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Health Effects of Manganese and Some Recent Issues in Manganese Neurotoxicity Research.

Korean Journal of Occupational and Environmental Medicine.2009;21(1):87-105.

INTRODUCTION: This article reviews the health effects of manganese (Mn) and introduces readers to recent issues in Mn neurotoxicity research. METHODS: An extensive Medline search that covered publications up to December 2008 was conducted and the relevant papers and their references were evaluated for review. RESULTS AND DISCUSSION: Exposure to excess levels of the essential trace element Mn produces cognitive, psychiatric, and motor abnormalities. The lungs and the gastrointestinal tract both absorb Mn, but homeostatic mechanisms limit the absorption of Mn by the gastrointestinal tract. Elimination of Mn occurs primarily by excretion into the bile. Average Mn levels in the blood reflect the total body burden on a group basis, but not on an individual basis. Previous studies have shown that blood Mn contributes to a high pallidal signal in a T1-weighted brain MRI and that the high signal is an effective predictor of neurobehavioral performance. Thus, a high pallidal signal on an MRI may offer clues concerning the target organ dose from Mn exposure in the spectrum of Mn symptomatology. Neuroimaging as well as a clinical evaluation with exposure history is very important in a differential diagnosis that can distinguish manganism from Parkinson disease (PD). Recent research on Mn neurotoxicity has focused on several issues. First, concerns about the interaction between manganism and PD have been raised, but further research is needed. Second, epidemiological studies on non-occupational Mn exposure have suggested that environmentally induced neurotoxicities may have features that are different from the classic features of occupational manganism, but, again, this requires further research. Third, liver cirrhosis could be used as a model of manganism. Finally, functional neuroimaging such as magnetic resonance spectroscopy, functional MRI, or diffusion tensor imaging appears to have promising applications in Mn research. CONCLUSION: Reviewing the health effects of Mn and recent issues in Mn neurotoxicity research provides us with important suggestions for how to pursue other lines of toxicological research as well as for how best to develop a systematic understanding of Mn symptomatology.
Absorption ; Bile ; Body Burden ; Brain ; Diagnosis, Differential ; Diffusion Tensor Imaging ; Functional Neuroimaging ; Gastrointestinal Tract ; Liver Cirrhosis ; Lung ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Manganese ; Neuroimaging ; Parkinson Disease

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The Relationship between Job Stress and Depressive Symptoms in Migrant Workers in Kyung-gi Province in Korea.

Sun Wung LEE ; Kyoo Sang KIM ; Tae Gyun KIM ; Hyang Woo RYU ; Mi Young LEE ; Yong Lim WON ; Yoon Hee SONG

Korean Journal of Occupational and Environmental Medicine.2009;21(1):76-86.

OBJECTIVES: To investigate the mental health status of migrant workers. We focused on the relationship between depressive symptoms and job stress. METHEOD: A questionnaire was administered to 488 migrant workers who visited NGO migrant worker centers located in Kyung-gi province. A structured, self-reported questionnaire was used to assess each responder's sociodemographics, work related characteristics, health behaviors, past medical history, job stress and depression symptoms. The job stress questionnaire was used according to KOSS-26 and depression symptoms were measured using CES-D, which was translated into Korean. We used multiple logistic regression analysis to assess the relationship between risk factors included job stress and depression symptoms. RESULTS: The prevalence of depression symptoms in survey subjects was 25.2%, but the prevalence of non-Chinese nationalities and illegal workers were 32.1% and 32.8%, respectively. Adjusting for confounding factors, job stress (OR 2.55, 95% CI=1.30-4.99) had a statistical meaningful relationship with depression symptoms. Among job stress domains, physical environment (OR 2.97, 95% CI=1.59-5.53), job demand (OR 2.33, 95% CI=1.26-4.32) and occupational climate(OR 3.10, CI=1.49-6.48) were most likely to experience depression symptoms. CONCLUSIONS: The prevalence of depressive symptoms among the study subjects was similar to the prevalence among the general population in Korea, but higher than that among the Korean workers. In particular, the prevalence among non-Chinese and illegal workers was higher. However, the job stress factor appeared to have a more direct correlation with depressive symptoms than the sociodemographic factors of nationality or residential status. Hence, in order to prevent depressive symptoms of the migrant workers, we believe that intervention on job stress is necessary.
Depression ; Ethnic Groups ; Health Behavior ; Humans ; Korea ; Logistic Models ; Mental Health ; Prevalence ; Questionnaires ; Risk Factors ; Transients and Migrants

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Framingham Risk Scores by Occupational Group: Based on the 3rd Korean National Health and Nutrition Examination Survey.

Min Chul CHOI ; Yoon Hee SONG ; Sang Youl RHEE ; Jeong Taek WOO

Korean Journal of Occupational and Environmental Medicine.2009;21(1):63-75.

OBJECTIVES: To find differences in Framingham risk scores which predict the probable risk of future cardiovascular disease, among three different occupational categories. METHODS: Subjects were selected from respondents of the 3rd Korean National Health and Nutrition Examination Survey. A total of 2,059 employed people between 20 to 59 years old were selected. The occupational categories were professional and office workers, salespeople and service workers and technicians and elementary occupations. The Framingham risk score was calculated to find the risk of cardiovascular disease within the next 10 years. In addition socio-demographic characteristics, life-styles, the prevalence of chronic disease, and cardiovascular disease were compared among the occupational categories. RESULTS: The average Framingham risk score was 2.77+/-6.44 for professional and office workers (n=771), 5.95+/-6.10 for salespeople and service workers (n=603) and 7.07+/-5.87 for technician and elementary occupations (n=685) Statistically significant multiple regression equations were derived (p<0.001). CONCLUSIONS: Framingham risk scores of technicians and elementary occupations were highest which suggests that this occupational group has the highest risk of cardiovascular disease.
Cardiovascular Diseases ; Chronic Disease ; Data Collection ; Humans ; Nutrition Surveys ; Occupational Groups ; Occupations ; Prevalence

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Occupational Chronic Obstructive Pulmonary Disease Cases Evaluated by Workers' Compensation in Korea.

Hwa Pyung LEE ; Dong Hee KOH ; Eui Cheol LEE

Korean Journal of Occupational and Environmental Medicine.2009;21(1):53-62.

OBJECTIVES: To analyse the characteristics of occupational COPD (Chronic obstructive pulmonary disease) cases that were evaluated by the Occupational Safety and Health Research Institute (OSHRI) of the Korea Occupational Safety & Health Agency (KOSHA). METHODS: Using the OSHRI database from KOSHA, we collected 13 cases of occupational COPD that had been evaluated from 1998 to 2007. RESULTS: Four cases had been evaluated as occupational COPD: 1) a nonsmoking road sweeper exposed to automobile exhaust gases and trash dust; 2) an oxygen welding worker exposed to cadmium fumes; 3) a cotton mill air conditioner cleaning worker exposed to cotton dust; and 4) a foundry grinding worker exposed to dust, gases, vapors and fumes. Nine cases had been evaluated as non-occupational COPD: 1) 4 cases in which smoking was determined to be the main cause rather than occupational exposure; 2) 1 case that was evaluated as another respiratory disease (severe tuberculosis sequelae); 3) 1 case that had been misdiagnosed as COPD; 4) 2 cases in which the exposure levels in the workplace environments were too low; and 5) 1 case that had developed before the employment. Among these 13 cases, a shipyard grinding worker had been evaluated in 2006 as having had a low occupational hazard, but a similar case (a foundry grinding worker) was evaluated as having had a high hazard in 2007. CONCLUSIONS: Proper evaluation of occupational COPD demands an accurate diagnosis of COPD itself and also the exclusion of other respiratory diseases that have similar symptoms; an investigation of the relevant occupatioonal hazards and the amount of the exposure; and a consideration of smoking history. The evaluation should also take into account any substantial loss of life due to occupational hazards as well as any disease-free periods.
Academies and Institutes ; Cadmium ; Dust ; Employment ; Gases ; Korea ; Occupational Exposure ; Occupational Health ; Oxygen ; Pulmonary Disease, Chronic Obstructive ; Smoke ; Smoking ; Tuberculosis ; Vehicle Emissions ; Welding ; Workers' Compensation

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A Case of Lead Poisoning by Ingesting Herbal Pills Tainted by Lead during the Manufacturing Process.

Young Hoo SHIN ; Jun Seok SON ; Young Wook KIM ; Chang Ho CHAE ; Ja Hyeon KIM ; Chan Woo KIM ; Jun Ho LEE

Korean Journal of Occupational and Environmental Medicine.2010;22(3):271-277.

BACKGROUND: This is a case report of lead poisoning after herbal pill ingestion. We report this case here as a reminder that contamination during the manufacturing process is an important issue regarding herbal pills. Case Report: A 37-year-old male was admitted to the hospital with abdominal pain caused by cholecystitis. He was transferred to the Department of Occupational and Environmental Medicine on 26 December 2008, because of anemia. On follow-up examination post cholecystectomy, the patient had increasing blood lead levels. There was no specific finding in his medical history, but he had been taking herbal pills for 3 months to treat dyspepsia. We performed an analysis on the herbal pills, and determined a lead concentration of 1485 mg/kg. When he was admitted to the hospital, the patient had a blood lead level of 84.13 microgram/dL and a zinc protoporphyrin level was 230 microgram/dL. The patient was treated with 250 mg of Penicillamine, 4 times per day. During follow-up 3 weeks later, the patient's blood lead level had been reduced to 36.52 microgram/dL which allowed us to take him off of Penicillamine. By 7 months follow-up, the patient's blood lead concentration had fallen from 36.52 microgram/dL to 20.93 microgram/dL. CONCLUSION: Lead poisoning was confirmed by analyzing blood lead levels and the cause was herbal pills. Upon analysis of the herbal pills, we have discovered that the herbal pills contained an amount of lead acquired during the manufacturing process, based on the high levels of this heavy metal in comparison to other metals. Private herbal pill manufacturing plants need systematic management and oversight.
Abdominal Pain ; Adult ; Anemia ; Cholecystectomy ; Cholecystitis ; Dyspepsia ; Eating ; Environmental Medicine ; Follow-Up Studies ; Humans ; Lead Poisoning ; Male ; Metals ; Penicillamine ; Protoporphyrins ; Zinc

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Influencing Factors in Approving Cerebrovascular and Cardiovascular Diseases as Occupational Disease in Seoul.

Tae Kyung LEE ; Soo Geun KIM ; Jong Uk WON ; Tae Won JANG ; Seong Sik CHO ; Young Su JU ; Young Jun KWON ; Hyoung June IM

Korean Journal of Occupational and Environmental Medicine.2010;22(3):262-270.

OBJECTIVES: This study was performed to analyze the factors that affected the decision making process in approving workers' compensation claims for cerebrovascular and cardiovascular diseases cases that occurred just before refoming approval standards of Industrial Accident Compensation Insurance Act on 1 July 2008 and to provide fundamental information in preparing better standards. METHODS: We examined 283 claims cases involving cerebrovascular and cardiovascular diseases that occurred between 1 January, 2006 and 31 December, 2007 and collected data based on the worker's compensation records from 3 Seoul Regional Centers of the Workers' Compensation & Welfare Service. We analyzed the approval rates and odds ratios according to the general characteristics, injury information, past medical histories, and work related information using chi-square or univariate logistic regression. In addition, we identified the factors affecting the approval using multivariate logistic regression. RESULTS: Overall, 101 of the 283 cases were approved and approval rate was 35.7%. Approval rates differed significantly according to type of disease, survival, accident site, accident time, the presence of associated disease and overwork (p-value <0.05). In the multivariate logistic regression analysis with adjusted for age and sex, approval rate of death cases with associated disease was lower than cases without associated disease (OR 0.22, 95% CI 0.12~0.42). Approval rate of cases occurred in worksite was higher than others (OR 4.81, 95% CI 2.22~10.40). Cases of accepted overwork had a higher approval rate significantly than cases of not accepted (OR 28.53, 95% CI 9.74~83.52). CONCLUSION: Factors in approving cases of cerebrovascular and cardiovascular disease as cases involving occupational disease included conditions of overwork, high rate of accidents in the workplace and the presence of associated disease. It is necessary to investigate further behaviors of work and chronic work-related stress.
Accidents, Occupational ; Cardiovascular Diseases ; Compensation and Redress ; Decision Making ; Insurance ; Logistic Models ; Occupational Diseases ; Odds Ratio ; Workers' Compensation ; Workplace

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The Concentration of Cadmium in Urine, and Its Role in Health-risk Assessment of Residents in the Vicinity of Abandoned Mines in Gyeongsangbuk-do, Korea.

Sung Ho YUN ; Chang Yoon KIM ; Tae Yoon HWANG ; Kyu Chang WON ; Jun Young DO ; Se Jin LEE ; Yeong Mog PARK ; Kwan Soo JUN ; Gae Ho LEE ; Do Young LEE ; Kwang Seub PARK ; Joon SAKONG

Korean Journal of Occupational and Environmental Medicine.2010;22(3):251-261.

OBJECTIVES: This study was conducted to assess the concentration of urine cadmium and health risks of residents in the vicinity of abandoned metal mines in Gyeongsangbuk-do. METHODS: The concentration of cadmium in the soil, water, and agricultural crops was measured in Gyeongsangbuk-do, Butdeun and Suksan, which have abandoned metal mines. We measured the concentration of cadmium in the urine of residents from the following areas: 78 from village A, 99 from village C and 147 from control areas. Other health-risk assessments were performed on each resident, such as measuring the concentration of beta2-MG and a bone density test. RESULTS: In abandoned mine areas, the mean concentration of cadmium was higher in agricultural soil and in the crops than in that of control areas. The concentration of cadmium in the stream exceeded the guideline level. In regard to provisional tolerable daily intake (PTDI) of cadmium, the actual intake rate through crops was 33.81%, 72.74% in abandoned mine areas and 5.03%, 6.16% in control areas. Residents in abandoned mine areas, A village and C village had a geometric mean of urine Cd of 1.90 microgram/g cr and 1.45 microgram/g cr. These measurements were significantly higher than those of residents in control areas, B village and D village, 0.59 microgram/g cr and 0.65 microgram/g cr (p<0.01). Following adjustments for age, sex, smoking habit, and occupational history, the concentration of urine cadmium of residents in the Butdeun abandoned meta mine was higher by 1.62 microgram/g cr as compared with the control group (p<0.01). Residents from the Suksan abandoned metal mine also had a higher concentration by 1.07 microgram/g cr (p<0.01). A multiple linear regression analysis was performed for the factors associated with T-score, and this showed that the concentration of urine cadmium was not an influential factor. CONCLUSIONS: Based on these measurements, areas with abandoned metal mines contaminated streams, agricultural soil, and crops of the adjacent areas, with cadmium. Because residents in the adjacent areas intake contaminated crops, their urine cadmium was increased. Despite a lack of evidence demonstrating the detrimental effect of increased urine cadmium in residents, an additional study is needed to assess the health risks of residents in the vicinity of abandoned metal mines.
Bone Density ; Cadmium ; Crops, Agricultural ; Korea ; Linear Models ; Rivers ; Smoke ; Smoking ; Soil ; Water

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Self-rated Health Level Comparisons by the Criteria of Precarious Employment Status: The Korean Labor and Income Survey.

Keunwhoe KIM ; Hun Jong CHUNG ; Sounghoon CHANG ; Hyeongsu KIM ; Daehee NOH ; Kyunghee JUNG-CHOI

Korean Journal of Occupational and Environmental Medicine.2010;22(3):240-250.

OBJECTIVE: The purpose of this paper is to analyze the effects of precarious employment status on the level of self-rated health, based on various criteria, by participants in the Korean Labor and Income Panel Survey. METHODS: Data were obtained from 3,268 subjects(2,057 men and 1,211 women), who participated in the 2005-2006 Korean Labor and Income Panel Survey. Group A was classified as Non-precarious employment by both the Ministry of Labor (MoLab) and the Korea Labor and Society Institute (KLSI). The group B was classified as Non-precarious employment by the MoLab and as precarious employment by the KLSI. The group C is classified as Non-precarious employment by both MoLab and KLSI. Outcome variables were self-rated health and a panel logistic regression analysis was performed on the data. RESULTS: The level of self-rated health was worse among group B males (OR: 1.45, C.I:1.00~2.11) and group C males (OR: 1.69, C.I:1.35~2.10) compared to group A males. A substantial difference(57.8%) in the level of self-rated health between groups A and B was attributed to the sociodemographic characteristics of the populations. The difference in self-rated health between groups A and C was explained by work environments(15.7%), as well as by sociodemographic characteristics(26.1%). For female workers, the level of self-rated health in group B and C was worse than in group A, but this finding was not statistically significant. CONCLUSIONS: These findings suggested that the policy to improve the working environment, as well as a more comprehensive effort to reduce the disparity, is needed for the precarious employment worker.
Employment ; Female ; Health Status ; Humans ; Korea ; Logistic Models ; Longitudinal Studies ; Male

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Characteristics of Occupational Lung Cancer from 1999 to 2005.

Jung Wook LIM ; So Young PARK ; Byung Soon CHOI

Korean Journal of Occupational and Environmental Medicine.2010;22(3):230-239.

OBJECTIVES: The aim of this study was to investigate the characteristics of occupational lung cancer. METHODS: We analyzed the characteristics of 53 occupational lung cancer cases among 128 lung cancer cases applied for industrial accident compensation insurance benefits and referred for the decision of work-relatedness between 1999 and 2005. Statistical analysis was conducted using the Chi-square test on 128 lung cancer cases. RESULTS: The age of diagnosis, smoking history, and cell type of lung cancer cases were not significantly different between 53 cases of occupational lung cancer and 75 cases of non-occupational lung cancer (p>.05). Here is a list of occupational lung cancer case numbers associated with certain carcinogens were: 33(62.3%) cases with asbestos, 23(43.4%) cases with polycyclic aromatic hydro carbon (PAH), 17 cases(32.1%) with chromium VI (Oxidation state), 14 cases(26.4%) with crystalline silica, 12 cases (22.6%) with nickel compounds, 2 cases(3.8%) with radon daughters, and 1 case(1.9%) with arsenic. Eighteen cases(34.0%) of occupational lung cancer had exposures to a single carcinogen, and 35 cases (66.0%) had exposures to more than 2 carcinogens. Job types associated with occupational lung cancer cases were: 16 cases(30.2%) with maintenance, 13 cases(24.5%) with welding; 6 cases(11.3%) with grinding; 4 cases(7.5%) with foundry; 3 cases(5.7%) with driving, casting, and painting' and 14 cases (26.4%) with 'other'. CONCLUSIONS: This study identified the characteristics of occupational lung cancer through the analysis of the age of diagnosis, smoking history, cell type, job, and carcinogen. There is no difference between occupational lung cancer and non-occupational lung cancer except exposure to the carcinogens. these results indicate that past exposure to occupational carcinogens remains an important determinant of occupational lung cancer occurrence.
Accidents, Occupational ; Arsenic ; Asbestos ; Carbon ; Carcinogens ; Chromium ; Compensation and Redress ; Crystallins ; Insurance Benefits ; Lung ; Lung Neoplasms ; Nickel ; Occupational Health ; Radon Daughters ; Silicon Dioxide ; Smoke ; Smoking

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The Relationship between Job Stress and Dyslipidemia in Express Bus Drivers.

Nam Soo LEE ; Kyung Jae LEE ; Joo Ja KIM ; Jin Woo LEE

Korean Journal of Occupational and Environmental Medicine.2010;22(3):221-229.

OBJECTIVES: To examine whether or not there is a relationship between job stress and dyslipidemia in male express bus drivers. METHODS: The study subjects were 301 male express bus drivers. The data was obtained from annual health surveillance. A structured questionnaire was used to assess sociodemographics, health-related behaviors and job characteristics. Job stress was measured by the Korean Occupational Stress Scale-Short Form. A measure of blood lipid levels, comprised of total cholesterol, HDL cholesterol, LDL cholesterol and triglycerides, was dichotomized and categorized into 'high' or 'low'. Multiple logistic regression modeling was used to determine an association between job stress and dyslipidemia, with blood lipid level as the dependent variable. RESULTS: We found that high job demand was associated with high total cholesterol (OR 3.25, 95% CI 1.18-8.95) and high LDL-cholesterol (OR 4.14, 95% CI 1.18-14.44) and lack of job control was associated with low HDL-cholesterol (OR 1.92, 95% CI 1.04-3.56). CONCLUSION: These results indicate that job demand and lack of job control were associated with dyslipidemia in male express bus drivers. A job stress management program that emphasizes job demand and lack of job control is needed to prevent dyslipidemia in male express bus drivers.
Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Dyslipidemias ; Humans ; Logistic Models ; Male ; Questionnaires ; Triglycerides

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