BACKGROUND: The goal of this study is to develop a general population job-exposure matrix (GPJEM) on asbestos to estimate occupational asbestos exposure levels in the Republic of Korea. METHODS: Three Korean domestic quantitative exposure datasets collected from 1984 to 2008 were used to build the GPJEM. Exposure groups in collected data were reclassified based on the current Korean Standard Industrial Classification (9th edition) and the Korean Standard Classification of Occupations code (6th edition) that is in accordance to international standards. All of the exposure levels were expressed by weighted arithmetic mean (WAM) and minimum and maximum concentrations. RESULTS: Based on the established GPJEM, the 112 exposure groups could be reclassified into 86 industries and 74 occupations. In the 1980s, the highest exposure levels were estimated in “knitting and weaving machine operators” with a WAM concentration of 7.48 fibers/mL (f/mL); in the 1990s, “plastic products production machine operators” with 5.12 f/mL, and in the 2000s “detergents production machine operators” handling talc containing asbestos with 2.45 f/mL. Of the 112 exposure groups, 44 groups had higher WAM concentrations than the Korean occupational exposure limit of 0.1 f/mL. CONCLUSION: The newly constructed GPJEM which is generated from actual domestic quantitative exposure data could be useful in evaluating historical exposure levels to asbestos and could contribute to improved prediction of asbestos-related diseases among Koreans.
Asbestos* ; Classification ; Dataset ; Mesothelioma ; Occupational Exposure ; Occupations* ; Republic of Korea* ; Talc

A 75-year-old man who was diagnosed as having a fluid-filled giant bulla was treated with a modified Brompton technique due to his poor performance status. Percutaneous drainage, suction, and talc sclerotherapy through a Foley catheter can be good treatment options for patients with conditions that are too poor to allow surgical intervention, especially if there is adhesion between a giant bulla and parietal pleura. Talc can also be used safely when mixed with normal saline as a sclerosant.
Aged ; Blister ; Catheters ; Drainage ; Humans ; Pleura ; Sclerotherapy ; Suction ; Talc

Humans ; Male ; Middle Aged ; Silicosis ; diagnosis ; therapy ; Talc ; adverse effects

Asbestos is a naturally occurring mineral in the Earth's crust, and it is not confined to the historic and current asbestos mining areas, but rather quite commonly encountered in certain geological environments across the world. The middle-west side of the Korean Peninsula (Chungnam province) has been composed of numerous talc and asbestos ore deposits derived from serpentine and dolomite. These areas have experienced epidemics of malignant mesothelioma and pleural plaques as a result of non-occupational "neighborhood" exposure and naturally occurring asbestos (NOA) exposure. However, asbestosis epidemics from environmental exposure were rare because asbestosis needs relatively high concentration of asbestos exposure. This review summarizes asbestosis epidemics which occurred in the residents who have lived past or current asbestos mining areas and natural in-place asbestos deposits (or asbestos-like mineral deposits) in the world, including Korean asbestosis endemics that occurred in Chungnam province, which has many historic asbestos mining. Also, this manuscript will describe effective public policies for managing NOA, minimizing potential hazards, and protecting public health from asbestos exposure.
Asbestos ; Asbestosis ; Calcium Carbonate ; Environmental Exposure ; Magnesium ; Mesothelioma ; Mining ; Public Health ; Public Policy ; Residence Characteristics ; Talc

The patients with prolonged air leak after lung resection surgery were generally treated by pleurodesis with sclerosing agents such as talc, tetracyclin, doxycyclin, bleomycin, vibramycin, and OK432. However, for the case like dead space resulted by incomplete reexpansion of the remaining lung, chemical pleurodesis has shown to be not as effective as expected. If the patients keep the chest tube for long period of time, the risk of thoracic empyema would increase. Most thoracic surgeons have experienced prolonged airleak which developed after lung resection. Pleurodesis with autoblood was reported as an effective method in treatment of patients with prolonged airleak. The mechanism of blood pleurodesis may be direct obliteration of BPF and reduction of dead space by clot. Therefore we successfully treated the two patients with prolonged airleak using the autoblood plus OK432 or vibramycin.
Bleomycin ; Chest Tubes ; Doxycycline ; Empyema, Pleural ; Humans ; Lung ; Picibanil ; Pleurodesis* ; Pneumothorax ; Sclerosing Solutions* ; Talc

Malignant pleural effusions (MPEs) are an important clinical problem in patients with neoplastic disease. They can occur as the initial presentation of cancer, a delayed complication in patients with previously diagnosed malignancies, or the first manifestation of cancer recurrence after therapy. Common cancer types causing MPEs include lymphomas, mesotheliomas, and carcinomas of the breast, lung, and ovaries. However, almost all tumor types have been reported to cause MPEs. Regardless of the etiology, the median survival from clinical recognition is 4 months. New imaging modalities assist the evaluation of patients with a suspected MPE. However cytologic or tissue confirmation of malignant cells is necessary to establish a diagnosis. Management of an MPE remains palliative. Managements are directed toward removing pleural fluids and when appropriate, performing pleurodesis or initiating long-term drainage to prevent fluid reaccumulation. Talc pleurodesis is still the choice of treatment although concerns about its safety remain. Several factors such as performance status, expected survival, lung re-expansion following pleural fluid drainage and co-morbidities should be considered before the treatment.
Breast ; Drainage ; Female ; Humans ; Lung ; Lymphoma ; Mesothelioma ; Ovary ; Pleural Effusion ; Pleural Effusion, Malignant ; Pleurodesis ; Recurrence ; Talc

Most of pneumoconiosis found in Korea can be categorized in coal worker's pneumoconiosis. However, in recent years, pneumoconiosis has been frequently found in the workers of manufacturing factories. Accordingly, this study was carried out to investigate relationship of dust exposure history and development and progress of pneumoconiosis. Chest radiographs, history of dust exposure, and other data of 144 workers, who were diagnosed as suspecter pneumoconiosis (0/l) or pneumoconiosis in special health examination center in Incheon from 1986 to 1996, were reviewed. The results were as follows ; 1. According to the type of main exposure, most common type of exposure was foundry dust(93workers, 64.6%), followed by welding fume(16workers, 11.1%), talc dust, lime dust and etc. 2. Among 144 workers, the history of dust exposure was investigated in 86 workers. Mean ages of 86 workers at the present study, initial exposure to the dusts, and at the time of initial diagnosis as having pneumoconiosis were 52.1, 29.1 and 46.5 years, respectively. The mean duration of exposure was 17.3 years. 3. Comparing the type of main exposure with dust exposure history, initially exposed age of welders, foundry workers, workers exposed to coal dust and other dusts were 24.6, 30.7, 28.0 and 28.5 years, respectively. Ages at the time of diagnosis as having pneumoconiosis of welders, foundry workers, coal dust and other dusts were 41.3, 49.3, 46.4 and 44.1 years, respectively. The duration of exposure to main dust of welders, foundry workers, workers exposed to coal dust and other dusts were 16.8, 18.2, 13.3 and 11.6 years, respectively. Therefore initially exposed age was significant difference between the welders and the foundry workers (p<.05). Age which was diagnosed pneumoconiosis was significant difference between the welders, workers exposed to other dusts and the foundry workers (p<.01). And exposure duration of main dust was significant difference between the workers exposed to other dusts and foundry workers (p<.01) 4. Initially diagnosed X-ray category of the workers were category 0/l (76workers, 52.8%), 1/0 (35workers, 24.3%) Therefore, workers' pneumoconiosis of manufacturing factories was mild, relatively. And there was no significant difference between initially diagnosed X-ray category of the workers and dust exposure history. 5. Among 97 workers, who could follow up more than 1 year, 60 workers(61.9%) were not changed, 24 workers (24.7%) were progressed, 13 workers (13.4%) were improved in their initially diagnosed X-ray category. Among 11 welders, initially diagnosed X-ray category of 5 welders(45.5%) were improved and of only 1 welder was progressed. But, among 19 workers exposed to other dusts, 10 (52.6%) workers were progressed and none of them were improved. 6. Among 53 workers, who were Initially diagnosed X-ray category was 0/l, 12 workers (22.6%) were progressed and 5 workers (9.4%) were improved in their initially diagnosed X-ray category. And among 40 workers, who were initially diagnosed X-ray category was 1, 12 workers(30.0%) were progressed and 7 workers(17.5%) were improved. Above results suggest that not a few workers of manufacturing factories have pneumoconiosis and their pneumoconiosis is progressed. Therefore, we have to prepare management plan and to study epidemiologic findings of pneumoconiosis with workers of manufacturing factories.
Anthracosis ; Coal ; Diagnosis ; Dust ; Follow-Up Studies ; Incheon* ; Korea ; Pneumoconiosis* ; Radiography, Thoracic ; Talc ; Welding

Most of pneumoconiosis found in Korea can be categorized in coal worker's pneumoconiosis. However, in recent years, pneumoconiosis has been frequently found in the workers of manufacturing factories. Accordingly, this study was carried out to investigate relationship of dust exposure history and development and progress of pneumoconiosis. Chest radiographs, history of dust exposure, and other data of 144 workers, who were diagnosed as suspecter pneumoconiosis (0/l) or pneumoconiosis in special health examination center in Incheon from 1986 to 1996, were reviewed. The results were as follows ; 1. According to the type of main exposure, most common type of exposure was foundry dust(93workers, 64.6%), followed by welding fume(16workers, 11.1%), talc dust, lime dust and etc. 2. Among 144 workers, the history of dust exposure was investigated in 86 workers. Mean ages of 86 workers at the present study, initial exposure to the dusts, and at the time of initial diagnosis as having pneumoconiosis were 52.1, 29.1 and 46.5 years, respectively. The mean duration of exposure was 17.3 years. 3. Comparing the type of main exposure with dust exposure history, initially exposed age of welders, foundry workers, workers exposed to coal dust and other dusts were 24.6, 30.7, 28.0 and 28.5 years, respectively. Ages at the time of diagnosis as having pneumoconiosis of welders, foundry workers, coal dust and other dusts were 41.3, 49.3, 46.4 and 44.1 years, respectively. The duration of exposure to main dust of welders, foundry workers, workers exposed to coal dust and other dusts were 16.8, 18.2, 13.3 and 11.6 years, respectively. Therefore initially exposed age was significant difference between the welders and the foundry workers (p<.05). Age which was diagnosed pneumoconiosis was significant difference between the welders, workers exposed to other dusts and the foundry workers (p<.01). And exposure duration of main dust was significant difference between the workers exposed to other dusts and foundry workers (p<.01) 4. Initially diagnosed X-ray category of the workers were category 0/l (76workers, 52.8%), 1/0 (35workers, 24.3%) Therefore, workers' pneumoconiosis of manufacturing factories was mild, relatively. And there was no significant difference between initially diagnosed X-ray category of the workers and dust exposure history. 5. Among 97 workers, who could follow up more than 1 year, 60 workers(61.9%) were not changed, 24 workers (24.7%) were progressed, 13 workers (13.4%) were improved in their initially diagnosed X-ray category. Among 11 welders, initially diagnosed X-ray category of 5 welders(45.5%) were improved and of only 1 welder was progressed. But, among 19 workers exposed to other dusts, 10 (52.6%) workers were progressed and none of them were improved. 6. Among 53 workers, who were Initially diagnosed X-ray category was 0/l, 12 workers (22.6%) were progressed and 5 workers (9.4%) were improved in their initially diagnosed X-ray category. And among 40 workers, who were initially diagnosed X-ray category was 1, 12 workers(30.0%) were progressed and 7 workers(17.5%) were improved. Above results suggest that not a few workers of manufacturing factories have pneumoconiosis and their pneumoconiosis is progressed. Therefore, we have to prepare management plan and to study epidemiologic findings of pneumoconiosis with workers of manufacturing factories.
Anthracosis ; Coal ; Diagnosis ; Dust ; Follow-Up Studies ; Incheon* ; Korea ; Pneumoconiosis* ; Radiography, Thoracic ; Talc ; Welding

BACKGROUND: Parenteral tetracycline is no longer available for pleural sclerosing agent for pleurodesis in Korea due to the discontinuation of the production. The purposes of this study were to determine whether oral doxycycline (ODC) could be used as an effective sclerosing agent for pleurodesis, and to compare the effectiveness of ODC to other agents, such as homologous blood and talc. MATERIAL AND METHOD: Twenty male rats were divided into four groups (A to D). Following agents were given to each group intrapleurally; 10 ml/kg of 0.9% saline to group A, 10 mg/kg of ODC to group B, 2 ml/kg of homologous blood to group C, and 70 mg/kg of talc slurry to group D. All animals were sacrificed 28 days after instillation. The pleural spaces were assessed grossly and microscopically and were graded from 0 to 3, and the thicknesses of the pleura were measured. RESULT: The gross score of group A was 0.0, group B was 1.4+/-0.9, group C was 1.0+/-0.7, and group D was 2.2+/-0.8. Significant adhesion were examined in group B and D grossly (p<0.05). The pleural thickness of group A was 0.7+/-0.2 /10(2) mm, group B was 1.2+/-0.4 /10(2) mm, group C was 1.4+/-0.4 /10(2) mm, and group D was 3.5+/-0.9 /10(2) mm. Group D showed pleural thickening significantly (p<0.05). The microscopic score of group A was 1.0, group B was 1.7+/-0.5, group C was 1.5+/-0.4, and group D was 2.8+/-0.4. Group B and D showed significant inflammations and depositions of collagen (p<0.05). CONCLUSION: ODC showed significant pleurodesis grossly and microscopically, and homologous blood did not show adhesion. Talc was a significant sclerosing agent for pleurodesis causing extensive inflammation and collagen depisotion.
Animals ; Collagen ; Doxycycline* ; Humans ; Inflammation ; Korea ; Male ; Pleura ; Pleurodesis ; Rats* ; Sclerosing Solutions* ; Talc* ; Tetracycline

BACKGROUND: Conventional treatment (i.e. chest tube insertion and chemical pleurodesis) still remains standard for patients with secondary spontaneous pneumothorax because the risk of surgical bullectomy is deemed high in this subset. However, it has been suggested that surgical treatment using thoracoscopy may expedite postoperative recovery and, thus, may reduce hospital stay. MATERIALS AND METHODS: Retrospective review of 61 patients with secondary spontaneous pneumothorax, who underwent conventional treatment (n=39) or video-assisted thoracoscopic surgery (VATS) (n=22) between January 2007 and December 2009, was performed. Talc was used for chemical pleurodesis in both groups. RESULTS: Hospital stay of conventional treatment group and VATS group was 14.2+/-14.2 days (4~58 days) and 10.6+/-5.8 days (5~32 days), respectively, with statistically significant difference (p=0.033). Recurrence rate of conventional treatment group was also significantly higher (12/39, 30%) compared to VATS group (1/22, 4.5%) (p=0.016). CONCLUSION: In selected patients with secondary spontaneous pneumothorax with continuous air leak or inadequate lung expansion, thoracoscopic surgery with chemical pleurodesis using talc results in shorter hospital stay and lower recurrence rate compared to conventional approach.
Chest Tubes ; Humans ; Length of Stay ; Lung ; Pleurodesis ; Pneumothorax ; Recurrence ; Retrospective Studies ; Talc ; Thoracic Surgery, Video-Assisted ; Thoracoscopy