• 한국안전학회지
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• 제34권3호
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• pp.83-88
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• 2019

The 7,993 cases of Survey Report of Fatal Industrial Accidents conducted jointly by the MEOL and the KOSHA for the recent seven years(2007-2013) were categorized according to personal and occupational characteristics, industry types, business sizes, job types, activities at the time accident, types of accidents, material agents(assailing materials), unsafe conditions, and unsafe acts. And it is found that among the 72.2 percent of fatal occupational accidents in the construction and manufacturing industries are caused by falling, sticking, bumping and being caught under objects & overturning. For this study, through the empirical analysis on causes of fatal industrial accidents, was used to identity high risk groups based on total data of 7,993 victims of occupational accidents. An annual fatal occupational injury (FOI) rate per 10,000 workers was about 0.47‱. The middle-aged group and the elderly group showed the highest FOI rates per 10,000 workers (0.73‱, 0.80‱), and the daily workers showed the highest FOI rate (1.46‱), and the craft and related trades workers showed the highest FOI rate (2.17‱). In case of industry type the mining industry (7.26‱) showed the highest FOI rate, followed by the sewerage, waste management, materials recovery and remediation activity industry (3.91‱) and the construction industry (2.71‱). The primary high risk target group that requires a strategy designed to reduce fatal occupation injuries caused by falling and bumping & contact(collision) is the construction industry, and the secondary high risk target group in the construction industry is classified as the equipment, machine operating and assembling workers in the construction industry, those aged 50 years old and above need the prevention measures against bumping & contact(collision) and being caught under an object & falling(objects), while those aged less than 50 years old need prevention measures against falling(persons).

• Safety and Health at Work
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• 제13권3호
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• pp.343-349
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• 2022

Background: In the United States, the dairy product manufacturing industry has consistently had higher rates of work-related nonfatal injuries and illnesses compared to the national average for industries in all sectors. The selection and implementation of appropriate safety performance indicators are important aspect of reducing risk within safety management systems. This study examined the leading safety indicators implemented in the dairy product-manufacturing sector (NAICS 3115) and their perceived effectiveness in reducing work-related injuries. Methods: Perceptions were collected from individuals with safety responsibilities in the dairy product manufacturing facilities. OSHA Incident Rate (OIR) and Days away, restricted and transferred (DART) rates from 2013 to 2018 were analyzed. Results: The perceived most effective leading were safety observations, stop work authority, near miss reporting, safety audits, preventative maintenance, safety inspections, safety training attendance, and job hazard analysis/safety analysis, respectively. The 6-year trend analysis showed that those implementing all eight top indicators had a slightly lower rates than those that did not implement all eight. Production focused mentality, poor training, and lack of management commitment were perceived as the leading causes of injuries in this industry. Conclusion: Collecting leading indicators with the unique interest to meet the regulatory requirements and to document the management system without the actual goal of using them as input to improve the system most probably will not lead to an effective reduction of negative safety outcomes. For leading indicators to be effective, they should be properly selected, executed, periodically evaluated and actions are taken when necessary.

• Archives of Hand and Microsurgery
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• 제23권4호
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• pp.306-312
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• 2018

안면 신경의 측두지는 그 해부학적 위치로 인하여 외상성 손상에 취약하며, 이로 인해 환자는 종종 상당한 미용적, 기능적 손실을 경험한다. 나아가 결손이 있는 만성 손상은 신경 이식 등의 추가적인 시술이 필요한 경우가 많기에 급성 손상에 비하여 그 치료가 까다롭다. 본 연구에서는 안면 신경의 측두지 손상 발생으로부터 1개월 후에 지연된 신경 이식을 한 남성 환자의 증례를 다루었다. 우리는 성공적으로 비복 신경을 분할 이식하였으며 환자는 양호한 미용적, 기능적 회복을 보였다.

• Journal of Trauma and Injury
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• 제28권2호
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• pp.60-66
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• 2015

Purpose: Cultivator accidents are frequent and often lead to abdomino-perineal organ injury and, if severe, to death. This study presents the clinical characteristics, outcomes, and factors associated with mortality in patients who sustained an abdomino-perineal organ injury in cultivator accidents. Methods: We retrospectively analyzed the records of 53 patients who visited the emergency department of a tertiary hospital with abdomino-perineal organ injuries caused in cultivator accidents from April 2005 to March 2010. Results: All 53 patients had visited other medical institutions before visiting our hospital. Their mean age was $64.0{\pm}11.1$ (range, 20-80) years and 32 (60.4%) patients were 65 or older. The male-to-female ratio was 46:7. The chief complaint was abdominal pain (38 cases, 71.7%). The 53 patients included 41 cultivator operators (77.4%), 11 passengers (20.8%), and 1 passerby (1.9%). The causes of the injuries included a direct impact of the handlebar in 20 cases (37.7%), a rollover in 21 cases (39.6%), a fall in 10 cases (18.9%), and a wheel in two cases (3.8%). Several of the 53 patients had injuries to multiple abdomino-perineal organs, and the injured organs included the liver (23 cases, 26.4%), spleen (16 cases, 18.4%), pancreas (7 cases, 8.0%), small bowel (7 cases, 8.0%), mesentery (6 cases, 6.9%), adrenal gland (5 cases, 5.8%), and other organs. According to the abbreviated injury scale (AIS) dictionary, a thoracic injury was the most frequent co-injury (33 of 53 cases, 62.3%). Abdomino-perineal surgery was performed in 31 cases (58.8%) and angio-embolization was performed for six liver and two kidney injuries. Thirteen patients died (24.5%); all were males. The Injury Severity Scale (ISS) was lower in the survivors ($17.8{\pm}8.5$ vs. $27.0{\pm}16.0$; p=0.010). Conclusion: With the aging of agricultural workers, safety education programs should be implemented. Furthermore, the patient transfer system in agricultural areas must be improved.

• Journal of Chest Surgery
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• 제31권8호
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• pp.804-810
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• 1998

배경: 다발성 외상환자는 교통사고, 산업재해, 우발적사고, 폭력 등의 증가로 최근 증가 추세에 있다. 다발성 외상은 심장, 폐, 대혈관 등의 흉부외상을 포함하는 경우가 많으며 이때는 환자의 생명을 위협할 수 있으므로 적절한 진단과 치료가 필요하다. 대부분의 흉부외상은 보존적 치료와 흉관 삽관술과 같은 간단한 외과적 시술 만으로 만족할 만한 치료효과를 보이지만 적절한 시기에 개흉술을 시행함으로써 환자의 생명을 구할 수 있는 경우가 있어 그 적응증 이나 시기의 판단에 있어서 경험있는 흉부외과 의사의 역할이 필요하다. 대상 및 방법: 저자는 다발성 외상 후 흉부개흉술이 필요했던 70례에 대하여 분석하였다. 환자들의 평균 나이는 35.6세 남녀비는 3.4:1이었다. 손상의 기전은 주로 교통사고, 추락사고, 자상이었다. 결과: 흉부손상의 가장 일반적인 유형은 혈흉이며, 두 번째는 횡격막 파열이었다. 환자의 60%에서 골절을 동반 하고 42.9%에서 복부손상을 37.1%에서 두부손상을 동반하고 있었다. 개흉술을 시행한 이유로는 출혈교정 혹은 지혈이 48.6%, 횡격막손상의 복구가 35.7%였으며, 폐 열상 봉합이 25.7% 였으며, 흉부 손상으로 인한 수술외에도 비장적출술(14.3%), 간엽절제술(8.6%) 간 열상 복구(5.7%)를 시행하였다. 수술후 합병증으로는 무기폐(8.6%), 창상감염(8.6%), 폐렴(4.3%)이었다. 수술후 6명의 환자가 사망하였고 수술사망율은 8.6%였다. 사망의 원인으로는 호흡부전증(2례), 급성 신기능부전증(2례), 패혈증(1례), 저혈량성 쇽(1례)이었다.

• Journal of Chest Surgery
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• 제40권7호
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• pp.480-484
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• 2007

서론: 주요 혈관 손상 시 적절한 진단 및 치료가 지연될 경우 환자가 생명을 잃거나 사지를 절단해야 할 위험이 있게 된다. 이러한 혈관 손상의 적절한 치료를 위한 지침을 세워보고자 본원에서 치료한 증례를 분석하였다. 대상 및 방법: 1999년 5월부터 2004년 9월까지 치료받은 외상성 혈관 손상 환자 26명을 대상으로 연령 및 성별 분포, 혈관 손상의 위치, 원인, 진단방법, 혈관 손상의 형태, 임상소견, 치료방법, 합병증 등을 살펴보았다. 결과: 환자의 연령분포는 평균 39.5세($12{\sim}86$세)였고 손상입은 혈관은 하행대동맥 6예, 대퇴 동맥 4예, 슬와 정맥 4예 등의 순으로 빈번하게 발생하였다. 손상의 원인으로는 의인성 손상이 8예로 가장 많았고 그 다음이 교통사고 7예, 자상 6예, 산업재해 5예 순이었다. 진단방법은 CT와 Arteriogram이 각각 9예씩으로 가장 많았고 수술 중에 발생한 의인성인 경우는 이학적 검사만으로도 진단이 가능하였다. 혈관손상의 형태는 동맥인 경우 가성 동맥류가 10예로 가장 많았고. 부분 절단된 경우가 5예, 완전 절단된 경우가 3예, 폐색이 3예 등이었다. 정맥손상의 경우는 부분절단이 6예, 완전 절단이 2예였고 동정맥루의 형태가 2예 등이었다. 임상 소견은 맥박손실 8예, 냉감 1예, 흉통 6예, 부종 5예, 출혈 5예 등이었다. 치료는 동맥손상인 경우 Graft interposition이 11예로 가장 많았고 primary repair가 4예, 단단 문합이 2예였고 동정맥루 2예는 모두 중재적 시술(endovascular repair)을 시행하였다. 심각한 합병증으로는 지연된 진단 및 치료로 인한 지체 소실이 3예 있었고 3예에서 동반된 신경손상으로 인한 운동장애 그리고 1예에서 다발성 장기 부전으로 사망하였다. 결론: 사지 보존율을 높이고 사망률을 줄이기 위해서는 즉각적인 진단과 치료를 시행할 수 있는 시스템 확보가 필수적이다. 또한 중재적 시술이 증가하는 요즘 경향을 볼 때 발생의 예방을 위한 의사 교육이 중요하며 발생 시 즉각적으로 혈관 외과의사가 개입할 수 있도록 원활한 의사 교환 및 협진 체제가 중요하다고 하겠다.

• Journal of Preventive Medicine and Public Health
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• 제46권5호
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• pp.261-270
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• 2013

Objectives: This study investigated the socio-demographic characteristics and medical causes of death among meteorological disaster casualties and compared them with deaths from all causes. Methods: Based on the death data provided by the National Statistical Office from 2000 to 2011, the authors analyzed the gender, age, and region of 709 casualties whose external causes were recorded as natural events (X330-X389). Exact matching was applied to compare between deaths from meteorological disasters and all deaths. Results: The total number of deaths for last 12 years was 2 728 505. After exact matching, 642 casualties of meteorological disasters were matched to 6815 all-cause deaths, which were defined as general deaths. The mean age of the meteorological disaster casualties was 51.56, which was lower than that of the general deaths by 17.02 (p<0.001). As for the gender ratio, 62.34% of the meteorological event casualties were male. While 54.09% of the matched all-cause deaths occurred at a medical institution, only 7.6% of casualties from meteorological events did. As for occupation, the rate of those working in agriculture, forestry, and fishery jobs was twice as high in the casualties from meteorological disasters as that in the general deaths (p<0.001). Meteorological disaster-related injuries like drowning were more prevalent in the casualties of meteorological events (57.48%). The rate of amputation and crushing injury in deaths from meteorological disasters was three times as high as in the general deaths Conclusions: The new information gained on the particular characteristics contributing to casualties from meteorological events will be useful for developing prevention policies.

• 대한두개안면성형외과학회지
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• 제11권1호
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• pp.28-32
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• 2010

Purpose: In accordance with the increasing number of accidents caused by various reasons and recently developed fine diagnostic skills, the incidence of orbital blow-out fracture cases is increasing. As it causes complications, such as diplopia and enophthalmos, surgical reduction is commonly required. This article reports a retrospective series of 5 blow-out fracture cases that had unusual nerve injuries after reduction operations. We represents the clinical experiences about treatment process and follow-up. Methods: From January 2000 to August 2009, we treated total 705 blow-out fracture patients. Among them, there were 5 patients (0.71%) who suffered from postoperative neurologic complications. In all patients, the surgery was performed with open reduction with insertion of $Medpor^{(R)}$. Clinical symptoms and signs were a little different from each other. Results: In case 1, the diagnosis was oculomotor nerve palsy. The diagnosis of the case 2 was superior orbital fissure syndrome, case 3 was abducens nerve palsy, and case 4 was idiopathic supraorbital nerve injury. The last case 5 was diagnosed as optic neuropathy. Most of the causes were extended fracture, especially accompanied with medial and inferomedial orbital blow-out fracture. Extensive dissection and eyeball swelling, and over-retraction by assistants were also one of the causes. Immediately, we performed reexploration procedure to remove hematomas, decompress and check the incarceration. After that, we checked VEP (visual evoked potential), visual field test, electromyogram. With ophthalmologic test and followup CT, we can rule out the orbital apex syndrome. We gave $Salon^{(R)}$ (methylprednisolone, Hanlim pharmaceuticals) 500 mg twice a day for 3 days and let them bed rest. After that, we were tapering the high dose steroid with $Methylon^{(R)}$ (methylprednisolon 4 mg, Kunwha pharmaceuticals) 20 mg three times a day. Usually, it takes 1.2 months to recover from the nerve injury. Conclusion: According to the extent of nerve injury after the surgery of orbital blow-out fracture, the clinical symptoms were different. The most important point is to decide quickly whether the optic nerve injury occurred or not. Therefore, it is necess is to diagnose the nerve injury immediately, perform reexploration for decompression and use corticosteroid adequately. In other words, the early diagnosis and treatment is most important.

• Safety and Health at Work
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• 제12권4호
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• pp.505-510
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• 2021

Background: Factors related to root causes can cause commonly occurring accidents such as falls, slips, and jammed injuries. An important means of reducing the frequency of occupational accidents in small- to medium-sized enterprises (SMSEs) of South Korea is to perform intensity analysis of the root cause factors for accident prevention in the cause and effect model like decision models, epidemiological models, system models, human factors models, LCU (life change unit) models, and the domino theory. Especially intensity analysis in a robot system and smart technology as Industry 4.0 is very important in order to minimize the occupational accidents and fatal accident because of the complexity of accident factors. Methods: We have developed the modern cause and effect model that includes factors of root cause through statistical testing to minimize commonly occurring accidents and fatal accidents in SMSEs of South Korea and systematically proposed educational policies for accident prevention. Results: As a result, the consciousness factors among factors of root cause such as unconsciousness, disregard, ignorance, recklessness, and misjudgment had strong relationships with occupational accidents in South Korean SMSEs. Conclusion: We conclude that the educational policies necessary for minimizing these consciousness factors include continuous training procedures followed by periodic hands-on experience, along with perceptual and cognitive education related to occupational health and safety.

• Parasites, Hosts and Diseases
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• 제46권3호
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• pp.119-125
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• 2008

Lymphatic filariasis, transmitted by mosquitoes is the commonest cause of lymphedema in endemic countries. Among 120 million infected people in 83 countries, up to 16 million have lymphedema. Microfilariae ingested by mosquitoes grow into infective larvae. These larvae entering humans after infected mosquito bites grow in the lymphatics to adult worms that cause damage to lymphatics resulting in dilatation of lymph vessels. This earliest pathology is demonstrated in adults as well as in children, by ultrasonography, lymphoscintigraphy and histopathology studies. Once established, this damage was thought to be irreversible. This lymphatic damage predisposes to bacterial infection that causes recurrent acute attacks of dermato-lymphangio-adenitis in the affected limbs. Bacteria, mainly streptococci gain entry into the lymphatics through 'entry lesions' in skin, like interdigital fungal infections, injuries, eczema or similar causes that disrupt integrity of skin. Attacks of dermato-lymphangio-adenitis aggravates lymphatic damage causing lymphedema, which gets worse with repeated acute attacks. Elephantiasis is a late manifestation of lymphatic filariasis, which apart from limbs may involve genitalia or breasts. Lymphedema management includes use of antifilarial drugs in early stages, treatment and prevention of acute attacks through 'limb-hygiene', antibiotics and antifungals where indicated, and physical measures to reduce the swelling. In selected cases surgery is helpful.