원전종사자 역학연구 설문자료의 신뢰도 평가

Reliability of a Questionnaire in an Epidemiological Study for Nuclear Power Plants Workers in Korea

  • 김한나 (한국수력원자력(주) 방사선보건연구원) ;
  • 정미선 (한국수력원자력(주) 방사선보건연구원) ;
  • 박은숙 (한국수력원자력(주) 방사선보건연구원) ;
  • 서수진 (한국수력원자력(주) 방사선보건연구원) ;
  • 진영우 (한국수력원자력(주) 방사선보건연구원)
  • Kim, Han-Na (Radiation Health Research Institute, Korea Hydro & Nuclear Power Co., Ltd.) ;
  • Jeong, Mee-Seon (Radiation Health Research Institute, Korea Hydro & Nuclear Power Co., Ltd.) ;
  • Park, Eun-Sook (Radiation Health Research Institute, Korea Hydro & Nuclear Power Co., Ltd.) ;
  • Suh, Su-Jin (Radiation Health Research Institute, Korea Hydro & Nuclear Power Co., Ltd.) ;
  • Jin, Young-Woo (Radiation Health Research Institute, Korea Hydro & Nuclear Power Co., Ltd.)
  • 투고 : 2010.03.17
  • 심사 : 2010.05.12
  • 발행 : 2010.06.30

초록

목적: 원전종사자 역학조사를 통해 수집된 설문자료의 신뢰성을 분석하여 향후 원전종사자의 질병 위험도 평가에서 관련 자료를 정확하게 활용하기 위한 타당성을 파악하고자 한다. 방법: 설문조사가 이루어진 전체 대상자 8,832명 중 조사가 중복 실시된 원전종사자 646명을 연구대상자로 선정하고, 1차와 2차 설문응답 결과를 비교하였다. 범주형 설문항목의 경우 1차와 2차 설문응답에서 일치율, 거짓 불일치율, 양성 불일치율 및 kappa 값을 산출하였다. 수치형 설문항목에 대해서는 1차와 2차 응답 차이의 유의성 검정을 수행하고 급내상관계수(ICC)를 평가하였다. 결과: 방사선의 질병 위험도를 평가하는데 중요한 교란 요인으로 알려진 흡연력에 대한 설문은 신뢰성이 아주 높았다(kappa=0.85). 또한 사회경제적 지표로 이용되는 교육수준 항목에서도 95.09%의 높은 일치율과 높은 신뢰성(kappa=0.89)을 보였다. 음주력과 의료검사 이력, 과거 질병력에 대한 설문자료에서는 중등도 이상의 신뢰도가 관찰되었다(kappa>0.4). 설문에서 수치를 기입하도록 조사된 신체치수, 흡연기간, 흡연량 및 음주기간 항목에서도 0.7 이상의 ICC 값이 관찰되어 설문응답의 신뢰성이 높은 것으로 평가되었다. 결론: 원전종사자 역학조사를 통하여 수집된 설문자료는 대부분의 항목에서 신뢰성이 높게 평가되어 향후 원전 종사자의 질병 위험도 평가에서 유용한 정보를 제공할 것으로 판단된다. 신뢰도가 다소 낮게 나타난 CT 검사이력, 고지혈증 질병력의 경우 설문지에 용어 설명이 보완된다면 신뢰도가 개선될 가능성이 있다. 이 연구에서 논의된 설문자료와 함께 질병 발생과 사망, 피폭기록, 의료 이용 기록에 대한 국가 데이터베이스를 활용하면 우리나라 원전종사자의 질병 위험도를 보다 정확하게 추정할 수 있을 것으로 판단된다.

Objectives: This study was conducted to evaluate the reliability of a questionnaire from an epidemiological study for nuclear power plants workers in Korea. Methods: Among a total of 8,832 nuclear power plants workers who participated in the questionnaire survey, we selected 646 workers who repeatedly submitted the self-reported questionnaire. The reliability of the questionnaire for the categorical items was measured using kappa statistics and percentages of exact agreement, false disagreement and positive disagreement. Significance was evaluated for the continuous items by paired t-tests and intra-class correlation coefficients (ICCs). Results: The questionnaire was observed to be highly reliable for the smoking history (kappa=0.85), which is known as an important confounding factor in assessing the cancer risk among radiation workers. Education level as a surrogate for the socio-economic status also appeared to be highly reliable with a kappa=0.89 and 95.09% of exact agreement. The history of alcohol drinking, medical exams and diseases showed more than moderately good agreement between the first and second responses (kappa>0.4). The self-reported values for physical measurements, the smoking period and smoking amount, and the period of alcohol drinking were highly correlated between the two responses (ICC>0.7). Conclusions: The questionnaire from an epidemiological study for nuclear power plants workers in Korea was found to be reliable for most items. To estimate the cancer or noncancer risk for nuclear power plants workers, we need to use the national database for incidence of diseases or death from diseases and the exposure history, and the medical records as well as the data collected from this study.

키워드

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