digit Span Test, Benton Visual Retention, and Purdue pegboard both hand). 3. After adjustment for covariates (age, sex, job duration, education level, BMI, smoking and drinking status), the signs of the regression coefficients for patella lead were negative for 12 of the 14 tests. Patella lead was a significant predictor of poorer scores on 8 tests (simple reaction time(ms). Purdue Pegboard assembly, Digit Span Test, Benton Visual Retention. Pursuit Aiming rest (no. of correct & no. of incorrect), Purdue pegboard non-dominant hand and both hand). With above results, blood lead and patella lead were associated with poorer performance of neurobehavioral tests. In addition, patella lead was confirmed to be better predictor of manual dexterity test in neurobehavioral test battery in lead workers

• Environmental Analysis Health and Toxicology
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• v.28
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• pp.15.1-15.8
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• 2013

Objectives The aim of this study was to determine the association between low-level mercury exposure and neurobehavioral functions in adults living in coastal regions of Korea. Methods We selected 172 adults aged 20-65 years living in a city in the coastal region of Korea. A sociodemographic survey was conducted, mercury levels in the blood, urine, and hair were measured, and the associations according to computerized neurobehavioral tests were determined using univariate analysis. After adjustment for associated variables, a multivariate linear regression analysis was performed. Results The geometric mean mercury levels in the blood, urine, and hair were $5.41{\mu}g/L$ (range, $0.00-15.84{\mu}g/L$), $1.17{\mu}g/g$-creatinine (range, $0.00-32.86{\mu}g/g$-creatinine), and 1.37 mg/kg (range, 0.42-6.56 mg/kg), respectively. Variables that were associated with simple reaction time according to the neurobehavioral test results were age and urine mercury level. Variables associated with choice reaction time were the recent use of Korean traditional medicine and urine mercury level. Variables associated with the right-hand finger tapping speed test were age, gender, smoking behavior, education level, monthly household income, and urine mercury level. Variables associated with the left-hand finger tapping speed test were age, gender, education level, and urine mercury level. After adjustment for associated variables, there was no significant association between urine mercury level and simple reaction time (${\beta}=25.96$; p =0.47), choice reaction time (${\beta}=50.37$; p =0.32), or the number of left-hand finger taps (${\beta}=-1.54$; p =0.21). However, urine mercury level was significantly associated with the number of right-hand finger taps (${\beta}=-3.86$; p =0.01). Conclusions We found no evidence that low-level mercury exposure in adults is associated with deficits in neurobehavioral functions. A longer follow-up study is required to confirm this conclusion.