BACKGROUND: In Korea, the only case of occupational erythema multiforme was found to be due to Bolivian rosewood, but there has been no case due to occupational chemicals in the manufacturing industry. Here, we report a case of erythema multiforme caused by dichlone and 3,3'-dichlorobenzidine(DCB) in a dye worker. CASE REPORT: We report a 43-year-old male worker manifesting erythema multiforme-like skin lesions during the DCB synthesis, The patient's dermatitis was relieved when he avoided the process, and it became aggravated when he restarted his work. Patch and prick tests confirmed positive irritant reactions to two chemicals. CONCLUSION: This case was diagnosed as erythema multiforme based on clinical manifestations. Symptoms worsened upon exposure to chemicals while avoiding exposure improved symptoms. Skin test results showed that dichlone and 3,3'-dichlorobenzidine induced irritant reactions. We assume that erythema multiforme occurring in workers is an occupational skin disease likely caused by dichlone and 3,3'-dichlorobenzidine.
3,3'-Dichlorobenzidine ; Adult ; Dermatitis ; Dermatitis, Contact ; Erythema ; Erythema Multiforme ; Humans ; Korea ; Male ; Naphthoquinones ; Skin ; Skin Diseases ; Skin Tests

OBJECTIVES: To report upon a case of toxic hepatitis in a worker exposed to chloroform. METHODS: A 28-year-old female who had worked as chemical analysis engineer in a laboratory using chloroform was hospitalized due to nausea, vomiting and generalized weakness. The authors evaluated her using blood tests, abdominal CT scan and her occupational history. RESULTS: The blood tests revealed acute toxic hepatitis. Other causes of hepatitis such as viral, drug induced or alcoholic hepatitis could be excluded. But autoimmune hepatitis couldn't be totally ruled out(ANA (++), IgG(serum) 1780 mg/dL). After admission, her symptoms improved and her liver enzyme levels(AST and ALT) were markedly reduced. She returned to her workplace after discharge. Afterwards, however, her liver enzyme levels increased again one week after returning to her workplace. Subsequent to a job change, her liver enzyme levels reduced and normalized after eight weeks. The airbone laboratory chloroform ranged from 3.155 to 9.037 ppm. CONCLUSIONS: The authors presume that this patient's liver injury was related to an interaction of chloroform toxicity and a predisposition to autoimmune hepatitis. The rapid improvement of the clinical symptoms and the progressive normalization of the liver function tests once the chloroform exposure eliminated supports the diagnosis.
Adult ; Chloroform ; Drug-Induced Liver Injury ; Female ; Hematologic Tests ; Hepatitis ; Hepatitis, Alcoholic ; Hepatitis, Autoimmune ; Humans ; Liver ; Liver Function Tests ; Nausea ; Vomiting

OBJECTIVES: Occupational health and safety guidelines have the goals of protecting workers, helping them to adapt to their working environment, and to promote their health and ability. In the work fitness evaluations done by occupational medicine doctors, one of their subjective duties is to assess a worker's working ability so as not to affect the health of the worker or his/her co-workers. A worker's functional capacity and reasonable accommodations should be considered. We studied a case regarding cerebral hemorrhage and muscle weakness after renal disease. CASE: This patient was a male who worked at a tobacco company. He suffered from acute renal failure in 2003. In 2004, during his treatment, a convulsion-seizure occurred. This patient had non-specific findings in family history, blood studies, urinary analysis, mental status examination, and showed no signs of depression. There was a decrease in muscle power found during a physical examination. As a result, an occupational and environmental doctor and an industrial hygienist went to the worker's company in order to analyze the workers tasks. They concluded that there were some problems regarding the worker' s daily activities. When considering reasonable accommodation it was determined that such cases could work in the qualify control department instead of current job, assembly department. CONCLUSIONS: Throughout this case, we considered the work compatibility of the various complications arising from a cerebral hemorrhage and convulsion-seizure disease which occurred to a factory worker who suffered from acute renal failure. We recommend it essential to create work compatibility guidelines regarding this case presentations, ensuring consistency to the efforts made by health care workers and physicians.
Acute Kidney Injury ; Cerebral Hemorrhage ; Delivery of Health Care ; Depression ; Epilepsy ; Humans ; Male ; Muscle Weakness ; Muscles ; Occupational Health ; Occupational Medicine ; Physical Examination ; Stress, Psychological ; Stroke ; Tobacco

BACKGROUND: Epilepsy affects an individual's ability to work as well as their daily activities. Patients with epilepsy have difficulties in finding and maintaining jobs, and they may not have opportunities to perform adequately. Therefore, evaluation of work-fitness is important for patients with epilepsy. In this report, the authors reviewed a case of epilepsy and discussed aspects of the case for evaluation of work-fitness. CASE REPORT: A 43-year-old man with epilepsy visited the hospital for evaluation of work-fitness. His job consisted of forklift driving and crane operation using a remote control. As a seizure attack could threaten worker's safety, we recommended a job change. The employer refused to approve a job change due to the company's circumstances, so we recommended several conditions, including continuous medication, use of protective equipment, restriction of night-shift work, restriction of strenuous exercise, and profound sleep. An epilepsy event occurred during the follow-up period, prompting his company to evaluate his work. There were frequent movements of forklift operations and workers in the workplace, so we recommended restriction of forklift driving and a job change if possible. As a result, the employer changed his job and we recommended "capable of performing work without any conditions". CONCLUSION: For evaluation of work-fitness in patients with epilepsy, adequate job analysis, assessment of patient's medical conditions, and interviews of coworker and employers should be conducted. It is also important to let the employer make the best decision in terms of the patient's health and coworker's safety.
Adult ; Epilepsy ; Follow-Up Studies ; Humans ; Linear Energy Transfer ; Seizures ; Work Capacity Evaluation

OBJECTIVES: The objectives of this study were to explore the association between shift work and the bone mineral density in a representative sample of Korean workers. METHODS: He data from the Fourth Korean National Health and Nutrition Examination Survey (2008-2009) was used. The participants were Korean workers aged 16 to 60 years. Logistic regression analysis was applied to determine the association between shift work and the bone mineral density after controlling for covariates using the SAS version 9.3 package program. RESULTS: The blood vitamin D level in shift workers was significantly lower than that of day workers in both males and females. In male shift workers, shift work was significantly associated with a decreased bone mineral density in the femoral neck (odds ratio(OR) 1.42, 95% confidence interval(CI)=1.05~1.92) and lumbar spine (OR 1.53, 95% CI=1.09~2.15) compared to day workers. After controlling for covariates, this association was still significant. In the case of female shift workers, shift work was significantly related to a decreased bone mineral density in the total femur (OR 2.84, 95% CI=1.69~4.79) and lumbar spine (OR 1.58, 95% CI=1.12~2.24). After controlling for covariates, this risk was not statistically significant. CONCLUSIONS: The blood vitamin D level of shift workers was significantly lower than that of day workers. In male shift workers, shift work can decrease the bone mineral density in the femoral neck and lumbar spine. Prospective studies with information on the shift work intensity and duration and exposuredata to explain mechanisms will be needed.
Aged ; Bone Density ; Female ; Femur ; Femur Neck ; Humans ; Logistic Models ; Male ; Nutrition Surveys ; Phenothiazines ; Spine ; Vitamin D ; Work Schedule Tolerance

OBJECTIVES: The purpose of this study was to determine the current status of presenteeism and absenteeism among railroad workers as well as to investigate whether or not job stress level and psychosocial well-being status are associated with presenteeism and absenteeism. METHODS: As the cross-sectional design, a self-reported questionnaire using the Korean Occupational Stress Scale(KOSS), Psychosocial Well-being Index(PWI), and Work Productivity and Impairment-General Health(WPAI-GH) was administered to railroad workers. Univariate and multivariate logistic regressions were used to analyze the association between job stress, psychosocial well-being status and presenteeism, absenteeism in 1,099 subjects. RESULTS: Among the study subjects, 52.0% and 22.0% experiened presenteeism and absenteeism, respectively. Job stress level in railroad workers was higher than that in general workers. Multivariate logistic regression with presenteeism as the dependent variable showed an elevated odds ratio of 3.56(95% CI 1.48-8.54) in the highest job stress group, and an odds ratio of 3.20(95% CI 1.94-5.26) in the high-risk psychosocial stress group. There was no significant association between job stress level and absenteeism, whereas weak association between psychosocial stress and absenteeism was found. CONCLUSIONS: Since railroad workers have a high level of job stress and elevated experience of presenteeism, a management strategy is required to control presenteeism and absenteeism in order to promote railroad workers' health and safety.
Absenteeism ; Efficiency ; Logistic Models ; Odds Ratio ; Questionnaires ; Railroads ; Sick Leave

OBJECTIVES: The aims of this study were to examine the prevalence of Attention Deficit Hyperactivity Disorder(ADHD) as well as the relationship between ADHD and related factors among elementary school students living nearby Shihwa-Banwol industrial complex. METHODS: A cross-sectional survey was conducted on 573 elementary students living nearby Shihwa-Banwol industrial complex. Dupaul ADHD rating scales were used for assessment of ADHD. Information on age, gender, birth weight, family history, environmental factors including second-hand smoke, house income, house type, bring up a child, road proximity and behavioral factors including outside activity time, eating habits, and cell phone usage were based on data from self-administered questionnaires. Multiple logistic regression analysis was performed, and all odds ratios were adjusted according to age and gender. RESULTS: The prevalence of ADHD was 9.4%, and those aged 10 years were the most affected. Male elementary school students were 3.19 times (95% CI:1.71~5.93) more likely to have ADHD than females. ADHD was significantly associated with family history of mental disease (adjusted OR 8.69; 95%CI 1.93~39.22), lack of cell phones usage (adjusted OR 2.27; 95%CI 1.21~4.26), a road adjacent to child's residence (adjusted OR 2.21; 95%CI 1.20~4.05) and lack of seafood consumption (adjusted OR 2.08; 95%CI 1.08~4.00). CONCLUSIONS: More research effort should be focused on determining the prevalence of ADHD and relevant factors among children living nearby industrial complexes.
Aged ; Attention Deficit Disorder with Hyperactivity ; Birth Weight ; Cellular Phone ; Child ; Cross-Sectional Studies ; Eating ; Female ; Humans ; Logistic Models ; Male ; Odds Ratio ; Prevalence ; Questionnaires ; Seafood ; Smoke ; Weights and Measures

OBJECTIVES: A standardized questionnaire is not available for use as a screening tool to assess individuals with MCS/IEI in Korea. The QEESI(c), originally developed by Miller & Prihoda in 1998, helps researchers, doctors, and their patients identify individuals with MCS/IEI. Therefore, this study was conducted in order to create a Korean version of the QEESI(c) and evaluate whether this Korean version could be used as an effective MCS/IEI screening tool in Korea. METHODS: The Korean version of the QEESI(c) was developed using a six-step approach: permission, forward translation, the first quality control, backward translation, cognitive debriefing and the second quality control, final proof reading. In order to collect data, we have done a sample survey in certain parts of Korea. A household was used as the sampling unit; we extracted random samples in each survey cluster and then interviewed two adults over 19 years of age living in each sampled household. A total of 300 subjects were recruited from the general population in local community. The factor structure in the Korean version of the QEESI was analyzed with 40 items on four sub-scales except for the 10 items in masking index using principal components analysis with Varimax rotation. A convergent validity test two sub-scales: chemical intolerance and symptom severity. We carefully compared the chemical intolerance with Nordin's chemical sensitivity scale and the symptom severity with Cho's subjective symptom score. RESULTS: The results showed that the 40 items on the four sub-scales,' chemical intolerances',' symptom severity', 'life impact', and 'other intolerances', were consistent with those reported for the US population by Miller and Prihoda. The convergent validity wes very good (r=0.4; p<0.001, r=0.5; p<0.001, respectively). A good internal consistency (Cronbach' alpha=0.86~0.96) and test-retest reliability (r=0.87~0.90) were found in all scales, except for the internal consistency in the masking index. CONCLUSIONS: The Korean version QEESI(c) showed a good reliability and validity. It should be necessary to conduct a MCS/IEI study adopting Korean version QEESI(c).
Adult ; Environmental Exposure ; Family Characteristics ; Humans ; Korea ; Masks ; Mass Screening ; Multiple Chemical Sensitivity ; Quality Control ; Questionnaires ; Reproducibility of Results ; Weights and Measures

OBJECTIVES: In this study, radiotechnologists who work performing PET and PET/CT methodologies were analyzed in order to find the cause for the differences in radiation exposure as they applied to general characteristics, work characteristics, knowledge, and exposure recognition or conduct. METHODS: From April 15th, 2010 to May 14th, 2010, we conducted a retrospective analysis on 80 radiotechnologists using data garnered from their individual general characteristics, work characteristics, knowledge, and exposure recognition or conduct. Their average annual radiation exposure dosages were measured using a thermoluminescence dosimeter. A multiple regression analysis was performed as a statistical tool. RESULTS: Regarding the general PET and PET/CT characteristics, when the work experience was short, the exposure dose was higher. The factors of age, marriage, work experience in nuclear medicine, PET, PET/CT, and sex were found to have statistically significant effects. The knowledge, recognition, and conduct factors for the radiotechnologists were affected by unsecure radiation exposure at the moment of carrying, unsecure radiation exposure at the moment of injection, the application of protection at the moment of injection, and the use of auto distributor. It was found that, the use of an auto distributor, efforts in reducing the radiation exposure, unsecure exposure when with a patient, and the application of protective procedures at the moment of injection affected the overall factor of radiotechnologists radiation exposure dose. CONCLUSIONS: We believe that if radiotechnologists would reduce their radiation exposure by using auto distributors, make efforts to reduce the chance of exposure, and be conscious of radiation, they would be able to reduce the radiation exposure dose even during unavoidable circumstances.
Humans ; Lifting ; Marriage ; Nuclear Medicine ; Retrospective Studies

OBJECTIVES: The objective of this study was to determine the relationship of physical and psychosocial risk factors to work-related musculoskeletal upper extremity symptoms amongst automobile manufacturing workers. METHODS: The cross-sectional study was conducted using male automobile manufacturing workers in order to examine the relationship of physical and psychosocial risk factors to work-related musculoskeletal upper extremity symptoms. A total of 1,793 male workers were asked to complete a self-administered questionnaire. The questionnaire consisted of questions regarding general characteristics, health related behaviors, work-related characteristics, job stress, ergonomic risk factors, and the presence of musculoskeletal symptoms (neck, shoulder, arm, and hand). Work-related musculoskeletal symptoms were evaluated using the National Institute of Occupational Safety and Health (NIOSH) surveillance criteria. In order to measure the physical risk factors, the American National Standard Institute (ANSI) Z-365 Quick checklist was incorporated into the questionnaire. Job stressors were measured using the Korean Occupational Stress Scale (KOSS). A binary logistic regression analysis was performed that examined the relationship of physical and psychosocial risk factors to musculoskeletal symptoms. RESULTS: The result showed that the physical and psychosocial risk factors were associated with musculoskeletal upper extremity symptoms. The workers with high physical risk factors reported more musculoskeletal symptoms than those having low physical risk factors (OR: 2.37, 95% CI: 1.56~3.62). The workers with high job stress were more likely to have an increased risk of musculoskeletal upper extremity symptom compared to those with normal job stress (OR: 2.65, 95% CI: 2.03~3.47). A significant relationship between the combined effects of physical and psychosocial risk factors on musculoskeletal upper extremity symptoms was also found. The workers exposed to high physical risk factors, high job stress, and long working hours were more likely to report musculoskeletal symptoms than those having low physical risk factors, normal job stress and moderate working hours(OR: 2.37, 95% CI: 1.56~3.62). CONCLUSIONS: The results suggest that some physical and psychosocial risk factors increase the risk of work-related musculoskeletal upper extremity symptoms amongst automobile manufacturing workers. In order to prevent or reduce musculoskeletal disorders amongst automobile manufacturing workers, it is strongly recommended to manage the physical psychosocial risks occurring in the workplace.
Arm ; Automobiles ; Checklist ; Cross-Sectional Studies ; Human Engineering ; Humans ; Logistic Models ; Male ; Occupational Health ; Questionnaires ; Risk Factors ; Shoulder ; Upper Extremity