Lead, which is widely used in industry, is a common element found in low concentrations in the Earth’s crust. Implementations to reduce environmental lead concentrations have resulted in a considerable reduction of lead levels in the environment (air) and a sustained reduction in the blood lead levels of the average citizen. However, people are still being exposed to lead through a variety of routes in everyday commodities.Lead causes health problems such as toxicity of the liver, kidneys, hematopoietic system, and nervous system. Having a carcinogenic risk as well, the IARC classifies inorganic lead compounds as probably carcinogenic to humans (Group 2A). Occupational lead poisonings have decreased due to the efforts to reduce the lead concentrations in the working environment. In contrast, health hazards associated with long-term environmental exposure to low concentrations of lead have been reported steadily. In particular, chronic exposure to low concentrations of lead has been reported to induce cognitive behavioral disturbances in children.It is almost impossible to remove lead completely from the human body, and it is not easy to treat health hazards due to lead exposure. Therefore, reduction and prevention of lead exposure are very important. We reviewed the toxicity and health hazards, monitoring and evaluation, and management of lead exposure.

A Case‐crossover Study of Transient Risk Factors for Occupational Traumatic Hand Injuries in Incheon, Korea: Won‐Jun CHOI, et al. Department of Ocean and Underwater Medicine, Maritime Medical Center, ROK Navy, Korea— Objectives A casecrossover study was conducted to identify transient risk factors for occupational acute hand injuries. Methods In total, 98 subjects were recruited from a hospital specializing in occupational accidents and trauma. Patients who had injured fingers, hands or wrists during work were interviewed within 30 days after their accidents. Results The relative risks for each factor were as follows: 22.9 for unusual or malfunctioning machines (95% confidence interval [CI] 14.4–36.4), 3.3 for wearing gloves (95% CI 1.9–5.7), 5.7 for unusual tasks (95% CI 3.8–8.8), 12.1 for altered work methods (95% CI 8.4–17.6), 4.1 for rushing (95% CI 2.6–6.3), 12.9 for being distracted (95% CI 7.9–20.9), 1.2 for feeling ill (95% CI 0.4–3.6) and 1.0 for working overtime (95% CI 0.6–1.6). Conclusion The results suggest that some transient risk factors were associated with occupational acute hand injuries. These risk factors are probably preventable, and modifying unsafe or unusual conditions is important to reduce occupational traumatic hand injuries.

BackgroundSeveral studies suggest that serum ferritin concentrations reflect systemic inflammation, and high ferritin levels can increase the risk of hypertension in adult men. Shift work is also known to increase the risk of hypertension; however, there has been no study about the relationship between serum ferritin levels and the prevalence of hypertension according to the working type.MethodsThis cross-sectional study included 4,442 male participants (3,651 daytime workers and 791 shift workers) who participated in the fifth Korean National Health and Nutrition Examination Survey. Hypertension was defined as a systolic blood pressure greater than or equal to 140 mmHg, a diastolic blood pressure greater than or equal to 90 mmHg or the current use of antihypertensive medications regardless of blood pressure values. For the statistical analyses, serum ferritin levels were reclassified into quartiles, and complex sample analyses were used to evaluate the relationship between serum ferritin levels and the prevalence of hypertension according to the working type in this study.ResultsSerum ferritin and shift work were positively associated with the prevalence of hypertension. The effect of interaction was above multiplicative. When compared to participants in the lowest serum ferritin quartile, the odds ratio for hypertension for participants in the highest serum ferritin quartile was 1.372 (1.027–1.833) in daytime workers and 2.009 (1.042–3.873) in shift workers after adjustment.ConclusionsThe prevalence of hypertension increased as ferritin levels increased in individuals, especially in shift workers.

Background Osteoarthritis (OA) and osteoporosis (OP) are the 2 most common bone disorders associated with aging. We can simply assume that older patients have a higher incidence of OA and OP with more severity. Although several papers have conducted studies on the relationship between OA and OP, none of them has demonstrated a conclusive link. In this study, we used radiological knee OA and bone mineral density (BMD; T-score of the total hip and lumbar spine) to analyze the incidence of OA and OP in a large population. We aimed to determine the relationship between OA and OP and investigate the associated risk factors Methods This cross-sectional study used data extracted from the 2010–2012 Korea National Health and Nutrition Examination Survey. We evaluated a total of 4,250 participants aged ≥ 50 years who underwent knee radiography and dual-energy X-ray absorptiometry and their laboratory results. The relationship between radiological knee OA and BMD was assessed. The generalized linear model was used to evaluate the relationship between BMD and Kellgren-Lawrence (KL) grade. Results The higher KL grade was associated with older age, higher body mass index (BMI), female sex, and lower hemoglobin level ( p < 0.001). No significant association was found between OA and the following variables: white blood cell, platelet, total cholesterol, vitamin D, alkaline phosphatase, parathyroid hormone, hypertension, diabetes, asthma, dyslipidemia, smoking status, alcohol consumption, and regular exercise ( p > 0.05). After adjusting for confounding factors (age, BMI, diabetes, hypertension, smoking, and alcohol consumption), the average T-scores of total hip and lumbar spine were the highest in the mild OA group with KL grade 2 (−0.22 ± 1.08 and −0.89 ± 1.46, respectively, p < 0.001). The average T-scores of the total hip and lumbar spine significantly decreased as OA progressed from moderate (KL grade 3; −0.49 ± 1.05 and −1.33 ± 1.38, respectively, p < 0.001) to severe (KL grade 4; −0.73 ± 1.13 and −1.74 ± 1.75, respectively, p < 0.001). T-scores of the moderate-to-severe OA group were significantly lower than those of the non-OA group (KL grades 0 and 1, p < 0.001). Conclusions Compared with the non-OA group, BMD (T-scores of the total hip and lumbar spine) was higher in the mild OA group and lower in the moderate-to-severe OA group.

Purpose Lunit INSIGHT CXR (Lunit) is a commercially available deep-learning algorithm-based decision support system for chest radiography (CXR). This retrospective study aimed to evaluate the concordance rate of radiologists and Lunit for thoracic abnormalities in a multicenter health screening cohort. Methods and materials We retrospectively evaluated the radiology reports and Lunit results for CXR at several health screening centers in August 2020. Lunit was adopted as a clinical decision support system (CDSS) in routine clinical practice. Subsequently, radiologists completed their reports after reviewing the Lunit results. The DLA result was provided as a color map with an abnormality score (%) for thoracic lesions when the score was greater than the predefined cutoff value of 15%. Concordance was achieved when (a) the radiology reports were consistent with the DLA results (“accept”), (b) the radiology reports were partially consistent with the DLA results (“edit”) or had additional lesions compared with the DLA results (“add”). There was discordance when the DLA results were rejected in the radiology report. In addition, we compared the reading times before and after Lunit was introduced. Finally, we evaluated systemic usability scale questionnaire for radiologists and physicians who had experienced Lunit. Results Among 3,113 participants (1,157 men; mean age, 49 years), thoracic abnormalities were found in 343 (11.0%) based on the CXR radiology reports and 621 (20.1%) based on the Lunit results. The concordance rate was 86.8% (accept: 85.3%, edit: 0.9%, and add: 0.6%), and the discordance rate was 13.2%. Except for 479 cases (7.5%) for whom reading time data were unavailable (n = 5) or unreliable (n = 474), the median reading time increased after the clinical integration of Lunit (median, 19s vs. 14s, P < 0.001). Conclusion The real-world multicenter health screening cohort showed a high concordance of the chest X-ray report and the Lunit result under the clinical integration of the deep-learning solution. The reading time slight increased with the Lunit assistance.

Objectives Several studies on the health effects of heat exposure on workers have been reported; however, only few studies have summarized the overall and systematic health effects of heat exposure on workers. This study aims to review the scientific reports on the health status of workers exposed to high temperatures in the workplace. Methods We reviewed literature from databases such as PubMed and Google Scholar, using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines to identify studies that address health effects of heat exposure among workers. Results In total, 459 articles were identified, and finally, 47 articles were selected. Various health effects of heat exposure on workers have been reported, such as heat-related diseases, deaths, accidents or injuries, effects on the urinary system, reproductive system, and on the psychological system. Conclusions Our review suggests that many workers are vulnerable to heat exposure, and this has a health effect on workers.

This study compared the association between working hours and self-rated health (SRH) according to sex, socioeconomic status, and working conditions. In all, 25,144 participants were selected from the Korea National Health and Nutrition Examination Survey (KNHANES), conducted from 2010 to 2018. The risks of poor SRH, according to working hours, were investigated using multiple logistic regression. Both short and long working hours were associated with poor SRH. Men working short hours and women working long hours were at risk of poor SRH. Workers with fewer than nine years of education were at risk of poor SRH when working short hours, whereas workers with more than nine years of education were at risk when working long hours. Similarly, simple laborers were at risk of poor SRH when working short hours, while managers and professional workers were at risk when working long hours. When working for short hours, paid employees were at risk of poor SRH. Workers with a non-fixed work schedule showed no risk of poor SRH when working long or short hours. In conclusion, workers working short hours with low education and workers working long hours with high education were at risk of poor SRH. Working conditions were significantly related to the association between SRH and working hours.

Exposure to extreme temperature is a critical occupational risk factor. This study aimed to investigate the association between exposure to extreme temperatures and injury at the workplace using data from 92,238 workers (46,175 male and 46,063 female) from the 2014 and 2017 Korean Working Condition Survey. Exposure to extremely high or low temperatures, injury experiences, and personal protective equipment (PPE) wearing behavior were investigated using a questionnaire. Logistic regression analyses were performed to investigate the association between exposure to extreme temperature and injury experience. The association between injury experience and PPE wearing behavior was analyzed for each exposure group. After adjusting for individual and occupational factors, the odds ratios (ORs) for injury experience were 2.06 (95% confidence interval (CI): 1.78–2.38) and 1.64 (95% CI: 1.44–1.85) in both high and low temperature exposure groups, respectively, and 1.45 (95% CI: 1.15–1.83) for those not wearing PPE when exposed to high temperature. There was no significant association shown with wearing PPE and injury experience in the low temperature exposure group. Exposure to extreme temperature tended to increase the risk of injury, and was higher in workers not wearing PPE in high temperature. PPE that can be worn comfortably in high temperature is needed to prevent occupational injury.