• Safety and Health at Work
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• 제10권4호
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• pp.428-436
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• 2019

Background: Metalworking fluids (MWFs) are mixtures with inhalation exposures as mists, dusts, and vapors, and dermal exposure in the dispersed and bulk liquid phase. A quantitative risk assessment was performed for exposure to MWF and respiratory disease. Methods: Risks associated with MWF were derived from published studies and NIOSH Health Hazard Evaluations, and lifetime risks were calculated. The outcomes analyzed included adult onset asthma, hypersensitivity pneumonitis, pulmonary function impairment, and reported symptoms. Incidence rates were compiled or estimated, and annual proportional loss of respiratory capacity was derived from cross-sectional assessments. Results: A strong healthy worker survivor effect was present. New-onset asthma and hypersensitivity pneumonitis, at 0.1 mg/㎥ MWF under continuous outbreak conditions, had a lifetime risk of 45%; if the associated microbiological conditions occur with only 5% prevalence, then the lifetime risk would be about 3%. At 0.1 mg/㎥, the estimate of excess lifetime risk of attributable pulmonary impairment was 0.25%, which may have been underestimated by a factor of 5 or more by a strong healthy worker survivor effect. The symptom prevalence associated with respiratory impairment at 0.1 mg/㎥ MWF was estimated to be 5% (published studies) and 21% (Health Hazard Evaluations). Conclusion: Significant risks of impairment and chronic disease occurred at 0.1 mg/㎥ for MWFs in use mostly before 2000. Evolving MWFs contain new ingredients with uncharacterized long-term hazards.

• Safety and Health at Work
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• 제12권2호
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• pp.174-183
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• 2021

Background: Toluene diisocyanate (TDI) is a highly reactive chemical that causes sensitization and has also been associated with increased lung cancer. A risk assessment was conducted based on occupational epidemiologic estimates for several health outcomes. Methods: Exposure and outcome details were extracted from published studies and a NIOSH Health Hazard Evaluation for new onset asthma, pulmonary function measurements, symptom prevalence, and mortality from lung cancer and respiratory disease. Summary exposure-response estimates were calculated taking into account relative precision and possible survivor selection effects. Attributable incidence of sensitization was estimated as were annual proportional losses of pulmonary function. Excess lifetime risks and benchmark doses were calculated. Results: Respiratory outcomes exhibited strong survivor bias. Asthma/sensitization exposure response decreased with increasing facility-average TDI air concentration as did TDI-associated pulmonary impairment. In a mortality cohort where mean employment duration was less than 1 year, survivor bias pre-empted estimation of lung cancer and respiratory disease exposure response. Conclusion: Controlling for survivor bias and assuming a linear dose-response with facility-average TDI concentrations, excess lifetime risks exceeding one per thousand occurred at about 2 ppt TDI for sensitization and respiratory impairment. Under alternate assumptions regarding stationary and cumulative effects, one per thousand excess risks were estimated at TDI concentrations of 10 - 30 ppt. The unexplained reported excess mortality from lung cancer and other lung diseases, if attributable to TDI or associated emissions, could represent a lifetime risk comparable to that of sensitization.

• 월간산업보건
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• 통권41호
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• pp.8-15
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• 1991

• Tuberculosis and Respiratory Diseases
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• 제53권2호
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• pp.101-112
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• 2002

연구배경 : 알레르기성 천식에서 기관지 재모형의 기전이 세포외 기질 침착에 의한다는 것은 잘 알려져 있다. MMP족중 특히 MMP-9은 천식의 기관지 재모형을 유발하는 주요 단백분해 효소이다. 또한, MMP-9은 기저막을 통한 호산구와 중성구의 이동을 유발한다고 알려져 있다. 최근에는 MMP가 천식의 쥐 모형에서 기도 과민성의 유발과 oval bumin 유발성 기도 염증 세포의 침윤에 있어서 중요한 역할을 한다고 보고되어졌다. 그러나, TDI 유발성 천식에 있어서 MMP의 역할에 대한 유효한 자료는 거의 없는 실정이다. 연구방법 : 특정 항원이 없는 암컷 BALB/c 쥐를 약간 변형된 Sugawara 등의 방법에 따라 ethyl acetate에 3% TDI를 녹인 용액을 5일 연속 매일 한번씩 비강내 주입하여 쥐를 감작시켰다. 기관지폐포 세척액의 채취하여 세포 분석과 MMPs의 측정하였고 폐조직에서 면역화학적 검사를 시행하였다. MMP 억제재를 TDI 부하(challenge) 30분전에 시작하여 24시간 간격으로 3회 복강내로 (10 또는 20mg/kg) 주입하고 기도 반응도를 측정하였다. 결 과 : TDI 감작 부하군에서 기관지폐포 세척액 염증 세포수와 MMP-9 및 폐조직의 면역화학적 검사상 MMP-9의 발현의 유의한 증가가 관찰되었다. MMP 억제재투여후 TDI 감작 부하군에서 기관지 폐포 세척액 염증 세포수와 MMP-9 및 폐조직의 면역화학적 검사상 MMP-9의 발현의 유의한 감소를 보였고 기도 과민성을 억제하였다. 결 론 : 본 연구의 결과는 MMP 억제재가 TDI 유발성 천식에 대한 훌륭한 치료제로서 향후 연구의 가치가 있음을 강력히 시사한다.

• Safety and Health at Work
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• 제4권2호
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• pp.77-83
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• 2013

There is still a considerable burden of occupational diseases and injuries in the world. It is not well known which interventions can effectively reduce the exposures at work that cause this burden. The objective of this article is to summarize evidence from systematic reviews of interventions to prevent occupational diseases and injuries. We included systematic reviews of interventions to reduce the incidence of work-related cancer, dust-related diseases, occupational asthma, chronic obstructive pulmonary disease, noise induced hearing loss, back pain, and occupational injuries. We searched Medline and Embase with predefined search strategies to locate systematic reviews of these interventions. We found 23 systematic reviews of which the results are also applicable to low- and middle income countries. Effective measures to reduce exposure leading to work-related cancer, dust-related diseases, asthma, chronic obstructive pulmonary disease, noise, and injuries are available. However, better implementation of these measures is needed. Regulation, enforcement of regulation, and incentives for employers are effective interventions to achieve this goal. There is evidence that feedback and rewards for workers help in reducing occupational injuries. There is no evidence in many studies that back pain can be prevented. Personal protective equipment technically has the potential to reduce exposure but this is difficult to put into effect. There is no evidence in the studies regarding the effectiveness of education and training, preventive drugs, or health examinations. There is evidence that the implementation of technical measures enforced by regulation can prevent occupational diseases and injuries. For other interventions such as education or health examinations, there is no evidence that supports their effectiveness. More systematic reviews are needed in the area of injury prevention.

• 한국환경보건학회지
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• 제38권3호
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• pp.223-232
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• 2012

Objective: We performed this study to determine the association between childhood asthma and residential environment risk factors including VOCs and formaldehyde exposure. Methods: We selected an asthma group (30) and a control gorup (30) through physicain diagnosis and assessed the VOCs and formaldehyde levels of exposure of elementary school children in Seoul. Results: In the results, there were no significant differences in socioeconomic factors between case and control groups. However, there were significant differences in family asthma history, amount of sunlight, level of humidity and number of household residents (p < 0.05). The level of VOC (toluene, ethylbenzene, stylene, m,p-xylene) exposure level of the case group was significantly higher than that of the control group (p < 0.05) and the result of logistic regression showed that asthma family history, amount of humidity and number of household residents were significant predictors of childhood asthma (p < 0.05). Conclusion: Some residential environments such as lower amounts of sunlight, greater amounts of humidity and smaller numbers of household residents and VOC exposure were determinded as risk factors for childhood asthma.

• 한국학교보건학회지
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• 제16권2호
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• pp.1-11
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• 2003

PURPOSE: The aim of our study was to assess the prevalence of respiratory symptoms and to determine their environmental risk factors in school children living in a city where traffic is particularly heavy. METHODS: From November 12th to November 19th, 2002, we sent questionnaires to parents for children's health and environmental factors, and ninety eight percent (516) of parents responded. RESULTS: The lifetime prevalence of chronic respiratory illness was 12.2% and 13.2% for wheeze, and 6.6% for physician diagnosed asthma. Using multiple logistic regression model, we found that family history of asthma(OR=3.47, 95% CI 1.36-8.78), atopy dermatitis(OR=5.48, 95% CI 2.37-12.66), and pets at home(OR=3.22, 95% CI 1.26-8.23) were associated with chronic respiratory illness in last 12 months. We also found that family history of asthma(OR=3.28, 95% CI 1.16-9.31), atopy dermatitis(OR=2.89, 95% CI 1.11-7.54), and short distance between the house and road(OR=2.85, 95% CI 1.03-7.87) were associated with asthma in last 12 months. CONCLUSIONS: Elementary school children in a city had a relatively high prevalence of chronic respiratory illness and symptoms. In addition to genetic factors, pets at home and outdoor air pollution are associated with respiratory illness and Symptoms in school children.

• Toxicological Research
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• 제17권
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• pp.305-307
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• 2001

Toluene diisocyanate (TDI) is widely used in the manufacture of polyurethanes and is a recognized cause of occupational asthma. Although extensive investigations have been undertaken, the molecular mechanism(s) of the disease is still unclear. We hypothesized that inflammatory cytokines are required during both the sensitization and elicitation phases of the disease and have utilized TNF-R knock-out (KO) mice to address the hypothesis. Black C57 TNFR knock-out mice were exposed to TDI by sc injection and challenged by inhalation of 100 ppb TDI vapor. Control animals included: wild type C57 animals, sham-exposed animals that were challenged with TDI, and animals that were injected with anti-TNF antibodies prior to sensitization and again prior to challenge. Total IgE was increased in the knock-out animals compared with the wild type sensitized and challenged animals whereas TDI-specific IgG antibodies did not differ significantly in KO and wild type animals. There was less inflammation in the nares and trachea in KO animals compared with the wild type animals exposed to TD1 as well as less goblet cell hyperplasia and epithelial damage. Airway reactivity was assessed in animals treated with anti-TNF$\alpha$ antibody and found to be substantially reduced compared with that in sensitized and challenged animals. These results indicate that TNF$\alpha$ plays a role in the immunologic and physiologic responses and in airways inflammation in this animal model and suggests a role for TNF in occupational asthma due to TDI.

• 보건교육건강증진학회지
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• 제18권2호
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• pp.141-156
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• 2001

This study was performed to identify the occupational diseases in the dental technicians working in Korea, and to elucidate the main related affecting factors for the occurrence of the occupational diseases. The research was carried out using a mail questionnaire and data collection was done for two months from April 15, 2000. The questionnaires were delivered to 1000 dental technicians working at 250 dental laboratories which were chosen among the total 1330 dental laboratories in south Korea. And 763 questionnaires were collected, then 739 questionnaires were used for a logistic and a multiple regression analyses. The results obtained in this study are summarized as follows: 1. The occupational diseases in the dental technicians included pneumoconiosis, chronic bronchitis, asthma, pneumonia, hyposmia, allergic dermatitis, eczema, contagious dermatitis, central nervous disorder, dysfunction of finger, vertebral disorder, dysfunction of interphalangeal joint, ophthalmitis, auditory dysfunction, otitismedia, optic trauma, and bum. 2. The main related affecting factors for the occurrence of the occupational diseases in the dental technicians were elucidated as follows: On the ccurrence of chronic bronchitis, vibration of equipment and job career were affected positively. On the ccurrence of asthma, job career and career on current working part were affected positively, but exhaust ventilation, work hour were affected negatively. On the occurrence of eczema, career on current working part and vibration of equipment were affected positively, but personal protective equipment, local exhaust ventilation, isolation of gas source were affected negatively. And eczema was occurred more in methyl methacrylate work than in any other work part. On the occurrence of finger dysfunction, vibration of equipment and noise of work place were affected positively. But personal protective equipment, local exhaust ventilation, isolation of dust and gas source were affected negatively. But finger dysfunction was occurred more in metal polishing than in any other work part. On the occurrence of auditory dysfunction, noise of work place were affected negatively. The results obtained in this study can give a valuable information for a prevention of the occupational diseases in the dental technicians working in Korea, and for keeping them in healthy. This study also can be helpful for a researcher who is aiming at a identification of occupational diseases and a elucidation of related affecting factors in a similar occupation.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 1995년도 제47차 추계 학술대회 연제집
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• pp.355-356
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• 1995