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BACKGROUND: Hot tub lung is a hypersensitivity pneumonitis caused by nontuberculous mycobacteria (NTM); the primary causative agent is Mycobacterium avium complex (MAC) post contaminated water exposure. Recently, 2 cases of hot tub lung were found in public bath bodyscrubbers working in Korea. However, the disease causing NTM was not identified in these cases. Here, we reported one case, along with clinical diagnostic approach to occupational medicine throughout worksite investigation. CASE: A 53 year-old woman working in the public bath for 13 months' duration developed shortness of breath. She had been cleaning the locker room, several pools and floors every day, and using scrubbers with detergent and warm water. After examination, the patient was diagnosed with hypersensitivity pneumonitis based on high resolution computerized tomography and lung biopsy. Because the Mycobacterium avium was identified in both the patient's sputum and the warm pool, she was diagnosed with hot tub lung due to MAC. CONCLUSION: Hot tub lung due to MAC was confirmed in public bath housekeeper. However, few cases have been reported, even though there are many cases. To prevent damages caused by hot tub lung, general environmental management such as ventilation and cleaning is important for bath operators. Likewise, awareness needs to be increased in workers with potential NTM environmental exposure and in clinicians through education about hot tub lung in order to reduce adverse harm from misdiagnosis and mistreatment of tuberculosis.
Alveolitis, Extrinsic Allergic ; Baths ; Biopsy ; Detergents ; Diagnostic Errors ; Dyspnea ; Environmental Exposure ; Female ; Floors and Floorcoverings ; Humans ; Korea ; Lung ; Mycobacterium ; Mycobacterium avium ; Mycobacterium avium Complex ; Nontuberculous Mycobacteria ; Occupational Medicine ; Sputum ; Tuberculosis ; Ventilation ; Workplace

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Effects of Workplace Noise and Hearing Protective Devices on Worker's Speech Intelligibility.

Hyoung Ouk PARK ; Chang Sun SIM ; Joong Keun KWON ; Kyoo Sang KIM ; Young Joo KWON ; Nam Jeong KIM ; Min Suk SEO ; Ji Ho LEE

Korean Journal of Occupational and Environmental Medicine.2010;22(2):154-165.

OBJECTIVE: The objective of this study was to evaluate the degree of intelligible speech in workers wearing hearing protective devices and the differences in background noise type. METHODS: A total 82 shipyard company employees and normal hearing volunteers were recruited as subjects from a company in Ulsan: subjects were classified to the hearing-impaired group or to the control group according to hearing status. They were tested pure tone and speech audiometry in varying test environments including signal-to-noise ratio and background noise type in a headphone and in a free field environment. RESULTS: For both groups, the attenuation of hearing protective devices was greater at high frequencies. For the hearing-impaired group, speech discrimination scores differences between the unprotected and the protected ear were not significant between background noise type, when speech was presented at 65 dBA. However speech intelligibility in white noise background was lower than in the other background noise types when speech was presented at 75 dBA. CONCLUSIONS: Workers' speech intelligibility increased with an increasing signal-to-noise ratio. Speech intelligibility was also dependent on background noise type. Workers and their colleagues were trained to pronounce words more loudly and more clearly when they wearing hearing protective devices or other communication methods that do not use sound signal should be considered.
Audiometry, Speech ; Ear ; Ear Protective Devices ; Hearing ; Humans ; Noise ; Signal-To-Noise Ratio ; Speech Intelligibility ; Speech Perception

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Risk Factors of Musculoskeletal Injuries among the Marine Corps Enlisted Trainees.

Seong Woo CHOI ; Jong Seo PARK ; Sun Ok JUNG

Korean Journal of Occupational and Environmental Medicine.2010;22(2):146-153.

OBJECTIVE: The Korean Marine Corps enlistees endure tremendous physical and mental stress during basic military training, resulting in an increased risk of musculoskeletal injuries. The aim of this study was to investigate the incidence and type of the musculoskeletal injury problems and the risk factors associated with injuries among the Marine Corps recruits and to suggest preventive measures. METHODS: The study subjects were the Marine Corps recruits (n=8,231) who were enlisted from July, 2008 to March, 2009 for basic military training. We used a prospective cohort design and collected basic demographic information and subject musculoskeletal injury risk factors through a questionnaire on the first day basic training. The subjects were followed for the subsequent 6-week military training period. RESULTS: The cumulative incidence of musculoskeletal injuries was 13.4% during the 6-week training period, and more than half of the injuries involved the lower limbs at or below the level of the knee. Based on multivariate logistic regression analysis, the following factors were related to an elevated risk for injuries: age, height, educational level, subjective health perception, injury history during the past year, and stress scale after entrance. CONCLUSION: Based on our study results, the application of injury prevention measures such as stress management program and gradual fitness increasing program to the Marine Corps recruit training would contribute to the reduction of musculoskeletal injuries.
Cohort Studies ; Humans ; Incidence ; Knee ; Logistic Models ; Lower Extremity ; Military Personnel ; Musculoskeletal System ; Prospective Studies ; Questionnaires ; Risk Factors

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Clusters of Pneumoconiosis among Residents Near Cement Factories.

Jong Han LEEM ; Jae Hwa CHO ; Eui Cheol LEE ; Jeong Hoon KIM ; Dong Hoon LEE ; Seung Jun LEE ; Ji Young LEE ; Hwan Cheol KIM

Korean Journal of Occupational and Environmental Medicine.2010;22(2):140-145.

OBJECTIVE: This study investigated case clusters of pneumoconiosis among residents near cement factories in Young_Wol, Korea. METHODS: There were 1,396 residents of a total 3,418 residents surveyed for this study. Informations on demographics, health-related behaviors (smoking and drinking), past medical history, and clinical symptoms were collected using a self-administered questionnaire. All study participants underwent a physical examination, including chest X-ray, and physicians' interview. Chest CT (computerized tomography) was taken if there was abnormal finding on chest X-ray and physicians' interview. RESULTS: We detected 5 cases of pneumoconiosis. 2 cases were related to occupational exposure to dust, such as underground mining and the breaking up of concrete. However, 3 cases were not related to occupational or environmental exposure, except that persons were living near cement factories and limestone mines. CONCLUSION: This study suggests that the long-term exposure of cement dust among residents near cement factories and mines may lead to the development of pneumoconiosis.
Calcium Carbonate ; Demography ; Dust ; Environmental Exposure ; Humans ; Korea ; Mining ; Occupational Exposure ; Physical Examination ; Pneumoconiosis ; Questionnaires ; Thorax

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