The applicability of WHO-NCTB in Korea

Neurotoxic chemical substances have been widely used in Korea since 1960. The World Health Organization-recommended Neurobehavioral Core Test Battery (WHO-NCTB) was introduced into Korea early in the 1990s and has been applied to the study of workers exposed to neurotoxic chemicals. Thirteen studies using the WHO-NCTB have been reported in Korean journals, two of which were published in English and the rest in Korean-language journals. Ten studies were reviewed to examine the influence of age, education and other factors on the WHO-NCTB in Korean workers. Pursuit Aiming, Digit Symbol, Digit Span and Benton Visual Retention test are effected by years of education, especially when years of education were less than 12. Santa Ana Dexterity test and Simple Reaction Time test were not effected. Pursuit Aiming, Santa Ana Dexterity test and Digit Symbol were effected by age, but not the Simple Reaction Time test, Benton Visual Retention test, or Digit Span. Some studies had difficulty in finding a proper reference group, because many workers exposed to neurotoxic chemicals were old and less educated than available reference groups. However, daily use of chopsticks by Koreans, especially coupled with work that requires skillful and quick hand movements, might develop psychomotor functions in exposed workers. The cultural and emotional differences between Korean and Caucasian led POMS to be applied only to two studies. In conclusion, the WHO-NCTB has been successfully applied to Korean workers for evaluating the neurobehavioral effects of individual chemicals, although age and education can be confounding factors. It was difficult to apply the WHO-NCTB to workers educated less than 12 years.