• 제목/요약/키워드: CAUSES OF INJURIES

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성인에서 AUDIT와 손상의 연관성 (Drinking Pattern and Nonfatal Injuries of Adults in Korea)

  • 유인숙;최은미;권호장;이상규
    • 한국산학기술학회논문지
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    • 제13권4호
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    • pp.1690-1698
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    • 2012
  • 음주는 손상의 가장 위험 요인으로 정확한 평가를 위하여 세계보건기구에서 개발한 Alcohol Use Disorders Identification Test (만성음주행태측정 이하 AUDIT)와 같은 도구를 이용하여 성인에서의 음주행태와 손상 발생률 및 손상 세부 특성과의 연관성을 평가하고자 실시 하였다. 본 연구는 2009년도 국민건강영양조사를 이용하였으며 성인 만 19세 이상 성인 중 7,893명이 참여하여 손상에 응답한 7,511명, 그 중 음주행태조사 참여는 6,6362명 설문에 무응답 104명을 제외 최종 6,258명 연구 대상으로 분석하였다. AUDIT범주에 따른 손상 발생률 및 세부특성 즉 신체부위, 유형, 기전별 손상 발생율의 비교위험도를 T-test, ANOVA, Logistic regression 이용하여 산출하였다. 통계분석은 SPSS 19.0 통계프로그램을 사용하였다. 분석결과 체전손상에서 남자가 손상의 발생이 유의하게 높았다. 음주 관련 손상의 경우에서 남자가 여자에 비해 손상의 발생 위험이 8.3배 높았다. 교육은 고등학교 졸업자가 AUDIT이 가장 높은 비율을 보여 유의하였으며, 결혼한 사람과 월소득이 201-300만원인 사람들이 AUDIT가 가장 높게 나타났으며 유의하였다. 문제음주자와 알코올의존자에서 의미있게 증가된 신체부위의 손상은 두 경부에서 0.0371로 유의하게 나타났고 AUDIT와 손상외인 기전에서는 운수사고, 미끄러짐, 기타, 부딪힘, 추락의 순으로 나타났으며, 손상의 유형 분류상 기타(열상, 좌상, 중독, 관통상 등)에서 유의하였다. 음주로 인한 손상 및 손상외인의 기전은 매우 중요하며, 상담자를 통한 동기유발 조정이 이루어 지게 되면 음주횟수를 줄여 음주로 인한 손상을 완화시킬 수 있는 장치가 필요하다.

이동식 크레인 사망재해의 인지공학적 대안 (Alternative Prevention on Human Error of Fatal Injuries by the Mobile Cranes)

  • 강현수;박범
    • 대한안전경영과학회지
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    • 제17권4호
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    • pp.135-141
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    • 2015
  • According to the statistics, occupational fatal injuries by mobile cranes were about 12 per year in whole industrial. Mobile cranes are widely used in various parts of industries to improve the efficiency of the work. However considerable number of fatal injuries happen each year during the operation of the machines. In this study, the current regulations to be adequate in industrial site have to be renew in order to prevent the fatal injuries by mobile cranes. Fatal injury analyses were conducted with several accident cases by the mobile cranes. For each accident, the causes of the injuries were examined and proper safety measures were proposed. In this study, the mobile crane showed a high fatality rate in industrial accidents and no detailed cause analysis of fatal accidents was conducted in terms of unsafe acts or conditions. This study proposed a revision of the standard guideline as an accident prevention measures through in-depth analysis of fatal accidents. First, among the mainly five machines caused the accidents, mobile crane was higher for the second showed 0.6% for number of fatalities compared to number of mobil cranes and for the third showed 11% for number of fatalities compared to number of injuries. Second, main cause of cognitive engineering agenda was visibility, responsibility, affordance. As the measures to prevent accidents before starting operation, alternative revision for the fool proof including visibility, responsibility, affordance etc. for the fool proof measures was proposed. Third, alternative revision as cognitive accident prevention for the fail safe measures was proposed.

Medical Care Expenditure in Suicides From Non-illness-related Causes

  • Sohn, Jungwoo;Cho, Jaelim;Moon, Ki Tae;Suh, Mina;Ha, Kyoung Hwa;Kim, Changsoo;Shin, Dong Chun;Jung, Sang Hyuk
    • Journal of Preventive Medicine and Public Health
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    • 제47권6호
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    • pp.327-335
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    • 2014
  • Objectives: Several epidemiological studies on medical care utilization prior to suicide have considered the motivation of suicide, but focused on the influence of physical illnesses. Medical care expenditure in suicide completers with non-illness-related causes has not been investigated. Methods: Suicides motivated by non-illness-related factors were identified using the investigator's note from the National Police Agency, which was then linked to the Health Insurance Review and Assessment data. We investigated the medical care expenditures of cases one year prior to committing suicide and conducted a case-control study using conditional logistic regression analysis after adjusting for age, gender, area of residence, and socioeconomic status. Results: Among the 4515 suicides motivated by non-illness-related causes, medical care expenditures increased in only the last 3 months prior to suicide in the adolescent group. In the younger group, the proportion of total medical expenditure for external injuries was higher than that in the older groups. Conditional logistic regression analysis showed significant associations with being a suicide completer and having a rural residence, low socioeconomic status, and high medical care expenditure. After stratification into the four age groups, a significant positive association with medical care expenditures and being a suicide completer was found in the adolescent and young adult groups, but no significant results were found in the elderly groups for both men and women. Conclusions: Younger adults who committed suicide motivated by non-illness-related causes had a higher proportion of external injuries and more medical care expenditures than their controls did. This reinforces the notion that suicide prevention strategies for young people with suicidal risk factors are needed.

100마리의 야생 멧돼지 사냥견에서 응급 외상성 질환의 분류 (Prevalence of Emergency Traumatic Injuries in 100 Wild Boar Hunting Dogs)

  • 고재진;김세훈;지중룡;심관섭;김남수
    • 한국임상수의학회지
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    • 제27권6호
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    • pp.718-722
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    • 2010
  • 전북지역에서 야생 멧돼지 사냥 시 발생한 응급 외상성 질환을 치료하기 위하여 내원한 사냥견 100마리를 외상의 정도에 따라 분류 하였다. 분류는 응급 외상성 질환의 경향과 정도를 부상의 원인, 부상 부위의 숫자와 위치, 부상의 중등도, 치사율과 같은 의료 기록들을 통하여 정보를 수집하였고 이를 토대로 후향성 조사를 실시 하였다. 사냥견 100마리의 환자에서 136개 (71마리의 단일 응급 외상성 질환과 29마리에서 복합 응급 외상성 질환)의 응급 외상성 질환이 발견되었다. 응급 외상성 질환의 원인으로는 야생 멧돼지 공격에 의한 응급 외상이 92마리, 오발로 인한 응급 외상이 7마리 그리고 덫에 의한 응급 외상이 1마리로 조사 되었다. 흉부는 응급 외상 질환이 가장 잘 발생하는 부위이며, 부상심각점수(ISS)는 2단계로 판단되었다. 치사율은 9% 였으며 사망에 이르게 된 증례는 모두 흉강에 외상을 입고 있었다. 야생 멧돼지 사냥 시에 발생하는 응급 외상성 질환은 사냥물을 공격할 때 대부분 발생하는 것으로 특히 가장 흔한 부위는 흉부였으며 이것은 임상 수의사가 흔히 접하는 일반적인 응급 질환들과는 매우 다른 특징을 나타내고 있었다. 본 연구를 통하여 야생 멧돼지 사냥견에서 응급 외상성 질환의 치료 경과, 발생 형태, 예후, 치사율 등 임상 응급 진료에 필요한 정보들을 알 수 있었다.

흉부손상의 임상적 고찰 (Clinical analysis of the chest trauma - 823 cases -)

  • 노태훈
    • Journal of Chest Surgery
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    • 제20권4호
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    • pp.715-722
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    • 1987
  • A clinical analysis was performed on 823 cases of the chest trauma experienced at department of thoracic & cardiovascular surgery, Kyung Hee University Hospital during the past 8 years from Jan, 1978 to Aug. 1986. 1. the ratio of male to female patient of the chest trauma was 3:1 in male predominance. 2. The common age groups were 3rd, 4th and 5th decades. 3. The most common causes of the chest trauma was traffic accidents [79.8%] were injured due to non-penetrating injuries and the remainders [166/823, 20.2%] were injured due to penetrating injuries 4. The frequently injured site of the chest trauma was left side of the chest [46%], and the right side was 42% 5. The most common injury from non-penetrating trauma was rib fracture [77.5%], and the incidence rate of flail chest was 59% of all cases of rib fractures. 6. The incidence rate of hemopneumothorax was 42.9% in non-penetrating traumas, and 84.3% in penetrating traumas. 7. The most common method of surgical treatment was closed tube thoracostomy [37.3%], and open thoracotomy was performed in 71 cases [8.6%]. 8. the overall mortality was 2.2%, and common causes of death were cerebral damage, respiratory insufficiency, and hypovolemic shock.

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의료인의 바늘자상 실태에 관한 연구 (A Study on Needle Stick Injuries in Health Professionals)

  • 김영분
    • 대한간호학회지
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    • 제26권3호
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    • pp.605-622
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    • 1996
  • Needle stick injury, in which blood-borne pathogens including Human Immune-Deficiency virus and hepatitis B virus are transmitted, is one of the major occupational hazards that health professionals face everyday. In order to provide basic data for the development of educational programs for health professionals aimed at preventing and effectively managing needle stick injuries, a retrospective descriptive study was carried out .The subjects of the study were 630 health professionals, 499 nurses and 131 physicians, from two university hospitals in Seoul, Korea. Data on episodes of needle stick experiences over the past is months September 1994 through August 1995, were collected between September 1 and 7, 1995. A Questionaire developed by the researcher was used. The frequencies and the percentile score for episodes of needle stick injuries were calculated using the PC-SAS program. The differences and similarities in reference to the structure, career, and specialty variables were analysed by X$^2$-tests. Results are as follows : 1. Of the sample, 521(82.7%) reported a needle stick injury, 33.4% reported 3 or more episodes of needle stick injuries. 2. The needle stick injuries occured in the following processes : process of percutaneous venepuncture for intra-venous injection and infusion(55.3%), medical examination and treatment(48.9%), per-cutaneous venepuncture for blood sampling (46.3%) and intra-muscular injection(42.2%). 3. The study showed that needle stick injuries occured before(19%), during(25%), and after (56%) client treatment. The major causes of needle stick injuries were perceived to be hastiness(82.2%) and carelessness(48.3%). Of these injuries, 91.8% occured in emergency situations. 4. Follow of care for the injury consisted of : treating the injured site immediately using disinfectants(89.7%), reviewing the clinical records of the patient involved(84.2%), immunological investigation for the status of antibodies(11.1%) and self-medication of antibiotics (10.7%). Only 16.3% of the total episodes were founded to have been reported to the administrative unit. 5. The length of clinical experience of the nurses, clinical specialty and length of clinical experience in physicians were found to have influenced the episodes of needle stick injuries ; nurses with less than 1 year and with more than 6 years of clinical experiences had significantly lower levels (X$^2$=25.04, P=.00), surgeons had significantly higher levels (X$^2$=9.89, P=.02) compared to that of internists and interns, higher(X$^2$=4.54, P=.03)than residents.

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우리나라 생활안전영역의 비의도적 손상 발생률 및 발생 양상 (The Incidence and Patterns of Unintentional Injuries in Daily Life in Korea: A Nationwide Study)

  • 박건희;은상준;이은정;이채은;박두용;한경훈;김윤;이진석
    • Journal of Preventive Medicine and Public Health
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    • 제41권4호
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    • pp.265-271
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    • 2008
  • Objectives: This study was conducted to estimate the cumulative incidence rate (CIR) of unintentional injuries in Korean daily life and to describe the pattern of unintentional injuries. Methods: The study population was the people who used the National Health Insurance because of injuries (ICD code: S00$\sim$T98) during 2006. The stratified sample according to gender, age and the severity of injury (NISS, New Injury Severity Score) was randomly selected. The questions on the questionnaire were developed as a reference for an international classification tool (ICECI, International Classification of External Causes of Injury). The questions included the locations of injury, the mechanisms of injury and the results of injury. Moreover, we used age, gender, region and income variables for analysis. Results: The CIR of unintentional injuries that occurred in daily life for 1 year per 100,000 persons was 17,606, and the CIR of severe injuries was 286. Many injuries were occurred at home (29.6%), public places (19.0%), school (13.7%) and near home (12.0%). The major mechanisms of injuries were slipping (48.8%), contact (14.0%), physical over-exertion (13.8%), and fall (6.6%). Infants and old aged people were vulnerable to injuries, and those who lived rural area and who were in a low income level were vulnerable too. Conclusions: We signified the risk groups and risk settings of unintentional injuries in Korean daily life. These results could contribute to establishing strategies for injury prevention and implementing these strategies.

건설산업재해 원인분석 조사연구 (The Study of Field Survey for the Analysis of Occupational Accident Causes in Korean Construction Industry)

  • 이영섭
    • 한국안전학회지
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    • 제1권1호
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    • pp.51-59
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    • 1986
  • This study was conducted to analyse the exact causes of occupational accidents in Korean construction industry and to contribute to the accident prevention programs. The results and conclusions of the field survey are as follows : 1) The accidents caused by hazardous conditions are 96 percent, and those by unsafe acts are 97.3 percent. The accidents caused simultaneously by two categories are nore than 96 percent. 2) The injured workers who were employed less than 3 months are 71.1 percent. Safety training for newly recruited workers should be required. 3) More than 40 percent of all accidents were occurred in the morning and more than 30 percent were in summer. Required caution should be paid for the time and season. 4) Fracture, cut/laceration/puncture and multiple injuries in the lower extremeties, upper entremeties and head as well as many kinds of injuries by the fall from elevation mainly occurred. Safety. shoes, safety gloves, safety helmets, safety glasses, face shields and safity belts should be used 5) As the sources of injuries, each of building/structure and materials is one third of all sources, and machinery is a quarter. 6) The use of hazardous methods/procedures, defects of agencies and inadequate guarding of builing/structure, materials' and machinery mainly caused the accident types, such as s truck by, struck against, fall from elevation, and fall on same level. Such a hazardous conditiion should not be used and be correctet 7) The unsafe acts, such as improper use of hands or body parts, the operation or working at unsafe speed and improper use of equipment mainly caused accidents. Safety training for the control of such a unsafe acts should be strengthened.

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횡복직근 유리피판술로 유방재건 후 발생한 화상의 임상적 특성 (Clinical Characteristics of Thermal Injuries Following Free TRAM Flap Breast Reconstruction)

  • 이백권;배준성;안상태;오득영;이종원;한기택
    • Archives of Plastic Surgery
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    • 제32권4호
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    • pp.403-407
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    • 2005
  • Following a transverse rectus abdominis musculocutaneous(TRAM) flap breast reconstruction, denervated state of the flap causes the flap skin prone to thermal injury, calling for special attention. During the last 5 years, 69 breast reconstruction with 72 free TRAM flaps, were performed. Four out of thesse 69 patients sustained burn injury. Heat sources were a warm bag(n=2), heating pad(n=1) and warming light (n=1). The thermal injuries occured from 2 days to 3 months following the reconstruction. Three patients healed with conservative treatment, but one patient required debridement and skin graft. Initially 3 out of 4 patients with the burn had shown superficial 2nd degree burn with small blebs or bullae. However all 4 patients healed with scars. Mechanism of burn injuries of the denervated flap are known to be resulting from; 1) loss of behavioral protection due to denervation of flap with flap elevation and transfer, 2) loss of autonomic thermoregulatory control with heat dissipation on skin flap vasculature contributing to susceptibility of burn injury. 3) changes of immunologic and normal inflammatory response increasing thromboxane, and a fall in substance P & NGF (nerve growth factor). Including the abdominal flap donor site, sensory recovery of the reconstructed breast varies individually from 6 month even to 5 years postoperatively. During this period, wound healing is delayed, resulting in easier scarring compared to that observed in the sensate skin. Patients should be carefully informed and warned of possible burn injuries and taught to avoid exposure to heat source at least until 3 years postoperatively.