Journal of agricultural medicine and community health (농촌의학ㆍ지역보건)

Korean Society for Rural Medicine and Community Health (한국농촌의학지역보건학회)
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Seroprevalence and Risk Factors for Severe Fever with Thrombocytopenia Syndrome among the Korea National Park Service Workers

국립공원 종사자의 중증열성혈소판감소증후군 혈청유병률 및 위험요인

  • Kim, Dong-Hwi (Gyeongbuk Center for Infectious Disease Control and Prevention) ;
  • Kim, Kye-Hyung (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Yi, Jongyoun (Department of Laboratory Medicine, Pusan National University School of Medicine) ;
  • Ko, Mee Kyung (Biomedical Research Institute, Pusan National University Hospital) ;
  • Park, Sung-Jun (Gyeongbuk Center for Infectious Disease Control and Prevention) ;
  • Yoo, Seok-Ju (Department of Preventive Medicine, Dongguk University College of Medicine) ;
  • Lee, Kwan (Gyeongbuk Center for Infectious Disease Control and Prevention) ;
  • Park, Ji-Hyuk (Gyeongbuk Center for Infectious Disease Control and Prevention)
  • 김동휘 (경상북도 감염병관리지원단) ;
  • 김계형 (부산대학교 의과대학 내과학교실) ;
  • 이종윤 (부산대학교 의과대학 진단검사의학교실) ;
  • 고미경 (부산대학교병원 의생명연구원) ;
  • 박성준 (경상북도 감염병관리지원단) ;
  • 유석주 (동국대학교 의과대학 예방의학교실) ;
  • 이관 (경상북도 감염병관리지원단) ;
  • 박지혁 (경상북도 감염병관리지원단)
  • Received : 2021.06.06
  • Accepted : 2021.09.08
  • Published : 2021.09.30
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Abstract

Objectives: This study was carried out to understand the seroprevalence and risk factors for severe fever with thrombocytopenia syndrome (SFTS) among the Korea National Park Service (KNPS) workers. Methods: We used the stored serum samples (763) and survey results collected from the previous investigation on scrub typhus and Lyme disease among the KNPS workers during 2016-2017. The serum samples were analyzed by double-antigen sandwich enzyme-linked immunosorbent assay, which was used to test the total antibody including IgG and IgM. Results: The SFTS seroprevalence among the KNPS worrkers was 1.4%. In multivariate logistic analysis, the national park exploration programs (odds ratio, 3.48; 95% confidence interval, 1.01-12.01) was significantly associated with the seroprevalence of SFTS. Conclusion: This study was the first serological study of SFTS among forestry workers in South Korea. Although the KNPS workers are at a high-risk group of SFTS, the prevention activities related to the working environment and habit was insufficient. Thus, systematic prevention education and training for the KNPS workers need to be strengthened.

이번 연구는 임업 종사자 중 하나인 국립공원 종사자를 대상으로 진드기 매개 감염병인 SFTS 혈청유병률을 확인하고 관련된 위험요인을 조사하고자 시행하였다. 2016-2017년에 실시한 "쯔쯔가무시증 및 라임병 고위험군에 대한 감염실태 조사" 사업으로 수집된 763명의 혈청 검체와 설문 조사 결과를 이용하였고, 혈청분석은 Double-antigen sandwich enzyme-linked immunosorbent assay로 IgG와 IgM을 포함한 전체 항체를 검사하였다. 국립공원 종사자 763명의 SFTS 혈청유병률은 1.4%였다. 일반적 특성 중 성별로는 여성이 1.7%로 더 높았고, 연령별로는 30-49세에서 2.0%로 가장 높았다. 학력에 따라 고등학교 졸업 이하가 2.5%로 더 높았고, 기관별로는 국립공원사무소분소 및 기타기관이 1.7%로 더 높았다. 근무기간에 따라 15년 이상이 2.2%로 가장 높았으며, 지역적으로는 북부에서 3.1%로 가장 높았다. 다변량 로지스틱 회귀분석 결과 학력, 탐방 프로그램 운영, 매일 작업복을 갈아입음이 최종 모델에 포함되었다. 이 중 탐방 프로그램을 운영할 경우는 교차비가 3.48(95% 신뢰구간=1.01-12.01)로 통계적으로 유의하게 높았다. 학력과 매일 작업복을 갈아입음은 통계적으로 유의하지 않았다. 이번 연구는 진드기에 노출될 수 있는 고위험 직업군인 국립공원 종사자를 대상으로 SFTS의 혈청유병률을 파악하기 위한 조사를 국내에서 최초로 시행하였다는 점에서 의미가 크다. 국립공원 종사자는 진드기 매개 감염병의 고위험 직업군임에도 불구하고 작업 중 SFTS 예방을 위한 작업환경 및 습관과 관련된 예방활동이 부족한 것으로 생각되며, 국립공원 종사자에 대한 체계적인 예방 교육 및 훈련을 보다 강화할 필요가 있다.

Keywords

Acknowledgement

본 연구는 대한민국 정부의 재원으로 '방역연계범부처감염병연구개발사업' 지원에 의하여 수행되었습니다(과제고유번호: HG18C0015).

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