5. 직업병 사례 연구-윤진하(연세대학교)

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미선 흥
6 years ago
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2 RESEARCH VS. ASSESSMENT

3 ??

4 ?

5 ,,,, : :,

6 vs Validity Reliability Generalization (Qualitative) (Quantitative)

7 , [ ].

8 Systematic Epidemiologic Methods Person, Time, Place Evidence level

9 Hazard environment Occupational Toxicology Industrial (Occupational) Toxicology Workers (Human) Health

10 Leonid Afremov

11 Case Environmental Effect The Institute for Occupational Health

12 Adelaide Ross Smith(1928)???

13 Percival Pott ( ) The first occupational cancer (scrotal cancer), by toxin (PAH, coal tar) in occupation (chimney sweep).??

1895, German Surgeon Ludwig Rehn Three cases

14 1895, German Surgeon Ludwig Rehn Three cases of bladder cancer in workers exposed to aromatic amines in a fuschin dye factory 1954, RAM CASE, Cancer researcher Tumour of the urinary bladder as an occupational disease in the rubber industry in England and Wales How long?

17 Sumerian BC 1,000,000 BC 8,000 Fire, Stone Bronze BC 3,500 IRON AD ~ 1930~ Modern Cement Asbestos X-ray Plastic Cokes furnace PVC, PS, PET, PP Steam Engine Spinning mill Modern oil Diesel-ship Diesel-car (water power) refinery The Institute for Occupational Health Cited from: ILO encylopaedia of occupational health & safety

19 Case (series) approach serves as a valuable indicator of occupational hazards, primarily in situations where the health outcome is rear and has dramatic manifestations and there is a characteristic exposure that can be identified as the probable cause.

20 Case study Example

21 ,

22 1. (coal) (COAL MINE). ADD 1.

23 2. (UNLOADING) ADD 1..

24 3.. ADD1. 1 ADD2.

25 4. ( 6 ),. ADD1..

26 5. (Hopper and conveyor). ADD1.

27 6. 1 (Crushing) (hammer) 48. ADD1. 2.

28 7. (Sorting). ADD1. 13mm 11mm 9mm 2

29 8. (Mixing) 2 2.

30 9. (Product). ADD

31 10. (Loading).. ADD1..

33 ( )

A case of lung cancer in a 67-year-old bus garage worker. During the past 16 years (from 30 years ago) Refueled to almost fifty buses, and it takes a 5 hours per day.

38 A case of lung cancer in a 67-year-old bus garage worker. During the past 16 years (from 30 years ago) Refueled to almost fifty buses, and it takes a 5 hours per day. Cleaned the bus in night and morning. He had 7 pack-years of smoking. and have no familial history of lung cancer The bus terminal was bankrupted, hence we reviewed various literatures for exposure assessment.

39 BBC news. CNN New York Times. news.

N ACGIH limit value: 20μg/m 3 Elemental Carbon GM GSD Range BUS (Korea) 17 23.0 2.2 1.7 67.2 JY Jeong. Bull.Nat.Sci.,Yong-In Univ.Vol.13.No.1.DEC.

40 N ACGIH limit value: 20μg/m 3 Elemental Carbon GM GSD Range BUS (Korea) JY Jeong. Bull.Nat.Sci.,Yong-In Univ.Vol.13.No.1.DEC Sampler was located at behind of bus driver Elemental carbon levels were / and / just behind at exhaust pipe. (ND Lee et al. Health risk assessment of diesel engine exhaust and asbestos in bus garage worker. KOSHA [Korean Report])

41 Date Elemental Carbon ( / ) GM Max Driving Time (Minute) Driving distance ( ) Back ground concentration: 0.5 / (parked)

42 Diesel engine exhaust regulation of Korea (ex. CO emission limit value per km driving, 1.4 t vehicle) 8 100% 6 78, 21 78% CO g/km % 12% 8% Hence, the exposure level of diesel engine exhaust before 1990 was 10 times and more high than that after 2006.

44 Cited from at

45 What are factors suspected?

46 Diesel Engine Exhaust Data sampling and analysis were done by Dr. Hyun-Seok Kwag and Dr. Boowook Kim

47 t truck (parked)= 0.5 μg/m Tunnel Jumbo Drill Anfo Charger Loader Dump Truck

50 0.077~0.090 % (0.077~0.090%) X 400 = 0.31~ ( 15 ), 3

시료형태작업내용및측정위치측정시간 ( 분 ) 호흡성결정형유리규산 ( mg / m3 ) 기계운전 / 관리 ( 조정실 ) 260 0.

56 시료형태작업내용및측정위치측정시간 ( 분 ) 호흡성결정형유리규산 ( mg / m3 ) 기계운전 / 관리 ( 조정실 ) 개인시료 지게차운전 믹서기청소 지역시료조정실앞 호흡성결정형유리규산노출기준 ( mg / m3 ) : 고용노동부 0.05, ACGIH 0.025

57 Multiple myeloma, 41 years old, male, exposure: 17 years AML, 35 years old, male, exposure: 10 years Benzene etc. NHL in spleen, 57 years old, male, exposure: 32 years The images of MM, AML, NHL were cited from medtube.net, tumblr.com, aafp.org, sciguru.com

58 Fume(metal) Crystalline silica etc

60 Hardener(catalyst) Xylensulfonic acid (or benzenesulfonic acid ) Thermal decomposition degree of one -SO 3 H ; 65 kcal = 1 kg x kcal/kg x t 1 t 1 = 157 Thermal decomposition degree of two CH 3 ; 2 x 83 kcal = 1 kg x kcal/kg x t 2 t 2 = 400

61 ? Job Melting & pouring Automatic molding Shake out Metal fumes Silica Silica, heavy metals Agents benzene

62 Dusts(mg/m 3 ) -Quartz - - -Respirable dust - - Metals(mg/m 3 ) -Cr 6+ -Nickel Melting Pouring Molding Core making Shake out Fettling ND ND ND PAH(mg/m 3 ) -Benzo(a)pyrene ND Benzo(b)fluoranthene ND Benzo(k)fluoranthene ND Chemicals(ppm) -Benzene ND Formaldehyde ND ND-0.300

63 Men Women Total Office Product ion Person-years 30, ,39 5 Leukemia n o n - Hodgkins lymphom a Lympho - hematop o i e t i c cancer Total 156,88 7 Office Producti on Total Office Producti on Total 11,887 14,396 26,284 42, , ,48 7 N SIR %CI N SIR %CI N SIR %CI

64 Leukemia in foundry WHO (IARC) reported that foundry work is lung carcinogenic to human (by PAH, coal tar, crystalline silica..) But some occupational toxicologists found cases of leukemia among foundry workers

65 Case study case can gives hypothesis Raw material à process emission Ex) diesel engine exhaust Welding fume Rubber manufacture

66 49,

68 Type of exposure Industrial classification Job classification [1993~2007]* [2008~2012.6] ** asbestos reinforcd plastic production and processing Manufacture of asbestos reinforced 5 machine operators plastic mixing & powder making 1 Manufacture of asbestos containing products U s e o f a s b e s t o s containing products in manufacturing process Handling of asbestos containing products during their work Manufacture of asbestos textiles Textile production and processing machine operators 3 5 Manufacture of stone products Stone splitters 1 Manufacture of cement Supervisor of stone quarry 1 1 M a n u f a c t u r e o f p a r t s a n d accessories for motor vehicles A l u m i n u m d o o r & w i n d o w manufacture and installation Manufacturer of brake lining and pad for motor vehicles 1 2 Manager and officer 2 Installer of aluminum door and window 1 Manufacture of pulp and paper engineering work 1 Health & safety manager 1 Manufacture of basic iron and steel Operator of electric furnace 1 1 Plumber 1 2 Ship breaking 1 Ship building and repairs Ship carpenter 1 1 Arrangement and cleaning 1 1 Assistant for panel work 1 Transportation Maintenance and repairman for taxi 1 Driver(Truck, Bus) 1 Construction Plumber 1 5 Bricklayer 1 scaffolding man 3 Foreman & safety manager 4 Welder 1 Painter 1 Electtrical engineer 1 Fire power generation Operator for differentiator, boiler and turbine 1 Welder 1 Mine Coal worker 2 *YS Ahn and SK Kang, Manufacture Industrial Health of electrical 2009, equipment 47, 113 Unknown The Institute for Occupational 1 Health 122 ** Submitted case of KCOML edited by JH Yoon

70 4 case Asbestos reinforced Plastic (6 case) 1 case Slip ring 1 case

71 Commutator A commutator is a rotary electrical switch in certain types of electric motors or electrical generators that periodically reverses the current direction between the rotor and the external circuit.

74 A grinder of asbestos

76 Asbestos-reinforced

77 The exposure levels of asbestos were (fiber/cc) ND ~ during grinding & polishing ND ~ during mixing of asbestos ~2002, 6 ton per month ~2007, 1~3 ton per month

78 Exposure (1 year) 36 years (from 13 years old) MM Exposure (29 years) 29 years (from 18 years old) MM Exposure (20 years) 37 years (from 15 years old) Exposure (15 years) 37 years (from 15 years old) MM MM

79 Two men One woman One woman

Percival Pott (1713-1788) The first occupational cancer (scrotal

80 Percival Pott ( ) The first occupational cancer (scrotal cancer), by toxin (PAH, coal tar) in occupation (chimney sweep). VS??

81 Sumerian BC 1,000,000 BC 8,000 Fire, Stone Bronze BC 3,500 IRON AD ~ 1930~ Modern Cement Asbestos X-ray Plastic Cokes furnace PVC, PS, PET, PP Steam Engine Spinning mill Modern oil Diesel-ship Diesel-car (water power) refinery The Institute for Occupational Health Cited from: ILO encylopaedia of occupational health & safety

82 Exposure (1 year) 36 years (from 13 years old) MM Exposure (29 years) 29 years (from 18 years old) MM Exposure (20 years) 37 years (from 15 years old) Exposure (15 years) 37 years (from 15 years old) MM MM

83 RESEARCH VS. ASSESSMENT

84 ?

88 . Research homepage: hl=ko&user=fze_zwaaaaaj&view_op=list_wor ks&sortby=pubdate

04_이근원_21~27.hwp

04_이근원_21~27.hwp 1) KIGAS Vol. 16, No. 5, pp 21~27, 2012 (Journal of the Korean Institute of Gas) http://dx.doi.org/10.7842/kigas.2012.16.5.21 실험실의 사례 분석에 관한 연구 이근원 이정석 한국산업안전보건공단 산업안전보건연구원 (2012년 9월 5일 투고, 2012년 10월 19일