• Journal of Trauma and Injury
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• 제36권3호
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• pp.187-195
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• 2023

Purpose: This study aimed to determine the risk factors associated with the severity of fall-related injuries among patients who suffered a fall from similar heights and analyze differences in injury sites according to intentionality and injury severity. Methods: The Emergency Department-based Injury In-depth Surveillance (EDIIS) data collected between 2019 and 2020 were used in this retrospective study. Patients with fall-related injuries who fell from a height of ≥6 and <9 m were included. Patients were categorized into the severe and mild/moderate groups according to their excessive mortality ratio-adjusted Injury Severity Score (EMRISS) and the intention and non-intention groups. Injury-related and outcome-related factors were compared between the groups. Results: In total, 33,046 patients sustained fall-related injuries. Among them, 543 were enrolled for analysis. A total of 256 and 287 patients were included in the severe and mild/moderate groups, respectively, and 93 and 450 patients were included in the intention and non-intention groups, respectively. The median age was 50 years (range, 39-60 years) and 45 years (range, 27-56 years) in the severe and mild/moderate groups, respectively (P<0.001). In multivariable analysis, higher height (odds ratio [OR] 1.638; 95% confidence interval [Cl], 1.279-2.098) and accompanying foot injury (OR, 0.466; 95% CI, 0.263-0.828) were independently associated with injury severity (EMR-ISS ≥25) and intentionality of fall (OR, 0.722; 95% CI, 0.418-1.248) was not associated with injury severity. The incidence of forearm injuries was four (4.3%) and 58 cases (12.9%, P=0.018) and that of foot injuries was 20 (21.5%) and 54 cases (12.0%, P=0.015) in the intention versus non-intention groups, respectively. Conclusions: Among patients who fell from a similar height, age, and fall height were associated with severe fall-related injuries. Intentionality was not related to injury severity, and patients with foot injury were less likely to experience serious injuries. Injuries in the lower and upper extremities were more common in intentional and unintentional falls, respectively.

• 한국안전학회지
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• 제35권2호
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• pp.67-75
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• 2020

Due to various industrial accident that occur to the staff in the broadcasting production sites, the issue of safety at the broadcast production site is becoming a social issue. Nevertheless, not many researches have been carried out on the actual conditions of the staff's production environment and its safety issues. Therefore, the purpose of this study was to prepare a countermeasure based on engineering knowledge by analyzing working environment to improve the poor working environment of staff. First, this study analyzed statistical data of industrial accidents over the past five years to find out the current status of disasters at broadcasting production sites. As a result, the intensity of the accident was not weak in that the loss days was more than one month in 85% of accident. In addition, the type of accident was high in the fall/trip accidents. Second, this study visited 10 broadcasting production sites for risk assessment. By analyzing the characteristics of the working environment and 104 questionnaires, we predicted the types of accidents that can occur in the broadcasting production site. As a result, accident types such as fall, collision, and trip were relatively high, similar to the characteristics of construction site. Third, it was possible to quantify the scale of the risk in the broadcasting production, and as a result, the quantity of temporary structure and accident risk were proportional. In other words, this study analyzes broadcasting work environment and defines risk factors based on safety engineering knowledge. Finally, this study suggested a guideline to improve the safety of the broadcasting production site.

• 대한안전경영과학회지
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• 제18권3호
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• pp.81-89
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• 2016

Floor slipperiness is a leading cause in slip and fall accidents which are a major source of occupational injuries in Korea. Researchers have estimated the slip and fall related accidents rank number one or two in number of the injured. The objectives of this study were to find the field contamination effect and improvement countermeasure. Slipping and falling are common accidents in large public facilities, especially facility which vulnerable adults generally use as like hospital. So, we measured the coefficient of friction of several floors on the floor in hospital, under dry and wet using BOT-3000. The results of the coefficient of friction measurements showed that floor type and surface conditions were all significant factors affecting the coefficient of friction. The most surprising finding of this study was that there were significant friction improvement when the floors were properly cleaned with cleaning equipments.

• 대한안전경영과학회지
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• 제11권3호
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• pp.33-40
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• 2009

Steel and iron manufacture works exist that many latency risk as melting liquid of high temperature, work of high place, and so on. Once in a while, the accident case make use of basic data for latency risk analysis in a place of business. In this paper, we investigated the cause of the accident in steel an iron works. The result, we came across that many latency risk in steel and iron manufacture works. The main type of risk are fall, narrow, come flying, etc. Most of the latency risk type are repetition and conventional accident. Accordingly, steel and manufacture works must prevent to repetition and conventional accident.

• Safety and Health at Work
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• 제4권1호
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• pp.46-51
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• 2013

Objectives: Load carrying tasks are recognized as one of the primary occupational factors leading to slip and fall injuries. Nevertheless, the mechanisms associated with load carrying and walking stability remain illusive. The objective of the current study was to apply local dynamic stability measure in walking while carrying a load, and to investigate the possible adaptive gait stability changes. Methods: Current study involved 25 young adults in a biomechanics research laboratory. One tri-axial accelerometer was used to measure three-dimensional low back acceleration during continuous treadmill walking. Local dynamic stability was quantified by the maximum Lyapunov exponent (maxLE) from a nonlinear dynamics approach. Results: Long term maxLE was found to be significant higher under load condition than no-load condition in all three reference axes, indicating the declined local dynamic stability associated with load carrying. Conclusion: Current study confirmed the sensitivity of local dynamic stability measure in load carrying situation. It was concluded that load carrying tasks were associated with declined local dynamic stability, which may result in increased risk of fall accident. This finding has implications in preventing fall accidents associated with occupational load carrying.

• 한국전문물리치료학회지
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• 제18권3호
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• pp.38-48
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• 2011

The aim of the study was to identify which fall-prevention program offered in community settings in Korea is the most effective in strengthening muscles. Muscle weakness is one of the major risk factors causing falls among the elderly. Randomized controlled trials and clinical controlled trials published between 1996 and February 2011 were included in this study. Seventeen of the 69 identified studies met the study's criteria and were included in this meta-analysis. The overall effect size of the program was .822 (95% confidence interval= .717~.927). The general strengthening exercise (1.608), dance sports training (1.538), Thera-band exercise for lower extremities (1.517), Seniorobic exercise (1.146), gait training (.959), balance training (.909), gradual resistive exercise (.888), and multifactorial fall prevention (.842) programs all show positive effects on muscle strengthening. Subgroup analyses found that more relative effects are seen in programs offered to the more elderly. In this study, the effect of increasing muscle strength on the prevention of falls can only be indirectly suggested; there are few available studies that report the frequency or history of falls in Korea. Further studies are needed to examine the direct effect of fall prevention exercise programs among the elderly.

• 여성건강간호학회지
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• 제24권2호
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• pp.209-218
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• 2018

Purpose: This study was conducted among older women to (1) identify their levels of knowledge, self-efficacy, and health behavior in dealing with osteoporosis and falls and (2) explore the relationships between the study variables based on a health-beliefs model. Methods: With a cross-sectional survey design, we recruited 94 older women of ages from 65 to 74 at a community setting via convenience sampling. The study participants completed two sets of structured questionnaires (on osteoporosis and fall prevention). Results: The general characteristics of the study participants demonstrated that the women were at high risk for osteoporosis and falls. Overall, the levels of knowledge about osteoporosis and falls, their self-efficacy, and their preventive behaviors were average or slightly above. The relationships between the study variables showed that self-efficacy and healthy behavior, such as doing osteoporosis exercise, eating an osteoporosis diet, and avoiding falls, were related (r=38, p<.001; r=.33, p<.05; r=.26, p<.05). In addition, there were statistically significant relationships between osteoporosis and fall prevention knowledge (r=.37~.46, p<.001), self-efficacy (r=.50~.53, p<.001), and preventive behaviors (r=.50, p<.001). Conclusion: The women's scores on osteoporosis and fall knowledge, self-efficacy, and preventive behaviors suggest an urgent need for the implementation of educational programs for older women. A close relationship between self-efficacy and health behaviors implies a need for transformation of a traditional one-way lecture form.

• 한국BIM학회 논문집
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• 제7권4호
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• pp.21-30
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• 2017

Due to the rapidly aging population, the death rate of elderly people by safety accidents has been increasing. In particular, precautions are needed for falls prevention because they either directly or indirectly cause death. In the case of elderly people, most of the fall accidents occur in dense residential areas, and particularly, the staircase poses a risk of falling. Therefore, a safety assessment should be performed from the design phase. However, in general, staircases are designed using existing stair data or only aims to satisfy the installation criteria. Laws and regulations only define minimum requirements for safety, so it is not possible to prevent fall accidents even if they satisfy the requirements. Therefore, this study proposes a simulation-based method for evaluating the safety of staircases. The behavioral characteristics of the elderly are implemented to an virtual user in a virtual space including staircases, and fall accidents are evaluated by the evaluation logic related to the behavioral characteristics. The result shows that the safety of staircases can be preevaluated and reflected on the design to reduce the possibility of fall accidents of the elderly.

• 대한간호학회지
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• 제41권1호
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• pp.119-128
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• 2011

Purpose: This study was done to determine the risk factors for recurrent fallers (2+falls) compared to single fallers. Methods: Participants were 104 community-dwelling people 65 yr of age or older. The data were collected from June 1, 2008 to June 30, 2009 using the Residential Assessment Instrument-Home Care. Results: Over the past 90 days, 55.7% of the 104 participants fell once, and 44.2% experienced recurrent falls (2+falls). In comparison of recurrent fallers with single fallers, there were significant differences in scores on the following factors: gender ($X^2$=4.22, p=.040), age ($X^2$=5.74, p=.017), educational level ($X^2$=5.22, p=.022), living arrangements ($X^2$=35.02, p<.001), cardiovascular diseases ($X^2$=17.10, p<.001), hypertension ($X^2$=4.43, p=.035), diabetes mellitus ($X^2$=4.44, p=.035), glaucoma ($X^2$=13.95, p<.001), Minimal Data Set (MDS)-Pain (t=-2.56, p=.012), fear of falling ($X^2$=4.08, p=.034), reduced vision (t=-3.06, p=.003), MDS-activity of daily living (t=3.46, p=.001), MDS-Instrumental Activities of daily living (t=3.24, p=.002), cognition (MDS-Cognition Performance Scale) (t=3.40, p=.001), and 'difficulties entering and leaving the house' ($X^2$=4.53, p=.033). Conclusion: It is important to assess the risk factors for recurrent falls and develop differentiated strategies that will help prevent recurrent falls. Additionally, utilizing a standardized tool, such as RAI-HC, would help health professionals assess multi-variate fall risk factors to facilitate comparisons of different community care settings.

• 기본간호학회지
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• 제17권3호
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• pp.334-342
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• 2010

Purpose: The purpose of this study was to examine the effects of Tai Chi exercise on flexibility, balance, walking ability, muscle strength, bone mineral density, and fracture risk in institutionalized elders. Method: A quasi-experimental pretest-posttest design with a nonequivalent comparison group was utilized, and 53 older adults living in one institution were recruited and assigned to one of two groups, experimental group (18) or comparison (20). Both groups completed posttest measures at 6 months. There was a 31% rate of dropouts. Tai Chi exercise was provided twice a week for 24 weeks. Outcome measurements were conducted by a physiotherapist at a university hospital health promotion center who did not know the group assignment. Results: At 6 months, the experimental group had significantly greater grip strength(t=2.12, p=.04), back muscle strength (t=2.42, p=.02), balance (t=5.31, p<001), and flexibility (t=3.57, p<.001). They also showed significantly greater bone mineral density of lumbar spine and femur, and reduced fracture risk. Conclusion: Tai Chi exercise was safely and effectively used with institutionalized elders for 6 months and significantly improved physical fitness, bone mineral density along with a reduction in fracture risk. Whether Tai Chi exercise would lead to prevention of fall episodes and fall related fractures in this population will require further study.