1.A Study on the Pervalence and Risk Factors of Liver Dysfunction among the Workers in Chemical Factors.
Hae Kwan CHEONG ; Joung Soom KIM
Korean Journal of Preventive Medicine 1997;30(1):103-128
The object of this study is to evaluate the possibility of chemical-induced liver disorder among workers exposed to various chemicals and to classify the the liver function abnormalities by causes and to analyse the risk factors for each liver disorders. A cross-sectional study including questionnaire survey, physical examination, laboratory tests and ultrasonography of liver was conducted on 1,126 workers, 459 workers in a coal chemical plant(company A) and 667 workers in an insulation material manufacturing factory(company B). An industrial hygienist reviewed the chemicals used in both companies and evaluated the work environments to classify the workers by chemical exposure semiquantitatively. The results are as follows; 1. Of 459 workers in company A, 83 workers(18.1 %) are classified as nonexposed, 163(35.5%) as short-term exposure group, 155(33.8 %) as intermediately exposed group and 58(12.6 %) as long-term exposed group based on the mean daily exposure to hepatotoxic chemicals evaluated by an industrial hygienist. Of 667 workers in company B, 484(72.6 %) workers were classified as nonexposed and 183(35.5 %) as exposed. 2. Workers with SGOT level higher than 40 IU/l were 46(10.0 %) in company A and 77(11.5 %) in company B, and those with SGPT level higher than 35 IU/l were 118(25.7 %) in company A and 198(29.7 %) in company B. The differences were not significant between companies and between exposure groups(p>0.05). Workers with ?-GT level higher than 62 IU/l were 29(6.3 %) in company A and 77(11.5 %) in company B(p<0.01). The difference between exposure groups was not significant(p>0.05) within companies. Workers with liver function abnormalities(defined as SGOT higher than 40 IU/l or SGPT higher than 35 IU/l, Ministry of Labor, 1989) were 338(30.0 %) among 1,126 workers. Of 338 workers with liver function abnormalities 139(12.3 %) had fatty liver by ultrasonography, 79(7.0 %) had alcoholic liver(defined as workers with liver function abnormalities with weekly alcohol consumption greater than 280 g for more than 5 years), 54(4.8 %) had hepatitis B, 12(1.1 %) had hepatitis C and the other 114(33.7 %) was not otherwise classified. Prevalences of alcoholic liver and fatty liver were significantly lower in company A(prevalence ratio 0.24 for alcoholic liver, p<0.001; prevalence ratio 0.76 for fatty liver, p<0.05) but prevalences of liver disorders between exposure groups within companies were not significant(p>0.05). 3. Summary prevalence ratios(SPR) of liver function abnormalities, fatty liver and other liver disorders, adjusted by age and company were not significantly higher in exposed group in any chemicals(p>0.05) but in some chemicals, SPRs were significantly lower. 4. On simple analysis of risk factors for liver function abnormalities, prevalence odds ratio(POR) of those with age between 30 and 39 was 1.54(p<0.01) and those with age over 40 was 1.51(p<0.01). POR of those with histories of liver disorders and general anesthesia was 1.77(p<0.001) and 4.02 for those with overweight and 6.23 for those with obesity, defined by body mass index(p<0.001). 5. On logistic regression analysis, risk factors of liver function abnormality were fatty liver(POR 2.92 for grade 1, 12.15 for grade 2), presence of hepatitis B surface antigen(POR 3.62) and obesity(POR 5.38 for overweight and 16.52 for obesity). Presence of hepatitis B surface antigen(POR 0.18) was the only preventive factor of fatty liver. Company(POR 0.30) and obesity(POR 2.49 for overweight, 4.52 for obesity) were related to the alcoholic liver. Obesity(POR 2.94 for overweight) was the only significant risk factor of hepatitis B and there was no significant risk factor for liver function abnormality not otherwise classified. It is concluded that the evidence of liver disorder related with chemical exposure is not evident in these factories. It is also postulated that fatty liver and alcoholic liver is most common causes of liver function abnormalities among workers and effort for weight control and improvement of life style should be done.
Alanine Transaminase
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Alcohol Drinking
;
Alcoholics
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Anesthesia, General
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Aspartate Aminotransferases
;
Coal
;
Cross-Sectional Studies
;
Fatty Liver
;
Hepatitis B
;
Hepatitis C
;
Humans
;
Life Style
;
Liver Diseases*
;
Liver*
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Logistic Models
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Obesity
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Overweight
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Physical Examination
;
Prevalence
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Surveys and Questionnaires
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Risk Factors*
;
Ultrasonography
2.Study on Relationship between Hypertension and Dietary intake in a Rural Adult Population.
Korean Journal of Preventive Medicine 1997;30(4):729-740
To determine the relationship between hypertension and nutrient intake cross-sectional study were performed in a rural area. Adult resident over 30-year-old age were measured blood pressure and body mass index(BMI), and interviewed about food intake for the previous 24 hours. 250 men and 297 women participated the survey. Significant correlation was shown in men between mean systolic blood pressure and protein density. Significant correlation with mean diastolic blood pressure was shown on protein density, protein energy(%), calcium density and energy-adjusted protein in men. We analysed risk factor for hypertension adjust the effect of age, BMI, sex and family history by multiple logistic regression. Protein density(odds ratio=3.18), fat density(odds ratio=1.94) and energy-adjusted protein(odds ratio=1.01) intake were positively associated with hypertension but sodium density(odds ratio=0.73) was shown to have inverse relationship.
Adult*
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Blood Pressure
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Calcium
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Cross-Sectional Studies
;
Eating
;
Female
;
Humans
;
Hypertension*
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Logistic Models
;
Male
;
Risk Factors
;
Sodium
3.a study on The Effect of The Tobacco Price Raise on The Smoking Rate and Smoking Attributable Death.
Jong Won KANG ; Joung Soom KIM
Korean Journal of Preventive Medicine 1997;30(4):697-707
This study was performed to estimate the quantity of the effects of tobacco price raise on the smoking rate, and the smoking attributable deaths in Korea. The data were collected by questionnaire survey from 538 male office workers. The questionnaire contained items on age, sex, living place, status of education, smoking history, the intention to quit smoking when the tobacco price be raised. The questionnaire were distributed to the offices of enterprises, hospitals, research centers, and public agencies and then collected. Data were analyzed by using the age specific smoking rate, relative risks of eight major smoking related diseases, vital statistics, and the population attributable risk of deaths of smoking males. On the other hand, the impact of the tobacco price raise on the population attributable risk of death due to smoking in Korea was estimated by applying the presumed smoking rate after the price raise. The results obtained were as follows: 1. The smoking rate of male white color workers in large cities was 59.5%. 2. The proportion of male smokers who has the intention to quit smoking when the tobacco price be raised was 61.5%. 3. The proportion of male smokers who has the intention to quit smoking if the price of tobacco be raised was proportional to the degree of increasing tobacco price. It is estimated that if the tobacco price were raised more than four times as now, the presumed smoking rate goes down as low as 26.7%. If the tobacco price be raised 20% each year, presumed smoking rate is 46.2%. 4. The number of attributable male death of smoking estimated by using 8 major smoking related diseases(lung cancer, laryngeal cancer, esophageal cancer, stomach cancer, pancreatic cancer, cerebrovascular disease, ischemic heart disease, chronic obstructive pulmonary disease) was 25,863 death each year. That is 20.1% of total age over 20 male deaths. 5. If the tobacco price were raised more than four times as now and all smokers who has intention to quit smoking quits smoking, 12,336 lives, or 47.7% of smoking related deaths could be saved. 6. If the actual practice rate of quitting smoking among male smokers with intention to stop smoking when the price of tobacco be raised is 10%, 25%, or 50%, then the expected decrease of death numbers when the tobacco price were raised more than four times as now can be 1,112, 3,483, 5,796 respectively.
Chronic Disease
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Education
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Esophageal Neoplasms
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Hand
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Humans
;
Intention
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Korea
;
Laryngeal Neoplasms
;
Male
;
Myocardial Ischemia
;
Pancreatic Neoplasms
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Surveys and Questionnaires
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Smoke*
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Smoking*
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Stomach Neoplasms
;
Tobacco*
;
Vital Statistics
4.A Case-Control Study on Association Between Hepatocellular Carcinoma and Infection of Hepatitis B and Hepatitis C Virus.
Hyeong Sik AHN ; Min Ho KIM ; Young Sick KIM ; Joung Soom KIM
Korean Journal of Preventive Medicine 1997;30(1):1-16
To investigate the association between hepatocellular carcinoma(HCC) and infection of hepatitis B virus(HBV) and hepatitis C virus(HCV) in an HBV endemic area , a case-control study of 254 patients with HCC and of 1,270 age and sex matched health control subjects was done. Among the 254 HCC patients 166(65.4%) were positive for hepatitis B surface antigen(HBsAg), 49(19.3%) were positive for HCV antibody(anti-HCV Ab). The crude odd ratio of patients with HBsAg was 36.1(95% CI :22.4-58.2) and with anti-HCV Ab was 9.0(95% CI :5.5-14.6). In an analysis, which HBsAg(-), HBcAb(-), anti-HCV Ab(-) group was chosen as referent group, odd ratio of HBsAg(+) group was 14.4(95% CI: 7.2-28.9) and of anti- HCV Ab(+) was 10.7(95% CI: 2.9-40.0). Odd ratio of anti-HCV Ab(+), HBsAg(+) group and anti-HCV Ab(+), HBsAg(-), HBcAb(+) group for HCC were elevated to 27.3(95% CI : 9.0-82.9) , 15.9(95% CI:7.1-35.8) respectly. The odd ratio of anti-HCV Ab(-), HBsAg(-), HBcAb(+) group was 2.4(95% CI : 1.1-5.0). These result suggested that HBV and HCV were associated with HCC. In HBV endemic area patients with HBcAb alone should be considered risk group for HCC.
Carcinoma, Hepatocellular*
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Case-Control Studies*
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Hepacivirus*
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Hepatitis B Surface Antigens
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Hepatitis B*
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Hepatitis C*
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Hepatitis*
;
Humans