직업성 긴장과 근로자 결근

차봉석,장세진,최홍렬,김형식,고상백,Cha, Bong-Suk,Chang, Sei-Jin,Choi, Hong-Ryul,Kim, Hyong-Sik,Koh, Sang-Baek 대한예방의학회 1999 Journal of Preventive Medicine and Public Health Vol.32 No.4

Objectives : The purpose of this study was to assess the relationship between job strains and absenteeism from work. Methods : The study design was cross-sectional, and the study subjects consisted of 1,166 workers who were employed in the small-sized industries. A self administered questionnaire was used to measure the general characteristics, job characteristics(job demand, job control), and social support(coworker support, supervisor support) at work. The Job Content Questionnaire(JCQ) was used to assess job demand(2 items) and decision lattitude(10 items). Social support at work (10 items) was measured using JCQ. Sick absence was collected using self-report and were rechecked by the attendance record of their company. Odds ratios and 95% confidence intervals for the association between job strain and sick absence were estimated. The modifying effect of social support was evaluated by stratification. Logistic regression was used to estimate the relationship between job strain and sick absence. Results : In the bivariate analysis, the variables related to sick absence were age, marital status, occupation, job demand. Four distinctly different kinds of level of job strain were generated by the combination of job demand and job control: low strain group, high strain group, active group, and passive group. The crude odds ratio of high job strain was 1.78(95% CI: 1.26-2.53), and those of active group and passive group were 1.33(95% CI: 1.07-1.66) and 1.13 (95% CI: 0.88-1.47), respectively. The odds ratio of high job strain after adjusting for age and occupation were still significant The odds ratio of high job strain in low social support was 5.96(95% CI: 2.45-14.51), but that in high social support was 0.73(95% CI: 0.26-2.01). Conclusions : Job strain was associated with increased risk of absenteeism from work, and social support at work modified the association between job strain and sick absence.

최적용수공급을 통한 부하이전 효과 분석

장성욱(Seong-Wook Chang),최홍렬(Hong-Ryul Choi),이경(Kyung Lee),안재후(Jae-Hoo Ahn),노상천(Sang-Chun Noh) 대한전기학회 2014 대한전기학회 학술대회 논문집 Vol.2014 No.7

만성적 소음노출과 혈압의 상관성에 관한 메타분석

김춘배,김재용,차봉석,최홍렬,이종태,남정모,이상윤,왕승준,박기호,김대열,고상백,Kim, Chun-Bae,Kim, Jai-Young,Cha, Bong-Suk,Choi, Hong-Ryul,Lee, Jong-Tae,Nam, Chung-Mo,Lee, Sang-Yun,Wang, Seung-Jun,Park, Kee-Ho,Kim, Dae-Youl,Koh, Sang-Ba 대한예방의학회 2000 예방의학회지 Vol.33 No.3

Objectives : This study was conducted to integrate the results of studies assessing the association between chronic noise exposure and blood pressure. Methods : Using a MEDLINE search with noise exposure, blood pressure and hypertension as key words, we retrieved articles from the literature that were published from 1980 to December 1999. The criteria for quality evaluation were as follows: 1) the study subjects must have been workers employed at a high noise level area 2) The paper should use average and cumulative noise exposure as method for exposure evaluation. 3) Blood pressure in each article should be reported in a continuous scale Among the 77 retrieved articles, six studies were selected for quantitative meta-analysis. Before the integration of the regression coefficients for the association between blood pressure and noise level, homogeneity tests were conducted. Results : All studies were a cross-sectional design and the study subjects were industrial workers. Five papers used a time-weighted average for noise exposure and only one paper calculated the cumulative noise exposure level. The measurement of blood pressure in the majority of studios were accomplished in a resting stale, and used an average of two or more readings. The homogeneity of studies was rejected in a fixed effect model, so we used the results in a random effect model. The results of the quantitative meta-analysis, the weighted regression coefficient of noise associated with systolic blood pressure and diastolic blood pressure were 0.05 (95% confidence interval [CI]: -0.03, 0.13) and 0.06 (95% CI: -0.01, 0.13), respectively. Conclusions : Our results suggested that chronic exposure to industrial noise does not cause elevated blood pressure.

콜타르가 함유된 페이트 사용 조선업 근로자에서 요중 1-hydroxypyrene glucuronide와 대사효소 유전자 다형성에 관한 연구

이경호(Kyoung-Ho Lee),이정미(Jeongmi Lee),최인미(Inmi Choi),김재용(Jaiyong Kim),임형준(Hyungjune Im),이상윤(Sang-Yun Lee),윤기정(Kijung Yoon),고상백(Sang Back Koh),최홍렬(Hong Ryul Choi),조수헌(Soo-Hun Cho),강대희(Daehee Kang) 한국환경성돌연변이발암원학회 2000 한국환경성돌연변이·발암원학회지 Vol.20 No.1

Although shipbuilding workers were exposed to a variety of genotoxic compounds including polycyclic aromatic hydrocarbons (PAHs), limited number of studies were conducted to evaluate the biomarkers related to PAH exposure in painting workers in shipbuilding industry. One hundred and thirty three workers<br/> including 73 employees using coal tar paints were recruited from a shipbuilding company located in South Korea. Urinary 1-hydroxypyrene glucuronide (1-OHPG), as internal dose of PAH exposure, were measured by synchronous fluorescence spectroscopy after immunoaffinity purification using monoclonal antibody 8E11. Glutathione S-transferase (GST)M1 and GSTT1 genotypes were assessed by multiplex PCR. Information on demographic characteristics, smoking habit, diet, job title, use of personal protective equipments were collected by self-administered questionnaire. Urinary 1-OHPG were higher in workers using coal tar paints than in workers using general paints, however, the difference was not statistically significant (p=0.20, Mann-Whitney U test). Urinary<br/> 1-OHPG levels in smokers were higher than in non-smokers (p<0.05 by Mann-Whitney U test) and there was a significant increase in urinary 1-OHPG levels with the numbers of cigarettes consumed per day (Spearman's correlation coefficient=0.28, p=0.02). Genetic polymorphisms of GSTM1 and GSTT1 did not influence the level of 1-OHPG in study subjects. Multiple regression analysis show that smoking is the only significant predictor for log-transformed 1-OHPG (overall model R²=0.1). These results suggest that workers using coal tar paints were exposed to significant amount of PAHs and individual difference in xenobiotic metabolism might affect the<br/> levels of internal dose of PAHs.

직무스트레스와 심혈관계 질환 위험인자로서 맥파전파속도의 관련성

공정옥(Jung Ok Kong),고상백(Sang Baek Koh),장세진(Sei Jin Chang),차봉석(Bong Suk Cha),정호근(Ho Keun Chung),최홍렬(Hong Ryul Choi),정최경희(Kyung-Hee Jung-Choi),전순자(Soon Ja Jeon) 대한직업환경의학회 2004 대한직업환경의학회지 Vol.16 No.4

VDT작업별 정신사회적 스트레스와 근골격계 장애에 관한 연구

백남종,강종두,주영수,배인근,권호장,박종만,조수헌,김돈규,김재용,최홍렬 大韓産業醫學會 1998 대한직업환경의학회지 Vol.10 No.4

It has been hypothesized that jobs that have both high psychological demands and low decision latitude("job strain") can lead to musculoskeletal disorder. The objective of this study was to test whether job strain was correlated with the presence of work-related musculoskeletal disorder, especially myofascial pain syndrome(MPS). Information on demographic factors, confounders such as household load and taking care of children or not, and scores for decision latitude, job demand, and social support was obtained by self-administered questionnaire, which had been developed in Korean language, by adopting NIOSH instrument and Extended Karasek Model(16 items). All subjects were also examined by rehabilitation medicine specialists for musculoskeletal disorders. Subjects(n=370) could be categorized into 4 groups, these were, housewives(n=89), shipyard CAD workers(n=89), general female workers(n=79; nurses, insurance counselors, public officials, clerks, etc), and telephone directory assistance operators(n=113). Results from univariate analyses indicated that all demographic factors, all confounders, scores for decision latitude and social support were not associated with the risk of musculoskeletal disorder. However, score for job demand was higher in musculoskeletal disorder cases than others. In subgroup analysis, this association was convinced again, in telephone directory assistance operators. Job strain model showed that the group of telephone directory assistance operators was high-stain group, and OR of musculo skeletal disorder was 2.446(95% C. I. : 1.174, 5.096), when comparing this with the low strain group. In conclusion, job strain is a risk factor for work-related musculoskeletal disorder.

조선소 근로자에서의 국소진동장해 진단방법에 대한 평가

손 홍,전순자,주영수,조성일,최홍렬,김미경,김형식 大韓産業醫學會 1998 대한직업환경의학회지 Vol.10 No.4

A hand-arm vibration syndrome, local vibration illness, occurs in some workers who use hand held vibration tools. It consists of white fingers, diffusely distributed finger neuropathy, pain in the hand and arm, and a small excess risk of osteoarthritis. This study is aimed to identify effective methods to confirm local vibration illness among various health exams, which are mentioned in worker's special health exam regulation. In addition, this study is aimed to quantitatively assess the daily vibration exposure level as a major determinant of vibration illness. The subjects, 46 vibration workers, were selected according to the results of the first special health exam about vibration hazards at shipbuilding industry in 1997. They all had experiences of work related blanching of fingers. Fifteen controls, who had no vibration exposure at all, were also recruited to compare their test results with the results of vibration workers. We adopted I subjective and 6 objective tests to evaluate the effectiveness and feasibility for confirming local vibration illness. These tests were history taking of subjective symptoms according to the Stockholm classification, checking blood pressure of finger, checking grasp power, checking finger skin temperature, nail-bed pressing test, vibration perceptional threshold test, and skin prick test for pain perception. Among these, checking skin temperature, nail-bed pressing test, and vibration perception test included cold water provocations. We also estimated some vibration exposure levels of hand held vibration tools by using previously published data from one automobile company. In conclusion, history taking of subjective symptoms according to the Stockholm classification, nail-bed pressing test, and vibration perceptional threshold test were discovered to be effective to diagnose local vibration illness. Furthermore, vibration perceptional threshold on right fingers showed a dose-response relationship to daily vibration exposure levels. The parameter β was 0.0005(±0.0002), and statistically significant by REM(random effects model).

일부 조선업 근로자의 직업성 요통 발생실태 및 위험요인에 관한 연구

고상백,김형식,최홍렬,김지희,송인혁,박준한,박종구,장세진,차봉석 大韓産業醫學會 2000 대한직업환경의학회지 Vol.12 No.1

목적 : 이 연구에서는 한 사업장의 동일한 코호트내에서 직업성 요통의 발생 및 발생원인에 대해 조사하고자 하였다. 방법 : 연구대상은 1995년 12월 현재 한 조선업체에 종사하는 근로자 중에서 1995년 12월 31일 까지 요통이 이미 발생한 근로자와 1995년 당시 검진 미수검자를 제외한 9,784명을 연구대상으로 하였다. 요통 발생군은 1996년부터 1998년까지 3년간 추적 관찰하여 요통으로 4일 이상 통원 또는 입원치료를 받은 근로자로 하였다. 발생률은 요통발생 당시 연도를 기준으로 하여 해당 연도의 4일 이상 신규치료를 받은 중등도 이상의 요통근로자를 분자로 하였고, 해당년도 사업장의 종사하는 근로자 총수(과거 요통자 제외)를 분모로 간주하였다. 요통 발생군은 외상성 요통과 직업관련성 요통으로 대별하였으며, 위험요인과 질병 발생간의 관련성을 보기 위한 Cox모형에서 그 위험도를 파악하고자 할 때에는 직업성 요통만을 환자군으로 선정하였다. 결과 및 결론 . 요통 발생률은 근로자 천명당 1998년 3.1명, 1997년 8.8명, 1996년 7.8명이었다. 요통점유율의 범위는 10.99∼25.66이었다. 연령별 요통 발생률은 30대, 40대에서 높은 발생률을 보였다. 진단명에 따른 발생률은 추간판 탈출증, 염좌, 척추골절, 척추분리증, 척추협착증 순이었다 직업성 요통 발생자들의 직업적 요인을 알아보기 위하여 요통 발생 당시 작업형태를 알아본 결과, 물건을 들다가 66명(35.3%)이 발생하여 가장 큰 빈도를 차지하였고, 물건을 옮기는 과정에서 19명(10.2%)이 발생하여 2위를 차지하였고, 넘어지거나(8.6%), 물건을 당기는 자세(8.0%), 값자기 일어서다(7.5%) 순으로 요통이 발생하였다. 직업성 요통에 영향을 주는 일반적 특성 및 직업적 특성에 판한 상대위험도 및 95% 신뢰구간를 구한 결과, 요통발생에 영향을 주는 유의한 변수로는 체질량 지수(비만도), 교대여부, 중량물 취급여부였다. Objectives : This study was conducted to estimate the incidence rate, and to identify the risk factors for the occupational low back pain among shipyard workers. Methods : The study subjects consisted of 9,784 workers who were employed in a ship-building industry (excluded workers who had a history of low pack pain before 1995 or did not take periodic health examination in 1995) . The cases were 220 people who experienced back pain from January 1, 1996 to December 31, 1998. To assess risk factors for occupational low back pain, Cox propotional hazard model was used. Results : During the recent three years from 1996 to 1998, the incidence rate per 1,000 persons was 7.8 in 1996, 8.8 in 1997, and 3.1 in 1998. The main causes of work-related low back pawn were sprain, strain and disc herniation. Lifting was the most common cause of back pain (35.3%) , and carrying (10.2%) and pulling (8.0%) were followed. In Cox proportional harzard model, independent risk factors for back pain were body mass index(R.R. ; 1.54, 95% C.1. : 1.06-2.25), shift work(R.R. ; 1.65, 95% C.1. : 1.19-2.28), and lifting heavy material(R. R., 3.95, 95% C.1. : 2.29-6.82). Conclusions . This study suggests that the risk factors of back pawn In shipyard work-ers were body mass index, shift work and lifting.

부산·울산·경남지역 직업병 감시체계

김정일,김병권,김정원,채창호,이철호,강동묵,김지홍,김진하,김영욱,이영하,이지호,김정호,윤형렬,유철인,정백근,장태원,김운규,윤동영,강진욱,김종은,안진홍,이동준,장준호,이광영,송혜란,최영희,이용환,조병만,최홍렬,고상백,김은아,이유진,홍영습,정갑열,김정만,김준연 大韓産業醫學會 2004 대한직업환경의학회지 Vol.16 No.1

Objective: Occupational medicine specialists in the Busan, Ulsan and Kyung-Nam areas established an area-based occupational disease surveillance system and used this system to collected case information for the purpose of preventing occupational diseases Methods: l l hospital participated in this system. The authors selected five main diseases, which were hand-arm vibration syndrome (HAVS), work-related musculoskeletal disorder (WRMSD), occupational asthma, occupational skin disease and occupational and occupational lung cancer and established their case definitions. All cases were reported on the web, and real time analysis was conducted. Results: Between April 2001 and April 2003, 192 cases of HAVS, 118 cases of WRMSD, 33 cases of occupational asthma, 17 cases of occupational skin disease and 17 cases of occupational lung cancer (for a total of 377 cases of these five main diseases) were reported. most of the HAVS cases came from shipbuilding, and 172 of them (92.7%) were associated with grinding. Of the four main types of WRMSD, carpal tunnel syndrome (CTS) was the most prevalent with 46 cases and shipbuilding was also the main industry involved (83.9%). The ergonomic risk factors involved mainly associated with the hand. In 19 (57.6%) and 4 (12.1%) cases of occupational asthma, the agents involved. The causative agents of occupational lung cancer included Cr, welding fume, PAH, Ni, etc. 10(58.8%) of the cases were diagnosed as squamous cell carcinoma and 5(29.4%) as adenoma. Conclusion: This result showed that an area-based occupational disease surveillance system might provide an effective method of evaluating the prevalence of such diseases, however the Busan, Ulsan and Kyung-Nam provinces are too large to be treated as individual areas. Therefore, the authors suggest that each province should establish its own surveillance system.