• 한국직업건강간호학회지
• /
• 제6권1호
• /
• pp.23-43
• /
• 1997

The work-related diseases due to continuous overwork are mainly cerebro- and cardio-vascular ones, which is commonly called 'Karoshi', death from overwork. Many factors are capable for Karoshi : occupational stress in relation to technological renovation and industrial rationalization, competitive social structure, and accumulated fatigue accured to long time or irregular working. And its occurence is on the rise. The World Labor Report 1993 released by ILO, pointed out the diseases related to overwork and stress as one of the most important occupational health problem. In Korea, social awareness of Karoshi is at an infant stage, and reliable statistics for its occurence are not compiled in a convenient manner. Despite the rising Karoshi, there are no reliable clauses in workmen's compensation enough to settle down the disputes. Therefore, it is not uncommon that the Labour Ministry and Civil Court find difficulties in reaching an agreement. This study was intended to provide proper compensation and prevention program for workers by suggesting reasonable compensation clauses for the death from overwork. This study consists of two comparative reviews on the compensaton clauses for the death from overwork. One is to review legal standards of Karoshi among three countries, such as Korea, Japan and Taiwan. The other is to investigate the cases of Karoshi in Korea, 121 cases identified at the Labor Welfare Corperation and the Labour Ministrial process of examination and reexamination, and 73 leading cases at the High Court of Justice. The main findings of the study are as follows : 1. Comparisons of comperative review on compensation clauses for the death from overwork among three countries. 1) All of three countries have the same kinds of disease for compensation, which were cerebro-and cardiao-vascular diseases, while for cardiac disease group, Korea has the smaller number of diseases for compensation than Japan. 2) As for the definition of overwork, the three countries share equally that overload for one week prior to collapse is considered as an important factor, but accumulated chronic fatigue is disregarded. 3) As the basis of overwork, in Japan, there is a tendency to move from the conditions of an ordinary healthy adult to those of the individual concerned in Japan, whereas there is no such concern yet in Korea. 4) All the three countries use a common standard of medical judgement in demonstrating causal relationship between a job and a disease. However, Korea is progressive in the sense that in the case of CVA at worksite, the worker himself has no obligation to prove the cause. 2. The results of a comparative review on excutive decisions by Labor Ministry and judicial decisions by the Court in Korea : A judicial decision is based on the legalistic probability, but a excutive decision is not. Therefore, excutive decisions have such restrictions that : 1) TIA (transitory ischemic cerebral attack) and myocarditis are excluded from compensation, and there is little consistency of decision in the case of cause-unknown death. 2) There is a tendency not to compensate for the death from overwork since the work terms such as repeated long-time working, shift work or night-shift work are not considered as overloading. 3) There is a tendency to regard the conditions of a ordinary healthy adult rather than those of the individual concerned(age, existing diseases, health state, etc.) as the comparative basis of overload. 4) There remains a tendency not to compensate for the death from overwork in the case of collapse occuring out of workplace, on the ground of 'on the course of working' and 'in the cause of accident'. Through the study, the fact manifests itself that Korea's compensation clauses for work-related diseases due to overwork are very restrictive. So, it is necessary to extend the Labor Ministry's clauses of compensation for the death from overwork following to the recent changes of other countries and internal judicial decisions. This is very important in the perspective of occupational health that aims at health promotion of workers including prevention of the Karoshi.

• Journal of Preventive Medicine and Public Health
• /
• 제32권2호
• /
• pp.162-169
• /
• 1999

Objectives: The aim of this study was to investigate the attitudes toward complementary and alternative medicine among 1,490 residents(339 households) in Suwon city. Methods: All respondents were asked about types, frequency, effects, side-effects, views, and cost of complementary or alternative medicine through a questionnaire from July 24th to 27th. Six therapies were investigated: diet; acupuncture/ massage/ chiropractic etc., mind control such as Ki/ Yoga/ spiritual therapy/ relaxation therapy etc.; nutritional supplements, cultural remedies; and Herb medications Results: The results of this survey were as follows: 35.6% of respondents had experiences with at least one or more types of complementary and alternative medicine. The average number of different types of therapies used was 3.4. More experience with various types of therapies were found among those respondents of higher education, older age group, higher income, married group, religious group than among the opposite groups of respondents. Herb medications were used most frequently(39.8%), followed by minor grains(37.9%), Ginseng(23.8%), Boshintang(21.5%), acupuncture(20.3%), Gaesojou(15.3%) Gingko nut(12.0%), mushroom(11.5%), Cupping therapy(10.2%), and black goat(0.0%). Acupuncture and Herb medications were used for treatment of hypertension the most frequently; minor grains or silkworm for treatment of diabetic mellitus; vegetables for treatment of obesity; acupuncture, Cupping Therapy, Herb medications for treatment of rheumatism; and acupuncture, Herb medications, or exercises for treatment of Cerebro Vascular Accident(CVA). The average costs of treatment were 108,000 Won for hypertension, 87,200 Won for diabetic mellitus, 16,800 Won for obesity, 68,800 Won for rheumatism, and 87,500 Won for CVA. Among 10.9% of respondents, there were 13 cases of side-effects with acupuncture, Herb medications, and Gaesojou. Among the cases of side-effects, majority was due to Herb medications. Respondents reported that Cupping Therapy was the most effective, followed by acupuncture, Ginseng, Gingko nut, Boshintang, black goat, minor grains, Gaesojou, Herb medications, vegetables, and mushroom. In response to the views of complementary and alternative medicine which they had used, they recommended minor grains first, followed by Ginseng, acupuncture, Gingko nut, Cupping Therapy, vegetables, Boshintang, black goat, mushroom and Herb medications. In contrast, they did not recommend Herb medications, acupuncture, nor Gaesojou. Conclusions: These findings indicate that many people use various complementary and alternative medicine without any guidelines for treatment of serious chronic diseases not even to invigorate themselves. It is, therefore, suggested that medical doctors or scientists verify the true effects or side-effects from the most common complementary or alternative therapies through experiments. Also medical doctors should provide a comfortable atmosphere for discussion among doctors and patients who would like to try these therapies.

• 대한간호학회지
• /
• 제30권3호
• /
• pp.549-559
• /
• 2000

The purpose of this study was to investigate the correlation between the knowledge and educational needs related to recurrent in coronary artery bypass graft patients as a basis to provide an individual nursing education for the population. The subjects consisted of 110 patients who had coronary artery bypass graft(CABG) at Asan Medical Center in Seoul and Sechong hospital in Buchon. Data was obtained from a knowledge questionnaire and a learning needs questionnaire between November 1998 and February 1999. Data were analyzed using SAS program for Wilcoxon rank sum test and Spearman correlation coefficient. The results were as follows : 1. With regard to the 18 items to measure knowledge, the mean (median) of items 'don't know' was 4.9(4) items. The mean (median) of items answered wrong was 3.2(3) items. The number of items answered 'don't know' tend to show higher in those who had less education, blue color jobs and myocardiac infarction history than in their counter parts. There were higher frequency of items answered 'don't know' in those who had no hypertension 2. With regard to the level of knowledge by questionnaire about CABG, The most "I dont know" (59.1%) highly response was 'He has to be treated with anticoagulant drug to prevent revasculized vessel from obstructing.' The seond highest response (56.4%) was 'If you were hypotensive, the coronary attack would collapse. 'During the hospitalized day, the patient has complete bedrest.' The highest error probability was cholesterol has not to intake.', 'After surgery, the sexual life is need controlled for 1 year. 3. The mean of educational needs was 3.38. With regard to the level of learning needs by sentence about CABG, 'Food that benefit heart disease', 'Recurrence possibility of heart disease', 'Management method of operation site', 'Risk symptom that visit hospital or report immediately' were higher than other sentenses. With regard to the level of learning needs by factor 'food(5 items)', 'disease(9 items)' and 'exercise(3 items)' showed the highest than other factors. The educational needs by patients characteristics tend to show higher in males, under the age of 49, middle or high school degree, previous experience of admission with coronary artery disease, history of myocardial infarction, expierience of PTCA, history of cerebro-vascular accident, previous expierience of smoking than in their counter parts. 4. The number of items answered 'don't know', wrong and correct weren't correlated with the level educational needs. As the results, the number of items answered 'don't know' tend to show higher in those who had less educated, blue color jobs and myocardiac infarction history than in their counter parts. There were higher frequency of items answered 'don't know' in those who had no hypertension .There were higher frequency of items answered 'don't know' on anti-thrombolitic theraphy, hypotension and pain relief. Also there were higher frequency of items answered wrong on bed rest period, cholesterol intake, and sexual life. Educational needs were higher in young age group, had previous experience of procesure and history of other disease. And when we educate CABG patients, education for diet, recurrence possibility of disease, management methods of operation site and risk symptom should be emphasized.

• 한국인구학
• /
• 제15권2호
• /
• pp.15-59
• /
• 1992

After world war II Japanese life expectancy has been improved remarkably, and reached the highest level in the world around late 1970's. The life expectancy of Korean has also shown tremendous improvement in recent years with about 20 year's gap from the Japanese. The reason of rapid improvement of life expectancy can be explained by changes in the structure of cause of death due to health system, living standard, social welfare, health behavior of individuals and so on. Korean in Japan is placed under different situations from both Korean in Korea and Japanese in these regards, and expected to show different picture of cause of death pattern. The objective of this study is the comparision of changing patterns of cause of death of three population groups, Korean in Japan, Korean in Korea and Japanese, and to investigate the reasons which effect to the structural difference of mortality cause with special emphasis on health ecological aspects. One of the major limitations of the Korean causes of death statistics is the under-registration which ranges about 10% of the total events, and inaccuracy of the exact cause of death. Some 20% of registered deaths were unable to classify by ICD. However, it is concluded that the Korean data are evaluated as sufficient to stand for over-viewing of trends of cause of death pattern. The evaluation is done by comparing data from registration and field survey over the same population sample. Population data of Korean in Japan differ between two sources of data; census and foreigner's registration. Correction is done by life table method under the assumption that age-specific mortality pattern would accord with that of the Japanese. The crude death rate was lowest among Korean in Japan, 5.7 deaths per 1,000 population in 1965. The crude death rates of Korean in Japan and Japanese are increasing recently influenced by age structure while Korean in Korea still shows decreasing tendency. The adjusted death rate is lowest among Japanese, followed by Korean in Japan, and Korean in Korea. The leading causes of death of Korean in Korea until 1960's was infectious diseases including pneumonia and tuberculosis. The causes of death structure changed gradually to accidents, neoplasm, hypertensive disease, cerebro-vascular disease in order. The main difference in cause of death between Korean and Japanese if high rate of liver diseases and diabetes for both Korean in Japan and Korea. A special feature of cause of death among Korean in Korea is remakably high rate of hypertensive disease, which is assumed to be caused by physicians tendency in choosing diagnostic categories. The low ischemic heart disease and high vasculo-cerebral disease are the distinctive characteristic of the three population groups compared to western countries. Specific causes of death were selected for detailed sex, age and ethnic group comparisons based on their high death rates. Cancer is the cause of death which showed most dramatical increase in all three population groups. In Korea 20.1% of all death were caused by cancer in 1990 compared with 10.5% in 1981. Cancer of the liver is the leading cause of cancer death among Korean in Japan for both sexes, followed by cancer of the lung and cancer of the stomach, while that of Korean in Korea is cancer of the stomach, followed by cancer of the liver and cancer of the lung for male. Causes of infant mortality were examined among the three population groups since 1980 on yearly bases. For both Japanese and Korean in Japan, leading cause of death ranks as conditions originating in the perinatal period, congenital anomalies, accidents and other violent causes. Trends since 1980 for these two population groups in the leading cause of infant mortality showed no changes. On the contrary, significant changes in leading cause of death structure in Korea were observed : the ranking of leading cause of death in 1981 were congenital asnomalies, pneumonia bronchitis, infectious disease, heart disease, conditions originating in the perinatal period, accident and other violent causes ; in 1990 the ranking shifted to congenital anomalies, accident, pneumonia bronchities, conditions originating in the perinatal period, infectious disease. The mortality rate by congenital anomalies in Korea continuously grew than any other causes. Larger increase ocurred during the 1990's

• 농촌의학ㆍ지역보건
• /
• 제27권1호
• /
• pp.115-123
• /
• 2002

1997년 1월 1일부터 2001년 12월 31일까지 5년간 울릉군 보건의료원 응급실을 내원하여 헬리콥터를 이용하여 육지병원으로 후송된 환자를 조사하였다. 헬리콥터가 운행된 회수는 5년간 88회, 후송된 환자들은 110명으로 113건이었다. 헬리콥터의 연도별 운행 회수는 1997년은 13회(14.8%), 1998년에는 17회(19.3%), 1999년에는 18회(20.5%), 2000년에는 17회(19.3%), 2001년에는 23회(26.1%) 운행하여 연도에 따라 헬리콥터 운행 회수가 증가하는 경향을 보였다. 헬리콥터 종류는 해양경찰 헬리콥터가 46회(52.3%), 119 소방 헬리콥터가 19회(21.6%), 해군 헬리콥터는 14회(15.9%), 민간 헬리콥터가 7회(8.0%) 운행하였다. 후송 시간대는 오전 6시부터 오후 6시 이전까지 79회(89.8%)가 후송되었다. 후송 환자의 계절별 분포는 가을에 25회(28.5%), 봄에 23회(26.2%) 운행하였다. 최종 후송 지역은 경상북도 포항시 47건(43.1%), 강원도 강릉시 34건(31.2%), 대구광역시 16건(14.7%) 서울 10건(8.8%) 등의 순이었다. 후송 환자의 성별 분포는 남자가 71건(65.1%), 여자가 38건(34.9%)으로 남자가 많았다. 연령별 분포는 60세 이상이 31건(28.4%), 30대가 20건(18.3%), 40대가 16건(14.7%) 등의 순이었다. 진료과별 분포는 신경외과 42건(37.1%), 내과 21건(18.6%), 일반외과와 정형외과가 각각 13건(11.5%) 등의 순이었다. 질병별 분포는 뇌졸중이 27건(23.9%)으로 가장 많았으며, 골절이 13건(11.5%), 두부손상 11건(9.7%), 임신과 관련된 출혈 및 통증 10건(8.8%), 복막염 8건(7.1%) 등의 순이었다. 한국표준질병사인분류(3-KSCD)에 의한 분포는 순환기계의 질환(IX)이34건(30.1%), 손상, 중독및기타(XIX)가34건(30.1%), 소화기계질환(XI)이 23건(20.4%) 등의순이었다. 울릉도를 비롯한 도서지역의 응급환자 후송에는 헬리콥터의 이용이 필수적이다. 보다 효율적인 응급환자 후송을 위해서는 헬리콥터의 야간 운행, 헬리콥터 내의 환자감시장치 등의 의료장비의 확보, 공식적인 응급후송용 헬리콥터의 확보 및 이를 위한 법 제정 등이 이루어져야 할 것이다.