Effects of the Thoracolumbar Exercise Program on Static Standing Balance and Pain in Low Back Pain Patients

Study Design: A randomized clinical trial. Background and Purpose: Several exercise programs have been reported to be beneficial in the treatment of low back pain (LBP). This study was to examine two different exercises, thoracolumbar exercise (TLE) and lumbar stabilizing exercise (LSE), for LBP. Methods: Ninety subjects (42 male, 48 female), who had mechanical LBP without other neurological symptoms, were exercised for 40 minutes, 3 times/week, for 8 weeks. This trial examined the Oswestry Disability Index, pain, static standing balance, thoracic mobility, and lumbar flexibility. Results: Subjects who participated in the TLE program were better than the LSE on the Oswestry Disability Index, thoracic mobility, and static standing balance. However, subject performances did not significantly differ in either exercise group in terms of pain and lumbar flexibility. Discussion: The TLE program has been demonstrated to be effective in patients with LBP in terms of lumbar functional disability including static standing balance.ope

페놀 노출 근로자의 요중 페놀농도에 영향을 미치는 요인

Objectives : The purpose of this study is to identify the characteristics that affect the urinary phenol of workers exposed to phenol. Subjects and Methods : Total 41 workers were selected at bisphenol A manufacturing plant and their urinary phenol concentration were measured before and after work along with the phenol concentration in the workplace air, and carried out a survey on work characteristics and lifestyle factors that could affect urinary phenol. Results : The phenol concentration in air during work hours was 0.91 (non-detection~2.88) mg/m3, and the worker’s urinary phenol concentrations before and after work were 100.27±75.76 and 138.13±109. 58 mg/g creatinine, respectively, which showed a statistically significant increase. Comparing smoking and urinary phenol concentration, smokers had 194.54±137.52 mg/g creatinine while non-smokers had 108.88±80.10 mg/g creatinine, thus showing the urinary phenol concentration of smokers to be statistically significantly higher (p=0.046). The urinary phenol concentration increased as work hours, the frequency of skin exposure to phenol, and the amount of drinking increased, and there were differences in its concentration depending on the work type and whether or not workers wore protective gear. The results of carrying out a multiple regression analysis showed that phenol concentration in air, work hours, frequency of skin exposure, and smoking were statistically significant. In other words, the urinal phenol concentration increased more for smokers than for non-smokers, when work hours became longer, and when the frequency of skin exposure was over five times. Conclusions : The factors that influenced urinary phenol in workers exposed to phenol were phenol concentration in air, work hour, frequency of skin exposure, smoking, work and lifestyle habits. Accordingly, biological monitoring for phenol exposure assessment must reflect these factors, and effort must be made to reduce skin exposure at workplace.ope

Study on Measurement of Carcinogen -DNA adduct s in exfoliated urothelial cells among worker s by 32P- postlabelling methods

Carcinogen-DNA adduct analysis has potential for biomonitoring the earliest effects of exposure to many chemical carcinogens. They are the covalent reaction products of electrophiles and nucle ophilic sites on DNA and the initial damage to DNA induced by many carcinogens. So many researchers begin to use them as biomarker for monitoring the earliest exposure of carcinogens and develop the effective analytical techniques about them. Randerath, Gupta and coworkers(1981, 1982) has also developed a 32P-postlabelling method as one among them. A major project for biomonitoring workers with carcinogen-DNA adducts is to develop noninvasive samples instead of tissues of target organs such as baldder and lung. This study use the exfoliated urothelial cells in urine for examine benzidine-DNA adducts. The content of exfoliated urothelial cells is not enough to significantly measure DNA content with spectrophotometer, and require the another way. So firstly washing the collected cells with PBS and 70% ethanol and centrifuge them for removing the crystals in urine, which block the isolation of DNA adducts. And then, measure the total nucleotide after 32P-postlabelling for calculating RAL. [γ-32 P]ATP using for 32P-postlabelling, can synthesize with [32P]H3PO4, and reagent and enzyme mixture (RM, EM), which is very economic in case of requiring a lot of them. Chromatography was composed of two steps. First step was to separate adduct ones from unadducted nucleotide, and secondary step was separate each adduct, which were performed with 4 kinds of solvents and different directions on TLC. With this procedure, we measure the DNA adducts in exfoliated urothelial cells of workers who were employed in benzidine and benzidine- dye company. RAL of adducts were 89.0×107 and 57.0×107 in them. In conclusion, we can significantly measure the DNA adduct in exfoliated urothelial cells by using the above 32P-postlabelling procedures, and use them to be biomonitoring workers who exposed carcinogens.ope

The association between concealing emotions at work and medical utilization in Korea

OBJECTIVES: We aimed to investigate the association between concealing emotions at work and medical utilization. METHODS: Data from the 2007-2009 4th Korea National Health and Nutrition Examination Survey (KNHANES IV) was used, 7,094 participants (3,837 males, 3,257 females) aged between 20 and 54 who were economically active and completed all necessary questionnaire items were included. Odds ratios (ORs) and 95% confidence intervals (95% CI) for differences in hospitalization, outpatient visits, and pharmaceutical drug use between those who concealed their emotions and those who did not were investigated using logistic regression models with and without gender stratification. RESULTS: Among those who concealed their emotions (n = 2,763), 47.4% were females, and 50.1% had chronic disease. In addition, 9.7% of the concealing emotions group had been hospitalized within the last year, 24.8% had been outpatients in the last two weeks, and 28.3% had used pharmaceutical drugs in the last two weeks. All ORs represent the odds of belonging to the concealing emotions group over the non-concealing emotions group. After adjustment for individual, occupational, socioeconomic and disease factors, the adjusted ORs (95% CI) in hospitalization are 1.29 (1.08 ~ 1.53) in the total population, 1.25 (0.98 ~ 1.60) in males and 1.30 (1.02 ~ 1.66) in females, in outpatient visits are 1.15 (1.02 ~ 1.29) in the total population, 1.05 (0.88 ~ 1.24) in males and 1.25 (1.06 ~ 1.47) in females and in pharmaceutical drug use are 1.12 (1.01 ~ 1.25) in the total population, 1.08 (0.92 ~ 1.27) in males and 1.14 (0.98 ~ 1.33) in females. CONCLUSIONS: Those who concealed their emotions at work were more likely to use medical services. Moreover, the health effects of concealing emotions at work might be more detrimental in women than in men.ope

Factors Related to Occupational Injuries and Health Problems for Some Female Workers in Non-standard Employment

Objectives: The purpose of this study was to examine certain factors associated with occupational injuries and health problems for some female workers in non-standard employment. Methods: We enrolled 754 female workers that were selected from 1,040 people who had agreed to be surveyed as part of a group or company in either the Seoul and the Kyonggi area. We performed univariate logistic regression on survey data and again performed multivariate logistic regression on those variables that were statistically significant. Results: In this study, the overall incidence of occupational injury for all workers was 12.5%. The incidence rates by position were as follows: 12.9%(insurance saleswoman), 7.4%(telemarketer), 9.2%(visiting teacher), 22%(golf caddy). The most frequent complaint was lower back pain(12.8%) in insurance saleswomen, voice symptoms(37%) in telemarketers, knee and ankle symptoms(33.8%) in golf caddies, and voice symptoms(14.4%) in visiting teachers. The factors related to occupational injuries included job type, and age. The factors related to health problems were job type, psychosocial stress, accident risk, and social support. The percentage of the cases that occurred without fringe benefits including social welfare was 30.4%, and the percentage of “paid out of the person’s own pocket” of ways to arrange costs of accidents was 32.5%. Conclusions: In this study, some female workers in non-standard employment had relatively high level of occupational injuries, accompanied by various health problems. In these occupational classes, the conditions for social insurance and social welfare were poor. It is necessary to expand the application of social insurances including industrial accident compensation insurance. Regardless of job category, psychosocial stress and social support were statistically significant for many symptoms. We believe that measurement of these factors is necessary. In the future, additional studies are required with the use of objective methods for additional job categoriesope

Worker’s demands and Group Health Service Agencys Intention for Worksite Medical Care

Objectives: This study was performed to survey worker’s demands for worksite medical care and agency’s intention for offering worksite medical care in Group Health Service Agency. Methods: One study subjects were employers, workers and office personnels in 167 factories. They were asked for medical care utilization behavior and worksite medical care demand. 121 employers (72.5%), 145 office personnels (86.8%) and 816 workers (60.5%) answered the questionnaire. The other subjects were doctors, nurses and administrators in 66 Group Health Service Agencies nationwide. They were asked for intention of offering worksite medical care in Group Health Service Agency through the mail survey. 31 doctors (47.0%), 38 nurses (57.6%) and 34 administrators answered the questionnaire. Results: 87 percentage of doctors and 94 percentage of nurses had experiences of being requested to prescribe and laboratory examination. All nurses, 94 percentage of adminis­trators and 76 percentage of doctors thought that it was necessary to give medical treatment at worksite. Also in worksite 85 percentage of employers, 86 percentage of office personnels and 81 percentage of workers answered that they accepted the worksite medical care when it would be given. Conclusions: Worksite medical care should be permitted because almost of all workers and employers requested worksite medical care, and doctors and nurses in Group Health Service Agency were willing to give worksite medical care and there was necessity to prevent occupational cerebrovascular disease.ope

Size-based characteristics of airborne bacteria and fungi distributed in the general hospital

The objective of this study is to provide fundamental data for pertinent management of indoor air quality through investigating the size-based characteristics of bioaerosol distributed in the general hospital. Measurement sites are main lobby, ICU, ward and laboratory and total five times were sampled with six-stage cascade impactor. Based on the result of this study, concentrations of airborne bacteria and fungi were the highest in main lobby as followed by an order of ward, ICU and laboratory. Concentrations of airborne bacteria was generally higher than those of airborne fungi and the ratio of indoor and outdoor concentration of both exceeded 1.0 in all the measurement sites of the general hospital. The predominant genera of airborne bacteria identified in the general hospital were Staphylococcus spp.(50%), Micrococcus spp.(15-20%), Corynebacterium spp.(5-20%), and Bacillus spp.(5-15%). On the other hand, the predominant genera of airborne fungi identified in the general hospital were Cladosporium spp.(30%), Penicillium spp.(20-25%), Aspergillus spp.(15-20%), and Alternaria spp.(10-20%). In regard to size distribution of bioaerosol, the detection rate was generally highest on 5 stage(1.1 2.1㎛) for airborne bacteria and on 1 stage(>7.0㎛) for airborne fungi. Cleanliness of facilities in the general hospital and condition of HVAC system should be monitored regularly to prevent indoor air contamination by airborne microorganisms.ope

Urinary Excretion of Thiodiglycolic Acid According to Sampling Tim in Workers Exposed to Vinyl Chloride Monomer

Objectives: The study was performed to investigate the changes of urinary thiodiglycolic acid (TDGA) concentration in workers exposed to vinyl chloride monomer (VCM) according to the time of sampling urine. Methods: The personal exposure to airborne VCM was assessed and urinary TDGA concentration was sampled in 31 workers employed in a VCM and polyvinyl chloride (PVC) manufacturing factory. Urinary TDGA was sampled three times: before the start of the shift after 3 days off (TDGA1), after the end of the first-day shift (TDGA2) and before starting the following day shift after completing the one-day shift (TDGA3). Urinary TDGA in 30 workers who had not been exposed to airborne VCM was sampled after the end of the shift. A gas chromatography/pulsed flame photometric detector (GC/PFPD) was utilized to analyze TDGA concentration in urine after the urine was methylated with trimethylsilyldia-zomethane (2.0M in diethyl ether). Results: The creatinine level was 0.179±0.271 ㎎/g in the control workers and 0.218±0.443 ㎎/g in the workers before the start of the shift after 3 days off (TDGA1), showing no significant difference (p=0.7035). Urine samples were compared according to sampling time in order to investigate the change of urinary TDGA concentration in the case of continuous exposure to airborne VCM. In VCM-exposed workers, urinary creatinine concentration was 0.434±0.623 mg/g in TDGA2 and 0.767±1.056 ㎎/g in TDGA3, which indicated a gradual but significant increase (p=0.024). In terms of the statistical correlation between airborne VCM and urinary TDGA to evaluate exposure dose per day, of the three urinary TDGA concentrations, TDGA3 showed the highest degree of regression (R2=0.4215) with 8h-TWA airborne VCM concentration. Conclusion: Based on this result, the excretion half-life of urinary TDGA was assumed to be less than 3 days, because the concentration of urinary TDGA at 3 days after exposure to airborne VCM was decreased to the level of urinary TDGA concentration in the control workers. The concentration of urinary TDGA increased in the case of continuous shift, due to the accumulation of residual metabolites of TDGA. It was considered that TDGA3 can be applied as a useful biological index to evaluate the exposure dose of airborne VCM during one day because TDGA3 showed the highest correlation with the exposure dose of airborne VCM in the previous shift day.ope

Analysis of Sufficient Conditions in Approving Cerebrovascular and Cardiovascular Disease as Occupational Disease

OBJECTIVES: This study was performed to analyze the factors that affect the decision to approve workers compensation claims for cerebrovascular and cardiovascular diseases and to analyze the worker characteristics. METHODS: Three hundred, sixty-nine cases were collected based on the workers compensation records of three Seoul and Incheon Regional centers of the Labor Welfare Corporation between 1998 and 1999. They contained the general characteristics, injury information and past medical histories. The x2-test and logistic regression were performed to investigate the factors affecting the approvals. Seventy-two survivors were surveyed by telephone for job stress. Job stress was surveyed in three parts: job demands, decision latitude and personal free time. RESULTS: Of the cases, 167 obtained approval from the Corporation; the others did not. Regardless of approval, 62% of all subjects had more than one of the cerebral and cardiovascular risk factors. Especially, 53.9% of subjects had hypertension. According to the logistic regression, the fatal cases had a higher approval rate (OR=26.4, CI=9.13-76.22). The cases with working condition change (OR=6.5, CI=3.45-12.07), accidents on worksite (OR=4.9, CI=2.39-10.07), female (OR=4.0, CI=1.21-13.3), accidents at night duty (OR=2.9, CI=.156-5.39), cases occurring on duty (OR=.25, CI=1.34-4.72) and cases without past disease history (OR=1.8, CI=1.02-3.36) also had higher approval rates. Telephone survey found that the approval rate increased with decreasing freedom of personal time schedule. However, the logistic regression revealed that job stress didnt affect the approvals. CONCLUSION: To prevent cerebrovascular and cardiovascular diseases, the most important aspect is to control hypertension which is the most common risk factor among the victims. Moreover, job stress and over working should be considered in the just approval of the workers compensation claims.ope

Pain Related Factors in Upper Extremities among Hospital Workers Using Video Display Terminals

OBJECTIVES: This study was designed to quantify symptoms in the upper extremities and to identify the pain related factors among hospital workers using video display terminals. METHODS: The subject-group consisted of 138 employees working at a hospital using video display terminals. A structured questionnaire was used to estimate the participants' general characteristics, and job contents. Job stress was measured using Karaseks JCQ (Job Content Questionnaire). Pain in the upper extremities was identified according to the NIOSH symptoms survey criteria. Quantification was measured using Kim Chul's method. Pearson's Correlation analysis was used to identify validity in quantification. VAS (visual analog scale) was used to compare with this method. Multiple regression analyses elucidated the relationship between quantified pain and various work factors, such as job stress. Data were analysed with SAS 6.12 program. RESULTS: First, in quantification using Kim Chul's method, the correlation between modified PRS (pain rating score) and VAS was extremely high by 0.60 (P<0.01), indicating the high validity of PRS. Second, the groups of high job demand, high job control, and females were related to an increased pain level. CONCLUSIONS: These results suggest that the self pain assessment method, PRS, is valuable and useful in analyzing occupational musculoskeletal symptoms. High demand, job control and gender may influence the levels of pain. Prospective studies about musculoskeletal disorder are required.ope