• 한국직업건강간호학회지
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• 제6권1호
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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).

• 한국산업보건학회지
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• 제20권3호
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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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• 제26권2호
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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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• 제9권4호
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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.

• 한국환경보건학회지
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• 제33권5호
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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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• 제31권4호
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• pp.692-707
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• 1998

우리나라 근로자의 특성과 산업보건 현실에 적합한 신경행동검사들을 선택하기 위하여 지금까지 국내의 일부 연구에서 사용되었던 신경행동검사들의 타당도를 비교평가하였다. 대구지역의 중소규모 사업장에서 톨루엔, 크실렌, 메틸에틸케톤, 이소프로필알콜, 메탄올에 폭로되는 유기용제 폭로군 96명과 대조군 100명을 대상으로 인구학적 변수와 직업관련 변수를 조사하고, 컴퓨터 신경행동검사 네 가지 검사항목(숫자 더하기, 부호숫자 짝짓기, 숫자 외우기, 손가락 두드리기)과 면접식 신경행동검사 일곱 가지 검사항목(Benton visual retention 검사, 숫자 외우기, 숫자부호 짝짓기, 숫자 더하기, 목적점찍기, 핀꼽기, 막대 두드리기)을 수행하였다. 11개의 신경행동검사 항목들 중 지각과 반응속도 영역에서 컴퓨터 부호숫자 짝짓기, 운동영역에서 컴퓨터 손가락 두드리기 및 미세운동영역에서 핀꼽기의 유사영역의 다른 검사에 비해 타당도가 상대적으로 높은 것으로 평가되었다. 이러한 결과는 산업장 근로자의 중추신경계장애의 선별을 위한 신경행동검사의 선택에 도움이 될 것으로 생각되나 대상자의 폭로기간이 길지 않고 폭로력과 재현성을 고려하지 못한 제한점을 가진다.

• Journal of Yeungnam Medical Science
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• 제33권2호
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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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• 제28권4호
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• pp.911-923
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• 1995

유기용제와 같은 신경독성 물질에 폭로되지 않은 제조업체 여성 근로자를 대상으로 세계보건기구의 Neurobehavioral core Test Battery(NCTB) 7가지 검사 항목 중 사업장 여건을 고려하여 산타아나 민첩성검사와 목적점 찍기, 숫자 기호화, 단순반응시간, 시각기억 검사 등 5가지 항목을 세계보건기구 표준방법에 따라 실시하여, 신경독성 물질폭로로 인한 신경행동학적인 영향을 평가하기 위한 대조군 자료를 마련하고자 본 연구를 시행하였다. 잘 쓰는 손과 반대편 손의 산타아나 민첩성검사 수행능력은 각각 $45.7{\pm}7.1$ 및 $41.9{\pm}6.4$개, 목적점 찍기는 $191.9{\pm}38.6$개였다. 숫자 기호화와 시각기억검사는 각각 $57.7{\pm}16.0$ 및 $7.8{\pm}1.7$개, 단순반응시간의 평균은 $274.8{\pm}44.6msec$였고 평균 표준편차는 $70.5{\pm}69.0msec$였다. 대부분의 신경행동검사 항목들은 피검자의 연령, 교육수준의 영향을 받는 것으로 나타났다. 산타아나 민첩성검사는 양손 모두에서 피검자의 교육년한에 영향을 받는 것으로 나타났다. 목적점 찍기 검사에서 올바르게 한 것은 피검자의 연령과 교육년한에 영향을 받는 것으로 나타났다. 숫자 기호화는 연령과 교육년한에, 단순반응시간은 교육년한에, 그리고 시각기억검사도 교육년한에 영향을 받는 것으로 나타났다. 전체적으로 볼 때 피검자의 교육수준은 모든 검사항목에서 주요한 영향 변수로 작용하고 있었고 연령은 일부 검사의 영향 변수로 작용하였다.

• 한국산업보건학회지
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• 제15권2호
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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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• 제28권
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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.