Occupational Neurotoxic Disease in Korea

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Occupational Neurotoxic Disease in Korea
September 29, 2005

• Seong-Kyu Kang, Eun A Kim,
• Yeon Soon Ahn, Byung Soon Choi

Korea Occupational Safety and Health Agency
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Occupational Neurotoxic Diseases in Korea

• Since late 80s to early 90
• Erupted with people movement for democracy
• Outbreaks
• Carbon disulfide poisoning at viscose rayon
  factory
• Mercury poisoning at thermometer and fluorescence
  lamp factories
• Demyelinating lesion by toluene and Toxic
  encephalopathy by many organic solvents
• Peripheral neuropathy by lead, acrylamide, normal
  hexane

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Carbon disulfide poisoning(1967-2004)

• Viscose rayon manufacturing
• started since 1965, first case came out in 1981
• outbreak in 1990, closed in 1993
• Claim accepted in more than 900 workers by 2004
• Findings
• Multiple cerebral infarction, peripheral
  neuropathy
• Retinal microaneurysm, degenerative changes
• Renal glomerulosclerosis
• Depression, Impotence
• Hypertension, coronary heart disease

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Carbon disulfide

• Ballïon industry in the mid 18th century
• Used to manufacture viscose rayon since 1890
• Many cases of carbon disulfide have waxed and
  waned in developed countries
• More than 100 out of 600 workers in Germany in
  1940s
• Moving continuously from continent to continent

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Mercury

• Thermometer
• Florescent lamp
• Outbreak in 1990
• Recycling process for waste of semiconductor
  production
• Outbreak in 2000
• Herbal medicine
• Acute cases were reported in herbal medicine

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Manganese

• 1990 Manganese refinery industry
• 1997-8 Parkinson syndrome in welders
• Exposed to high level of manganese
• Some developed Parkinson syndrome
• Showed high signal intensity in MRI
• Positron Emission tomography (PET)
• Manganese Parkinsonism
• Parkinson syndrome develops in early age than
  usual in workers exposed to manganese.

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Lead Neurotoxicity

• Cases
• Mostly diagnosed based on Blood lead
• Not many cases were reported as a view of
  neurotoxicity.
• Industry
• Battery manufacturing
• Plastic manufacturing for stabilizer
• Lead based painting
• Glass industry for coloring

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Toluene poisoning

• Cases
• Spray painters, thinner, gravure printing
• Shoe industry
• adhesives
• Non Occupational
• Glue sniffer

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Methyl Bromide

• Three cases of methyl bromide poisonings in
  fumigation workers in 2000.
• They showed central nervous system disorders and
  peripheral neuropathy.
• Methyl bromide is using in fumigation for
  imported or exporting woods, cereals and some
  fruits in Korea

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Purpose

• Review the occupational neurotoxic diseases
  investigated by KOSHA

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• Request for investigation by compensation agency
• 117 cases
• Accepted cases by KOSHA investigation
• 45 cases

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Occupational Disease Diagnosis
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Occupational Disease Diagnosis
Consulting Physician
Clinician
Health Exam
KLWC
Request of Investigation
Clajm
KOSHA
Worker
Clinical Evaluation
Appeal
University Hospital
Minstry of Labor
Reappeal
Request opinion
High court
Court
Administative appeal
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Occupational Neurotoxic Disease

• CNS disease (20 cases)
• solvents encephalitis(4), Parkinsonism(4),
  infectious encephalitis(2), brain tumor
• Peripheral nervous system diseases (11)
• Neuropathy(8), motor neuron diseases(3)
• Cranial nerve diseases(6)
• facial palsy(5), ocular nerve palsy(1)
• central and peripheral nervous system disease(6)

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Causative agents

• Solvents
• Solvents (9), toluene(4) n-hexane(3)
  acetonitrile(2) lead
• cyclohexane, methylene chloride, acrylonitrile,
• Metals
• manganese(4) mercury(3)
• Other Chemicals
• methyl bromide(3), phosphate trioxide, hydrogen
  sulfate
• Physical
• cold(4), electricity, electromagnetic field.
  awkward position,
• Infection
• virus(2)

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In Summary

• Many workers were suffered from neurotoxic
  chemicals in Korea.
• Only few cases were accepted as occupational
  neurotoxic diseases
• There is no case accepted based on the
  neurobehavioral test result so far

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Visit Bulkuksa (Temple)
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Manuscript Submission

• By 20 October
• http//www.neurotoxicology.com