We examined associations between hospital quality in the workers' compensation system and injured patients' return to work after controlling for injury severity, occupational factors, and demographic factors. Return to work data of injured workers were constructed from 2 datasets: 23,392 patients injured in 2009-2011 from the Korea Workers' Compensation & Welfare Service and return to work data from Korea Employment Information Services. After de-identifying the data, quality scores were matched for each hospital that cared for injured patients. Injury severity was measured by Abbreviated Injury Scales. Relative risk and 95% confidence interval were calculated using log binomial regression models. After adjusting for age, sex, injury severity, occupation, factory size, city, and hospital type, the relative risk (95% confidence interval) for the total score was 1.04 (1.02-1.06), 1.06 (1.04-1.09), and 1.07 (1.05-1.10) in the 2nd, 3rd, and 4th quartiles, respectively, compared to the 1st quartile. The RR (95% CI) in the 2nd, 3rd, and 4th quartiles was 1.05 (1.02-1.07), 1.05 (1.02-1.08), and 1.06 (1.04-1.09) for the process score; and 1.02 (1.01-1.04), 1.05 (1.03-1.07), and 1.06 (1.04-1.09) for the outcome score compared to the 1st quartile score, respectively. In conclusion, our study design with blinded merge methods shows that total, process, and outcome qualities are related to the return to work of injured workers after controlling for other factors.
Adult ; Databases, Factual ; Demography ; Disability Evaluation ; Female ; Hospitals ; Humans ; Male ; Middle Aged ; Occupational Diseases/*pathology/rehabilitation ; Odds Ratio ; *Quality Assurance, Health Care ; Republic of Korea ; *Return to Work ; Risk ; Severity of Illness Index ; Workers' Compensation

OBJECTIVETo discuss the clinical features of Indium-related lung diseases.

METHODSWe searched database of Chinese and Pubmed, Embase, Web of Science to collect research data of indium-related lung diseases from Jan. 1998 to Aprl. 2014. Case reports, exposure histories and lab results were analysed and summarized.

RESULTS1998 to Mar 2010, ten cases of indium-related lung diseases were published. Seven cases of interstitial pneumonia were reported in Japan, two cases of pulmonary alveolar proteinosis (PAP) were reported in the USA and one case of PAP reported in China. Chest computer tomography (CT) showed diffuse or local ground glass appearance (GGA) in 8 cases, 3 of which also showed centrilobular nodules; Pulmonary function test were normal only in one out of 8 cases. Cholesterol clefts were found in 4 cases of interstitial pneumonia. 3 cases died among 6 cases who were followed-up.

CONCLUSIONSOccupational exposure to indium compounds are contributory to different pulmonary diseases, which are composed of interstitial pneumonia and pulmonary alveolar proteinosis. The relationships between In-C, In-S and these pulmonary diseases are unclear.

China ; Glass ; Humans ; Indium ; toxicity ; Japan ; Lung Diseases, Interstitial ; etiology ; pathology ; Occupational Exposure ; adverse effects ; Pulmonary Alveolar Proteinosis ; etiology ; pathology ; Respiratory Function Tests ; Tomography, X-Ray Computed

OBJECTIVETo analyze the clinical features and investigate the clinical diagnostic methods of hard metal lung disease (HMLD), then provide reference for the diagnostic criteria of occupational HMLD.

METHODSRetrieved the open published case reports associated with HMLD from January, 2000 to June, 2014. Regarding the ages, sex, types and years of work, clinical features and laboratory results for analyzing.

RESULTSCollected 21 clinical cases of HMLD belonged to 6 internal reports and 15 oversea reports. Among them 15 male and 6 female, ages were from 22 to 58, length of service between 1 year and 43 years. Clinical presentations included cough (20 cases), dyspnea on progressive (10 cases), and pulmonary function testing showed a restrictive abnormality. The imaging features presented as bilateral areas of ground-glass attenuation, diffuse small nodules, extensive reticular opacities and traction bronchiectasis. The finding of giant cell interstitial pneumonia (GIP) was almost pathognomonic for hard metal pneumoconiosis. The main pathological findings contained a different levels of lymphocyte, acidophilic cell infiltration, hyperplasia of fibrous tissue and numerous large multinucleated histiocytes which ingested inflammatory cells were admixed with macrophages. 16 cases of the 21 reports showed GIP.

CONCLUSIONSClinical presentations include cough and dyspnea on progressive, and pulmonary function testing show a restrictive abnormality. The imaging features present as bilateral areas of ground-glass attenuation, areas of consolidation, diffuse small nodules, extensive reticular opacities and traction bronchiectasis. The prime pathological findings contain interstitial pneumonia with intra-alveolar macrophages and a large amount of multinucleated histiocytes.

Adult ; Alloys ; Cobalt ; Female ; Humans ; Lung ; physiopathology ; Lung Diseases, Interstitial ; pathology ; Macrophages, Alveolar ; Male ; Middle Aged ; Occupational Diseases ; pathology ; Pneumoconiosis ; pathology ; Tungsten ; Young Adult

Coal workers' pneumoconiosis (CWP) is characterized as a chronic inflammation of the lung associated with activation of macrophages and endothelial cells in the lung. The aim of the present study was to compare the levels of serum interleukin-8 (IL-8), macrophage inflammatory protein-1alpha (MIP-alpha), and intercellular adhesion molecule-1 (ICAM-1) as biomarkers for progressive massive fibrosis (PMF) in 106 subjects (27 non-CWP and 79 CWP patients). The levels of serum IL-8 (P<0.001) and ICAM-1 (P=0.001) of subjects with PMF were higher than those of non-CWP subjects. The IL-8 levels of PMF subjects were also higher than those of simple CWP subjects (P=0.003). Among the subjects without PMF, IL-8 levels in the subjects with International Labour Organization (ILO) category II or III were higher than those in the subjects with ILO category 0 (P=0.006) and with category I (P=0.026). These results suggest that high serum levels of IL-8 and ICAM-1, which are important as neutrophil attractants and adhesion molecules, are associated with PMF.
Aged ; Anthracosis/*blood/pathology ; Biological Markers/blood ; Chemokine CCL3/*blood ; Coal Mining ; Humans ; Intercellular Adhesion Molecule-1/*blood ; Interleukin-8/*blood ; Lung/pathology ; Male ; Middle Aged ; Occupational Diseases/blood/pathology ; Pulmonary Fibrosis/*blood/pathology

Coal workers' pneumoconiosis (CWP) is characterized as a chronic inflammation of the lung associated with activation of macrophages and endothelial cells in the lung. The aim of the present study was to compare the levels of serum interleukin-8 (IL-8), macrophage inflammatory protein-1alpha (MIP-alpha), and intercellular adhesion molecule-1 (ICAM-1) as biomarkers for progressive massive fibrosis (PMF) in 106 subjects (27 non-CWP and 79 CWP patients). The levels of serum IL-8 (P<0.001) and ICAM-1 (P=0.001) of subjects with PMF were higher than those of non-CWP subjects. The IL-8 levels of PMF subjects were also higher than those of simple CWP subjects (P=0.003). Among the subjects without PMF, IL-8 levels in the subjects with International Labour Organization (ILO) category II or III were higher than those in the subjects with ILO category 0 (P=0.006) and with category I (P=0.026). These results suggest that high serum levels of IL-8 and ICAM-1, which are important as neutrophil attractants and adhesion molecules, are associated with PMF.
Aged ; Anthracosis/*blood/pathology ; Biological Markers/blood ; Chemokine CCL3/*blood ; Coal Mining ; Humans ; Intercellular Adhesion Molecule-1/*blood ; Interleukin-8/*blood ; Lung/pathology ; Male ; Middle Aged ; Occupational Diseases/blood/pathology ; Pulmonary Fibrosis/*blood/pathology

OBJECTIVEWe sought to master the clinical characteristics and prognosis of hard mental lung disease, improving this disease's diagnosis and treatment quality.

METHODSWe recruited two suspected patients with hard mental lung disease and collected their occupational history, examination results of occupational health, and past medical records. By virtue of laboratory tests, high Kv chest radiography, CT and HRCT of chest, fiberoptic bronchoscopy and ECG examination, diagnostic report was synthesized respectively by respiratory physicians and pathologist from three different agencies. Then the report was submitted to diagnosis organizations of occupational disease, and diagnostic conclusion of occupational disease was drawn after discussion by at least three diagnosticians of occupational disease.

RESULTSWe found that both of the two suspected patients were exposed to dusts of hard metal, and length of exposure service ranged from 8 to 9 years. Clinical manifestations were dominated by dry cough, wheezing after activities, and pathological manifestation was characteristic giant cell interstitial pneumonia. The prognosis and outcome of the disease were different.

CONCLUSIONAccording to exact occupational exposure history, clinical manifestations, combined with the results of high Kv chest radiography, CT of chest and pathological manifestation, it can be diagnosed with hard mental lung disease.

Alloys ; adverse effects ; Bronchoscopy ; Cobalt ; adverse effects ; Dust ; Humans ; Lung ; pathology ; Lung Diseases ; diagnosis ; etiology ; Occupational Diseases ; diagnosis ; etiology ; Occupational Exposure ; adverse effects ; Tungsten ; adverse effects

Standards for the recognition of occupational diseases (ODs) in Korea were established in 1954 and have been amended several times. In 2013, there was a significant change in these standards. On the basis of scientific evidence and causality, the International Labour Organization list, European Commission schedule, and compensated cases in Korea were reviewed to revise the previous standards for the recognition of ODs in Korea. A disease-based approach using the International Classification of Diseases (10th version) was added on the previous standards, which were agent-specific approaches. The amended compensable occupational neurological disorders and occupational mental disorders (OMDs) in Korea are acute and chronic central nervous system (CNS) disorders, toxic neuropathy, peripheral neuropathy, manganese-related disorders, and post-traumatic stress disorder. Several agents including trichloroethylene (TCE), benzene, vinyl chloride, organotin, methyl bromide, and carbon monoxide (CO) were newly included as acute CNS disorders. TCE, lead, and mercury were newly included as chronic CNS disorders. Mercury, TCE, methyl n-butyl ketone, acrylamide, and arsenic were newly included in peripheral neuropathy. Post-traumatic stress disorders were newly included as the first OMD. This amendment makes the standard more comprehensive and practical. However, this amendment does not perfectly reflect the recent scientific progress and social concerns. Ongoing effort, research, and expert consensus are needed to improve the standard.
Female ; Humans ; Mental Disorders/chemically induced/*economics/pathology ; Nervous System Diseases/chemically induced/*economics/pathology ; Occupational Diseases/*economics ; Occupational Exposure ; Republic of Korea ; Stress Disorders, Post-Traumatic/diagnosis/*economics ; Workers' Compensation/*economics

The Korean list of occupational skin diseases was amended in July 2013. The past list was constructed according to the causative agent and the target organ, and the items of that list had not been reviewed for a long period. The revised list was reconstructed to include diseases classified by the International Classification of Diseases (10th version). Therefore, the items of compensable occupational skin diseases in the amended list in Korea comprise contact dermatitis; chemical burns; Stevens-Johnson syndrome; tar-related skin diseases; infectious skin diseases; skin injury-induced cellulitis; and skin conditions resulting from physical factors such as heat, cold, sun exposure, and ionized radiation. This list will be more practical and convenient for physicians and workers because it follows a disease-based approach. The revised list is in accordance with the International Labor Organization list and is refined according to Korean worker's compensation and the actual occurrence of occupational skin diseases. However, this revised list does not perfectly reflect the actual status of skin diseases because of the few cases of occupational skin diseases, incomplete statistics of skin diseases, and insufficient scientific evidence. Thus, the list of occupational diseases should be modified periodically on the basis of recent evidence and statistics.
Burns, Chemical/pathology ; Dermatitis, Contact/pathology ; Humans ; Occupational Diseases/*economics ; Occupational Exposure ; Republic of Korea ; Skin/*pathology ; Skin Diseases/*economics/*pathology ; Skin Diseases, Infectious/pathology ; Stevens-Johnson Syndrome/pathology ; Vitiligo/pathology ; Workers' Compensation/*economics

The respiratory system is one of the most important body systems particularly from the viewpoint of occupational medicine because it is the major route of occupational exposure. In 2013, there were significant changes in the specific criteria for the recognition of occupational diseases, which were established by the Enforcement Decree of the Industrial Accident Compensation Insurance Act (IACIA). In this article, the authors deal with the former criteria, implications of the revision, and changes in the specific criteria in Korea by focusing on the 2013 amendment to the IACIA. Before the 2013 amendment to the IACIA, occupational respiratory disease was not a category because the previous criteria were based on specific hazardous agents and their health effects. Workers as well as clinicians were not familiar with the agent-based criteria. To improve these criteria, a system-based structure was added. Through these changes, in the current criteria, 33 types of agents and 11 types of respiratory diseases are listed under diseases of the respiratory system. In the current criteria, there are no concrete guidelines for evaluating work-relatedness, such as estimating the exposure level, latent period, and detailed examination methods. The results of further studies can support the formulation of detailed criteria.
Alveolitis, Extrinsic Allergic/economics/pathology ; Asbestosis/economics/pathology ; Asthma/economics/pathology ; Humans ; Lung Diseases/*economics ; Occupational Diseases/*economics ; Occupational Exposure ; Pneumoconiosis/economics/pathology ; Pulmonary Disease, Chronic Obstructive/economics/pathology ; Republic of Korea ; Workers' Compensation/*economics

Isolated laryngeal histoplasmosis is a very rare entity. It has variable clinical presentations that might mimic both benign and malignant lesions, and is usually associated with pulmonary and other disseminated forms of histoplasmosis. Herein, we report a case of primary laryngeal histoplasmosis without the involvement of other systems in a 70-year-old Chinese man, who previously worked as a miner. He presented with a history of hoarseness for two months, with no other associated symptoms. Direct laryngoscopy revealed irregularity of the posterior one-third of both vocal folds. Histopathological examination revealed the presence of Histoplasma capsulatumon periodic acidSchiff and Grocott's methenamine silver staining. The lesion resolved after one month of oral itraconazole treatment. However, the patient had to complete six months of antifungal treatment to prevent recurrence.
Aged ; Amphotericin B ; therapeutic use ; Antifungal Agents ; therapeutic use ; Histoplasma ; isolation & purification ; Histoplasmosis ; diagnosis ; drug therapy ; microbiology ; Humans ; Laryngitis ; diagnosis ; drug therapy ; microbiology ; Laryngoscopy ; Larynx ; microbiology ; pathology ; Male ; Occupational Diseases ; diagnosis ; drug therapy ; microbiology ; Occupational Exposure ; adverse effects