• 제목/요약/키워드: 고엽제

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미국의 군복무 관련 질환의 보상에 관한 연구 (A Study on The Compensation about Diseases Related Military of United States of America)

  • 김태열
    • 한국산학기술학회:학술대회논문집
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    • 한국산학기술학회 2009년도 춘계학술발표논문집
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    • pp.18-23
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    • 2009
  • 지난 50여년간 국가유공자 및 제대군인의 보상은 전쟁 및 군복무중 발생한 상이처로 인해 장애를 입은 자를 중심으로 보상해 왔으며, 군 복무 중 발생한 질병의 보상에 대해서는 아직까지 심도 있게 논의된바 없다. 우선 한국의 군복무와 관련한 질병 보상과 관련한 본격적인 논의에 앞서 중요하게 고려되야 할 부분은 우리보다 100여년 이상 앞서 연구해 왔고 지금까지도 활발히 진행중인 미국의 질병 보상 제도와 질병 인정범위에 대해 분석해볼 필요성이 제기된다. 미국의 군복무와 관련한 질병에 관한 최초 보상의 역사는 1800년대로 군복무와 관련한 질병에 관한 대표적인 최초의 보상 질환은 PTSD(Post Traumatic Stress Disorder)의 초기 형태인 향수병(nostalgia)으로 이 질환이 군복무와 연관된 질환으로 인정받은 최초 질병이었다. 미국의 경우 미국의 군복무와 관련된 질환은 직접질환과 추정 질환으로 분류되는데 먼저 군복무 직접 질환의 경우 질병 보상이 되는 대표적 질환은 고혈압, 당뇨, 빈혈, 동맥경화증, 관절염, 심장염, 간질, 신장염, 정신병, 활동성 결핵, 위궤양 등 거의 모든 질환이 포함되어 있다. 특히, 정신병 흡연과 음주에 의한 질환 자살도 남에게 피해를 주지 않은 경우는 대부분 보상이 된다. 이상 살펴본 바와 같이 선진국에 비해 한국의 군복무와 관련한 질병보상 범위와 너무도 상이한데 국가유공자예우에 관한 법률 시행령 제 14조에 의거 1급부터 7급까지 등급판정을 부여하는데 이는 대부분 외상에 의한 절단, 관통상, 신체 기능상실자를 위주로 보상을 하고 있어 외상과의 합병증이 없는 질병에 대한 보상은 실질적으로 거의 인정을 받지 못하고 있는 실정이다. 끝으로 군복무와 관련한 질병 보상과 의료, 복지증진을 위한 종합적인 발전 방안을 몇가지 제언코자 한다. 첫째, 제대군인 질병연구센타 설립. 둘째, 정신질환, 외상후 스트레스장애군(PTSD), 진행성 질환 무상의료 지원 및 연금지급 셋째, 고엽제 2세환자의 역학조사가 필요하다.

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고엽제 노출과 병원 밖 심정지 후 생존 퇴원과의 연관성 (Association between defoliant exposure and survival to discharge after out-of-hospital cardiac arrest)

  • 김동욱;계유찬;이정엽;정의기;김동성;최현정;이영
    • 대한임상독성학회지
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    • 제19권1호
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    • pp.38-43
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    • 2021
  • Purpose: We investigated the association between defoliant exposure and survival to discharge after out-of-hospital cardiac arrest. Methods: This is a retrospective case-control study based on the cardiopulmonary resuscitation (CPR) registry. The electronic medical records of out-of-hospital cardiac arrest victims from 6/9/2008 to 12/31/2016 were analyzed statistically. The case patients group had a history of defoliant exposure while the control group did not. Among the 401 victims studied, a total of 110 patients were male out-of-hospital cardiac arrest patients. Baseline characteristics and the parameters involved in cardiac arrest were analyzed and compared between the two groups after propensity score matching. The primary outcome was survival to discharge, and secondary outcomes were sustained return of spontaneous circulation (ROSC) and survival to admission. Results: After propensity score matching a total of 50 patients (case=25, control=25) were analyzed. Primary outcome (survival to discharge) was not significantly different between case and control groups [(OR, 1.759; 95% C.I., 0.491-6.309) and (OR, 1.842; 95% C.I., 0.515-6.593), respectively]. In the subgroup analysis, there were also no significant differences between the control group and subgroups in primary and secondary outcomes according to defoliant exposure severity. Conclusion: There is no statistically significant association between defoliant exposure and survival of out-of-hospital cardiac arrest.

베트남전 참전자 2세의 건강상태에 관한 조사 - 부산지역 고엽제 위해증 환자를 대상으로 한 설문조사 결과 - (A Study on the Health Status of Korean Vietnam Veterans' Children - A Result of Questionnaire Survey on Vietnam Veterans of Pusan Area Who Diagnosed as Cases by Korean Veteran's Hospital Diagnostic Criteria -)

  • 김학준;손혜숙;엄상화;박수경;유병철;이종태;전진호
    • Journal of Preventive Medicine and Public Health
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    • 제33권1호
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    • pp.17-24
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    • 2000
  • Objectives : To propose the referential data to evaluate the health impacts of Vietnam veterans' children whose father were exposed to herbicides in Vietnam War. Methods : Vietnam veterans who visited to Pusan Veteran Hospital for medical care were recruited from April to October, 1998. They were 71 and asked about their own combat history, symptoms and illness, and health status of their 182 children. The informations were collected by direct and phone interview. Exposure estimation was also performed as exposure score depending on year and unit of participation, and personal episodes related to exposure to herbicide in the war. It classified into three groups; lower(<18.0), moderate(18-53), high$(\geq53)$ exposure group. Results : The mean age and the period into the combat of the veterans were 52.8 years and 15.0 months. The mean exposure score was $18.1{\pm}9.9$, and mainly distributed in lower (46.5%) and moderate(52.1%) exposure group. Most(90.1%) of them were diagnosed as sequelae(21 cases) and suspected sequelae(43 cases) of the herbicides by Korean veteran's hospital diagnostic criteria. The major sequelae was peripheral neuropathy 13 cases, chloracne 5 cases, and the major suspected sequelae was hypertension 20 cases, diabetes mellitus 18 cases, liver disease 12 cases, central neuropathy 11 cases, etc. About birth, 42.2% and 16.9% experienced spontaneous abortion and stillbirth, respectively. The mean exposure score was higher in stillbirth experience group(p<0.05). About half of the children(90 cases, 49.5%) hold the abnormal health status: those were skin pigmentation 38 cases, rash 23 cases, congenital anomaly 15 cases, general weakness 12 cases, purpura 8 cases, visual disturbance 8 cases, etc. These health problems had no association with father's exposure level(p>0.05). Conclusions : These results were depend on their own answers, and expectation for compensation did not excluded, therefore, this study may have limitations: inaccuracy of informations due to recall bias and response bias. Nevertheless, through this study, we could image the fundamental aspect for health impacts of Vietnam veterans' children for preparing the national control program and policy. A large scale epidemiologic study with valid exposure assessment on the health impacts of Vietnam veterans' children is recommneded.

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파월국군장병의 고엽제 위해에 관한 예비적 역학조사 (A Preliminary Epidemiologic Study on Korean Veterans Exposed to Herbicides in Vietnam War)

  • 김정순;임현술;이홍복;이원영;박영주;김성수
    • Journal of Preventive Medicine and Public Health
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    • 제27권4호
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    • pp.711-734
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    • 1994
  • Among chemical agents in herbicides, dioxin (2, 3, 7, 8-tetrachloro dibenzo-$\rho$-dioxin : TCDD), a chemical contaminant in herbicides sprayed during the Vietnam War has been known to be the major agent causing toxic effects. Approximately 320,000 korean soldiers participated the Vietnam War from 1964 to 1974. Although the potential hazards of the herbicides among Korean veterans exposed were implicated, the problem had not been a public issue until 1991 when Korean veterans were informed U.S. companies, the herbicides manufacturer payed fund, from which a trust fund for New Zealand and Australian Class members were established in 1985. After a series of appeals and demonstration by the Korean Veterans demanding medical care and compensation for their serious health damages, a bill of medical care and compensation for herbicides victims was promulgated in March 1993 and become effective from May 1993, This study was carried out with two major objectives : the first to understand the health problems caused from the herbicides by reviewing literatures published, and the second to examine the nature and extent of health impacts among Korean veterans exposed and to develop valid study methods for the major study by interviewing and reviewing records on a part of veterans (638 persons) registered and completed medical examination in Seoul Veterans Administration Hospital from June to October 1993. The results obtained are as followings: 1. The literature review of 107 papers revealed that 1) Dioxin is teratogenic, carcinogenic and affects almost all organs including nervous, endocrine, and reproductive systems in animal experiments. 2) The diseases showing evidence of causal association were Hodgkin's disease, non-Hodgkin's disease, lung cancer, lymphoma, soft tissue sarcoma, chloroacne and polyneuropathy when judged on the basis of consistency in study results and biological plausibility. 2. Interview and medical record review study on 638 veterans, though limited validity owing to lack of control group, crude estimates of dioxin exposure levels (no biomarkers measurable), and uncertainty of diagnosis, showed that: 1) Most of the study subject's were in their 40's of age and had been dispatched to Vietnam during the period from $1965{\sim}1970$ around one year. 2) Most frequently complained symptoms in medical examination were motor weakness (32%), sensory abnormalities in extremities (23%), skin diseases (22%), and pain in extremities (20%) whereas in Interview they were more frequent in order of skin problem (44%), motor weakness (38%), sensory abnormalities and pain in extremities(17% and 19% each). Kappa indices on the same category of complaints between two sources of information were variable and relatively low. 3) On medical examination, only a part of the 638 subjects had initial impression (442 pts) and final diagnosis (218 pts) suggesting decision making on diagnosis appeared to be difficult even with all available modern medical technologies: in initial impression disorders from peripheral and central neuropathy were predominant whereas in final diagnosis various types of skin disorder were most frequent 4) When dose-response relationship between several conditions (from questionnaire) and arbitrary exposure scores were examined by CMH linear trend test, spontaneous abortion, sexual problems and health problem of offsprings showed statistically significant linear trends. However, pregnancy, accident and suicidal attempts did not show any relationship in this study capacity. 5) Among complaints, psychosis and neurosis (anxiety, phobia) in interview study, and memory disorder and psychosis in medical record study revealed linear trend. 6) Skin disorder was the only condition showing linear trend in initial impression and none in final diagnosis on medical examination. Even though objective to select out dioxin-related disease or group of diseases from this study was not achieved the research experiences provided firm basis for developing various methodological approaches. 3. From this preliminary study we concluded that a larger scale major epidemiologic study on health impacts of herbicides among Korean veterans exposed is not only Indispensible but also well designed study with more valid exposure information and diagnosis may be able to establish causal relationship between certain groups of diseases and exposure to the herbicides among Korean veterans.

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