OBJECTIVES: We report two cases of anosmia that were suspected to be caused by chronic chlorine exposure in cleansing works METHODS: We examined the cases in order to assess the work-relatedness of their anosmia. We conducted olfactory threshold test and olfactory perception test repeatedly at one-month intervals. Using ion chromatography, we analyzed the detergent that the workers had been using for several years before their olfactory function decreased. RESULTS: A 59-year-old male who had worked in a cleansing process for 10 years (1983-1993) and a 58-year-old female who had worked in the same process for 8 years (1987-1995) were diagnosed with anosmia. The cause of the anosmia was presumed to have been the chlorine gas that was generated from the process of heating the detergent-dissolved water, in which chloride was detected. CONCLUSIONS: This is the first report on anosmia due to chronic chlorine exposure. Greater attention needs to be focused on the prevention of anosmia because there are many workers who have been exposed to chlorine gas in chlorine treating and generating processes.
Chlorine* ; Chromatography ; Detergents ; Female ; Heating ; Hot Temperature ; Humans ; Male ; Middle Aged ; Olfaction Disorders* ; Olfactory Perception ; Water

Occupational hearing loss became the leading occupational disease by constituting 56% of all work-related diseases in Korea. However, the prevalence rates showed wide variations among the specific medical examination providers (SHFEPs) and were very low (0.8-1.4%) compared with those of 8.4% in Japan. This study was designed to identify sources of these variations by inyestigating current audiometric testing methods and the diagnostic criteria utilized by the ShfEPs. A questionnaire was distributed to each of 27 SMEPS selected from total 70 SMEPS. Among them, 20 ShfEPs were interviewed and the rest of them were given the questionnaire from by mail. Included in the survey from were questions concerning audiometric testing methods and procedure equipment, facility personnel and the diagnostic criteria utilized, The results were as follows: 1. Employee audiometric testings were primaTily conducted by nurses and nurse-aids who had formal training for audiometry because no training program had been established. No requirement about the quality of audiometric testing personnel was specified in the regulation. 2. Although audiometric testing equipment used by the SDfEPs should be periodically calibrated, a significant number of them were not properly calibrated. Most of the calibration services were provided by the outside contractors and were done with no uniformly established periods. No SMEPS conducted the daily functional calibration. Most of the ShfEPs did not keep their calibration records. 3. Initial audiometric testings were conducted at any available spaces in the workplace or at the testing room without considering noise level in that place. Follow-up audiometric testings were also provided without considering the worker's noise exposure. Although audiometric booths were used during tHe follow-up testinga most of them did not meet the ANSI noise reauirement for audiometric booths. 4. AltHough a standard diagnostic criterion was promulgated in the law, the criterion was not used uniffrmly by the SMEPs. In addition, some SMEPS were applying age corrections which were not incorporated into the regulation yet. Therefore wide range of prevalence in NIHU among SMEPS could have possibly been caused by variable audiometric testing procedures and methods. In conclusion, it was recommended that systematical and general measures, such as formal and regular training program for testers, quality control regulation of instnlment calibration, and establishment of standard diagnostic criteria, be established for solving current problems and assuring equity among SMEPs in diagnosing occupational hearing losses.
Audiometry ; Calibration ; Education ; Follow-Up Studies ; Hearing Loss* ; Hearing* ; Japan ; Jurisprudence ; Korea ; Noise ; Noise, Occupational* ; Occupational Diseases ; Postal Service ; Prevalence ; Quality Control ; Questionnaires

In the field of industrial health, it is important to establish the efficient system for health management of workers. The management of health information of workers using data base will contribute to such a system. In this context, the utility of method using Mahalanobis distance(D(2)), the general probability distance in multivariate analysis, for decision of the results of health examination was evaluated. Six items of test among the health examination data of 278 prospective employee was used to calculate D(2). Sensitively and specificity of decision method using D(2) with 99% normal range was 95.8% and 90.2% respectively as compared with decision by doctor. This finding suggests the utility of method using D2 for decision of the results of mass screening for industrial workers.
Mass Screening ; Multivariate Analysis ; Occupational Health ; Reference Values ; Sensitivity and Specificity

Ambient air monitoring(environmental monitoring) and biological monitoring of mixed organic solvents exposure have been used in exposure assessment of these compounds in the work environment. Environmental monitoring is more useful when assessing low level exposure to these compounds. The specific objectives of this study were to measure air organic solvent levels in the work environment, to test the agreement of items measured in this study with items which have been reported to the administrative agency, and finally to evaluate the appropriateness of environmental monitoring items. The study subjects were 13 small companies in which less than 300 employees were working and presumably exposed to mixed organic solvents(e.g. automotive repair and painting, 6; textile dyeing, 2; printing, 2; electronics, etc, 3). Personal air samplings were performed by the flow-lite sampling pump(MSA) and the 600mg charcoal tube with air velocity of 100ml/min for qualitative analysis and 2l/min for quantitative analysis. Samples were analysed by gas chromatography/mass spectrometry(Hewlett-Packard 5890/5970). High levels of toluene, n-hexane, and MIBK were detected in most study companies and low levels of ethylbenzene, xylene, n-butylacetate were also detected. When these measured items were compared with those of reported items, only 6 of 13 companies showed relatively good agreement between them. Two companies failed to report items exceeding the limit value. In conclusion, qualitative analysis of ambient air organic solvents seemed to be as important as quantitative analysis of these compounds and a periodic evaluation of monitoring items reported to the administrative agency should be required.
Charcoal ; Environmental Monitoring* ; Humans ; Mass Spectrometry ; Paint ; Paintings ; Solvents* ; Textiles ; Toluene ; Workplace* ; Xylenes

Twenty-four factories registered at the Ministry of Labor as factories using or producing cadmium in 1991 were investigated to know the present state of occupational exposure to cadmium in 1992. Nine factories among 24 stopped using or changed to other substances and 1 factory didn't produce any more, but delivered it to other factories through imports. Therefore, only 14 factories were producing or using cadmium. But, alloying materials were uspplied to about 20 and more factories, however, they couldn't be investigated because of limited information. Three factories had less than 50 workers were 3, 6 had 50-300 and 5 had more than 300. About 167 workers were exposed to cadmium. According to the classification by process, there were 4 alloy processes, 2 refinary, 2 elctroplating, 2 dry cell making, 1 industrial battery and 1 copper refinary. 8 factories used metal cadmium, 3 cadmium oxide, 2 cadmium sulfide, and 1 cadmium hyroxide. One factory was importing cadmium stearates only and supplying them to the PVC making factories. The amount of metal cadmium producing in 2 refinary factories was about 50-65 ton per month. The other cadmium compounds were imported. According to exposure level of cadmium in air of the 10 factories examined, each factory could be divided into high, moderate and low exposure groups. 1 battery recycling factory and 3 alloy factories were in the high exposure group and their mean air concentrations were 0.06679, 0.05481, 0.02492, and 0.003mg/m3, respectively. Refinary and industrial battery making factories were in the middle exposure group and their mean air concentrations were 0.00773 and 0.00613 mg/m3, respectively. Finally, low exposure group were copper smelting, dry cell case making, duplicator drum making and electroplating factory and their mean air concentrations were 0.00096, 0.00071, 0.00057 and 0.00054 mg/m3 respectively.
Alloys ; Cadmium Compounds ; Cadmium* ; Classification ; Copper ; Electroplating ; Korea* ; Occupational Exposure* ; Osmeriformes ; Recycling ; Stearates

This study was carried out to evaluate the relations between smoking and serum lipid levels in a group of 1,138 male white collar workers, ages 20 to 69 years. Smoking history on daily smoking amount, duration of smoking and duration of smoking cessation was obtained by questionnaire and was pack year. The levels of seurm lipid such as total cholesterol(TC), high density lipoprotein cholestoerol(HDL), triglyceride(TG), and low density lipoprotein cholesterol(LDL) were measured by enzyme method. We also observed the effects of various variables such as age, education, income, exercise, fasting blood suger, body mass index and alcohol. The correlation, ANOVA and multiple regression analysis were performed using SAS pakege programme. The results obtained were as follows; 1. Age was positively related to TC, TG and LDL; income was positively related to TC and LDL; exercise was positively related to HDL; body mass index was positively related to HC, TG and LDL and was inversely related to HDL; alcohol intake was positively related to HDL and TG. 2. TC, TG and LDL increased and HDL decreased significantly with increasing daily smoking amount, duration of smoking or pack year. 3. The differences found among the various groups by duration of smoking cessation were not significant for the adjust means of TC, HDL, TG and LDL. 4. Multiple regression analysis demonstrated that smoking contributed independently to all serum lipid levels of other variables such as age, education, income, exercise, body mass index, alcohol and fasting blood sugar. However, the contribution rate of smoking to the serum lipid levels was only 1-2%.
Blood Glucose ; Body Mass Index ; Education ; Fasting ; Humans ; Lipoproteins ; Male* ; Questionnaires ; Smoke* ; Smoking Cessation ; Smoking*

A cross-sectional study was performed to evaluate the effects of chronic exposure to solvent on neurobehavioral performance of solvent exposed 89 workers engaged in a video tape manufacturing fatory. A control group of 43 workers was selected fro different sections of the factory. The mean age and the mean duration of employment were 29 years and 5.4 years. Each workers completed a medical and occupational questionnaire. Adverse effects on the central nervous system were assessed by self reported Scandinavian questionnaire 16, New Anxiety-Depression Scale and seven test of Swedish Performance Evaluation System. These included simple reaction time, choice reaction time, digit classification, finger tapping speed, additions, symbol digit and digit span. Several potential confounding factors were included as indepedent variables in all analysis of neurobehavioral tests and symptoms. These included age, sex, educational level, familiarity with computer, alcohol drinking and amount of smoking. No significant associations were found between solvent exposure and total symptom score and mood score, Although the mean duration of employment was 5.4 years, comparison of mean performance scores adjusted for confounding factors showed a significantly poorer performance on choice reaction time(p<0.05), digit classification (p<0.01), additions (p<0.01) and symbol digit(p<0.01) in exposed group. Factor matrix of neurobehavioral tests produced by varimax rotation showed three distinct factors, which correspond to assessments of "memory", "coordination" and "response speed". These factors accounted for 62.6% of the total variance of the sample. Familiarity with computer was found to be associated with performance of symbol digit and amount of smoking appeared to slow finger tapping speed. Male and college graduate workers have less errors than others. There were no significant correlation between neurotoxic symptom score and performance of neurobehavioral tests.
Alcohol Drinking ; Central Nervous System ; Classification ; Cross-Sectional Studies ; Employment ; Fingers ; Humans ; Male ; Questionnaires ; Reaction Time ; Recognition (Psychology) ; Self Report ; Smoke ; Smoking ; Solvents*

In order to develop questionnaire estimating vinyl chloride monomer(VCM) exposure levels, to reset selection criteria for detailed tests, to measure current VCM exposure levels, to evaluate the mutagenic effects of VCM exposures and to develop multiphasic screening method of PVC- or VCM-handling workers, VCM concentrations of work environments were measured and tentative self-administrative questionnaire, physical examination, sister chromatid exchange(SCE) test and some clinical chemical test were applied to 195 men who had been handling VCM or PVC(Exposed Group) and 37, in the same factories without exposure to VCM or in polyethylene- or polypropylene-related factories(Control Group). Mean VCM concentrations of work environments were 0.268+/-0.183 ppm under PVC synthesis processes, 0.160+/-0.200 ppm under VCM synthesis process, 0.076+/-0.111 ppm under PVC pipe producing processes, 0.090+/-0.108 ppm under PVC wall paper, sheet, or film producing processes, 0.071+/-0.051 ppm under PVC floor producing processes, 0.243+/-0.250 ppm under PVC sash producing processes, and 0.020+/-0.031 ppm under triming process. VCM levels of work environments under manual resin mixing processes (0.209+/-0.168 ppm)were higher than those of the others (0.209+/-0.168 ppm) (p-value<0.05). There was no VCM-related symptoms, the positive response rates of which were higher in the Exposed Group. Overall abnormal rate in clinical chemistry test of the Exposed Group was higher than that of the Control Group, but due to extermely low exposure level of exposure group and to small sample size of the Control Group, no statistical significance was found(p-value>0.05). SCE frequencies of the Exposed Group were significantly higher than those of Contorl Group(p-value<0.05) and those of test-abnormal persons were higher than those of test-normal persons. SCE frequencies linearly increased with not only current but also cumulative VCM exposure levels(p-value<0.05). These results suggest that adverse health effect may ensue from VCM exposure to as low as 1 ppm. But SCE frequencies had no statistically significant correlation with drinking amounts, smoking amoutns, or radiation dose equivalents. Questionnaire was revised by referring to these results and formula estimating cumulative VCM exposure levels based on occupational history in questionnaire were made. In addition, were presented methods evaluating work environments and multiphasic screening test for PVC workers.
Chromatids ; Clinical Chemistry Tests ; Drinking ; Humans ; Male ; Multiphasic Screening* ; Patient Selection ; Physical Examination ; Polyvinyl Chloride* ; Polyvinyls* ; Questionnaires ; Sample Size ; Siblings ; Sister Chromatid Exchange ; Smoke ; Smoking ; Vinyl Chloride*

Lung function test can be influenced by technical as well as biological variables, and the quality control of test has been stressed as an important part of lung function test program. This study was done to survey the current status of lung function test program in workers' health examination, and examine the variablity of test results when quality control is not achieved. Forty nine Workers' Health Examination Institutes and 7 Pneumoconiosis Referal Centers were surveyed for their current lung function tests, types of spirometers, and performance of technicians. To examine the effect of quality control program of lung function tests on the variablity of test results, 118 miners were tested under a quality control guideline and the results were compared to those obtained ignoring 4 major areas of the guideline-spirometer calibration, minimum number of tests per session, suitable prediction equations, and selection process of final results for each tested subjects. Among surveyed Institutes and Centers, only 38%(20/53) are performing any calibration of spirometers, and most of those calibrations are done automatically by the machine. All the surveyed Institutes and Centers obtain acceptable test no more than 2 times. The background of technicians include office workers and nurse aids without an adequate training in pulmonary physiology, and the testing posture and formats vary among Institutes and Centers. When the types of pulmonary dysfunction under the definition of the Ministry of Labor were compared between those obtained with and without quality control guidelines, spirometer calibration affected the test results in 6(5.1%) out of 118 subjects. The change in the minimum number of adequate tests from 1 to 3 and more brought changes in 19(16.1%) subjects. The test results of 9(7.6%) subjects differed between two different prediction equations, and the results of 7(5.9%) subjects differed between two different selection process of final results. The current practice of lung function tests of workers needs quality control programs, and the results of this study indicate that the first remedy should be to bring the minimum number of acceptable test to more than 3.
Academies and Institutes ; Calibration ; Lung* ; Physiology ; Pneumoconiosis ; Posture ; Quality Control* ; Respiratory Function Tests*

Lung Function test results can be influenced by race, socioeconomic status, and physical fitness. The choice of the most appropriate predictive equations should be based upon these considerations as well as age, sex, and body size. About 70% of Korean males smoke, and non-smokers can be a selective group in Korea. In this study, lung function test results of 683 healthy Korean male workers were analyzed to get the predictive equations of Forced Vital Capacity(FVC), Forced Expiratory Volume in 1 second(FEV(1)), and FEV(1)/FVC (FEV(1)%). The age of studied workers ranged from 18to 60, and most of those finished high school or less. Healthy smokers without any respiratory symptoms or disease history were included in the study, while the effect of smoking on the test results were examined in the analysis. FVC, FEV(1), and FEV(1)% were regressed against age, height, weight and smoking status or smoking amount. Age and height explained FVC and FVC(1) most efficiently and the contribution of other variables were not significant. Whereas, smoking was significantly associated with a decrease in FEV(1)% even among healthy un-symptomatic workers. For FEV(1)%, age, height, and smoking amount were significant variables, constituting the most efficient prediction model. The lower limit of normal for percent predicted values was calculated from lower 95 percentile as well as 95% confidence interval. When the results of this study was compared to those from studies of white Caucasians, the predicted FVC and FEV(1) were lower for the given age and height but the differences were less than 10%. The slopes of regression equation for height and age were, however, not significantly different when the social backgrounds of the studied subjects were similar.
Body Size ; Continental Population Groups ; Forced Expiratory Volume ; Humans ; Korea ; Male* ; Physical Fitness ; Respiratory Function Tests ; Smoke ; Smoking ; Social Class