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KMID : 0606019960020010027
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Soonchunhyang Journal of Industrial Medicine
1996 Volume.2 No. 1 p.27 ~ p.52
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The Effect of Industry Type Specific Occupational Health Service on the Health Status of Lead Workers
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Abstract
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In order to evaluate the effect of industry type specific occupational health service on the health status of lead workers, total 39.203 record of 5 year accumulated data of workers from 1989 to 1993 in lead using industries which made special
contract
of group occupational health service with Soochunhyang university, institute of industrial medicine were studied.
Blood zinc protoporphyrin (ZPP) and 15 lead related symptoms were selected as a health indices and air concentration of lead (PbA) was selected as a environmental index of lead industries.
Blood ZPP and symptoms survey were carried out twice a year for lead workers and once a year for non-lead office workers. Environmental measurements of lead in air were done twice a year in every lead using industries. Lead industries were
divided
into
4 group of lead industries arbitrarily such as storage battery industries for group I, secondary smelting, litharge making and related operation for group II, telecommunication for group III and primary smelting and crystal glass making for group
IV.
Data for group III only available for 3.5 years from 1990 to first half of 1993.
Blood ZPP was measured with hematoflurometer (Aviv model 206). Fifteen questionnaire of lead related symptoms were provide dot all workers and filled by themselves and confirmed by interview doctor at the site.
@ES The results obtained were as follows :
@EN 1. While the geometric means of lead in air of group I, II, IV in 1989 were 0.333, 0.353 and 0.113 ㎎/, those in 1993 were decreased to 0.081, 0.162 and 0.037 ㎎/㎥ respectively. On the other hand the geometric means of lead in air of group
III
were
always below 0.020 ㎎/㎥ throughout the study period.
2. While the geometric mean of lead in air in medium/large storage battery industries was 0.313 ㎎/㎥ in 1989, it was decreased to below 0.05 ㎎/㎥ since 1992, that in small storage battery industries was 0.395 ㎎/㎥ and it was still 0.101 ㎎/㎥
in
1993. This data suggested that the effect of group occupational health service were more effective in medium/large storage battery industries.
3. The overall percent of distribution of lead in air of below 0.05, 0.05-0.15 and over 0.15 ㎎/㎥ in group I for 5 years were 87.54%, 9.29% and 3.16% respectively. On the other hand, for group II and III, those were 77.19%, 15.21%, 7.6%, and
92.78%,
3.72% and 92.78%, 3.72%, 3.5% respectively. The overall percent of distribution of lead in air of above three category in medium/large and small storage battery industries were 90.42%, 7.32%, 2.25% and 79.96%, 14.47%, 5.57% respectively.
4. The mean blood ZPP of male lead workers decreased from 52.61±68.67 ㎍/100ml in 1989 to 33.31±34.62 ㎍/100ml and those of female lead workers decreased from 84.01±79.06 ㎍100ml in 1989 to 58.35±47.30 ㎍/100ml. While the mean blood ZPP of
male
lead workers for group I, II and IV in 1989 was 39.65±40.41, 132.9±121.1 and 32.9±55.51 ㎍100ml, those in 1993 were 29.75±28.38, 77.35±64.48 and 31.41±21.35 respectively. The mean blood ZPP for group III were ranged from 13.11±8.53 to
26.43±8.83
㎍/100ml for 3 and half years period.
5. The mean blood ZPP of male lead workers in medium/large and small storage battery industries in 1989 were 32.16, 82.53 ㎍/100ml in 1989 and those in 1993 were decreased to 25.69 and 76.22 ㎍/100ml respectively. Those of female lead workers in
both
industries in 1989 were 53.36, 126.3 ㎍/100ml and 43.68, 90.17 ㎍/100ml respectively.
6. The overall percent of distribution of blood ZPP of below 50, 50-99, 100-149 and over 150 for 5 years were 72.83% (male: 76.63%, female: 44.59%), 16.97% (male : 15.23, female : 29.93%), 5.23% (male: 4.18%, female: 13.04%) and 4.96% (male:
3.96%,
female: 12.44%) respectively. Among 4 groups, the percent of workers whose blood ZPP over 50㎍/100ml highest in group II>
7. The mean of overall symptoms of male and female lead workers in 1989 were 5.2 and 4.9 and decreased to 4.6 and 4.3 in 1993 respectively. The mean of overall symptoms of male and female lead workers in medium/large storage battery industries
in
1989
were 5.7, 5.9 and decreased to 4.8, 5.2 in 1993. Those in small storage battery industries in 1989 were 4.8, 5.2 and 3.8, 3.2 respectively.
8. The most frequent symptom among 15 lead related symptom questionnaires for 5 year duration was 'generally fatigue' (male: 63%, female: 53%) and the least frequent symptom was 'acute abdominal pain around umbilicus' (male: 12%, female: 9%).
Among
male lead workers of 4 groups the prevalence of lead related symptoms was highest in group 4 and followed by group 3, I and 2 in descending order. Among female lead workers it was highest in group 3 and followed by group 1, 2, and 4 in descending
order.
9. The prevalence of lead related symptoms were high in group whose blood ZPP below 100㎍/100ml than those with blood ZPP over 100 ㎍/10ml. The prevalence of lead related symptoms of male lead exposed workers were higher or same with male
non-lead
exposed workers in every symptoms except questionnaire 11. But for workers the prevalence of lead related symptoms of lead exposed workers were lower than non-exposed lead workers except questionnaire 1, 4, 5, 6, 7, 8, 12, 15.
10. There was very similar pattern of symptom prevalence over the 5 years in lead exposed and non-exposed workers for both sex.
11. The prevalence of lead related symptoms was higher in young age group than old age group and there was no big difference of prevalence according to the work duration.
With above results, group occupational health service for lead workers improved working condition of lead industries under special contract with Soonchunhyang university, institute of industrial medicine in term of decrease of lead in air,
particularly
more effective in medium/large storage battery industries. It also brought out the the decrease of lead burden of most lead workers in terms of blood ZPP of lead workers which is a good index of lead intoxication. But symptom servery did not give
any
clue of dose-response relationship between lead exposure and lead related symptoms with current symptom questionnaire. It is recommended to revise the way of questioning lead related symptoms from lead workers.
On the other hand, for group II and III, those were 77.19%, 7.6% and 92.78%, 3.72%, 3.5% respectively.
The overall percent of distribution in air of above three category in medium/large and small storage battery industries were 90.42%, 7.32%, 2.25% and 79.96%, 14.47%, 5.57% respectively.
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