The first case of karoshi was reported in 1969 with the death from a stroke of a 29-year-old, married male worker in the shipping department of Japan's largest newspaper company. It was initially called occupational sudden death. Shift work and an increased work load, together with excessive overwork in spite of ill health just before the stroke, were finally recognized as the occupational causes of death. It took five years for the family to receive compensation. In 1982, the first book entitled "Karoshi" was published by three physicians. This was the origin of the term karoshi. Karoshi is not a pure medical term but a sociomedical term. Karoshi-deaths were associated with long working hours, shift work, stress, and irregular work schedules. In Korea, karoshi was introduced in 1990. The cases with cerebral hemorrhage, subarachnoid cerebral hemorrhage, cerebral infarction, hypertensive encephalopathy, angina pectoris, myocardial infarction, and dissecting aneurysm would be compensated as occupational diseases if the patients had overworked. Now, the magnitude and kinds of diseases of karoshi is being extended. Medical doctors must understand the karoshi and make efforts to make the victims of karoshi be compensated. The evidence that overwork causes sudden death is still incomplete. More studies are needed to clarify the causal relationship. To prevent karoshi, the working hours should be shortened and health promotion programs for all workers should be encouraged.
Adult ; Aneurysm, Dissecting ; Angina Pectoris ; Appointments and Schedules ; Cause of Death ; Cerebral Hemorrhage ; Cerebral Infarction ; Compensation and Redress ; Death, Sudden ; Health Promotion ; Humans ; Hypertensive Encephalopathy ; Karoshi Death ; Korea ; Male ; Myocardial Infarction ; Occupational Diseases ; Ships ; Stroke

Nicotine is a liquid alkaloid present in tobacco leaves at a 1~6% concentration. Green tobacco sickness is an occupational illness caused by absorption of nicotine through skin exposed to wet tobacco leaves. It occurs throughout the world in tobacco-growing areas. The almost universal symptoms of weakness, nausea, vomiting, diarrhea, and dizziness may be confused with pesticide poisoning or heat stress illness. Since its recognition in the 1970s, green tobacco sickness is self-limited, usually lasting 1 to 2 days. There is no antidote, so treatment is supportive (for example, intravenous fluids for hypotension, antiemetics). The diagnosis can beconfirmed by measuring the nicotine concentration in the serum or urine, but its half-life is only 3~4 hours. Cotinine, the major nicotine metabolite, has a half-life of 36 hours, and thus is more useful. Young workers may be at higher risk for green tobacco sickness. Tobacco use is thought to offer weak protection by inducing tolerance. Handling tobacco that is wet from rain or dew increase the risk of green tobacco sickness. Repeated daily exposure over more than a week may also increase the risk. Green tobacco sickness is preventable by use of protective clothing and by avoiding skin contact with wet tobacco. When clothing becomes wet from environmental dampness or sweating, it should be changed to maintain an effective barrier. The best treatment is avoidance of poisoning : in addition to wearing gloves, long pants and a full shirt, workers picking or handling tobacco leaves should clean their hands frequently.
Absorption ; Clothing ; Cotinine ; Diagnosis* ; Diarrhea ; Dizziness ; Half-Life ; Hand ; Hot Temperature ; Hypotension ; Nausea ; Nicotine ; Poisoning ; Protective Clothing ; Rain ; Seizures ; Skin ; Sweat ; Sweating ; Tobacco Use ; Tobacco* ; Vomiting

This survey was conducted to find out demage done to the farmers by ;Agrochemicals in a rural area of Korea from January to October, 1980. Choon Sung Gun, Kang Won Province was the survey area and the 412 males were surveyed among all those that have sprayed agrochemicals. during 10 Months in 1980. Obtained results and findings from this survey are summarized as follows; 1. The total spray days of 413 males were 3,114 days and avarage spray days per person were 7.54 days. Also avarage spray hours per person were 4.7 hours. 2. The incidence rate per 100 persons of self-recognized skin manifestation was 12.6 persons and incidence rate per spray day was 2.7 percent. The incidence rate per 1Q0 persons of self-recognized intoxication was 23.0 persons and incidence rate per spray day was 3.6 percent. 3. In cases where mask was not used, when it was syrayed in hot weather, when stronger solution was used, the results were higher percentage in self-recognized intoxication (P<0.01). 4. The symptoms of self-recognized intoxication were headache (55.8%), dizziness (46.9%),. nausea (17.7%), fatigue (17.0%), and vomiting (17.0;%). 5. Number of intoxication per 100 used standardized unit by agrochemicals was parathion (93.8 spells), sumithion (91.8 spells) and folithion (66.7 spells). 6. Treatment was done by health facility utilization (27 cases), visits to drug store (13 cases) and visits to health center (7 cases).
Agrochemicals* ; Dizziness ; Fatigue ; Fenitrothion ; Gangwon-do ; Headache ; Health Facilities ; Humans ; Incidence ; Korea* ; Male ; Masks ; Nausea ; Parathion ; Skin Manifestations ; Vomiting ; Weather

BACKGROUND: Musculoskeletal symptoms, such as pain, numbness, and ganglions on involved joints were common problems in repetitive job workers, who exposed to prolonged, repetitive use of the wrist in factory. This study was performed to compare the degree of musculoskeletal symptoms and prevalence of soft tissue mass (esp. ganglion on wrist) in repetitive job group with those of non-repetitive job group and to evaluate the association of development of ganglion and the duration of wrist use. METHODS: Study subjects were 253 workers who work on a brick manufacturing factory and they were composed of 153 non-repetitive job workers and 100 repetitive job workers. Authors conducted a questionnaire survey among workers in the factory and examined their lesions. RESULTS: There were no significant difference statistically in age, level of education and work duration in both groups. It was statistically significant that the degree of wrist use was more frequent in repetitive job group than in non-repetitive job group(P<0.01). Musculoskeletal symptoms, such as pain and numbness on affected joints were more common in repetitive job group than in non-repetitive job group. Affected side was bilateral in three joints and right only in two joints(P<0.01, P<0.05). The prevalence of ganglions in repetitive job group(6 subjects, 6.0%) was much higher statistically than that in the non-repetitive job group(2 subjects, 1.3%). In a comparison of two groups according to the existence of ganglions, no stasistically significant differences were found in age, level of education and work duration. However, duration of wrist use was statistically significant relation with development of wrist ganglions(P<0.05). The 8 subjects with ganglion on wrist all worked on manufacturing part in the factory. The duration of work ranged from two to fourteen years. The affected sides of ganglions on wrist were right in 3 cases and left in 5 cases. Size of ganglions ranged from 0.5 to 3 cm in diameter. Painful symptom in the ganglion was complained by two cases(25%) among 8 cases. CONCLUSIONS: We suggest that prolonged, repetitive activities such as carrying a brick, have a tendency to develop musculoskeletal symptoms and ganglions in the workers. Because high prevalence of ganglions in this factory seems to be an important occupational problem among repetitive job workers, further studies on the factors contributing to development of ganglions in this factory are needed.
Education ; Ganglion Cysts* ; Hypesthesia ; Joints ; Prevalence ; Wrist ; Surveys and Questionnaires

No abstract available.
Diatomaceous Earth* ; Pneumoconiosis*

To test if exposure history to rifle fire or cannonade training during military duty can induce hearing loss, history of personal military service and history of gunshot exposure were asked to 228 male college students with self-administrative questionnaire. Otoscopic examination and Rinne's test were performed if any abnormal finding was detected by pure-tone audiometry. Average hearing threshold levels of 500 Hz, 1,000 Hz, 2,000 Hz, 4,000 Hz and threshold levels at 4,000 Hz were calculated for 112 students who were remained after exclusion of cases with history of ear disease, of ototoxic drug administration, and of neuropsychiatric disease, and mean of those were compared between group of students who have completed military duty (completed group) and group of those who have not (not-completed group), and between group exposed(exposed group) and group unexposed to gunshot sound(unexposed group). Mean of average hearing threshold level and mean of threshold levels at 4,000 Hz of completed group and those of exposed group were higher than those of not-completed group and unexposed group, respectively. Proportion of cases that average threshold level was greater than 40 dB of threshold levels at 4,000 Hz was greater than 50 dB were higher also in completed group and exposed group than in duty not-completed group and unexposed group, respectively. Multiple linear regression analysis including age, duration of military service, degree of gunshot sound exposure as independent variables and average hearing threshold level as dependant variable, was performed in order to estimate the effect of age on hearing, and any considerable effect of age on hearing could not be found. In conclusion, hearing impairment can be induced by rifle fire or cannonade training.
Audiometry, Pure-Tone ; Ear Diseases ; Fires ; Hearing Loss ; Hearing* ; Humans ; Linear Models ; Male ; Military Personnel* ; Surveys and Questionnaires

No abstract available.
Hearing Loss* ; Hearing* ; Iron*

The Department of Veterans Affairs(VA) maintains some large automated databases that provide the opportunity for studying long-term health effects of military service. The Beneficiary Identification and Record Locator Subsystem(BIRLS) is an excellent source of vital status information on veterans. The VA Patient Treatment File(PTF) is a computerized hospital discharge abstract system of inpatient records, including patients' demographic data, surgical and procedural transactions, and patient movements and diagnosis. The computerized Agent Orange Registry data include veteran's name, address, some information on military service, and findings at the time of his physical examination. The US conducted 235 atmospheric nuclear tests from 1945 through 1962. Many of the 250,000 test participants were exposed to low levels of radiation. The overall average radiation dose was estimated as 0.6 rem per year. In 1976, a claim relating acute myelocytic leukemia to radiation exposure from nuclear weapon testing received extensive publicity. Several thousand "atomic veterans" have sought medical care and compensation from VA for medical conditions that they believe are related to the nuclear weapon testing. Many WWII veterans have contracted the US VA about health problems that they attribute to their exposure to mustard gas. From 1962 to 1971, 75 million liters of herbicides, including over 41 million liters of the phenoxy herbicide Agent Orange, were sprayed on almost 9% of Vietnam. Many studies have been conducted to determine the association of various cancers with military service in Vietnam. Some diseases have been compensated for Vietnam veterans. Health problems reported following the Gulf War include a wide variety of symptoms similar to those found in acute combat reaction, posttraumatic stress disorder, and chronic fatigue. Health problems associated with war have continued and in some ways intensified. Therefore, The United States developed a plan for establishing a national center for the study of war-related illnesses and post-deployment health issues.
Americas* ; Citrus sinensis ; Compensation and Redress ; Diagnosis ; Fatigue ; Gulf War ; Herbicides ; Humans ; Inpatients ; Leukemia, Myeloid, Acute ; Military Personnel ; Mustard Gas ; Nuclear Weapons ; Persian Gulf Syndrome ; Physical Examination ; Stress Disorders, Post-Traumatic ; United States* ; Veterans* ; Vietnam

No abstract available.
Child* ; Humans ; Visual Acuity*

OBJECTIVES: A dermatologic outbreak occurred in a factory usingliquid waste mixtures at Gyeongju. We conducted this study to identify causative factors. METHODS: We conducted a questionnaire interview composed of general andjob characteristics. A dermatologist carried out medical examination, European standard patch test and 'as is' patch test. We evaluated the cases with over 5 criteria of Mathias's 7 definitions of occupational dermatologic diseases. RESULTS: Seven of 9 workers were diagnosed with dermatosis and 3 subjects (cases 2, 4 and 6) with Mathias's 7 criteria were confirmed as having occupational dermatologic diseases and were diagnosed as irritant contact dermatitis. Two subjects (cases 1 and 9) with over 5 criteria were evaluated as suspicious status. The remaining 2 subjects (cases 3 and 5) were not compatible with those criteria. The main sources of this outbreak were suggested to be the wasted solvents in the factory of car accessories and aluminum products because the subjects (cases 2, 4, 6, 1 and 9) had the positive skin reaction against those sources in 'as is 'patch test. Furthermore, 4 of the 5 subjects cases 2, 4, 6 and 9) had some skin reactions against the waste solvents of chemical material in 'as is'patch test. CONCLUSION: This outbreak occurred by direct skin contact of liquid waste mixtures of a factory making car accessories and aluminum products. The cutting oils and metal working fluids in those liquid waste mixtures were estimated as the most suspected materials. In addition, this outbreak may have been caused by the hazard effect of mixed waste organic solvents of manufacturing of chemical materials.
Aluminum ; Dermatitis, Contact ; Gyeongsangbuk-do ; Occupations ; Oils ; Patch Tests ; Questionnaires ; Skin ; Skin Diseases* ; Solvents