Jung-Wan Koo

Long Work Hours and Obesity in Korean Adult Workers

Long Work Hours and Obesity in Korean Adult Workers: Tae‐Won JANG, et al. Department of Occupational and Environmental Medicine, College of Medicine, The Catholic University of Korea, Korea—

Dose-related effect of urinary cotinine levels on bone mineral density among Korean females

SummaryTo evaluate the dose-dependent relationship between smoking and bone mineral density (BMD), the present study used the BMD dataset of the Korean National Health and Nutrition Examination Survey IV (KNHANES IV). The linearity of BMD for urinary cotinine levels was demonstrated with statistical significance in postmenopausal females.IntroductionIt is well established that smoking is an important lifestyle risk factor for bone health (bone loss, osteoporosis, and fracture). However, several studies demonstrated conflicting evidence for a dose-dependent relationship between smoking and bone health. To evaluate the dose-dependent relationship between smoking and BMD, the present study estimated dose-related effects of smoking (urinary cotinine level) on BMD at various sites (femur neck, total femur, and lumbar spine) in females with controlling menopausal status.MethodsThe present study used the BMD dataset of the KNHANES IV, which was performed in 2008 and 2009. A total of 4,260 pre- and postmenopausal females were included in the present study. Dose–response relationships between BMD and urinary cotinine levels were estimated using analysis of covariance in pre-menopausal females and postmenopausal females, respectively.ResultsIn postmenopausal females, the regression coefficients for BMD with urinary cotinine levels were −0.006, −0.006, and −0.008 (g/cm2 per ng/ml) at femur neck, total femur, and lumbar spine, respectively (p value < 0.05). Thus, the linearity of BMD for urinary cotinine levels was demonstrated with statistical significance in postmenopausal females.ConclusionOur findings suggested a significant dose-related effect of urinary cotinine level with BMD at femur neck, total femur, and lumbar spine among postmenopausal females.

Association between Blood Cadmium Levels and 10-Year Coronary Heart Disease Risk in the General Korean Population: The Korean National Health and Nutrition Examination Survey 2008–2010

Background Non-occupational heavy metals are considered risk factors for coronary heart disease (CHD). Several recent epidemiologic studies have evaluated the relationship between non-occupational cadmium exposure and risk factors for cardiovascular disease (CVD). This study was designed to investigate the relationship between non-occupational cadmium exposure and risk factors for CHD using the Framingham estimate of 10 year CHD risk. Methods The heavy metal dataset of the Korean National Health and Nutrition Examination Survey for 2008 through 2010, a cross-sectional survey of a representative sample of 4,668 non-institutionalized Koreans, was analyzed. Subjects were stratified into seven age groups to minimize the effects of age. The log-transformed blood cadmium concentrations were compared with the Framingham estimate of 10 year CHD risk in each age stratum. Results The Framingham estimate of 10 year CHD risk was significantly associated with the log-transformed blood cadmium concentrations (p<0.05) in all age groups of Korean men, with the lowest regression coefficient (0.254) for men aged 20 to <35 years and the highest (3.354) for men aged 55 to <60 years; similar results, however, were not observed in Korean women. After adjusting for survey year, age, and urinary cotinine concentration, the log-transformed blood cadmium levels among men aged 20 to <35, 40 to <45, 50 to <55, and 60 to <65 years were significantly associated with systolic blood pressure (p<0.05), but not with total and high density lipoprotein (HDL) cholesterol concentrations. Conclusions Cadmium exposure, even at non-occupational levels, may be associated with CHD risk in men. Despite the declines in non-occupational cadmium exposure over the past several decades, more efforts are needed.

Smoking Rate Trends in Korean Occupational Groups: Analysis of KNHANES 1998–2009 Data

Smoking Rate Trends in Korean Occupational Groups: Analysis of KNHANES 1998–2009 Data: Tae‐Won JANG, et al. Department of Preventive Medicine and Center for Occupational and Environmental Medicine, College of Medicine, The Catholic University of Korea, Korea—

Relationship between Bone Mineral Density and Moderate to Severe Chronic Kidney Disease among General Population in Korea

Recent studies in Western countries have reported a significant association between glomerular filtration rate (GFR) and bone mineral density (BMD) in the absence of dialysis among the general population. However, there have been few studies regarding renal function and BMD among Korean or Asian subjects with moderate to severe (stage 3 or 4) chronic kidney disease (MS-CKD). The aim of the present study was to investigate the association between MS-CKD and BMD in the general Korean population. BMD, serum creatinine and other measures were obtained from 3,190 subjects (1,428 males and 1,762 females; the fourth Korean National Health and Nutrition Examination Survey). GFR was estimated using the Cockcroft-Gault formula, with adjustment for body surface area. After adjustment for all variables, multiple regression analysis showed that BMD in the femur neck, total femur and lumbar spine were positively associated with eGFR in both males and females. Additional analysis showed that MS-CKD was also significantly associated with osteoporosis in both males and females (odds ratio [OR] 2.20, 95% confidence interval [CI] 1.15-4.20 in males; and OR 1.96, 95% CI 1.33-2.88 in females). Individuals with MS-CKD may be at higher risk of osteoporosis even among Asians.

Which type of cane is the most efficient, based on oxygen consumption and balance capacity, in chronic stroke patients?

Canes are widely prescribed as walking aids, but little is known about the effects of canes on the physiological cost of walking. The purpose of this study was to investigate the differences in oxygen consumption associated with the gaits of hemiplegic patients in terms of balance capacity according to the type of cane used. Twenty-nine patients with chronic stroke were divided into poor-balance (n=15) and relatively-better-balance groups (n=14) based on a cutoff score of 49 on the Berg balance scale (BBS). Each patient completed three consecutive days of walking with a randomly assigned singlepoint cane, quad cane, or hemi-walker. We measured the oxygen expenditure and oxygen cost using a portable gas analyzer and heart rate during a 6-min walk test (6MWT) and a 10-m walk test (10MWT). The oxygen expenditure, gait endurance, and gait velocity were higher with the single-point cane (p<0.01) than with any of the other cane types, and the oxygen costs were lower (p<0.01) with the single-point cane among the patients with relatively better balance. The oxygen cost for the quad cane was lower (p<0.01) than that found for any the other cane types among the patients with relatively poor balance. Our study revealed that single-point canes require less oxygen use at a given speed and permits greater speed at the same oxygen consumption for hemiplegic patients with good balance. Walking aids with a greater base support may be more suitable than those with a smaller base support for patients with relatively poor balance. However, our conclusions are only preliminary because of the small sample size (KCT0001076).

Overwork and cerebrocardiovascular disease in Korean adult workers

Overwork and cerebrocardiovascular disease in Korean adult workers: Tae‐Won JANG, et al. Department of Occupational and Environmental Medicine, College of Medicine, The Catholic University of Korea, Republic of Korea—

Concentrations of VOCs and Formaldehyde in Newly Constructed Apartment Buildings Before and After Residence

This study was performed to measure the changed concentrations of formaldehyde and volatile organic compounds after moving in the newly constructed apartment buildings at Seoul. From December 2004 to October 2005, we measured the concentration of formaldehyde and volatile organic compounds in newly constructed apartment buildings before and after residence. In conclusion, it showed that there was a significant relationship association between the con centration of the volatile organic compound and the formaldehyde and remodeling of the house, built in-furniture, and ventilation of the house. Therefore, it was suggested that we need preventive measures and management plans about various factors such. as remodeling, and built in-furniture, ventilation to decrease the concentrations of volatile organic compounds and formaldehyde.

Work-related infectious diseases among Korean workers compensated under the Industrial Accident Compensation Insurance Law, 2006-2011

Abstract Background: Korea has no surveillance system for work-related infectious disease. However, these diseases are compensated by the Korea Workers’ Compensation & Welfare Service (KCOMWEL). Objectives: To understand the nature and distribution of compensated occupational infectious diseases in Korea. Methods: We used the KCOMWEL electronic database to analyze compensated cases of work-related occupational infectious disease. We reviewed and confirmed diagnoses excluding denied claims, secondary infections, dermatoid diseases, duplicated cases and those with missing information. We calculated the distribution of work-related infectious disease in Korea by occupation, calendar year, gender, age, and employment duration, as well as the annual compensated claim rates (per million). Results: We included 1,062 compensated cases of work-related infectious disease. The most common was scrub typhus (n = 567, 53·4%), followed by tuberculosis (n = 227, 21·4%), viral hepatitis (n = 55, 5·2%), and viral influenza (n = 53, 5·0%). A sudden increase in scrub typhus was observed in 2009. Unskilled laborers, including short-term contract workers in public sectors, were most commonly affected by these diseases, followed by health care professionals. Conclusions: Workers employed in forestry care in the public sectors and in hospitals were most vulnerable to infections. Proper surveillance systems to monitor infectious diseases among vulnerable working groups and improved prevention measures are needed.

The education and practice program for medical students with quantitative and qualitative fit test for respiratory protective equipment

Tuberculosis infection is prevalent in Korea and health care workers are vulnerable to tuberculosis infection in the hospital. The aims of this study were to develop and validate an education program that teaches senior medical students how to wear and choose the proper size and type of respiratory protective equipment (RPE), which may help reduce the risk of contracting Mycobacterium tuberculosis (MTB) from patients. Overall, 50 senior medical students participated in this education program. Methods of choosing the proper type of RPE, performing a fit check of the RPE, and choosing a suitable mask size were taught by certified instructors using the real-time quantitative fit test (QNFT). The validity of education program was evaluated with qualitative fit test (QLFT) before and after the education as pass or fail. The education program was effective, as shown by the significantly pass rate (increased 30 to 74%) in the QLFT after the education program (p<0.05). Among study participants, changing mask size from medium to small significantly increased the pass rate (p<0.001). Incorporation of this program into the medical school curriculum may help reduce risk of MTB infection in medical students working in the hospital.