<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD Journal Publishing DTD v2.3 20070202//EN" "journalpublishing.dtd">
<?xml-stylesheet type="text/xsl" href="ViewNLM-v2.3.xsl"?>
<article xml:lang="KO" article-type="research-article">

<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">J Korean Med Assoc</journal-id>
<journal-id journal-id-type="publisher-id">JKMA</journal-id>
<journal-title>Journal of the Korean Medical Association</journal-title>
<issn pub-type="ppub">1975-8456</issn>

<publisher>
<publisher-name>Korean Medical Association</publisher-name>
</publisher>
</journal-meta>

<article-meta>
<article-id pub-id-type="doi">10.5124/jkma.2010.53.6.483</article-id>
<article-categories>
<subj-group>
<subject>Focused Issue of This Month</subject>
<subj-group>
<subject>Occupational Health Problems in Health Care Workers</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Health Disorders Caused by Physical Factors among Health Care Workers - Focusing on Ionizing Radiation -</article-title>
</title-group>

<contrib-group>

<contrib contrib-type="author" corresp="yes">
<name>
<surname>Lim</surname>
<given-names>Hyun-Sul</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A1"></xref>
</contrib>

</contrib-group>

<aff id="A1">Department of Preventive Medicine, Dongguk University College of Medicine, Korea.</aff>

<author-notes>
<corresp>Corresponding author: Hyun-Sul Lim. <email>wisewine@dongguk.ac.kr</email></corresp>
</author-notes>

<pub-date pub-type="ppub">
<month>06</month>
<year>2010</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>06</month>
<year>2010</year>
</pub-date>
<volume>53</volume>
<issue>6</issue>
<fpage>483</fpage>
<lpage>491</lpage>

<permissions>
<copyright-statement>Copyright &#x00A9; 2010 Korean Medical Association</copyright-statement>
<copyright-year>2010</copyright-year>
</permissions>

<abstract>
<p>Health care workers encounter many physical hazards in hospitals, including ionizing radiation, noise, and heat. Ionizing radiation is used in hospitals for diagnostic radiology, therapeutic radiology, dermatology, nuclear medicine, and in radiopharmaceutical laboratories. Radiation hazards may also exist in areas where radioactive materials are stored or discarded. Occupational exposure to ionizing radiation can lead to erythema or radiodermatitis. Ionizing radiation can cause gene mutation and chromosomal alteration. Other somatic effects that result from irradiation include several types of cancers (myelogenous leukemia, bone cancer, skin cancer, thyroid cancer, etc.), cataracts, aplastic anemia, and sterility. The chief methods for reducing doses of ionizing radiation from external X-rays and gamma rays are to limit the time of exposure, increase the distance from the source of the exposure, shield the source with protective materials, and avoid unnecessary exposures. Improved equipment, knowledge, and reduced exposures can greatly reduce the risk of radiation exposure for workers. Many work areas in hospitals were identified as noisy enough to decrease productivity. Noise may trigger changes in cardiovascular, endocrine, neurological, and other physiological functions. Working in high-noise areas makes it difficult for workers to communicate among themselves or to concentrate on critical job functions. Many places in hospitals including the laundry, boiler room, and kitchen may be hot during the summer months, especially in older facilities that have inadequate ventilation and cooling systems. Health care workers should pay attention to health disorders caused by physical factors to protect themselves against many hazards in hospitals.</p>
</abstract>

<kwd-group>
<kwd>Health care worker</kwd>
<kwd>Ionizing radiation</kwd>
<kwd>Noise</kwd>
<kwd>Heat</kwd>
</kwd-group>

</article-meta>
</front>

<back>

    <ref-list>
  <ref id="B1">
    <label>1</label>
    <nlm-citation citation-type="book">
      <person-group person-group-type="author">
        <name>
          <surname>Barbanel</surname>
          <given-names>CS</given-names>
        </name>
      </person-group>
      <person-group person-group-type="editor">
        <name>
          <surname>McCunney</surname>
          <given-names>RJ</given-names>
        </name>
      </person-group>
      <article-title>Medical center occupational health and safety</article-title>
      <source>Medical center occupational health and safety</source>
      <year>1999</year>
      <edition>1st ed</edition>
      <publisher-loc>Philadelphia</publisher-loc>
      <publisher-name>Lippincott Williams and Wilkins</publisher-name>
      <fpage>1</fpage>
      <lpage>14</lpage>
    </nlm-citation>
  </ref>

  <ref id="B2">
    <label>2</label>
    <nlm-citation citation-type="journal">
      <person-group person-group-type="author">
        <name>
          <surname>Chung</surname>
          <given-names>HK</given-names>
        </name>
      </person-group>
      <article-title>Occupational injuries in health care workers: present situation and countermeasure</article-title>
      <source>J Korean Med Assoc</source>
      <year>2000</year>
      <volume>43</volume>
      <fpage>259</fpage>
      <lpage>264</lpage>
    </nlm-citation>
  </ref>

  <ref id="B3">
    <label>3</label>
    <nlm-citation citation-type="journal">
      <person-group person-group-type="author">
        <name>
          <surname>Kim</surname>
          <given-names>CS</given-names>
        </name>
      </person-group>
      <article-title>The history of radiation accidents</article-title>
      <source>J Korean Med Assoc</source>
      <year>2003</year>
      <volume>46</volume>
      <fpage>871</fpage>
      <lpage>878</lpage>
    </nlm-citation>
  </ref>

  <ref id="B4">
    <label>4</label>
        <nlm-citation citation-type="web">
        <article-title>Radiation Safety Information System</article-title>
        <source>Information of radiation safety</source>
        <access-date>Accessed Apr 11, 2010</access-date>
        <comment>Available at: 
        <ext-link ext-link-type="uri" xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="http://rasis.kins.re.kr/rasis/index.jsp">http://rasis.kins.re.kr/rasis/index.jsp</ext-link></comment>
        </nlm-citation>
      </ref>

  <ref id="B5">
    <label>5</label>
    <nlm-citation citation-type="journal">
      <person-group person-group-type="author">
        <name>
          <surname>Preston</surname>
          <given-names>DL</given-names>
        </name>
        <name>
          <surname>Kusumi</surname>
          <given-names>S</given-names>
        </name>
        <name>
          <surname>Tomonaga</surname>
          <given-names>M</given-names>
        </name>
        <name>
          <surname>Izumi</surname>
          <given-names>S</given-names>
        </name>
        <name>
          <surname>Ron</surname>
          <given-names>E</given-names>
        </name>
        <name>
          <surname>Kuramoto</surname>
          <given-names>A</given-names>
        </name>
        <name>
          <surname>Kamada</surname>
          <given-names>N</given-names>
        </name>
        <name>
          <surname>Dohy</surname>
          <given-names>H</given-names>
        </name>
        <name>
          <surname>Matsuo</surname>
          <given-names>T</given-names>
        </name>
        <name>
          <surname>Nonaka</surname>
          <given-names>H</given-names>
        </name>
        <name>
          <surname>Thompson</surname>
          <given-names>DE</given-names>
        </name>
        <name>
          <surname>Soda</surname>
          <given-names>M</given-names>
        </name>
        <name>
          <surname>Mabuchi</surname>
          <given-names>K</given-names>
        </name>
      </person-group>
      <article-title>Cancer incidence in atomic bomb survivors Part III Leukemia lymphoma and multiple myeloma 1950-1987</article-title>
      <source>Radiat Res</source>
      <year>1994</year>
      <volume>137</volume>
      <fpage>S68</fpage>
      <lpage>S97</lpage>
    </nlm-citation>
  </ref>

  <ref id="B6">
    <label>6</label>
    <nlm-citation citation-type="journal">
      <person-group person-group-type="author">
        <name>
          <surname>Pierce</surname>
          <given-names>DA</given-names>
        </name>
        <name>
          <surname>Shimizu</surname>
          <given-names>Y</given-names>
        </name>
        <name>
          <surname>Preston</surname>
          <given-names>DL</given-names>
        </name>
        <name>
          <surname>Vaeth</surname>
          <given-names>M</given-names>
        </name>
        <name>
          <surname>Mabuchi</surname>
          <given-names>K</given-names>
        </name>
      </person-group>
      <article-title>Studies of the mortality of atomic bomb survivors Report 12, Part I. Cancer: 1950-1990</article-title>
      <source>Radiat Res</source>
      <year>1996</year>
      <volume>146</volume>
      <fpage>1</fpage>
      <lpage>27</lpage>
    </nlm-citation>
  </ref>

  <ref id="B7">
    <label>7</label>
    <nlm-citation citation-type="journal">
      <person-group person-group-type="author">
        <name>
          <surname>Moysich</surname>
          <given-names>KB</given-names>
        </name>
        <name>
          <surname>Menezes</surname>
          <given-names>RJ</given-names>
        </name>
        <name>
          <surname>Michalek</surname>
          <given-names>AM</given-names>
        </name>
      </person-group>
      <article-title>Chernobyl-related ionising radiation exposure and cancer risk: an epidemiological review</article-title>
      <source>Lancet Oncol</source>
      <year>2002</year>
      <volume>3</volume>
      <fpage>269</fpage>
      <lpage>279</lpage>
    </nlm-citation>
  </ref>

  <ref id="B8">
    <label>8</label>
    <nlm-citation citation-type="journal">
      <person-group person-group-type="author">
        <name>
          <surname>Lim</surname>
          <given-names>HS</given-names>
        </name>
        <name>
          <surname>Cheong</surname>
          <given-names>HK</given-names>
        </name>
        <name>
          <surname>Kim</surname>
          <given-names>SK</given-names>
        </name>
        <name>
          <surname>Park</surname>
          <given-names>BC</given-names>
        </name>
        <name>
          <surname>Lee</surname>
          <given-names>K</given-names>
        </name>
      </person-group>
      <article-title>A case of acute myelogenous leukemia occurring in a nuclear power plant worker</article-title>
      <source>Dongguk J Med</source>
      <year>2002</year>
      <volume>9</volume>
      <fpage>122</fpage>
      <lpage>138</lpage>
    </nlm-citation>
  </ref>

  <ref id="B9">
    <label>9</label>
    <nlm-citation citation-type="journal">
      <person-group person-group-type="author">
        <name>
          <surname>Oh</surname>
          <given-names>SH</given-names>
        </name>
        <name>
          <surname>Choi</surname>
          <given-names>SM</given-names>
        </name>
        <name>
          <surname>Lee</surname>
          <given-names>MJ</given-names>
        </name>
        <name>
          <surname>Park</surname>
          <given-names>KN</given-names>
        </name>
        <name>
          <surname>Choi</surname>
          <given-names>SP</given-names>
        </name>
        <name>
          <surname>Kim</surname>
          <given-names>YM</given-names>
        </name>
        <name>
          <surname>So</surname>
          <given-names>BH</given-names>
        </name>
        <name>
          <surname>Kim</surname>
          <given-names>HJ</given-names>
        </name>
        <name>
          <surname>Cho</surname>
          <given-names>YS</given-names>
        </name>
        <name>
          <surname>Hong</surname>
          <given-names>TY</given-names>
        </name>
      </person-group>
      <article-title>Survey of radiation exposure to emergency physicians</article-title>
      <source>J Korean Soc Emerg Med</source>
      <year>2008</year>
      <volume>19</volume>
      <fpage>541</fpage>
      <lpage>550</lpage>
    </nlm-citation>
  </ref>

  <ref id="B10">
    <label>10</label>
    <nlm-citation citation-type="book">
      <collab>National Dose Registry</collab>
      <source>2008 Report occupational radiation exposure in diagnostic radiology</source>
      <year>2009</year>
      <publisher-loc>Seoul</publisher-loc>
      <publisher-name>National Institute of Food and Drug Safety Evaluation, Korea Food and Drug Administration</publisher-name>
    </nlm-citation>
  </ref>

  <ref id="B11">
    <label>11</label>
    <nlm-citation citation-type="journal">
      <person-group person-group-type="author">
        <name>
          <surname>Jeong</surname>
          <given-names>TS</given-names>
        </name>
        <name>
          <surname>Shin</surname>
          <given-names>BC</given-names>
        </name>
        <name>
          <surname>Moon</surname>
          <given-names>CW</given-names>
        </name>
        <name>
          <surname>Cho</surname>
          <given-names>YD</given-names>
        </name>
        <name>
          <surname>Lee</surname>
          <given-names>YH</given-names>
        </name>
        <name>
          <surname>Yum</surname>
          <given-names>HY</given-names>
        </name>
      </person-group>
      <article-title>The Analysis of radiation exposure of hospital radiation workers</article-title>
      <source>J Korean Soc Ther Radiol Oncol</source>
      <year>2000</year>
      <volume>18</volume>
      <fpage>157</fpage>
      <lpage>166</lpage>
    </nlm-citation>
  </ref>

  <ref id="B12">
    <label>12</label>
    <nlm-citation citation-type="journal">
      <person-group person-group-type="author">
        <name>
          <surname>Jeong</surname>
          <given-names>JH</given-names>
        </name>
        <name>
          <surname>Kwon</surname>
          <given-names>JW</given-names>
        </name>
        <name>
          <surname>Lee</surname>
          <given-names>JK</given-names>
        </name>
      </person-group>
      <article-title>Occupational radiation exposure in Korea: 2002</article-title>
      <source>J Radiat Prot</source>
      <year>2005</year>
      <volume>30</volume>
      <fpage>175</fpage>
      <lpage>183</lpage>
    </nlm-citation>
  </ref>

  <ref id="B13">
    <label>13</label>
    <nlm-citation citation-type="journal">
      <person-group person-group-type="author">
        <name>
          <surname>Broder</surname>
          <given-names>J</given-names>
        </name>
        <name>
          <surname>Warshauer</surname>
          <given-names>DM</given-names>
        </name>
      </person-group>
      <article-title>Increasing utilization of computed tomography in the adult emergency department, 2000-2005</article-title>
      <source>Emerg Radiol</source>
      <year>2006</year>
      <volume>13</volume>
      <fpage>25</fpage>
      <lpage>30</lpage>
    </nlm-citation>
  </ref>

  <ref id="B14">
    <label>14</label>
    <nlm-citation citation-type="journal">
      <person-group person-group-type="author">
        <name>
          <surname>Mettler</surname>
          <given-names>FA</given-names>
          <suffix>Jr</suffix>
        </name>
        <name>
          <surname>Wiest</surname>
          <given-names>PW</given-names>
        </name>
        <name>
          <surname>Locken</surname>
          <given-names>JA</given-names>
        </name>
        <name>
          <surname>Kelsey</surname>
          <given-names>CA</given-names>
        </name>
      </person-group>
      <article-title>CT scanning: patterns of use and dose</article-title>
      <source>J Radiol Prot</source>
      <year>2000</year>
      <volume>20</volume>
      <fpage>353</fpage>
      <lpage>359</lpage>
    </nlm-citation>
  </ref>

  <ref id="B15">
    <label>15</label>
    <nlm-citation citation-type="journal">
      <person-group person-group-type="author">
        <name>
          <surname>Hellawell</surname>
          <given-names>GO</given-names>
        </name>
        <name>
          <surname>Mutch</surname>
          <given-names>SJ</given-names>
        </name>
        <name>
          <surname>Thevendran</surname>
          <given-names>G</given-names>
        </name>
        <name>
          <surname>Wells</surname>
          <given-names>E</given-names>
        </name>
        <name>
          <surname>Morgan</surname>
          <given-names>RJ</given-names>
        </name>
      </person-group>
      <article-title>Radiation exposure and the urologist: what are the risks?</article-title>
      <source>J Urol</source>
      <year>2005</year>
      <volume>174</volume>
      <fpage>948</fpage>
      <lpage>952</lpage>
    </nlm-citation>
  </ref>

  <ref id="B16">
    <label>16</label>
    <nlm-citation citation-type="journal">
      <person-group person-group-type="author">
        <name>
          <surname>Vano</surname>
          <given-names>E</given-names>
        </name>
        <name>
          <surname>Gonzalez</surname>
          <given-names>L</given-names>
        </name>
        <name>
          <surname>Fernandez</surname>
          <given-names>JM</given-names>
        </name>
        <name>
          <surname>Alfonso</surname>
          <given-names>F</given-names>
        </name>
        <name>
          <surname>Macaya</surname>
          <given-names>C</given-names>
        </name>
      </person-group>
      <article-title>Occupational radiation doses in interventional cardiology: a 15-year follow-up</article-title>
      <source>Br J Radiol</source>
      <year>2006</year>
      <volume>79</volume>
      <fpage>383</fpage>
      <lpage>388</lpage>
    </nlm-citation>
  </ref>

  <ref id="B17">
    <label>17</label>
    <nlm-citation citation-type="journal">
      <person-group person-group-type="author">
        <name>
          <surname>Kuipers</surname>
          <given-names>G</given-names>
        </name>
        <name>
          <surname>Velders</surname>
          <given-names>XL</given-names>
        </name>
        <name>
          <surname>de Winter</surname>
          <given-names>RJ</given-names>
        </name>
        <name>
          <surname>Reekers</surname>
          <given-names>JA</given-names>
        </name>
        <name>
          <surname>Piek</surname>
          <given-names>JJ</given-names>
        </name>
      </person-group>
      <article-title>Evaluation of the occupational doses of interventional radiologists</article-title>
      <source>Cardiovasc Intervent Radiol</source>
      <year>2008</year>
      <volume>31</volume>
      <fpage>483</fpage>
      <lpage>489</lpage>
    </nlm-citation>
  </ref>

  <ref id="B18">
    <label>18</label>
    <nlm-citation citation-type="journal">
      <person-group person-group-type="author">
        <name>
          <surname>Kim</surname>
          <given-names>KP</given-names>
        </name>
        <name>
          <surname>Miller</surname>
          <given-names>DL</given-names>
        </name>
      </person-group>
      <article-title>Minimising radiation exposure to physicians performing fluoroscopically guided cardiac catheterisation procedures: a review</article-title>
      <source>Radiat Prot Dosimetry</source>
      <year>2009</year>
      <volume>133</volume>
      <fpage>227</fpage>
      <lpage>233</lpage>
    </nlm-citation>
  </ref>

  <ref id="B19">
    <label>19</label>
    <nlm-citation citation-type="journal">
      <person-group person-group-type="author">
        <name>
          <surname>Ciraulo</surname>
          <given-names>DL</given-names>
        </name>
        <name>
          <surname>Marini</surname>
          <given-names>CP</given-names>
        </name>
        <name>
          <surname>Lloyd</surname>
          <given-names>GT</given-names>
        </name>
        <name>
          <surname>Fisher</surname>
          <given-names>J</given-names>
        </name>
      </person-group>
      <article-title>Do surgical residents, emergency medicine physicians, and nurses experience significant radiation exposure during the resuscitation of trauma patients?</article-title>
      <source>J Trauma</source>
      <year>1994</year>
      <volume>36</volume>
      <fpage>703</fpage>
      <lpage>705</lpage>
    </nlm-citation>
  </ref>

  <ref id="B20">
    <label>20</label>
    <nlm-citation citation-type="journal">
      <person-group person-group-type="author">
        <name>
          <surname>Braun</surname>
          <given-names>BJ</given-names>
        </name>
        <name>
          <surname>Skiendzielewski</surname>
          <given-names>JJ</given-names>
        </name>
      </person-group>
      <article-title>Radiation exposure of emergency physicians</article-title>
      <source>Ann Emerg Med</source>
      <year>1982</year>
      <volume>11</volume>
      <fpage>535</fpage>
      <lpage>540</lpage>
    </nlm-citation>
  </ref>

  <ref id="B21">
    <label>21</label>
    <nlm-citation citation-type="journal">
      <person-group person-group-type="author">
        <name>
          <surname>Grazer</surname>
          <given-names>RE</given-names>
        </name>
        <name>
          <surname>Meislin</surname>
          <given-names>HW</given-names>
        </name>
        <name>
          <surname>Westerman</surname>
          <given-names>BR</given-names>
        </name>
        <name>
          <surname>Criss</surname>
          <given-names>EA</given-names>
        </name>
      </person-group>
      <article-title>Exposure to ionizing radiation in the emergency department from commonly performed portable radiographs</article-title>
      <source>Ann Emerg Med</source>
      <year>1987</year>
      <volume>16</volume>
      <fpage>417</fpage>
      <lpage>420</lpage>
    </nlm-citation>
  </ref>

  <ref id="B22">
    <label>22</label>
    <nlm-citation citation-type="journal">
      <person-group person-group-type="author">
        <name>
          <surname>Jeong</surname>
          <given-names>JH</given-names>
        </name>
        <name>
          <surname>Lim</surname>
          <given-names>YS</given-names>
        </name>
        <name>
          <surname>Park</surname>
          <given-names>KN</given-names>
        </name>
        <name>
          <surname>Kim</surname>
          <given-names>YM</given-names>
        </name>
        <name>
          <surname>Choi</surname>
          <given-names>SM</given-names>
        </name>
        <name>
          <surname>Lee</surname>
          <given-names>MJ</given-names>
        </name>
        <name>
          <surname>Oh</surname>
          <given-names>JS</given-names>
        </name>
        <name>
          <surname>Oh</surname>
          <given-names>YM</given-names>
        </name>
        <name>
          <surname>Hong</surname>
          <given-names>TY</given-names>
        </name>
      </person-group>
      <article-title>Radiation exposure to physicians in the emergency department</article-title>
      <source>J Korean Soc Emerg Med</source>
      <year>2008</year>
      <volume>19</volume>
      <fpage>125</fpage>
      <lpage>130</lpage>
    </nlm-citation>
  </ref>

  <ref id="B23">
    <label>23</label>
    <nlm-citation citation-type="book">
      <person-group person-group-type="author">
        <name>
          <surname>Kim</surname>
          <given-names>KS</given-names>
        </name>
        <name>
          <surname>Kim</surname>
          <given-names>SG</given-names>
        </name>
        <name>
          <surname>Kim</surname>
          <given-names>HJ</given-names>
        </name>
        <name>
          <surname>Lee</surname>
          <given-names>JT</given-names>
        </name>
        <name>
          <surname>Lee</surname>
          <given-names>CR</given-names>
        </name>
        <name>
          <surname>Ha</surname>
          <given-names>MN</given-names>
        </name>
      </person-group>
      <person-group person-group-type="editor">
        <name>
          <surname>Joo</surname>
          <given-names>YI</given-names>
        </name>
      </person-group>
      <article-title>Physical factor</article-title>
      <source>Preventive medicine and public health</source>
      <year>2010</year>
      <edition>1st ed</edition>
      <publisher-loc>Seoul</publisher-loc>
      <publisher-name>Gye-chuk Munhwasa</publisher-name>
      <fpage>585</fpage>
      <lpage>619</lpage>
    </nlm-citation>
  </ref>

  <ref id="B24">
    <label>24</label>
    <nlm-citation citation-type="journal">
      <person-group person-group-type="author">
        <name>
          <surname>Kim</surname>
          <given-names>ES</given-names>
        </name>
      </person-group>
      <article-title>Diagnostic and therapeutic management of acute radiation syndrome and internal contamination</article-title>
      <source>J Korean Med Assoc</source>
      <year>2003</year>
      <volume>46</volume>
      <fpage>879</fpage>
      <lpage>888</lpage>
    </nlm-citation>
  </ref>

  <ref id="B25">
    <label>25</label>
    <nlm-citation citation-type="book">
      <person-group person-group-type="author">
        <name>
          <surname>Lee</surname>
          <given-names>UJ</given-names>
        </name>
      </person-group>
      <source>Radiation safety management</source>
      <year>2001</year>
      <publisher-loc>Seoul</publisher-loc>
      <publisher-name>Gold</publisher-name>
    </nlm-citation>
  </ref>

  <ref id="B26">
    <label>26</label>
    <nlm-citation citation-type="book">
      <collab>International commission on radiological protection</collab>
      <source>Annals of the ICRP supporting guidance 2-radiation and your patient: a guide for medical practitioners</source>
      <year>2001</year>
      <publisher-loc>Pergamon</publisher-loc>
      <publisher-name>Stockholm</publisher-name>
    </nlm-citation>
  </ref>

  <ref id="B27">
    <label>27</label>
    <nlm-citation citation-type="journal">
      <person-group person-group-type="author">
        <name>
          <surname>Ha</surname>
          <given-names>SW</given-names>
        </name>
      </person-group>
      <article-title>Is radiation harmful?</article-title>
      <source>J Korean Med Assoc</source>
      <year>1995</year>
      <volume>38</volume>
      <fpage>1348</fpage>
      <lpage>1354</lpage>
    </nlm-citation>
  </ref>

  <ref id="B28">
    <label>28</label>
    <nlm-citation citation-type="journal">
      <person-group person-group-type="author">
        <name>
          <surname>Ha</surname>
          <given-names>JW</given-names>
        </name>
      </person-group>
      <article-title>The basic concept of radiation protection</article-title>
      <source>J Korean Med Assoc</source>
      <year>1995</year>
      <volume>38</volume>
      <fpage>1355</fpage>
      <lpage>1363</lpage>
    </nlm-citation>
  </ref>

  <ref id="B29">
    <label>29</label>
    <nlm-citation citation-type="book">
      <person-group person-group-type="author">
        <name>
          <surname>Parmeggiani</surname>
          <given-names>L</given-names>
        </name>
      </person-group>
      <source>Encyclopaedia of occupational health and safety</source>
      <year>1983</year>
      <publisher-loc>Geneva</publisher-loc>
      <publisher-name>International labour office</publisher-name>
    </nlm-citation>
  </ref>

  <ref id="B30">
    <label>30</label>
    <nlm-citation citation-type="journal">
      <person-group person-group-type="author">
        <name>
          <surname>Singer</surname>
          <given-names>CM</given-names>
        </name>
        <name>
          <surname>Baraff</surname>
          <given-names>LJ</given-names>
        </name>
        <name>
          <surname>Benedict</surname>
          <given-names>SH</given-names>
        </name>
        <name>
          <surname>Weiss</surname>
          <given-names>EL</given-names>
        </name>
        <name>
          <surname>Singer</surname>
          <given-names>BD</given-names>
        </name>
      </person-group>
      <article-title>Exposure of emergency medicine personnel to ionizing radiation during cervical spine radiography</article-title>
      <source>Ann Emerg Med</source>
      <year>1989</year>
      <volume>18</volume>
      <fpage>822</fpage>
      <lpage>825</lpage>
    </nlm-citation>
  </ref>

  <ref id="B31">
    <label>31</label>
    <nlm-citation citation-type="journal">
      <person-group person-group-type="author">
        <name>
          <surname>Niklason</surname>
          <given-names>LT</given-names>
        </name>
        <name>
          <surname>Marx</surname>
          <given-names>MV</given-names>
        </name>
        <name>
          <surname>Chan</surname>
          <given-names>HP</given-names>
        </name>
      </person-group>
      <article-title>Interventional radiologists: occupational radiation doses and risks</article-title>
      <source>Radiology</source>
      <year>1993</year>
      <volume>187</volume>
      <fpage>729</fpage>
      <lpage>733</lpage>
    </nlm-citation>
  </ref>

  <ref id="B32">
    <label>32</label>
    <nlm-citation citation-type="journal">
      <person-group person-group-type="author">
        <name>
          <surname>Sander</surname>
          <given-names>D</given-names>
        </name>
        <name>
          <surname>Brunner</surname>
          <given-names>G</given-names>
        </name>
      </person-group>
      <article-title>Studies on radiation exposure of personnel in endoscopy</article-title>
      <source>Z Gastroenterol</source>
      <year>1992</year>
      <volume>30</volume>
      <fpage>151</fpage>
      <lpage>155</lpage>
    </nlm-citation>
  </ref>

  <ref id="B33">
    <label>33</label>
    <nlm-citation citation-type="journal">
      <person-group person-group-type="author">
        <name>
          <surname>Lee</surname>
          <given-names>WJ</given-names>
        </name>
        <name>
          <surname>Cha</surname>
          <given-names>ES</given-names>
        </name>
        <name>
          <surname>Ha</surname>
          <given-names>M</given-names>
        </name>
        <name>
          <surname>Jin</surname>
          <given-names>YW</given-names>
        </name>
        <name>
          <surname>Hwang</surname>
          <given-names>SS</given-names>
        </name>
        <name>
          <surname>Kong</surname>
          <given-names>KA</given-names>
        </name>
        <name>
          <surname>Lee</surname>
          <given-names>SW</given-names>
        </name>
        <name>
          <surname>Lee</surname>
          <given-names>HK</given-names>
        </name>
        <name>
          <surname>Lee</surname>
          <given-names>KY</given-names>
        </name>
        <name>
          <surname>Kim</surname>
          <given-names>HJ</given-names>
        </name>
      </person-group>
      <article-title>Occupational radiation dosesamong diagnostic radiation workers in south Korea, 1996-2006</article-title>
      <source>Radiat Prot Dosimetry</source>
      <year>2009</year>
      <volume>136</volume>
      <fpage>50</fpage>
      <lpage>55</lpage>
    </nlm-citation>
  </ref>

  <ref id="B34">
    <label>34</label>
    <nlm-citation citation-type="book">
      <collab>Department of health and human services</collab>
      <source>Guidelines for protecting the safety and health of health care workers</source>
      <year>1988</year>
      <publisher-loc>Washington DC</publisher-loc>
      <publisher-name>US government printing office</publisher-name>
    </nlm-citation>
  </ref>

  <ref id="B35">
    <label>35</label>
    <nlm-citation citation-type="journal">
      <person-group person-group-type="author">
        <name>
          <surname>Lee</surname>
          <given-names>K</given-names>
        </name>
        <name>
          <surname>Lim</surname>
          <given-names>HS</given-names>
        </name>
        <name>
          <surname>Kim</surname>
          <given-names>SK</given-names>
        </name>
      </person-group>
      <article-title>Status of the occupational health and safety programs of several hospitals in Korea</article-title>
      <source>Korean J Occup Environ Med</source>
      <year>2003</year>
      <volume>15</volume>
      <fpage>351</fpage>
      <lpage>363</lpage>
    </nlm-citation>
  </ref>

  <ref id="B36">
    <label>36</label>
    <nlm-citation citation-type="journal">
      <person-group person-group-type="author">
        <name>
          <surname>Martin</surname>
          <given-names>CJ</given-names>
        </name>
      </person-group>
      <article-title>A review of radiology staff doses and dose monitoring requirements</article-title>
      <source>Radiat Prot Dosimetry</source>
      <year>2009</year>
      <volume>136</volume>
      <fpage>140</fpage>
      <lpage>157</lpage>
    </nlm-citation>
  </ref>

  <ref id="B37">
    <label>37</label>
    <nlm-citation citation-type="journal">
      <person-group person-group-type="author">
        <name>
          <surname>Jeong</surname>
          <given-names>MS</given-names>
        </name>
        <name>
          <surname>Jin</surname>
          <given-names>YW</given-names>
        </name>
        <name>
          <surname>Lim</surname>
          <given-names>HS</given-names>
        </name>
        <name>
          <surname>Kim</surname>
          <given-names>CS</given-names>
        </name>
      </person-group>
      <article-title>Use of screening dose to evaluate the work-relatedness of cancers occurring among Korean radiation workers</article-title>
      <source>Korean J Occup Environ Med</source>
      <year>2007</year>
      <volume>19</volume>
      <fpage>196</fpage>
      <lpage>203</lpage>
    </nlm-citation>
  </ref>

  <ref id="B38">
    <label>38</label>
    <nlm-citation citation-type="journal">
      <person-group person-group-type="author">
        <name>
          <surname>Blomkvist</surname>
          <given-names>V</given-names>
        </name>
        <name>
          <surname>Eriksen</surname>
          <given-names>CA</given-names>
        </name>
        <name>
          <surname>Theorell</surname>
          <given-names>T</given-names>
        </name>
        <name>
          <surname>Ulrich</surname>
          <given-names>R</given-names>
        </name>
        <name>
          <surname>Rasmanis</surname>
          <given-names>G</given-names>
        </name>
      </person-group>
      <article-title>Acoustics and psychosocial environment in intensive coronary care</article-title>
      <source>Occup Environ Med</source>
      <year>2005</year>
      <volume>62</volume>
      <fpage>1</fpage>
      <lpage>8</lpage>
    </nlm-citation>
  </ref>

  <ref id="B39">
    <label>39</label>
    <nlm-citation citation-type="book">
      <person-group person-group-type="author">
        <name>
          <surname>Berglund</surname>
          <given-names>B</given-names>
        </name>
        <name>
          <surname>Lindvall</surname>
          <given-names>T</given-names>
        </name>
        <name>
          <surname>Schwela</surname>
          <given-names>DH</given-names>
        </name>
      </person-group>
      <source>Guidelines for community noise</source>
      <year>1999</year>
      <publisher-loc>Geneva</publisher-loc>
      <publisher-name>World Health Organization</publisher-name>
    </nlm-citation>
  </ref>

  <ref id="B40">
    <label>40</label>
    <nlm-citation citation-type="journal">
      <person-group person-group-type="author">
        <name>
          <surname>Busch-Vishniac</surname>
          <given-names>IJ</given-names>
        </name>
        <name>
          <surname>West</surname>
          <given-names>JE</given-names>
        </name>
        <name>
          <surname>Barnhill</surname>
          <given-names>C</given-names>
        </name>
        <name>
          <surname>Hunter</surname>
          <given-names>T</given-names>
        </name>
        <name>
          <surname>Orellana</surname>
          <given-names>D</given-names>
        </name>
        <name>
          <surname>Chivukula</surname>
          <given-names>R</given-names>
        </name>
      </person-group>
      <article-title>Noise levels in Johns Hopkins Hospital</article-title>
      <source>J Acoust Soc Am</source>
      <year>2005</year>
      <volume>118</volume>
      <fpage>3629</fpage>
      <lpage>3645</lpage>
    </nlm-citation>
  </ref>

  <ref id="B41">
    <label>41</label>
    <nlm-citation citation-type="journal">
      <person-group person-group-type="author">
        <name>
          <surname>Topf</surname>
          <given-names>M</given-names>
        </name>
        <name>
          <surname>Dillon</surname>
          <given-names>E</given-names>
        </name>
      </person-group>
      <article-title>Noise-induced stress as a predictor of burnout in critical care nurses</article-title>
      <source>Heart Lung</source>
      <year>1988</year>
      <volume>17</volume>
      <fpage>567</fpage>
      <lpage>574</lpage>
    </nlm-citation>
  </ref>

  <ref id="B42">
    <label>42</label>
    <nlm-citation citation-type="journal">
      <person-group person-group-type="author">
        <name>
          <surname>Morrison</surname>
          <given-names>WE</given-names>
        </name>
        <name>
          <surname>Haas</surname>
          <given-names>EC</given-names>
        </name>
        <name>
          <surname>Shaffner</surname>
          <given-names>DH</given-names>
        </name>
        <name>
          <surname>Garrett</surname>
          <given-names>ES</given-names>
        </name>
        <name>
          <surname>Fackler</surname>
          <given-names>JC</given-names>
        </name>
      </person-group>
      <article-title>Noise, stress, and annoyance in a pediatric intensive care unit</article-title>
      <source>Crit Care Med</source>
      <year>2003</year>
      <volume>31</volume>
      <fpage>113</fpage>
      <lpage>119</lpage>
    </nlm-citation>
  </ref>

  <ref id="B43">
    <label>43</label>
    <nlm-citation citation-type="journal">
      <person-group person-group-type="author">
        <name>
          <surname>Bayo</surname>
          <given-names>MV</given-names>
        </name>
        <name>
          <surname>Garc&#x00ED;a</surname>
          <given-names>AM</given-names>
        </name>
        <name>
          <surname>Garc&#x00ED;a</surname>
          <given-names>A</given-names>
        </name>
      </person-group>
      <article-title>Noise levels in an urban hospital and workers' subjective responses</article-title>
      <source>Arch Environ Health</source>
      <year>1995</year>
      <volume>50</volume>
      <fpage>247</fpage>
      <lpage>251</lpage>
    </nlm-citation>
  </ref>

  <ref id="B44">
    <label>44</label>
    <nlm-citation citation-type="book">
      <person-group person-group-type="author">
        <name>
          <surname>Joseph</surname>
          <given-names>A</given-names>
        </name>
        <name>
          <surname>Ulrich</surname>
          <given-names>R</given-names>
        </name>
      </person-group>
      <source>Sound control for improved outcomes in healthcare settings</source>
      <year>2007</year>
      <publisher-loc>Concord, CA</publisher-loc>
      <publisher-name>The center for health design</publisher-name>
    </nlm-citation>
  </ref>

  <ref id="B45">
    <label>45</label>
    <nlm-citation citation-type="journal">
      <person-group person-group-type="author">
        <name>
          <surname>Montague</surname>
          <given-names>KN</given-names>
        </name>
        <name>
          <surname>Blietz</surname>
          <given-names>CM</given-names>
        </name>
        <name>
          <surname>Kachur</surname>
          <given-names>M</given-names>
        </name>
      </person-group>
      <article-title>Ensuring quieter hospital environments</article-title>
      <source>Am J Nurs</source>
      <year>2009</year>
      <volume>109</volume>
      <fpage>65</fpage>
      <lpage>67</lpage>
    </nlm-citation>
  </ref>

  <ref id="B46">
    <label>46</label>
    <nlm-citation citation-type="journal">
      <person-group person-group-type="author">
        <name>
          <surname>Lee</surname>
          <given-names>CU</given-names>
        </name>
      </person-group>
      <article-title>Environmental health for physicians (VII)-noise</article-title>
      <source>J Korean Med Assoc</source>
      <year>1996</year>
      <volume>39</volume>
      <fpage>992</fpage>
      <lpage>996</lpage>
    </nlm-citation>
  </ref>

  <ref id="B47">
    <label>47</label>
    <nlm-citation citation-type="journal">
      <person-group person-group-type="author">
        <name>
          <surname>Kim</surname>
          <given-names>RK</given-names>
        </name>
      </person-group>
      <article-title>Diagnosis and treatment of heat stroke</article-title>
      <source>J Korean Med Assoc</source>
      <year>2001</year>
      <volume>44</volume>
      <fpage>883</fpage>
      <lpage>891</lpage>
    </nlm-citation>
  </ref>

    </ref-list>

</back>

<floats-wrap>
<table-wrap position="float" id="T1">
<label>Table 1</label>
<caption>
  <p>Current status of radiation workers in diagnostic radiology over a five-year period (2004~2008)(<xref ref-type="bibr" rid="B10">10</xref>), (unit: number of persons)</p>
</caption>
<graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="jkma-53-483-i001" alt-version="no"></graphic>
</table-wrap>

<table-wrap position="float" id="T2">
<label>Table 2</label>
<caption>
  <p>Current status on workers received dose interval in 2008 by occupation (<xref ref-type="bibr" rid="B10">10</xref>)</p>
</caption>
<graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="jkma-53-483-i002" alt-version="no"></graphic>
</table-wrap>

<table-wrap position="float" id="T3">
<label>Table 3</label>
<caption>
  <p>Deterministic effects after whole-body and localized irradiation by X and gamma rays; approximate absorbed threshold doses for single (short-term) and fractionated or low dose-rate (long-term) exposures (<xref ref-type="bibr" rid="B26">26</xref>)</p>
</caption>
<graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="jkma-53-483-i003" alt-version="no"></graphic>
</table-wrap>
</floats-wrap>
</article>