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During the periodic physical checkups in 1997-2000, the authors have found eleven cases of nasal septum perforation among 2,869 welders in Ulsan, Korea. They have not suffered from diseases and conditions that could cause septum perforation such as tuberculosis, syphilis, and long-term use of topical corticosteroids. And also they did not have trauma history and surgical experiences on their nasal septum. To investigate the cause of septum perforation we reviewed the past history of pre-employment, the results of annual working environment survey and the material safety data sheets of welding rods and steels with which they have dealt. We also analyzed the concentration of several metals of welding fume and the concentration of blood and urinary chromium. In the result, we assumed that the nasal septum perforation of welders was due to chronic exposure to low-level hexavalent chromium.

Background Development of hernias among active workers is a major occupational problem, however, the work-relatedness of hernias has not been well investigated. It is a difficult question for occupational and primary care physicians who must often address whether a worker with an inguinal hernia should be restricted from work requiring lifting of heavy objects. Methods To evaluate the possible work-relatedness of inguinal hernias, a cross-sectional study was performed. The goal of the study was to determine hernia incidence according to occupation with the Annual Survey of Occupational Injuries and Illnesses from the Bureau of Labor Statistics in 1994. Hernia incidence rates (per 10,000 workers) for industry and occupation categories were calculated with the estimates of the number of hernias in males and the employed male workers from the Current Population Survey. Rate ratios (RR) of hernia incidence rates were calculated. Results In 1994, an estimated 30, 791 work-related hernias in males were reported by US private establishments. The occupation groups with the highest RR were laborers and handlers (RR, 2.47; 95% confidence interval (CI), 2.14–2.80), machine operators (RR, 2.13; 95% CI, 1.81–2.44), and mechanics and repairers (RR, 1.72; 95% CI, 1.43–2.00). Conclusions Rate ratios for hernias vary considerably within industries and occupations, with the highest ratios found in industries and occupations involving manual labor. This provides support for the hypothesis that the hernias are work-related, especially in work involving strenuous, heavy manual labor. Am. J. Ind. Med. 36:638–644, 1999. Published 1999 Wiley-Liss, Inc.

Assessment of Workers'' Exposure to Antimony Trioxide in Korea: Ki-Woong KIM, et al. Industrial Health Research Institute, KISCO—The assessment of workers'' exposure to antimony trioxide was conducted for the workers at three antimony trioxide factories located in Kyeonggi-do, Chungnam, Cheonnam, Korea during the period of September 4 to October 28, 1995. The objective of this study was to investigate any exposure of workers to antimony. The results were as follows: 1. Mean of the total antimony concentration in the air near the workplace was 0.0223 mg/m3 in the oxidation part and 0.2806 mg/m3 in the packing part (p 0.05). 3. The average urinary antimony level in the oxidation part was 0.1827 mg/g creatinine and that of packing part was 0.1371 mg/g creatinine. But they were not statistically significant (p>0.05).

Asbestos, which is a well-known risk factor for lung cancer and malignant mesothelioma, has also been suggested as a gastrointestinal (GI) carcinogen. This study was conducted to assess the relationship between high asbestos exposure occupations and the occurrence of G1 cancer. Death certificate data were analyzed from 4,943,566 decedents with information on occupation and industry from 28 states from 1979 through 1990. Elevated proportionate mortality ratios (PMRs) for mesothelioma were used to identify occupations potentially having many workers exposed to asbestos. All PMRs were age-adjusted and sex- and race-specific. The PMRs for GI cancers in white males were then calculated for these occupations after excluding mesothelioma, lung cancer, and non-malignant respiratory disease from all deaths. We identified 15,524 cases of GI cancer in the 12 occupations with elevated PMRs for mesothelioma. When these occupations were combined, the PMRs for esophageal, gastric, and colorectal cancer were significantly elevated at 108 (95% confidence interval = 107-110), 110 (106-113), and 109 (107-110), respectively. Esophageal cancer was elevated in sheet metal workers and mechanical workers. Gastric cancer was elevated in supervisors in production and managers. Colorectal cancer was elevated in mechanical and electrical and electronic engineers. However, high exposure occupations like insulation, construction painter supervisors, plumbers, furnace operators, and construction electricians showed no elevations of GI cancers. In conclusion, this death certificate study supports an association between asbestos exposure and some GI cancer, however the magnitude of this effect is very small.

To investigate the effects of short-term exposure of beryllium on the human immune system, the proportion of T-lymphocytes such as CD3+, CD4+, CD8+, CD95, and NK cells, andthe proportion of B cells and TNFα level in peripheral blood and immunoglobulins in the serum of 43 exposed workers and 34 healthy control subjects were studied. External exposure to beryllium was measured by atomic absorption spectrometer as recommended by the NIOSH analytical method 7300. T lymphocyte subpopulation analysis was carried out with flow cytometer. The working duration of exposed workers was less than 3 months and the mean ambient beryllium level was 3.4 μg/m(3), 112.3 μg/m(3), and 2.3 μg/m(3) in molding (furnace), deforming (grinding), and sorting processes, respectively (cited from Kim et al., 2008). However, ambient beryllium level after process change was non-detectable (0.1 μg/m(3)). The number of T lymphocytes and the amount of immunoglobulins in the beryllium-exposed workers and control subjects were not significantly different, except for the total number of lymphocytes and CD95 (APO1/FAS). The total number of lymphocytes was higher in the beryllium-exposed individuals than in the healthy control subjects. Multiple logistic regression analysis showed lymphocytes to be affected by beryllium exposure (odd ratio = 7.293; p0.001). These results show that short-term exposure to beryllium does not induce immune dysfunction but is probably associated with lymphocytes proliferation.

The list of occupational diseases established in the international and national legal system has played important roles in both prevention of and compensation for workers’ diseases. This report reviewed the historical development in the ILO list of occupational diseases and suggested implications of the trends. Since the first establishment of the ILO list of occupational diseases in 1925, the list has played a key role in harmonizing the development of policies on occupational diseases at the international level. The three occupational diseases (anthrax, lead poisoning, and mercury poisoning) in the first ILO list of occupational diseases, set up in 1925 as workmen’s compensation convention represented an increase of occupational diseases from the Industrial Revolution. Until the 1960s, 10 occupational diseases had been representative compensable occupational diseases listed in Convention No. 121, which implies that occupational diseases in this era were equated to industrial poisoning. Since 1980, with advancements in diagnostic techniques and medical science, noise-induced hearing loss, and several bronchopulmonary diseases have been incorporated into the ILO occupational list. Since 2002, changes in the structure of industries, emerging new chemicals, and advanced national worker’s compensation schemes have provoked the ILO to revise the occupational disease list. A new format of ILO list appended in Recommendation 194 (R194) was composed of two dimensions (causes and diseases) and subcategories. Among 50 member states that had provided their national lists of occupational diseases, until 2012 thirty countries were found to have the list occupational diseases having similar structure to ILO list in R194.

Objectives: The extent of the occupational cancer burden has rarely been estimated in Korea. The aim of this study is to provide an estimation of the population attributable fraction (PAF) of occupational cancer in Korea. Methods: Nine kinds of Group 1 carcinogens addressed by the International Agency for Research on Cancer (IARC) and 7 kinds of cancer were selected for the target carcinogens and diseases, respectively. The prevalence of carcinogen-exposed workers was estimated and correction factors were applied so that the value would be representative of the total population. Data on relative risk (RR) were taken from IARC reports and were compared with the RRs from the studies on Korean workers. The PAF was estimated according to Levin’s formula. Results: The proportion of the general Korean population exposed to carcinogens was 9.7%. The PAF of total cancer was 1.1% for incident cancer cases and 1.7% for cancer deaths. The PAFs of lung cancer and leukemia were 7.0% and 4.5%, respectively. With the RRs reported from Korean studies, the PAF for lung cancer and leukemia were 3.7% and 3.4%, respectively. Conclusion: The PAF in this study (1.1%) was lower than that reported in previous studies (2-4%) from developed countries. Considering that only 9 of the 29 kinds of Group 1 carcinogens were included in this study, the PAF might be underestimated. However, because the process of industrialization in Korea differs from that which occurred in other developed countries, 1.1% of the PAF might be appropriate for Korea.

We searched databases and used various online resources to identify and systematically review all articles on occupational psychiatric disorders among Korean workers published in English and Korean before 2009. Three kinds of occupational psychiatric disorders were studied: disorders related to job stress and mental illness, psychiatric symptoms emerging in victims of industrial injuries, and occupational psychiatric disorders compensated by Industrial Accident Compensation Insurance (IACI). Korea does not maintain official statistical records for occupational psychiatric disorders, but several studies have estimated the number of occupational psychiatric disorders using the Korea Workers' Compensation and Welfare Service (COMWEL, formerly KLWC) database. The major compensated occupational psychiatric disorders in Korea were "personality and behavioral disorders due to brain disease, damage, and dysfunction", "other mental disorders due to brain damage and dysfunction and to physical diseases", "reactions to severe stress and adjustment disorders", and "depressive episodes". The most common work-related psychiatric disorders, excluding accidents, were "neurotic, stress-related, and somatoform disorders" followed by "mood disorders".

Radiation risk has become well known through epidemiological studies of clinically or occupationally exposed populations, animal experiments, and in vitro studies; however, the study of radiation related or induced disease has been limited in Korea. This study is to find the level of occupational radiation exposure for various kinds of accidents, compensated occupational diseases, related studies, and estimations on future occupational disease risks. Research data of related institutions were additionally investigated. About 67% of 62,553 radiation workers had no exposure or less than 1.2 mSv per year. The 5 reported cases on radiation accident patients in Korea occurred during nondestructive testing. According to the recent rapid increase in the number of workers exposed to radiation, a higher social recognition of cancer, and an increasing cancer mortality rate, it is expected that occupational disease compensation will rapidly increase as well. Therefore, it is important to develop scientific and objective decision methods, such as probability of causation and screening dose in the establishment of an exposure and health surveillance system.

A male welder who had been working in an industrial machine plant for more than 20 years experienced acute intense pain in his left eye with continuous lacrimation while performing arc welding in 1997. Later in 1997, at the age of 39 yr, macular edema was found in his left eye. He was diagnosed with macular degeneration (MD) of the left eye in 2002, and with right eye MD in 2004. Radiation in the visible and near infrared (IR) spectra penetrates the eye and is absorbed by the retina, possibly causing thermal or photochemical damage. Such retinal damage may be permanent and, therefore, sight-threatening. The young age and history of an acute painful eye injury are not consistent with age related macular degeneration (AMD) but rather is likely maculopathy caused by welding arc exposure.

Background In the iron and steel industry, workers are potentially exposed to a number of carcinogens and are involved in a number of processes of a hazardous nature. The cancer morbidity of iron and steel workers from modern plants in a developing country is described. Methods Cancer morbidity at two Korean iron and steel complexes was analyzed using Poisson regression methods. Work histories were merged with the national cancer registry for 44,974 workers who were followed from 1988–2001. Results Four hundred sixty-four cancers, in 1% of the population, were diagnosed over 14 years. Based on national cancer rates, the cohort exhibited a healthy worker effect for all cancer (SIR = 0.87, 95% CI = 0.79–0.95) reflecting relative good health, particularly for lung cancer (SIR = 0.58, 95% CI = 0. 04–0.82), stomach cancer (SIR = 0.78, 95% CI = 0.64–0.93), and liver cancer (SIR = 0.83, 95% CI = 0.68–1.01). Lung cancer morbidity was significantly elevated at the affiliated plants versus the parent plants (SRR = 2.35, 95% CI = 1.07–4.92), and all-cancer morbidity was significantly elevated for maintenance workers compared to office and production workers (SRR = 1.27, 95% CI = 1.00–1.60). Lymphohematopoietic cancer incidence was higher in the coke plants (SRR = 3.46, 95% CI = 1.02–8.91) and stomach cancer incidence was higher in the maintenance departments (SRR = 1.66, 95% CI = 1.05–2.56). Conclusions This recent steelworker cohort exhibits possible excess cancer morbidity in some processing areas. Further follow-up of this cohort and alternate study designs such as case-control study will be needed to elucidate the relationship of exposure and health risks of iron and steel workers. Am. J. Ind. Med. 2006. Published 2006 Wiley-Liss, Inc.

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease affecting the motor neurons of the spinal cord and brain. Although the definite etiology of ALS remains unclear, occupational or environmental exposures have been considered as one of the potential causes of ALS. Here, we report the case of a patient with ALS who used to work in a factory manufacturing electronic parts and has evidence of acute exposure to lead in excess. A 39-year-old man visited a neurology clinic with symptoms of progressive limb weakness and spasticity, which began 2 years ago. Upon neurological examination, symptoms of atrophy, spasticity and fasciculation of the lower extremities were evident. There were no signs of impairment of the cranial nerves, and cognitive and sensory functions were normal. Complete blood counts, blood chemistries and urinalysis were normal. Serial electromyography showed progressive denervative changes, which were consistent with motor neuron diseases. ALS was diagnosed according to the standard of the "Diagnostic criteria of the World Federation of Neurology". The patient was handling lead oxide (PbO) for development of positive temperature coefficient (PTC) thermist, without being provided with proper respiratory protective equipment. Blood lead level of the patient was measured at 30.86 microg/dL 6 months after he quit his job. Bone lead levels from X-ray fluorescence (XRF) were below the normal range (3 ppm). Blood lead level of his co-workers at the same workplace were above the ACGIH recommended biological exposure index (BEI: 30 microg/dL). We speculated that the ALS in this case was related to excessive exposure to lead.

Introduction Using previously obtained cross-sectional data from a nationwide survey on workers exposed to manganese (Mn), we assessed the relation of high signal intensity with neurobehavioral effects, and reevaluated the preexisting cross-sectional data to get additional findings on the relation of high signals with other Mn-exposure indices. Subjects and methods Subjects were the same as those in the previous study. The exposure status was reassessed based on similar exposure groups. The signal intensity of the globus pallidus (GP) relative to frontal white matter was subjectively evaluated as either with or without increased signals, and the increased signals were further graded into three categories. For quantitative evaluation of signal intensities of the GP we also calculated the pallidal index (PI). Neurobehavioral function was assessed using the World Health Organization Neurobehavioral Core Test Battery. In addition, computerized finger tapping speed was included to assess motor speed. Results The mean blood Mn for those with grade III was significantly greater than those without increased signals and those with grade I. Airborne Mn and PI also showed similar findings. PI paralleled subjective MRI gradings. The proportion of workers with increased signals increased with all the Mn-exposure variables, airborne and blood Mn, the duration of work, and cumulative exposure. The PI was significantly associated with a correct score of pursuit aiming II tests and finger tapping of the dominant hand after control of age and educational level among neurobehavioral performances. Discussion The present findings showed that signal index on T1-weighted MRI showed a dose–response relationship with all the Mn-exposure variables. The two neurobehavioral tests reflecting fine motor function were significantly decreased above 107.1 of PI, the cutoff point between those with and without increased signals. Hence, signal intensity on MRI is an effective predictor of the neurobehavioral performance of Mn exposed workers.

Benzene has been used in various industries as glues or solvents in Korea. Since 1981, a preparation containing more than 1% benzene is not allowed to be manufactured, used or dealt with in the workplace, except in laboratories and in those situations benzene must be used in a completely sealed process as specified in Industrial Safety and Health Act (ISHA). Claims for compensation of hematopoietic diseases related to benzene have been rising even though the work environment has been improved. This study was conducted to assess the status of benzene exposure in different industries in Korea. We reviewed the claimed cases investigated by the Korea Occupational Safety and Health Agency (KOSHA) between 1992 and 2000. The Survey of National Work Environment Status in 1998 was analyzed to assume the number of workers and factories exposed to benzene. In 2000, six factories were investigated to evaluate benzene exposure. Personal air monitoring was performed in 61 workers and urine samples were collected from 57 workers to measure trans,trans-muconic acid (t,t-MA). Hematologic examination has performed. Thirty-four cases of hematopoietic diseases were investigated by KOSHA including eight cases of myelodysplastic syndrome and eight cases of acute myelocytic leukemia. Eight cases were accepted as related to benzene exposure. The number of workers possibly exposed to benzene can be estimated to be 196,182 workers from 6219 factories based on the database. The geometric mean of benzene in air was 0.094 (0.005-5.311) ppm. Seven samples were higher than 1 ppm but they did not go over the 10 ppm occupational exposure limit (OEL) value in Korea. The geometric mean of trans,trans-muconic acid in urine was 0.966 (0.24-2.74) mg/g creatinine. The benzene exposure level was low except in a factory where benzene was used to polymerize other chemicals. The ambient benzene from 0.1 to 1 ppm was significantly correlated with urine t,t-MA concentration (r=0.733, p0.01). Hematologic parameters did not show significant difference among groups divided into the level of exposure. Korean workers were not highly exposed to benzene and the level of exposure was mostly less than 1 ppm. However, there might be an excessive risk of hematopoietic disorders due to relatively high past exposure. The OEL value of benzene was amended to 1 ppm from 10 ppm in 2002 and was effective since July 2003.

Benzene causes many kinds of blood disorders in workers employed in many different environments. These diseases include myelodisplastic syndrome and acute and chronic myelocytic leukemia. In the present study, five occupational work places, including six industrial process types, namely, printing, shoe-making, methylene di-aniline (MDA), nitrobenzene, carbomer, and benzene production were selected, and the levels of breath benzene, and trans,trans-muconic acids (t,t-MA) and phenol in urine were evaluated, as well as hematological changes and lymphocyte DNA damage. The concentration of benzene in breath was less than 3 ppm in the workplaces, and benzene exposure was found to be higher in work places where benzene is used, than in those where benzene is produced. At low levels of benzene exposure, urinary t,t-MA correlated strongly with benzene in air. Highest Olive tail moments were found in workers producing carbomer. Levels of breathzone benzene were found to be strongly correlated with Olive tail moment values in the lymphocytes of workers, but not with hematological data in the six workplaces types. In conclusion, the highest benzene exposures found occurred in workers at a company, which utilized benzene in the production of carbomer. In terms of low levels of exposure to benzene, urinary t,t-MA and DNA damage exhibited a strong correlation with breath benzene, but not with hematological data. We conclude that breath benzene, t,t-MA and lymphocytic DNA damage are satisfactory biomonitoring markers with respect to benzene exposure in the workplace.

We have used a structural equation model (SEM) to analyze the interrelationships among exposure markers, magnetic resonance imaging (MRI) signal index, and neurobehavioral effects. Based on exposure groups, we assessed blood manganese, MRI measurements of pallidal index (PI), and neurobehavioral core test battery (WHO-NCTB) on 111 male workers occupationally exposed to manganese, including welders, smelter workers, and welding rod manufacturing workers. Latent variables were constructed to represent the neurobehavioral effects in an integrated way. The structural equation model revealed that airborne manganese and blood manganese contribute to PI significantly. Manganese exposure in the ambient air may lead to an increase in the internal dose, not only indirectly, by increasing blood manganese level, but also directly, independent of blood concentration. PI significantly contributed to a decrease in neurobehavioral test scores. We found that airborne manganese contributed to PI, and that PI is the most effective predictor of neurobehavioral performance, after adjusting for age and level of education. In conclusion, PI on MRI reflects target organ dose of occupational manganese exposure.

Objectives: The objective of this study is to assess the exposure and intake dose of N,N-dimethylformamide (DMF) and the correlation between them, according to the type of exposure for the workers in the DMF industry. Methods: We monitored 345 workers occupationally exposed to DMF, from 15 workshops in the synthetic fiber, fiber coating, synthetic leather and paint manufacturing industries. Ambient monitoring was carried out with personal samplers to monitor the external exposure. Biological monitoring was done to determine the internal dose by analyzing N-methylformamide (NMF) in end-shift urine. Work procedure and exposure type of each DMF workshop was carefully surveyed, to classify workers by exposure type according to work details. Workers were classified into three groups (Group A: continuous and direct exposure through inhalation and skin; Group B: intermittent and short-term exposure through inhalation and skin; Group C: continuous and indirect exposure mostly through inhalation). Results: Geometric mean of DMF concentration in air was 2.62 (GSD 5.30) ppm and that of NMF in urine was 14.50 (GSD 3.89) mg/l. In the case of continuous absorption through inhalation and dermal exposure (Group A), the value of NMF in urine corresponding to 10 ppm of DMF was 45.3 mg/l (r=0.524, n=178), 39.1 mg/g creatinine (r=0.424), while it was 37.7 mg/l (r=0.788, n=37), 24.2 mg/g creatinine (r=0.743) in the case of absorption mostly through inhalation (Group C). Creatinine correction reduced the correlation between two parameters. Conclusion: The NMF in urine corresponding to 10 ppm DMF, of the dermal and inhalation exposure group was 39.1 mg/g creatinine (r=0.424, n=178), while that of the inhalation exposure-only group was 24.2 mg/g creatinine (r=0.743, n=37). Co-exposure with toluene reduced the NMF excretion in urine.

A study was carried out to evaluate: (a) the value of a cumulative exposure estimate (CEE) calculated from limited information on air concentration; and (b) whether chronic exposure to mixed organic solvents at a shoe manufacturing factory has induced neurobehavioral changes. The Neurobehavioral Core Test Battery was administered to 40 female workers from a shoe manufacturing factory and 28 housekeepers as referents. The airborne concentrations of the solvents as a mixture were 0.46-0.71 at the frame making process and 1.83-2.39 at the adhesive process. Performance was analyzed by three exposure indices: current department, exposure duration, and CEE. The Santa Ana Dexterity test showed statistically significant differences only in CEE. In particular, the group with higher exposures had a significantly poorer performance than the reference group, on preferred hand trials. The results suggested that CEE appeared to be a better indicator of mixed organic solvents exposure, and neurobehavioral changes were associated with CEE over 10 years.

The Korean analytical quality assurance (KAQUA) program on biological monitoring was performed by the Industrial Health Research Institute in Korea in spring, 1995. The object of the KAQUA program is to improve the analysis capability for the biological monitoring of hazardous chemicals and to confirm the reliability of data from each laboratory. The items chosen for the first round were analyses of lead in blood (PbB) and of hippuric acid in urine (HAU). Eighty-eight laboratories in Korea participated in this program. Two levels of samples, randomly chosen among six levels for each item, were sent to the participants. The consensus value from participants and reference laboratories was determined by statistical analysis and used as a reference value. The tolerance range was +/-15% (+/-6 micrograms/dl for PbB below 40 micrograms/dl) of the reference value. The mean proficiency rate of analytical data increased dramatically in the first round compared with a pre-round that was provided as part of a training course for participants before performing the first round. The mean proficiency rate of PbB was 69% at pre-round and increased at 91% at the first round; for HAU the increase was from 58% to 88%. Not only the analytical results but also raw data were reviewed to find problems which might have arisen during the analytical process. Re-education courses provided after final evaluation of each participant by means of telephone discussion, correspondence course, and experimental practice, were helpful in achieving the purpose of the analytical quality assurance program.

The purpose of this survey was to obtain information on the overall blood lead concentrations of the Korean population due to environmental exposure. Five hundred and twenty-five Korean adults from four provinces who had no previous occupational exposure to lead were chosen by random sampling to represent the general (normal) population. Blood lead determinations were performed by atomic absorption spectrometry with a graphite furnace. Interlaboratory quality control for analysis of blood lead was carried out in seven laboratories in Korea and Europe. The geometric mean were 6.36 micrograms/dl for males and 5.09 micrograms/dl for females. There was no correlation between blood lead concentration and age. The mean concentration of blood lead in smokers was higher than that in nonsmokers (P0.0005). The mean blood lead concentration in male nonsmokers was higher than that in female nonsmokers (P0.0005). Differences in mean blood lead values according to residential area were observed, and this result showed good agreement with the results of ambient monitoring.

Biological exposure indices (BEIs) of toluene, perchloroethylene (PCE) and methyl ethyl ketone (MEK) for Korean workers were studied respectively. Exposure in workplace to organic solvents were measured by personal sampling. Blood toluene, blood PCE, urinary trichloroacetic acid and urinary MEK were determined by headspace GC. Urinary hippuric acid was determined by HPLC and corrected for creatinine. BEIs for Korean workers were calculated with the levels of the determinants corresponding to permissible exposure limits in Korea which were the same with TLV of ACGIH. Blood toluene level of 2.2 mg/l and urinary hippuric acid level of 1.7 g/g creatinine corresponded to exposure of 100 ppm toluene. Blood PCE concentration of 1.6 mg/l and urinary trichloroacetic acid concentration of 2.9 mg/l corresponded to exposure to 50 ppm PCE. Urinary MEK concentration of 1.4 mg/l corresponded to exposure to 200 ppm of MEK. In conclusion, BEIs for Korean workers determined in this study were different to ACGIH's BEI as urinary determinants were lower and blood determinants were higher than ACGIH's BEI.

The purpose of this study was to review the existing studies on lymphohematopoietic (LHP) cancer in Korea, estimate the prevalence of workers exposed to carcinogens, and determine the population attributable fraction (PAF) of leukemia. Two case series and 4 case reports were reviewed. Using official statistics, the prevalence of benzene exposure and ionizing radiation exposure was estimated. Based on the prevalence of exposure and the relative risk, The PAF of leukemia was calculated. Between 1996 and 2005, 51 cases of LHP cancer were reported from the compensation system. Greater than 50% of occupational LHP cancer was leukemia, and the most important cause was benzene. In a cohort study, the standardized incidence ratio was 2.71 (95% CI, 0.56-7.91). The prevalence of exposure was 2.5% and 2.2% in 1995 and 2000, respectively. Using the 1995 prevalence, 3.6-4.8% and 0.1% of cases with leukemia were attributable to benzene and ionizing radiation exposure, respectively, which resulted in 39.7-51.4 cases per year. Benzene is the most important cause of occupational leukemia in Korea. Considering the estimated PAF in this study, the annual number of occupational LHP cancer (51 cases during 10-yr period), might be underreported within the compensation system.

Cerebro-cardiovascular disease (CVD) is one of compensable occupational diseases in Korea as in Japan or Taiwan. However, most countries accept only cardiovascular diseases (ischemic heart diseases) as compensable occupational diseases if any, but not cerebrovascular diseases. Korea has a prescribed list of compensable occupational diseases. CVD was not included in the list until 1993. In the early 1990s, a case of cerebral infarction was accepted as occupational disease by the Supreme Court. The decision was based on the concept that workers' compensation system is one of the social security systems. In 1994, the government has established a diagnostic criterion of CVD. The crude rate of compensated cerebrovascular disease decreased by 60.0% from 18.5 in 2003 to 7.4 in 2008 per 100,000 workers, and that of compensated coronary heart disease decreased by 60.5% from 3.8 in 2003 to 1.5 in 2008 per 100,000 workers. The compensated cases of CVD dramatically increased and reached its peak in 2003. Since many preventive activities were performed by the government and employers, the compensated cases have slowly decreased since 2003 and sharply decreased after 2008 when the diagnostic criterion was amended. The strategic approach is needed essentially because CVDs are common, serious and preventable diseases which lead to economic burden.

Korea has industrialized since the 1970s. Pneumoconiosis in coal miners was the most common occupational disease in the 1970s to 1980s. With the industrialization, the use of many chemicals have increased since the 1970s. As a consequence, there were outbreaks of occupational diseases caused by poisonous chemicals, such as heavy metal poisoning, solvent poisoning and occupational asthma in the late 1980s and early 1990s with civil movement for democracy. Many actions have been taken for prevention by the government, employers and employees or unions. In the 1990s most chemical related diseases and pneumoconiosis have rapidly decreased due to improving work environment. In the late 1990s, cerebro-cardiovascular diseases related to job stress or work overloads have abruptly increased especially after the economic crisis in 1998. After the year 2000, musculoskeletal disorders became a major problem especially in assembly lines in the manufacturing industry and they were expanded to the service industry. Mental diseases related to job stress have increased. Infectious diseases increased in health care workers and afforestation workers. Occupational cancers are increasing because of their long latency, although the use of carcinogenic substances are reduced, limited, and even banned.

목적: 이 연구는 2001년부터 2003년까지 최근 3년 동안 근로복지공단에서 업무상질병으로 인정한 사례를 정밀분석하여 직업병의 종류와 특성을 밝힘으로써 직업병 예방사업이나 산업보건연구의 우선순위를 결정하는데 기초자료로 제공하기 위하여 실시하였다. 방법: 근로복지공단 주전산망을 통하여 요양 승인일자가 2001...

1) Objectives: The problem of noise-induced hearing loss (NIHL) was objectively and sys- tematically investigated by diagnosing three workers who complained of tinnitus and hearing disturbance. Methods: Atypical hearing loss is diagnosed as a work-related disease by using general medical methods, such as environmental survey, neurological examination, otoscopy, pure-tone audiometry, speech audiometry, otoacoustic emissions (OAE), auditory-evoked potentials, and interview on the history of past disease, family and occupation. Results: Three results were found according to the work-related hearing loss as fol- lows; (1) hearing loss that is caused by exposure to continuous noise of less than 85 dB(A) or impact noise of greater than 135 dB peak, (2) mixed hearing loss that has pro- gressed due to noise with past otitis media, and (3) atypical hearing loss that showed remarkable differences between air and bone conduction due to tinnitus. Conclusions: The criteria for work-related hearing loss should be carefully investigated by considering exposure to impact noise, the effect of continuous noise on mixed hearing loss patients, and the hearing loss caused by tinnitus.