직업성천식 감시체계에 등록된 우리나라의 직업성천식 실태

Abstract

Background : Since asthma caused by toluene diisocyanate (TDI) was reported at a polyurethane paint factory, occupational asthma there has been increasing concern of in both allergic and occupational health. However,, the statistics of occupational asthma did not reflected its seriousness because of many barriers related to legal reporting. Since fild a voluntary report from a clinician sent directly to a surveillance center would allow more cases to be filed without any disadvantage to workers and employers, we developed a surveillance system to facilitate the reporting of occupational asthma. Methods : Allergists and pulmonary physicians were asked to report to the Occupational Asthma Surveillance Center(OASC) using a mail. fax or e-mail if work-related asthma was diagnosed. A claimed case for occupational asthma to the Occupational Health Research Institute was also included. The OASC contacted the workers by phone and investigated the workplace if necessary. The reported Cases from October, 1998 to November, 1999 were analysed. Results : Thirty-three cases were reported with 29 males and four females. The mean age was 44 and the mean latency period was 5.4 years. Twenty-one cases were caused by a known allergen inducer with objective evidence. The causative agents included TDI in 45.5%(15), followed by reactive dye in 24.2%(8), welding fume(2), formaldehyde(1), paint(1), toluene(1), styrene(1), exhaustive gas(1), and wood dust(1). Among these cases, there were seven dyers, Four painters, three machine operators and furniture finishers, two assemblers and tanneries. Eighteen cases had claimed Workers Compensation Insurance and all were accepted. The reasons for not claiming Insurance included ignorance(28.5%), feat of job dismissal(23.8%), other reasons(9.5%), agreement with the employer(14.3%) and employer himself(9.5%) Conclusion : The OASC by allergists was an effective system to find unreported cases and to provide a prevention strategy of occupational asthma. Occupational asthma was mostly caused by TDI and Reactive dye. Painters. and dyers were the most common occupations causing occupational asthma. Only half of occupational asthma patients claimed compensation because of worker's ignorance and fear of being fired.