Ambient air quality and subjective stress level using Community Health Survey data in Korea

OBJECTIVES Air pollution causes various disease in exposed populations, and can lead to premorbid health effects manifested as both physical and psychological functional impairment. The present study investigated the subjective stress level in daily life in relation to the level of air pollution. METHODS Data from the Community Health Survey (2013), comprising 99,162 men, and 121,273 women residing in 253 healthcare administrative districts, were combined with air pollutant concentration modelling data from the Korean Air Quality Forecasting System, and were stratified by subjective stress levels into five strata for multiple logistic regression. Levels of exposure were divided into five quintiles according to the annual concentration of nitrogen dioxide (NO2), and were analyzed using a single-pollutant model using NO2 concentration only, and a multi-pollutant model adjusted for the concentration of particulate matter <10 μm in diameter. RESULTS Analysis of men and women in various age groups showed the highest odds ratio (OR) for subjective stress level at the highest NO2 concentration quintile in men and women aged 30–64 years (men: 2.91; 95% confidence interval [CI], 2.12 to 4.01; women: 1.82; 95% CI, 1.32 to 2.51). As the NO2 concentration quintile increased, the OR increased. Men showed higher ORs than women in all strata. CONCLUSIONS In the present study, annual NO2 concentrations were found to be associated with subjective stress levels. This association was especially clear among socioeconomically active men and women aged 30-64 years

Extreme Drug Resistance in Acinetobacter baumannii Infections in Intensive Care Units, South Korea

BACKGROUND: Difference in adaptability responses to stress has been observed amongst bird species, strains, and individuals. Components of the HPA axis, one of the internal systems involved in homeostasis re-establishment following stress, could play a role in this variability of responses. The aim of the present study was 1) to identify genes involved in the regulation of adrenal activity following ACTH stimulation and 2) to examine adrenal genes differentially expressed in individuals with high and low plasma corticosterone response following ACTH treatment. RESULTS: Analysis with 21 K poultry oligo microarrays indicated that ACTH treatment affected the expression of 134 genes. Several transcripts assigned to genes involved in the adrenal ACTH signaling pathway and steroidogenic enzymes were identified as differentially expressed by ACTH treatment. Real-time PCR on 18 selected genes confirmed changes in transcript levels of 11 genes, including MC2R, CREM, Cry, Bmal1, Sqle, Prax1, and StAR. Only 4 genes revealed to be differentially expressed between higher and lower adrenal responders to ACTH treatment. CONCLUSION: The results from the present study reveal putative candidate genes; their role in regulation of adrenal functions and adaptability to stress should be further investigated

Transmission of Seasonal Outbreak of Childhood Enteroviral Aseptic Meningitis and Hand-foot-mouth Disease

This study was conducted to evaluate the modes of transmission of aseptic meningitis (AM) and hand-foot-mouth disease (HFMD) using a case-control and a case-crossover design. We recruited 205 childhood AM and 116 HFMD cases and 170 non-enteroviral disease controls from three general hospitals in Gyeongju, Pohang, and Seoul between May and August in both 2002 and 2003. For the case-crossover design, we established the hazard and non-hazard periods as week one and week four before admission, respectively. In the case-control design, drinking water that had not been boiled, not using a water purifier, changes in water quality, and contact with AM patients were significantly associated with the risk of AM (odds ratio [OR]=2.8, 2.9, 4.6, and 10.9, respectively), while drinking water that had not been boiled, having a non-water closet toilet, changes in water quality, and contact with HFMD patients were associated with risk of HFMD (OR=3.3, 2.8, 6.9, and 5.0, respectively). In the case-crossover design, many life-style variables such as contact with AM or HFMD patients, visiting a hospital, changes in water quality, presence of a skin wound, eating out, and going shopping were significantly associated with the risk of AM (OR=18.0, 7.0, 8.0, 2.2, 22.3, and 3.0, respectively) and HFMD (OR=9.0, 37.0, 11.0, 12.0, 37.0, and 5.0, respectively). Our findings suggest that person-to-person contact and contaminated water could be the principal modes of transmission of AM and HFMD

Grand Rounds: An Outbreak of Toxic Hepatitis among Industrial Waste Disposal Workers

CONTEXT: Industrial waste (which is composed of various toxic chemicals), changes to the disposal process, and addition of chemicals should all be monitored and controlled carefully in the industrial waste industry to reduce the health hazard to workers. CASE PRESENTATION: Five workers in an industrial waste plant developed acute toxic hepatitis, one of whom died after 3 months due to fulminant hepatitis. In the plant, we detected several chemicals with hepatotoxic potential, including pyridine, dimethylformamide, dimethylacetamide, and methylenedianiline. The workers had been working in the high-vapor-generating area of the plant, and the findings of pathologic examination showed typical features of acute toxic hepatitis. DISCUSSION: Infectious hepatitis and drug-induced hepatitis were excluded by laboratory findings, as well as the clinical course of hepatitis. All cases of toxic hepatitis in this plant developed after the change of the disposal process to thermochemical reaction–type treatment using unslaked lime reacted with industrial wastes. During this chemical reaction, vapor containing several toxic materials was generated. Although we could not confirm the definitive causative chemical, we suspect that these cases of hepatitis were caused by one of the hepatotoxic agents or by a synergistic interaction among several of them. RELEVANCE TO CLINICAL OR PROFESSIONAL PRACTICE: In the industrial waste treatment process, the danger of developing toxic hepatitis should be kept in mind, because any subtle change of the treatment process can generate various toxic materials and threaten the workers’ health. A mixture of hepatotoxic chemicals can induce clinical manifestations that are quite different from those predicted by the toxic property of a single agent