A 46-year-old man who had worked as a bumper spray painter in an automobile body shop for 15 years developed lung cancer. The patient was a nonsmoker with no family history of lung cancer. To determine whether the cancer was related to his work environment, we assessed the level of exposure to carcinogens during spray painting, sanding, and heat treatment. The results showed that spray painting with yellow paint increased the concentration of hexavalent chromium in the air to as much as 118.33 μg/m(3). Analysis of the paint bulk materials showed that hexavalent chromium was mostly found in the form of lead chromate. Interestingly, strontium chromate was also detected, and the concentration of strontium chromate increased in line with the brightness of the yellow color. Some paints contained about 1% crystalline silica in the form of quartz.
Purpose: The pnuemoconiotic findings on chest radiograph for pneumoconiosis are affected by the technique, the equipment and the reading environment. We report here on the results of evaluating the thoracic radiology of the Medical Institutions for Pneumoconiosis (MIPs). Materials and Methods: For the first time, we visited the MIPs to evaluate the thoracic radiography that is used to treat patients with pneumoconiotic complications, and this included evaluating the equipment and the technical parameters for thoracic radiography, the computed tomography, the education for quality assurance health care and the reading environment. We used the guideline published by the Occupational Safety and Health Research Institute (OSHRI). Ten images were randomly picked from the MIPs for evaluating the image quality, and then these were rated by two experienced chest radiologists for pneumoconiosis according to the criteria of the OSHRI. Results: Of the 33 institutions, the failed group (mean vs. , p vs. , p vs. , p
Background: The aim was to estimate the differences between pulmonary disability grades according to the spirometry reference equations (the Korean equation and the Morris equation).Methods: Spirometry was performed on 16,916 male and 1,353 female special examination for pneumoconiosis, in the period of 2007∼2009.Changes in predictive values for forced expiratory volume in one second (FEV 1 ), forced vital capacity (FVC) and FEV1/FVC and in disability grade were evaluated using both equations.Results: Mean FVCs for men and women were 4,218.7 mL and 2,801.5 mL in predictive values after the application of the Korean equation, and 3,763.9mL and 2,395.6 mL after the Morris equation, respectively.Compared with the Morris equation, the Korean equation showed 10.8% and 14.5% of excesses for men and women (p＜0.001).Mean FEV 1 s for men and women were 3,102.5 mL and 2,107.1 mL in the Korean equation, and 2,667.8mL and 1,699.6 mL in the Morris equation, respectively.Compared with the Morris equation, the Korean equation showed 14.0% and 19.3% of excesses for men and women (p＜0.001).Men and women who showed the changes of disability grades using the Korean equation in place of the Morris equation were 23.9% (4,052/16,916) and 22.9% (311/1,353) on FVC, and 23.1% (3,913/16,916) and 10.7% (145/1,353) on FEV 1 .Conclusion: Applying different reference equations for spirometry has resulted in changes for disability grades in special examination for pneumoconiosis.
Here, we present a case of lung cancer in a 48-year-old male horse trainer. To the best of our knowledge, this is the first such case report to include an exposure assessment of respirable crystalline silica (RCS) as a quartz. The trainer had no family history of lung cancer. Although he had a 15 pack/year cigarette-smoking history, he had stopped smoking 12 years prior to his diagnosis. For the past 23 years, he had performed longeing, and trained 7-12 horses per day on longeing arena surfaces covered by recycled sands, the same surfaces used in race tracks. We investigated his workplace RCS exposure, and found it to be the likely cause of his lung cancer. The 8-hour time weight average range of RCS was 0.020 to 0.086 mg/m(3) in the longeing arena. Horse trainers are exposed to RCS from the sand in longeing arenas, and the exposure level is high enough to have epidemiological ramifications for the occupational risk of lung cancer.
Background: We tried to examine the small airway diseases which can be found early, in workers exposed to inorganic dusts.This is measured in normal breath by using the impulse oscillometry (IOS).Methods: The Pulmonary function test (forced vital capacit [FVC], forced expiratory volume in one second [FEV 1 ], forced expiratory flow between 25% and 75% of vital capacity [FEF 25-75 ]), IOS resistance (Rrs at 5,10,15,20,25, 35 Hz) and reactance (Xrs at 5,10,15,20,25, 35 Hz) were measured for 454 workers.The subjects were classified into 173 workers of normal (38.1%) and 281 patients with pneumoconiosis (61.9%).Results: There were significant differences between normal and patients with FVC (3.82±0.61 vs. 3.53±0.56L), FEV1 (2.67±0.63 vs. 2.35±0.48L), and FEF25-75 (1.88±0.95 vs. 1.47±0.80L/sec) between groups (p＜0.05).And as for IOS, there was no significant difference in resistance (Rrs) (p＞0.05), and there were significant differences between normal and patients with reactance (Xrs) 15 Hz (0.003±0.05 vs. -0.006±0.04kPa/L/s), 20 Hz (0.043±0.05 vs. 0.031±0.04kPa/L/s), and 35 Hz (0.141±0.05 vs. 0.131±0.05kPa/L/s) between groups (p＜0.05). Conclusion:We could find out that 15 Hz, 20 Hz, and 35 Hz values of reactance were significantly influenced by pneumoconiosis.When usefulness and reproducibility to carry out the IOS are considered, it is thought that in future work will be required to draw the reference values for normal Korean persons.
Background: Pulmonary emphysema (PE) is major cause of obstructive pulmonary function impairment (OPFI), which is diagnosed by spirometry.PE by high resolution CT is known to be correlated with OPFI.Recently, low dose CT (LDCT) has been increasingly used for screening interstitial lung diseases including PE.The aim of this study was to evaluate OPFI risks of subjects with PE detected by LDCT compared with those detected by simple digital radiography (SDR).Methods: LDCT and spirometry were administered to 266 inorganic dust exposed retired workers, from May 30, 2007 to August 31, 2008.This study was approved by our institutional review board and informed consent was obtained.OPFI risk was defined as less than 0.7 of forced expiratory volume in one second (FEV1)/forced vital capacity (FVC), and relative risk (RR) of OPFI of PE was calculated by multiple logistic regression analysis.Results: Of the 266 subjects, PE was found in 28 subjects (10.5%) by LDCT and in 11 subjects (4.1%) by SDR; agreement was relatively low (kappa value=0.32,p＜0.001).FEV1 and FEV1/FVC were significantly different between PE and no PE groups determined by either SDR or LDCT.The differences between groups were larger when the groups were divided by the findings of SDR.When PE was present in either LDCT or SDR assays, the RRs of OPFI were 2.34 and 8.65, respectively.Conclusion: LDCT showed significantly higher sensitivity than SDR for detecting PE, especially low grade PE, in which pulmonary function is not affected.As a result, the OPFI risks in the PE group by LDCT was lower than that in the PE group by SDR.
The range of diseases covered by workers' compensation is constantly expanding. However, new regulations are required for the recognition of occupational diseases (ODs) because OD types evolve with changes in industrial structures and working conditions. OD criteria are usually based on medical relevance, but they vary depending on the social security system and laws of each country. In addition, the proposed range and extent of work-relatedness vary depending on the socio-economic conditions of each country. The Labor Standards Act (LSA) and the Industrial Accident Compensation Insurance Act (IACIA) of Korea employ lists based on their requirements without listing causes and diseases separately. Despite a considerable reshuffle in 2003, the basic framework has been maintained for 50 yr, and many cases do not fit into the international disease classification system. Since July 1, 2013, Korea has expanded the range of occupational accidents to include occupational cancers and has implemented revised LSA and IACIA enforcement decrees. There have been improvements to OD recognition standards with the inclusion of additional or modified criteria, a revised and improved classification scheme for risk factors and ODs, and so on.
Background: The aim of this study was to investigate annual changes in pulmonary function in workers who were exposed to inorganic dust.Methods: The subjects were 2,922 male patients who had been diagnosed with pneumoconiosis more than twice during 6 years from 2005 to 2010.Results: Of the 2,922 cases, forced vital capacity (FVC) decreased by 54 mL in 1 year.In contrast, the annual change of forced expiratory volume in one second (FEV 1 ) decreased by 56 mL.Conclusion: This is the first study that has investigated the annual change in pulmonary function in workers exposed to inorganic dust.The results will help estimate the pulmonary condition of patients who are unable to perform a pulmonary function test due to age or a disorder.
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