This study intended to obtain an useful information for health management of lead exposed measuring the lead exposure indices and workers and determine biological monitoring interval in early period of exposure by work duration in all male workers (n=433 persons) exposed less than 1 year in 6 storage battery industries and in 49 males who are not exposed to lead as control. The examined variables were blood lead concentration(PBB), Zinc-protoporphyrin concentration(ZPP), Hemoglobin(HB) and personal history; also measured lead concentration in air(PBA) in the workplace. According to the geometric mean of lead concentration in the air, the factories were grouped into three categories: A; When it is below 0.05mg/m3, B; When it is between 0.05 and 0.10mg/m3, and C; When it is above 0.10mg/m3. The results obtained were as follows: 1. The means of blood lead concentration(PBB), ZPP concentration and hemoglobin(HB) in all male workers exposed to lead less than 1 year in storage battery industries were 29.5+/-12.4 microgram/100ml, 52.9+/-30.0 microgram/100ml and 15.2+/-1.1 gm/100ml. 2. The means of blood lead concentration(PBB), ZPP concentration and hemoglobin(HB) in control group were 5.8+/-1.6 microgram/100ml, 30.8+/-12.7 microgram/100ml and 15.7+/-1.6 microgram/100ml, being much lower than that of study group exposed to lead. 3. The means of blood lead concentration and Zpp concentration among group A were 21.9+/-7.6 microgram/100ml, 41.4+/-12.6 microgram/100ml; those of group B were 29.8+/-11.6 microgram/100ml, 52.6+/-27.9 microgram/100ml; those of group C were 37.2+/-13.5 microgram/100ml, 66.3+/-40.7 microgram/100ml. Significant differences were found among three factory group(P<0.01) that was classified by the geometric mean of lead concentration in the air, group A being the lowest. 4. The mean of blood lead concentration of workers who have different work duration(month) was as follows; when the work duration was 1-2 month, it was 24.1+/-12.4 microgram/100ml,; When the work duration was 3-4 month, it was 29.2+/-13.4 microgram/100ml; and it was 28.9+/-34.5 microgram/100ml for the workers who had longer work duration than other. Significant differences were found among work duration group(P<0.05). 5. The mean of ZPP concentration of workers who have different work duration(month) was as follows; When the work duration was 1 2 month, it was 40.6 18.0 g/100ml, When the work duration was 3-4 month, it was 53.4+/-38.4 microgram/100ml; and it was 51.5+/-60.4 microgram/100ml for the workers who had longer work duration than other. Significant differences were found among work duration group(P<0.05). 6. Among total workers(433 person), 18.2% had PBB concentration higher than 40 microgram/100ml and 7.1% had ZPP concentration higher than 100 microgram/100ml; In workers of factory group A, those were 0.9% and 0.0%; In workers of factory group B, those were 17.1% and 6.9%; In workers of factory group C, those were 39.4% and 15.4%. 7. The proportions of total workers(433 person) with blood lead concentration lower than 25 microgram/100ml and ZPP concentration lower than 50 microgram/100ml were 39.7% and 61.9%, respectively; In workers of factory group A, those were 65.5% and 82.3%; In workers of factory group B, those were 36.1% and 60.2%; In workers of factory group C, those were 19.2% and 43.3%. 8. Blood lead concentration (r=0.177, P<0.01), ZPP concentration (r=0.135, P<0.01), log ZPP (r=0.170, P<0.01) and hemoglobin (r=0.096, P<0.05) showed statistically significant correlation with work duration (month). ZPP concentration (r=0.612, P<0.01) and log ZPP(r=0.614, P<0.01) showed statistically significant correlation with blood lead concentration. 9. The slopes of simple linear regression between work duration(month, independent variable) and blood lead concentration(dependent variable) in workplace with low air concentration of lead was less steeper than that of poor working condition with high geometric mean air concentration of lead. The study result indicates that new employees should be provided with biological monitoring including blood lead concentration test and education about personal hygiene and work place management within 3~4 month.
Education ; Environmental Monitoring ; Humans ; Hygiene ; Linear Models ; Male* ; Workplace

Naive CD4 T cells activated by antigen-presenting cells (APCs) undergo terminal differentiation in the periphery. Multiple mechanisms determine their fates, that is, whether they differentiate into conventional T (Tconv) cells or regulatory T (Treg) cells. The key event during Treg generation is expression of the transcription factor Foxp3, which is the lineage-determining regulator for Treg differentiation and function. Here we show that the transcription factor Batf3 acts as a fate-decision factor with respect to Tconv versus Tregs by restraining Treg differentiation. Batf3 was preferentially expressed in effector CD4 T cells but not in Treg cells, and ectopic expression of Batf3 inhibited Foxp3 induction. Batf3-deficient CD4 T cells favorably differentiated into Treg cells in vitro and in colonic lamina propria. Batf3 KO mice also showed enhanced Treg function in gut-associated immune disease models (for example, ovalbumin tolerance and inflammatory bowel disease models). Batf3 bound to the CNS1 region of the Foxp3 locus and reduced expression of the gene. Thus, Batf3 is a transcriptional suppressor of Treg differentiation.
Animals ; Antigen-Presenting Cells ; Colon ; Ectopic Gene Expression ; Immune System Diseases ; In Vitro Techniques ; Inflammatory Bowel Diseases ; Mice ; Mucous Membrane ; Ovalbumin ; T-Lymphocytes ; T-Lymphocytes, Regulatory* ; Transcription Factors*

To evaluate the follow-up management state and related factor of lead battery workers in periodic health examination as part of program of group occupational health service, author studied 293 workers with questionnaire on knowledge of results and follow-up management state and related factors, and compared the responses to their periodic health examination result charts. The results were as follows: 1. 252(86%) workers responsed that they had received the health examination result chart, but only 116(39.6%) workers responsed that they had been educated or explained about the result of health examination, and 11(57.9%) workers among 19 workers with non-occupational disease D, 101(44.3%) workers among 228 workers with non-occupational disease C, and 19(28.4%) workers among 67 workers with occupational disease C knew accurately their health examination results. 2. 78(24.8%) of the workers responsed that they had follow-up management, and contents of follow-up management were follow-up(36.6%), out-patient treatment(31%), change worksite(8.5%), temporary retirement(7.0%) and others(16.9%). 3. Most of the workers responsed that the health examination were necessary, but three-fourths of the workers responsed that the health examination had been superficial or that they didn't know. 4. In this study, follow-up management show significant association with only explanation or education about health examination result chart.
Education ; Follow-Up Studies* ; Humans ; Knowledge of Results (Psychology) ; Occupational Diseases ; Occupational Health Services ; Outpatients ; Surveys and Questionnaires

Measurement of blood lead (PbB) and blood zinc protoporphyrin (ZPP) are most common biological indices to identify the individual at risk for excess or the health sequences by lead exposure. Because PbB is known most important and reliable index of lead exposure, PbB is often regarded as a gold standard to detect lead exposure. But in Korea PbB is a secondary test item of detailed health check-up with positive finding of screening test in most occasion. Our lead standard requires all lead workers to take annual heath-check twice a year for investigation of their health effect due to lead exposure. Blood ZPP is one of most important index to detect high lead absorption in lead workers as a screening test. Measurement of blood ZPP is known well to correlate with PbB in steady state of exposure in most lead workers and is often used as a primary screening test to detect high lead absorption of lead workers with the advantage of simplicity, easiness, portability and low cost. The current cut-off criteria of blood ZPP for further detailed health check-up is 100 ng/dl which is supposed to match the level of 40 ng/dl of PbB according to our standard. Authors tried to investigate the validity of current criteria of cut-off level(100 ng/dl) of blood ZPP and possible another better cut-off level of it to detect the lead workers whose PbB level over 40 ng/dl. The subjects in our study were 212 male workers in three small scale storage battery industries. Blood ZPP, PbB and hemoglobin(Hb) were selected as the indices of lead exposure. The results were as follows. 1. The mean of blood ZPP, PbB and Hb in lead workers were 79.5+/-46.7 ng/dl, 38.7+/-15.1 ng/dl, and 14.8+/-1.2 g/dl, respectively. There were significant differences in blood ZPP, PbB and Hb by industry(P<0.01). 2. The percents of lead workers whose blood ZPP were above 100 ng/dl in the group of work duration below 1, 1-4, 5-9 and above 10 years were 8.6%, 17.2%, 47.6%, and 50.0%, respectively. The percents of lead workers whose PbB were above 40 ng/dl in those were 31.4%, 40.4%, 71.4%, and 86.4%, respectively. 3. The percents of lead workers whose PbB were below 40 ng/dl, 40-59 ng/dl and above 60 ng/dl were 54.7%, 34.9% and 10.4%, respectively. Those of lead workers whose blood ZPP were below 100 ng/dl, 100-149 ng/dl and above 150 ng/dl were 79.2%, 13.7% and 7.1%, respectively. 4. Simple linear regression of PbB on blood ZPP was statistically significant(P<0.05) and as PbB was 40 ng/dl, blood ZPP was 82.1 ng/dl. 5. While the highest sensitivity and specificity of blood ZPP test to detect lead workers with PbB over 40 ng/dl were observed in the cut-off level of 50 ng/dl and 100 ng/dl of blood ZPP, respectively, the highest validity(sensitivity+specificity) of blood ZPP to detect lead workers with PbB over 40 ng/dl was observed in the cut-off level of around 70 ng/dl of blood ZPP. But even with optimal cut-off level of around 70 ng/dl of blood ZPP, still 25.0% of false negative and 20.7% false positive lead workers were found. As the result of this study, it was suggested that reconsideration of current blood ZPP cut-off of our lead standard from 100 ng/dl to somewhat lower level such as around 70 ng/dl and the inclusion of PbB measurement as a primary screening test for lead workers was highly recommended for the effective prevention of lead workers.
Absorption ; Humans ; Korea ; Linear Models ; Male ; Mass Screening ; Sensitivity and Specificity ; Zinc*

OBJECTIVES: To evaluate the effects of lead on the liver function indices in male lead workers. METHODS: The study comprised of 274 lead workers and 113 non-lead workers who were confirmed not to have HBsAg (Hepatitis B surface Antigen). Blood lead (PbB), blood zinc protoporphyrin (ZPP) and urinary delta-aminolevulinic acid (ALAU) were selected as parameters for monitoring exposure to lead while aspartate aminotransferase (SGOT), alanine aminotransferase (SGPT) and gamma-glutamyltransferase (gamma-GTP) were chosen as parameters for monitoring liver function. Demographic information, such as age, smoking and drinking histories were collected. The duration of work for the lead workers, and their BMI(body mass index), were also obtained. RESULTS: After adjusting for possible confounders {age, BMI, work duration, smoking (pack-year) and drinking (bottles of Soju consumed per week)}, blood lead was observed to be a significant variable from the logistic regression analysis of the abnormalities of SGOT( >35 IU/L), with an odds ratio of 1.04 (95 % CI, 1.008-1.066). The amount of alcohol drunk (odds ratio 1.28: 95 % CI, 1.054-1.549) and BMI (odds ratio 1.24: 95 % CI, 1.075-1.421) were also significant variables. From the multiple linear regression analyses, blood lead was significantly, and positively, associated with SGOT (p<0.05). CONCLUSIONS: These findings suggest that exposure to lead may have an effect on SGOT in male lead workers.
Alanine Transaminase ; Aminolevulinic Acid ; Aspartate Aminotransferases ; Drinking ; gamma-Glutamyltransferase ; Hepatitis B Surface Antigens ; Humans ; Linear Models ; Liver* ; Logistic Models ; Male* ; Odds Ratio ; Smoke ; Smoking ; Zinc

In order to identify the necessary information of biochemical indices for renal effect of lead for the early detection in medical surveillance of lead worker, the reference values of urinary N-acetyl-beta-D-glucosaminidase(NAG) activities were studied with 205 office workers in one industrial complex area who were not exposed to lead occupationally. While study variables selected for lead exposure were blood lead (pbB), blood zinc protoporphyrin(ZPP) and delta-aminolevulinic acid (DALA) in urine, those for renal effect were urinary N-acetyl-beta-D-glucosaminidase(NAG), blood urea nitrogen(BUN), serum creatinine(cr), serum uric acid (Ua), and urinary total protein (U-Tp). The results obtained were as follows: 1. The mean values of blood lead, ZPP and DALA in all subjects were 14.39+/-4.02 microgram/dl, 21.61+/-8.00 microgram/dl, and 2.73+/-0.90 microgram/l respectively. 2. The mean value of urinary NAG activities in all subjects was 3.51+/-2.01 U/l. The mean value of urinary NAG activities, which calculated from NAG activities divided by urinary creatinine concentration (CNAG), was 5.42+/-5.53 U/g creatinine and logarithmic normal distributed. 3. The reference value of urinary NAG activity was 12.06 U/g creatinine (95% CI=10.57-14.76U/g creatinine). 4. Logarithmic CNAG(r=0.781 P<0.01), U-TP(r=0.670 p<0.01) and ZPP (r=0.172 p<0.05)showed statistically significant correlation with CNAG.
Acetylglucosaminidase* ; Aminolevulinic Acid ; Creatinine ; Occupations ; Reference Values ; Urea ; Uric Acid ; Zinc

OBJECTIVES: This study was carried out to assess psychosocial distress of lead workers and to examine the relationship between lead exposure indices and psychosocial distress. METHODS: The study design was cross-sectional and research subjects were 234 lead workers in primary smelting industry. General characteristics, job characteristics and social support were obtained by self-administered questionnaire and history taking. Psychosocial distress was measured using PWI(Psychosocial Well-being Index), a 45-item self-administered instrument. Blood lead(PbB), zinc protoporphyrin(ZPP), -aminolevulinic acid in urine(ALAU) were selected as indicators of lead exposure. RESULTS: There was significant difference in PWI according to lead exposure level and job characteristics. The results of correlation analysis showed that PWI was significantly correlated with PbB(r=0.203, P=0.002). CONCLUSIONS: Our results supported the association between lead exposure and psychosocial distress. The inclusion of psychosocial distress measurement as a special health examination for lead workers was highly recommended for the effective health management.
Humans ; Osmeriformes ; Questionnaires ; Research Subjects ; Zinc

Two hundred and six male lead workers (86 lead workers from secondary smelting industries and 120 lead workers from litharge making industries) and 212 office workers who were not exposed to lead occupationally were studied to investigate the effect of lead on the health of lead workers in high risk operation to lead. Blood lead (PbB), zinc protoporphyrin in whole blood (ZPP), delta-aminolevulinic acid in urine (ALAU), Hematocrit (Hct) and hemoglobin (Hb) were selected as an index of lead exposure. Questionnaires of 15 lead related symptoms were provided to all study subject and filled up by themselves and reconfirmed the symptom answers by interviewing medical doctor. While the mean value of PbB, ZPP and ALAU of lead workers in secondary smelting industries were 62.7+/-14.6 microgram/dl, 103.1+/-60.5 microgram/dl and 7.4+/-10.3 mg/liter, those of lead workers in litharge making industries were 58.8+/-14.1 microgram/dl, 74.2+/-45.2 microgram/dl and 5.3+/- 7.9 mg/liter respectively, and there were statistically significant difference of mean values between two groups. Simple linear regression analysis of PBB on ZPP and ALAU shoved the steeper slope in secondary smelting industries than litharge making industries. Higher symptom prevalence rates of lead exposed group were observed in lead colic related symptom (S4) and neuromuscular symptoms compared with non-exposed workers. The prevalence of neuromuscular symptoms only showed dose-response relationship by the increase of PBB and ZPP. But more statistical significances were observed in neuromuscular symptoms by the increase of PBB than ZPP. On stepwise multiple regression using total symptom score as a dependent variable and PBB, ZPP, ALAU, Hct, Hb, age and work duration as a independent variables only ZPP and age contributed to the lead related symptoms.
Aminolevulinic Acid ; Colic ; Hematocrit ; Humans ; Linear Models ; Male ; Occupations ; Osmeriformes* ; Prevalence ; Questionnaires ; Zinc

Clinical experience with a rare case of sparganosis invading the spinal epidural space was reported with review of the literatures. A 58-year-old man who had food hakit of eating raw snakes was hospitalized with chief complaint of low back and left leg pain.
Eating ; Epidural Space* ; Humans ; Leg ; Middle Aged ; Snakes ; Sparganosis ; Sparganum*

Spinal cord compression associated with plasma cell neoplasm is observed always in the patients suffering from the multiple myeloma or solitary plasmacytoma that occur in the marrow of the spine. Authors report a rare case of extramedullary plasmacytoma forming a mass in the epidural space of the thoracic spine. In 70 year old woman with paraplegia, MRI of the thoracic spine indicated a presence of epidural mass at the 2nd to 8th thoracic vertebrae. There was no abnormal bony changes in the spine on plain X-ray and MRI. Total removal of the epidural mass was performed by posterior approach. Histopathologic examination including immunohistochemical stain showed the plasma cell neoplasm producing IgM and kappa light chain. Cancer workup after operation including bone marrow study and whole body simple radiologic studies supported the diagnosis of extramedullary plasmacytoma.
Aged ; Bone Marrow ; Diagnosis ; Epidural Space* ; Female ; Humans ; Immunoglobulin M ; Magnetic Resonance Imaging ; Multiple Myeloma ; Neoplasms, Plasma Cell ; Paraplegia ; Plasmacytoma ; Spinal Cord Compression ; Spine ; Thoracic Vertebrae