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정호근,임정기,최병순 大韓産業醫學會 1997 대한직업환경의학회지 Vol.9 No.3
For the initial step of quality assurance program for the reading of pneumoconiosis, we developed 85 simple chest P-A films by stepwise panel readings of 8 highly qualified radiologists. Intra-reader reliability(overall kappa value) for the pneumoconiotic findings of 76 films except films for differential diagnosis by 6 radiologists participating in the panel readings was as follows: 0.44 and 0.73 in profusion by complete and short classification, 0.45 and 0.40 in primary and secondary small opacity, 0.62 in extent of small opacity, 0.67 and 0.22 in costophrenic angle(CPA) obliteration and diffuse pleural thickening(DPT). Interreader reliability was as follows: 0.40 and 0.67 in profusion by complete and short classification, 0.48 and 0.43 in primary and secondary small opacity, 0.54 in extent of small opacity, 0.60 and 0.30 in CPA obliteration and DPT. Pneumoconiotic findings of the 44 films selected from the above 76 films were compared with those of 39 radiologists working in agencies for specific health screening, agency for pneumoconiosis, and other university hospitals. According to the category, profusion(excluding 0/0 category) agreed completely in 10-40% of the corresponding small opacity and 55-80% of the large opacity by complete classification. Within 1 minor category 55.85% of films agreed. By short classification it agreed in 50-80% and 91.2% of small and large opacity respectively. Shape and size of primary and secondary small opacity agreed completely in 41.0% and 23.2%, and extent of small opacity agreed in 47.9%. Only in the films read as pneumoconiosi by readers, 51.3% and 29.8% of primary and secondary small opacity agreed in shape and size, and 60.4% in extent. In CPA obliteration and DPT, 81.8% and 78.3% of the corresponding films agreed respectively. Considering the above results, it is necessary to develop educational and quality assurance program for increase of reading agreement.
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Current Status of Pneumoconiosis Patients in Korea
최병순,박소영,이정오 대한의학회 2010 Journal of Korean medical science Vol.25 No.-
This study identifies the number of pneumoconiosis patients after eliminating deceased patients between 2003 and 2008 as of January 1st and estimates it for the next five years. From 2003 to 2008, the pneumoconiosis patients were 16,929, 17,224, 17,366, 17,566,17,542, and 17,546, respectively. The number of pneumoconiosis patients will have increased by 1,014 from 2008 to 18,560 in 2013 after applying the average change rates taken from 2003 to 2007. It takes 15-20 yr to develop coal workers’ pneumoconiosis (the main cause in Korea) and patients will continue to be diagnosed with pneumoconiosis for some years to come since it has only been 20 yr since the decline of the coal mining industry in Korea. In addition, pneumoconiosis patients are increasing in industries in which the risk of pneumoconiosis was relatively low shows the necessity to improve dust-exposed workplace environments.
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최병순 大韓産業醫學會 1997 대한직업환경의학회지 Vol.9 No.4
To find the factors affecting reading agreement of pneumoconiotic findings of simple chest P-A films and to develop the definite quality assurance (Q.A) program for the reading of pneumoconiosis, I gathered the reading reports of the previously developed forty four chest films from nationwide thirty nine radiologists and compared those with the findings decided by the stepwise panel readings of the highly qualified eight radiologists. The reading agreement of profusion by complete of short classification was higher in the radiologists with sufficient reading experiences of pneumoconiosis during residency training. It was also higher in the radiologists with reference to ILO standard films or those working in the agencies for pneumoconiosis within one category of profusion by complete classification. Other factors were not related with the reading agreement of profusion. In small opacity and pleural thickening, there were not any consistent and meaningful findings between the reading agreement and radiologists' characteristics. From the above results, it is necessary to develop the Q.A program to improve the reading agreement of pneumoconiotic findings, especially small opacity and pleural lesions.
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최병순,채정욱,Choi, Byung-Soon,Chae, Jeong-Uk 한국농촌의학지역보건학회 1998 농촌의학·지역보건 Vol.23 No.2
To find health problems of Pohang city and to plan the activities to solve them in the situation of localization, the mortalities of the citizens in recent three years from 1994 to 1996 were analyzed from the notices and the certificates of death. The ratios of the notices with the certificates of death In the rural area of Pohang city were higher than those of whole country, the ratios of the urban area were lower than the respective ones, and the ratio differences between the rural and urban area were increasing. It may be that medical facilities are not within easy access of the rural inhabitants. especially in the rural south district with high population density. The proportional mortality indicators(PMI) were lower them those of whole country, much lower in male. So the health status of young aged males is relatively unsatisfactory. The urban inhabitants died in hospitals about two times more than the rural inhabitants and the differences were increasing. It may be that living and housing conditions and socio-cultural differences affected on the places of death. Because it is thought that death in hospitals will be growing at high speed, it is necessary to enlarge facilities fur funeral services. The age standardized mortalities were lower than those of whole country and age grouped mortalities were also the same. There were not any consistent and meaningful findings in the sex ratios of mortality according to the age groups or the calendar years. The mortalities by neoplasms and cardiovascular diseases according to the twenty one major causes of death were rapidly increased from the middle ages in both male and female. So it is important to plan the activities for early detection and health maintenance or promotion by behavior modifications. The leading causes of death were cardiovascular diseases, hypertensive diseases, and traffic accidents. And accidental drowning because of coastal area, liver diseases in male, and low respiratory tract diseases in female were the leading causes of death in part of age groups.
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한국의 석탄광업에서 발생한 진폐증의 실태 : 발생에 관여하는 요인 및 발생률 Risk Factors and Incidence Density
최병순 大韓産業醫學會 1996 대한직업환경의학회지 Vol.8 No.1
Pneumoconiosis, especially Coalworkers' Pneumoconiosis(CWP), is the principal occupation-related disease in Korea because of the large number of effected workers. Coal mines and miners have been reduced abruptly during recent 8 year, but coal mining should be kept in Korea. Recently, pneumoconiotic workers are increasing in manufacturing industry. It is necessary to know the characteristics of CWP to prevent the development of CWP and manage employed or retired pneumoconiotic workers. Furthermore, it is also necessary to study CWP to protect workers from pneumoconiosis in manufacturing industry. Of the total of 6,452 workers who were diagnosed as CWP initially during the 20 years from 1973 to 1992, X-ray category was as follows : category 1(35.2%). category 2(23.1%), suspicious(0/1 category, 13.4%), category 3(5.7%), large opacity(3.5%), unknown by complete classification(19.1%). The patients' cardiopulmonary disability was as follows : no disability 79.3%, slight 14.2%, mild 4.1%, moderate 1.9%, severe 0.5%. The patients' X-ray category and disability were not related with the initially exposed age or job position, but their severity was positively related with the exposed duration that was adjusted by the initially exposed age. Also, the patients' X-ray category and disability had positive relationship each other. the cumulative exposure dose of silica was more important than that of respirable dust in the development of large opacity CWP. The annual incidence density of CWP was 73.2 persons in 1982 and 75.8 persons in 1986 per 10,000 person years. Afterthen it has been gradually decreasing and was in the range of 20-30 persons in the period of 1989-1992.
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