인천지역 제조업 종사 근로자들의 진폐증

노재훈,안연순,김규상,정호근,황일순 大韓産業醫學會 1997 대한직업환경의학회지 Vol.9 No.4

Most of pneumoconiosis found in Korea can be categorized in coal worker's pneumoconiosis. However, in recent years, pneumoconiosis has been frequently found in the workers of manufacturing factories. Accordingly, this study was carried out to invstigate relationship of dust exposure history and development and progress of pneumoconiosis. Chest radiographs, history of dust exposure, and other data of 144 workers, who were diagnosed as suspected pneumoconiosis (0/1) or pneumoconiosis in special health examination center in Incheon from 1986 to 1996, were reviewed. The results were as follows; 1. According to the type of main exposure, most common type of exposure was foundry dust(93workers, 64.6%), followed by welding fume (16workers, 11.1%), talc dust, lime dust and etc. 2. Among 144 workers, the history of dust exposure was investigated in 86 workers. Mean ages of 86 workers at the present study, initial exposure to the dusts, and at the time of initial diagnosis as having pneumoconiosis were 52.1, 29.1 and 46.5 years, respectively. The mean duration of exposure was 17.3 years. 3. Comparing the type of main exposure with dust exposure history, initially exposed age of welders, foundry workers, workers exposed to coal dust and other dusts were 24.6, 30.7, 28.0 and 28.5 years, respectively. Ages at the time of diagnosis as having pneumoconiosis of welders, foundry workers, coal dust and other dusts were 41.3, 49.3, 46.4 and 44.1 years, respectively. The duration of exposure to main dust of welders, foundry workers, workers exposed to coal dust and other dusts were 16.8, 18.2, 13.3 and 11.6 years, respectively. Therefore initially exposed age was significant difference between the welders and the foundry workers(p<.05). Age which was diagnosed pneumoconiosis was significant difference between the welders, workers exposed to other dusts and the foundry workers (p<.01). And exposure duration of main dust was significant difference between the workers exposed to other dusts and foundry workers(p<.01) 4. Initially diagnosed X-ray category of the workers were category were category 0/1(76workers, 52.8%), 1/0(35workers, 24.3%). Therefore, workers' pneumoconiosis of manufacturing factories was mild, relatively. And there was no significant difference between initially diagnosed X-ray category of the workers and dust exposure history. 5. Among 97 workers, who could follow up more than 1 year, 60 workers (61.9%) were not changed, 24 workers (24.7%) were progressed, 13 workers (13.4%) were improved in their initially diagnosed X-ray category. Among 11 welders, initially diagnosed X-ray category of 5 welders (45.5%) were improved and of only 1 welder was progressed. But, among 19 workers exposed to other dusts, 10 (52.6%) workers were progressed and none of them were improved. 6. Among 53 workers, who were Initially diagnosed X-ray category was 0/1, 12 workers(22.6%) were progressed and 5 workers (9.4%) were improved in their initially diagnosed X-ray category. And among 40 workers, who were initially diagnosed X-ray category was 1, 12 workers (30.0%) were progressed and 7 workers (17.5%) were improved. Above results suggest that not a few workers of manufacturing factories have pneumoconiosis and their pneumoconiosis is progressed. Therefore, we have to prepare management plan and to study epidemiologic findings of pneumoconiosis with workers of manufacturing factories.

우리 나라 제조업 및 광업 진폐증의 역학적 특성 비교

이원철,맹광호,임현우,장정희 大韓産業醫學會 1999 대한직업환경의학회지 Vol.11 No.3

Objectives: This study was planned to compare the epidemiological features such as radiological and clinical features between coal worker's pneumoconiosis and manufacturing pneumoconiosis in connection with their age and dust exposure duration. Methods : For the study, detailed examination records of those workers who had been confirmed to have pneumomoniosis in coal mining and manufacturing industries by the ministry of Labour during two year period of 1991 and 1992. Total number of study subjects was 895 pneumoconiosis cases : 504 from coal mining and 391 from manufacturing industries. Information variables for the data analysis were sex, age, dust exposure duration, work position as the independent variables and radiological pneumoconiosis category, pulmonary function test results and pulmonary tuberculosis complication status as the dependent study variables. Results : There was a significant difference in distribution of radiological categories of both pneumoconiosis groups. The proportion of suspicious and category 1 pneumoconiosis was higher in manufacturing pneumoconiosis group than in coal mine pneumoconiosis group whereas category 2 and large opacity pneumoconiosis was higher in coal mine pneugroup whereas category 2 and large opacity pneumoconiosis was higher in coal mine pneumoconiosis group than in manufacturing pneumoconiosis group. Major ventilatory indices such as FVC and FEV₁ were significantly lower in coal mine pneumoconiosis group than in manufacturing pneumoconiosis group even after other variables such as age and smoking history were statistically adjusted for. Conclusions : It is suggested that some selected outcome variables such as radiological category of pneumoconiosis, ventilatory impairment, and pulmonary tuberculosis complication rate were significantly different between coal mine pneumoconiosis and manufacturing pneumoconiosis.

진폐환자에서 활동성 폐결핵 발병률

황주환 한국산업보건학회 2019 한국산업보건학회지 Vol.29 No.4

Objects: Although active pulmonary tuberculosis(active PTB) is manifested as one of the complications of pneumoconiosis, attacks of active PTB among patients with pneumoconiosis is still unexplored. The objective of the present study was to identify the attack rate of active PTB among workers in dusty environments who were diagnosed with pneumoconiosis. Methods: The study was performed using the results of the Pneumoconiosis Examination Council’s assessment from the Korea Workers’ Compensation and Welfare Service(KCOMWEL) database between January 1, 1984 and December 31, 2017. Pneumoconiosis was defined as Category 1 or more in the radiological findings of pneumoconiosis. Active PTB was defined as a positive result for active PTB in the results of the Pneumoconiosis Examination Council’s assessment. Results: A total of 37,946 workers in dusty environments who received a health examination for diagnosing pneumoconiosis between January 1, 1984 and December 31, 2017 were selected as study subjects. The attack rate of active TB among subjects who were diagnosed with pneumoconiosis and those who were diagnosed without pneumoconiosis were 8.5% and 1.4%, respectively. In the multivariate logistic analysis including age, sex, radiological findings, complications, male[odds ratio(OR), 2.0; 95% confidence interval(CI), 1.4-3.1] and pneumoconiosis(OR, 6.5; 95% CI, 5.7-7.4) were associated with an increased risk of developing active PTB. Conclusions: The present study determined that dusty workers who were diagnosed with pneumoconiosis had a high rate of active PTB compared to TB patients and patients who were diagnosed with silicosis. Therefore, in addition to silicosis, it is necessary to include pneumoconiosis among the high-risk groups for TB.

탄광부 진폐증에서 혈장 Transforming Growth Factor-${\beta}_1$의 의의

김정주,라원연,홍애라,신표진,용석중,신계철,Kim, Chong-Ju,Lee, Won-Yeon,Hong, Ae-Ra,Shin, Pyo-Jin,Yong, Suk-Joong,Shin, Kye-Chul 대한결핵및호흡기학회 2001 Tuberculosis and Respiratory Diseases Vol.50 No.1

연구배경 : 탄광부 진폐증은 석탄 분진의 흡입에 의한 폐조직의 손상에 대하여 부적절하고 과도한 염증반응이 일어나 폐섬유화를 유발하여 발병하는 것으로 생각되어지고 있다. 이 반응에는 대식세포를 비롯한 많은 염증세포들과 그 세포들에서 분비되는 매개물질들이 중요한 역할을 한다. TGF-$\beta$는 특발성 폐섬유화증, 규폐증 및 석면증의 폐섬유화 과정에 관여한다고 알려져 있다. 그러나 비슷한 기전에 의해 폐 섬유화가 진행되는 것으로 생각되는 탄광부 진폐증에서는 TGF-$\beta$의 관여여부에 대한 보고가 거의 없다. 본 연구는 탄광부 진폐증 환자에서 혈청 TGF-${\beta}_1$을 측정하여 섬유화의 정도에 따른 그 활성도의 변화를 비교하여 탄광부 진폐증의 폐섬유화 과정에 TGF-${\beta}_1$이 관여하는지 알아 보고자 하였다. 방법 : 직업력과 방사선학적 소견 상 탄광부 진폐증으로 진단 된 환자 중 단순 탄광부 진폐증 20예와 복잡성 탄광부 진폐증 20예를 대상으로 하였다. 정상소견인 자 10명을 대조군으로 설정하였으며, 각 대상을 human TGF-${\beta}_1$ immunoassay kit (R&D system, Minneapolis, MN)을 이용하여 혈장 내 TGF-${\beta}_1$을 측정하였다. 결과 : 단순 탄광부 진폐증($0.64{\pm}0.17$ ng/mL)과 정상 대조군($0.63{\pm}0.18$ ng/mL)보다 복잡성 탄광부 진폐증 ($0.79{\pm}0.18$ ng/mL)의 혈중 TGF-${\beta}_1$의 농도가 의미 있게 높았다(p<0.05). 결론 : 탄광부 진폐증의 섬유화 진행 과정에 TGF-${\beta}_1$이 관여함을 알 수 있었다. 따라서 단순 탄광부 진폐증과 복잡성 탄광부 진폐증의 감별진단과 경과 예측인자로서 혈장 TGF-${\beta}_1$이 유용하리라 생각되며, TGF-${\beta}$의 생성을 억제한다면 탄광부 진폐증의 섬유화 진행을 저지함으로써 탄광부 진폐증의 치료에 있어 중요한 역할을 할 수 있을 것으로 기대된다. Background : Coal workers' pneumoconiosis is a fibrotic lung disease resulting from chronic inhalation of coal dust. The precise mechanism of lung fibrosis in coal workers' pneumoconiosis is uncertain. However, a relationship between the stimulation of fibroblast proliferation and collagen production by mediators released from in flammatory and resident lung cells is thought to be a major factor. The transforming growth factor-$\beta$(TGF-$\beta$), a multifunctional cytokine and growth factor, plays a key role in the scarring and fibrotic processes due to its ability to induce extracellular matrix proteins and modulate the growth and immune function of many cell types. To determine the involvement of TGF-$\beta$ in the development of lung fibrosis in coal workers' pneumoconiosis, the TGF-${\beta}_1$ level in plasma was measured in patients with coal workers' pneumoconiosis. Methods : Plasma was collected from 40 patients with coal workers' pneumoconiosis (20 with simple coal workers' pneumoconiosis and 20 with complicated coal workers' pneumoconiosis) and from 10 normal controls. The ELISA method was used to measure the plasma TGF-${\beta}_1$ concentration. Results : Compared to the control group ($0.63{\pm}01.8$ ng/mL), there was no significant difference in the plasma TGF-${\beta}_1$ level in patients with simple coal workers' pneumoconiosis ($0.64{\pm}0.17$ ng/mL) (p>0.05). However, in patients with complicated coal workers' pneumoconiosis the plasma TGF-${\beta}_1$ level ($0.79{\pm}0.18$ ng/mL) was significantly higher than in patients with simple coal workers' pneumoconiosis and the control group (p<0.05). Conclusion : The data suggests that TGF-${\beta}_1$ has some influence in the development of lung fibrosis in coal workers' pneumoconiosis.

제조업 분야 근로자의 진폐증 사후관리 실태

김성군,노재훈,안연순 大韓産業醫學會 1994 대한직업환경의학회지 Vol.6 No.2

Most of the pneumoconiosis, which is common occupational diseases, is found here in Korea can be categorized to coal miner's pneumoconiosis. However, recently pneumoconiosis has been found in the workers of manufacturing factories. Periodic health examination is important not only detection of occupational disease but also post-examination health care of occupational disease patient. Accordingly, to study post-examination health care status of workers with pneumoconiosis diagnosed from 1991 to 1993 in the periodic health examination, all 43 pneumoconiosis patients in 22 manufacturing factories in Incheon were reviewed. Chest radiologic findings of 43 workers were suspected pneumoconiosis (20 workers, 46.5%), pneumoconiosis stage Ⅰ(20 workers, 46.5%) and pneumoconiosis stage Ⅱ (3 workers, 7.0%). Among the respondents, 40 workers (93.0%) answered that they received their health examination results and 25 workers (55.8%) had reguest for compensation of occupational disease. only 14 workers (32.6%) had changed their workplace while 21 workers(48.8%) did not. Reasons for not taking the post-examination health care enough were worker's ignorance of adminstrative process for compensation (28 workers, 65.1%), mild status of disease (6 workers, 14.0%) and financial problem (3 workers, 7.0%). Post-examination health care of the workers diagnosed as pneumoconiosis had significant correlation with the presence of health care manager in workplace and the employer concerns for occupational disease of workers. The improvement of working environment is related with the presence of labor union in workplace. These results suggested that the presence of health care manager in the workplace and concerns for workers health by employer were important in performing appropriate post-examination health care for workers with pneumoconiosis in manufacturing factories.

연료단지 진폐증 환자 분포현황 및 노출특성

정종현 한국환경과학회 2024 한국환경과학회지 Vol.33 No.2

This study was conducted to identify the pollutants generated by the fuel complex and to determine the health effects of the surrounding residents. In addition, based on the results of epidemiological surveys and health impact surveys of local residents, we analyze the distribution of patient groups and exposure characteristics according to the distance from the fuel complex boundary. Samples were collected from the briquette plant within the fuel complex and analyzed by SEM-EDXA, X-ray Fluorescence Spectrometer, and ICP. In addition, the distribution of patients and exposure characteristics were analyzed according to the distance from the fuel complex and yard boundaries. Analysis of briquette samples from the fuel complex showed that the average particle size was 10-30 ㎛, the shape was irregular, and SiO2 accounted for more than 50%. It is believed that silica, which causes pneumoconiosis, may have been scattered into the air. In particular, there was a large distribution of 5 μm particles that affect respiratory diseases. According to the analysis of the residential addresses and distribution of pneumoconiosis cases, many pneumoconiosis cases were located in the area between 200 and 500 meters from the boundary of the fuel complex. In addition, 28 pneumoconiosis cases were identified as a result of the epidemiological survey and health impact survey at the fuel complex. In detail, there were 8 cases of occupational pneumoconiosis, 6 cases of environmental pneumoconiosis, and 14 cases of occupational and environmental pneumoconiosis. The confirmed pneumoconiosis cases were located between 0.3 and 1.1 kilometers from the fuel complex. It was found that environmental pollutants generated by the fuel complex adversely affect the health of local residents. In particular, there are many cases of pneumoconiosis in the area between 200 and 500 meters from the boundary of the fuel complex, and this distance is considered to be the direct and indirect impact zone of the briquette plant.

진폐증의 연구와 진단을 위한 방사선학적 방법들의 비교 : Simple Radiography and Computed Tomography 단순 방사선검사와 컴퓨터 단층촬영

최병순 大韓産業醫學會 1995 대한직업환경의학회지 Vol.7 No.2

The classification for pneumoconiosis which was developed by International Labour Office(ILO) on the basis of Radiological findings of simple chest radiography has been widely used for the study and diagnosis of pneumoconiosis. But many problems have been revealed during the pneumoconiosis study using this classification. Those problems come from simple radiography itself or classification systems. Among those, inter-reader and intra-reader variability are the severest problems, even though many efforts have been devoted to lessen the variability. With introduction of computed tomography(conventional CT and HRCT), we are learning many new aspects about the occupational lung diseases, especially pneumoconiosis. So the studies for pneumoconiosis using tomography are reviewed, focusing on silicosis, coalworkers' pneumoconiosis, and asbestosis. But in our country, the studies of that kind are very scant. It is necessary to study and diagnose pneumoconiosis by CT, because that is the need of workers and the responsibility of physicians working in the field of occupational medicine. CT is superior to simple radiography in early detection, determination of severity, and follow-up of pneumoconiosis. But simple radiography is and should be the main method for the study and diagnosis of pneumoconiosis. Although, because of radiation hazard, cost, time, and geographical availability, the method can not and should not be used on the routine basis, we have to consider the use of CT, if possible and if necessary. Before using CT widely, we should develop the standardized criteria regarding to scanning methods and reading criteria. If not, the same problems as those of simple radiography will be occurred, and then there will be no progress in occupational medicine and workers' health.

Levels of Exhaled Breath Condensate pH and Fractional Exhaled Nitric Oxide in Retired Coal Miners

Lee, Jong-Seong,Shin, Jae-Hoon,Lee, Joung-Oh,Lee, Kyung-Myung,Kim, Ji-Hong,Choi, Byung-Soon Korean Society of ToxicologyKorea Environmental Mu 2010 Toxicological Research Vol.27 No.4

Inhaled inorganic dusts, such as coal, can cause inflammation and fibrosis in the lungs, known as pneumoconiosis. Diagnosis of pneumoconiosis depends on morphological changes by radiological findings and functional change by pulmonary function test (PFT). Unfortunately, current diagnostic findings are limited only to lung fibrosis, which is usually irreversibly progressive. Therefore, it is important that research on potential and prospective biomarkers for pneumoconiosis should be conducted prior to initiation of irreversible radiological or functional changes in the lungs. Analytical techniques using exhaled breath condensate (EBC) or exhaled gas are non-invasive methods for detection of various respiratory diseases. The objective of this study is to investigate the relationship between inflammatory biomarkers, such as EBC pH or fractional exhaled nitric oxide ($FE_{NO}$), and pneumoconiosis among 120 retired coal miners (41 controls and 79 pneumoconiosis patients). Levels of EBC pH and FENO did not show a statistically significant difference between the pneumoconiosis patient group and pneumoconiosis patients with small opacity classified by International Labor Organization (ILO) classification. The mean concentration of $FE_{NO}$ in the low percentage $FEV_1$ (< 80%) was lower than that in the high percentage (80% $\leq$) (p = 0.023). The mean concentration of $FE_{NO}$ in current smokers was lower than that in non smokers (never or past smokers) (p = 0.027). Although there was no statistical significance, the levels of $FE_{NO}$ in smokers tended to decrease, compared with non smokers, regardless of pneumoconiosis. In conclusion, there was no significant relationship between the level of EBC pH or $FE_{NO}$ and radiological findings or PFT. The effects between exhaled biomarkers and pneumoconiosis progression, such as decreasing PFT and exacerbation of radiological findings, should be monitored.

Levels of Exhaled Breath Condensate pH and Fractional Exhaled Nitric Oxide in Retired Coal Miners

Jong Seong Lee,Jae Hoon Shin,Joung Oh Lee,Kyung Myung Lee,Ji Hong Kim,Byung-Soon Choi 한국독성학회 2010 Toxicological Research Vol.26 No.4

Inhaled inorganic dusts, such as coal, can cause inflammation and fibrosis in the lungs, known as pneumoconiosis. Diagnosis of pneumoconiosis depends on morphological changes by radiological findings and functional change by pulmonary function test (PFT). Unfortunately, current diagnostic findings are limited only to lung fibrosis, which is usually irreversibly progressive. Therefore, it is important that research on potential and prospective biomarkers for pneumoconiosis should be conducted prior to initiation of irreversible radiological or functional changes in the lungs. Analytical techniques using exhaled breath condensate (EBC) or exhaled gas are non-invasive methods for detection of various respiratory diseases. The objective of this study is to investigate the relationship between inflammatory biomarkers, such as EBC pH or fractional exhaled nitric oxide (FENO), and pneumoconiosis among 120 retired coal miners (41 controls and 79 pneumoconiosis patients). Levels of EBC pH and FENO did not show a statistically significant difference between the pneumoconiosis patient group and pneumoconiosis patients with small opacity classified by International Labor Organization (ILO) classification. The mean concentration of FENO in the low percentage FEV₁ (< 80%) was lower than that in the high percentage (80% ≤) (p = 0.023). The mean concentration of FENO in current smokers was lower than that in non smokers (never or past smokers) (p = 0.027). Although there was no statistical significance, the levels of FENO in smokers tended to decrease, compared with non smokers, regardless of pneumoconiosis. In conclusion, there was no significant relationship between the level of EBC pH or FENO and radiological findings or PFT. The effects between exhaled biomarkers and pneumoconiosis progression, such as decreasing PFT and exacerbation of radiological findings, should be monitored.

The Serum Inflammatory Cytokines in Retired Workers Exposed to Inorganic Dusts

( Jae Hoon Shin ),( Joohwan Hwang ),( Jong Seong Lee ),( Byung-soon Choi ) 대한결핵 및 호흡기학회 2021 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.129 No.-

Pneumoconiosis, caused by occupational exposure to inorganic dusts such as coal, is characterized by a progressive fibrotic reaction and irreversible functional damage in the lung. Inflammatory cytokines have been suggested as important mediators of toxic and pathogenic effects in humans exposed to inorganic dusts. The diagnosis for pneumoconiosis has been based on radiological findings and pulmonary function test, but there have been some limitations in the detection of the early stage of pneumoconiosis. This study aimed to evaluate the serum tumor necrosis factor (TNF)-alpha, interleukin (IL)-6, -8, and monocyte chemoattractant protein (MCP)-1 levels as the prospective biomarkers of pneumoconiosis. The study population contained 136 retired workers exposed to inorganic dusts. We analyzed serum concentration of TNF-alpha, IL-6, IL-8, and MCP-1 using Biochip array. The serum concentration of IL-6 (p=0.021) and IL-8 (p=0.015) was significantly increased as the increase of severity of pneumoconiosis. Also, the serum concentration of TNF-α increased as the increase of severity of pneumoconiosis, but there was no statistical significance. The serum concentration of MCP-1 in workers with large opacity (4A and 4B) was significantly higher than those of workers with category 0 and small opacity (p=0.045). In this study, there were positive correlations between analyzed inflammatory cytokines and severity of pneumoconiosis, but serum concentration of inflammatory cytokines is affected by most of the biological and inflammatory reactions. It is necessary to evaluate the other inflammatory mediators related to the pneumoconiosis such as clara cell secretory protein (CC)-16 and surfactant protein (SP)-D.