• 제목/요약/키워드: Non-Public Records

검색결과 94건 처리시간 0.022초

예방접종력이 있는 초등학생의 홍역 항체 양성률 및 기여 요인 (Seroprevalence of Measles Antibody and its Attributable Factors in Elementary Students of Routine 2-dose Schedule Era with Vaccination Record)

  • 임현술;고운영;양병국;김영택;이종구;배근량
    • Journal of Preventive Medicine and Public Health
    • /
    • 제38권4호
    • /
    • pp.431-436
    • /
    • 2005
  • Objectives : We investigated the seroprevalence of the measles antibody and its at tributable factors for the students who underwent routine 2-dose Schedule Era. Methods : The subjects were 996 students of the national measles seroepidemiologic study in December 2000 who had vaccination records. We conducted a questionnaire survey and we performed serologic testing for the measlesspecific IgG by using an enzyme linked immunosorbent assay. Results : The coverage for the first dose of the MMR vaccination at 12-15 months of age was 95.1% and the coverage for the second dose of MMR at 4-6 years of age was 35.0%. The proportion of subjects undergoing 2-dosesof MMR dec reased as the age of the subjects increased. The seropositive rate of the measles antibody was significantly high in the second dose vaccinees (93.5% in the second dose group, 84.7% in the non-second dose group, p<0.001) and it was 72.0% in the 0-dose group, 85.4% in the 1-dose group and 93.7% in the 2-dose group (p<0.001). Two point eight percent of the subjects had a past history of measles infection. On the multiple logistic regression analysis, the first and second dose (odds ratio, 8.54; 95% CI.=3.05-23.91), the first dose (odds ratio, 3.06; 95% CI.=1.20-7.81) and the outbreak in the year 2000 (odds ratio, 1.89; 95% CI.=1.24-2.88) were the significant factors for the seropositivity. Conclusions : Maintaining high coverage with a 2-dose vaccination program would be the decisive factor to prevent an outbreak of measles and to eliminate measles in Korea.

지적공부의 세계측지계 변환에 따른 문제점 및 개선방안 (Problems and Improvement Measures for the transformation of World Geodetic System)

  • 김근배;정구하;전정배
    • 지적과 국토정보
    • /
    • 제49권2호
    • /
    • pp.123-134
    • /
    • 2019
  • 지적 분야의 세계측지계 도입은 세계적인 표준을 도입하고, 공간정보 기반의 타 산업과 융복합 함으로써 신산업창출의 기반이 될 수 있다. 하지만 「공간정보의 구축 및 관리 등에 관한 법률」의 기본 목적인 국민의 소유권 보호 측면에서 새로운 불부합지의 발생가능성이 있기 때문에 이에 대한 해결방안이 필요한 실정이다. 본 연구에서는 세계측지계 변환에 따른 사례 조사를 분석하고, 이에 따른 문제점을 파악하여, 이 문제점을 해결하기 위한 제도적 개선방안을 제시하고자 한다. 이를 위하여 사유지간 겹치는 사례와 국공유지간 겹치는 사례를 통하여 현장에서 발생하는 문제점 해결을 위한 제도적인 개선방안을 도출하고자 한다. 개선방안으로 세계측지계로 변환된 도면에 지적공부로서의 기능을 부여하기 위해 세계측지계 변환 검증측량을 도입해야한다. 또한 검증측량을 통해 경계조정 및 위치정정이 가능하도록 법적 제도적 근거를 확립해야 한다. 마지막으로 업무지역별로 측량성과가 다르기 때문에 공통점의 좌표값도 달라짐에 따라 변환계수를 결정하기가 어려운 실정이다. 따라서 2021년 세계측지계에 의한 지적측량 기준을 사용하는 것을 연기해야 할 것으로 판단된다.

Shift Work and Occupational Stress in Police Officers

  • Ma, Claudia C.;Andrew, Michael E.;Fekedulegn, Desta;Gu, Ja K.;Hartley, Tara A.;Charles, Luenda E.;Violanti, John M.;Burchfiel, Cecil M.
    • Safety and Health at Work
    • /
    • 제6권1호
    • /
    • pp.25-29
    • /
    • 2015
  • Background: Shift work has been associated with occupational stress in health providers and in those working in some industrial companies. The association is not well established in the law enforcement workforce. Our objective was to examine the association between shift work and police work-related stress. Methods: The number of stressful events that occurred in the previous month and year was obtained using the Spielberger Police Stress Survey among 365 police officers aged 27-66 years. Work hours were derived from daily payroll records. A dominant shift (day, afternoon, or night) was defined for each participant as the shift with the largest percentage of total time a participant worked (starting time from 4:00 AM to 11:59 AM, from 12 PM to 7:59 PM, and from 8:00 PM to 3:59 AM for day, afternoon, and night shift, respectively) in the previous month or year. Analysis of variance and covariance were used to examine the number of total and subscale (administrative/professional pressure, physical/psychological danger, or organizational support) stressful events across the shift. Results: During the previous month and year, officers working the afternoon and night shifts reported more stressful events than day shift officers for total stress, administrative/professional pressure, and physical/psychological danger (p < 0.05). These differences were independent of age, sex, race/ethnicity, and police rank. The frequency of these stressful events did not differ significantly between officers working the afternoon and night shifts. Conclusion: Non-day shift workers may be exposed to more stressful events in this cohort. Interventions to reduce or manage police stress that are tailored by shift may be considered.

탄산음료와 탄산수의 대체관계에 영향을 미치는 식품선택요인 연구 (The Effect of Consumers' Factors of Food Choices on Replacing Soft Drinks with Carbonated Water)

  • 박서영;이동민;정재석;문정훈
    • 대한지역사회영양학회지
    • /
    • 제24권4호
    • /
    • pp.300-308
    • /
    • 2019
  • Objectives: This research was conducted to identify the consumers' food choice factors that affect the consumers' replacement of soft drinks with carbonated water. Methods: The present study used secondary data from a consumer panel survey conducted by the Rural Development Administration of Korea, and the data included the panel members' purchase records based on their monthly spending receipts. The survey asked the participants about their food choice factors and their personal responsibility for their health. This survey included independent variables for the consumers' food purchase factors. As a dependent variable, two types of groups were defined. The replacement group included those people who increased their purchase of carbonated water and decreased their purchase of soft drinks. The non-replacement group included those people who did not change their purchase patterns or they increased their purchase of soft drinks and they decreased their purchase of carbonated water. Logistic regression analysis was conducted to determine the consumers' food choice factors that were associated with replacing soft drinks with carbonated water. Results: The replacement group was significantly associated with (1) a younger age (OR=0.953), (2) being a housewife (OR=2.03), (3) higher income (OR=1.001) and (4) less concern about price (OR=0.819) when purchasing food. This group also showed (5) higher enjoyment (OR=1.328) when choosing food and (6) they took greater responsibly for their personal health (OR=1.233). Conclusions: This research is the first study to mainly focus on soft drinks and carbonated water. The result of this research showed that young, health-conscious consumers with a higher income and who are more interested in food have more possibilities to replace soft drinks with carbonated water. These research findings may be applied to consumers who have characteristics that are similar to the young health-conscious consumers and the results can help to suggest ways to reduce sugar intake and improve public health. However, this research has a limitation due to the application of secondary data. Therefore, a future study is needed to develop detailed survey questions about food choice factors and to extend these factors to all beverages, including soft drinks made with sugar substitutes, so as to reflect the growth of alternative industries that use artificial sweeteners or different types of sugar to make commercially available drinks.

응급의료센터 내원환자 진료시 소요시간과 관련된 요인 (Factors Related to Waiting and Staying Time for Patient Care in Emergency Care Center)

  • 한남숙;박재용;이삼범;도병수;김석범
    • 한국의료질향상학회지
    • /
    • 제7권2호
    • /
    • pp.138-155
    • /
    • 2000
  • 3차 의료기관 응급의료센터의 총 진료소요시간을 단축하여 업무의 효율성을 높이고 환자적체를 해소하는 방안을 마련하기 위하여 l997년 4월 1개월 동안 대구광역시 소재 영남대학교병원 응급의료센터 내원환자 1,742명을 대상으로 환자의 특성, 응급진료와 관련된 내용 및 응급진료시간, 그리고 상호관련성을 분석하였다. 평균 초진소요시간은 83.3분이었고, 남자 83.1분, 여자 84.9분여였으며, 평균 총 진료소요시간은 전체 698분이었고, 남자 718.0분 여자 670.5분이었다. 총 진료소요시간은 고령일수록 증가하였으며 의료보호환자에서 초진 및 퇴실시간이 가장 많이 소요되었고 산재환자는 가장 적게 소요되었다. 전원시 소견서를 구비하지 않은 경우에 초진소요시간어이 많았으며, 총 진료소요시간은 외래어에서 전과된 경우, 타병원으로부터 전원된 경우, 전원시 소견서를 구비한 경우와 OCS를 부분적으로 사용한 경우에 많았다. 약물중독환자, 심폐소생술을 시행한 환자, 내과환자 수혈을 받은 환자 및 복합진료 여부가 3개과 이상이었던 환자에서 총 진료소요시간이 많았으며 당직인턴수가 4명이었던 경우가 총 진료소요 시간이 5명이었던 경우에 비해 더 많이 걸렸다. 입원한 경우, 입원명령후 공실이 없었던 경우에서 역시 총 진료소요시간이 증가하였으며 총 진료소요시간과 유의한 상관관계를 갖는 연속변수로는 환자의 연령, 방사선검사수 및 일반검사수였다. 초진소요시간에 대한 중회귀분석결과, 응급의학과 환자, 응급환자, 내원시 심폐소생술 시행환자유무, 내원시 기관내삽관 여부 등이 유의한 독립변수였다. 총 진료소요시간에 대한 중회귀분석결과, 공실유무, 일반검사수, 최종진료과, 타병원 전원유무, 방사선검사수, 퇴원약 유무, 입원실 종류, 입원유무, 담당전공의 연차, 내원원인, 내원시 심폐소생술 시행환자 유무, 수술여부, 병원직원 지인유무 및 특수검사수가 유의한 독립변수였다. 이상의 결과로 보아 응급의료센터내의 환자적체현상을 해결하기 위한 방안으로는 응급환자와 비응급환자를 분류하는 제도적 장치가 필요하며, 필수적인 경우에 한해 일반검사 및 방사선검사를 실시하도록 하며, 병동내의 과별 지정병상을 유동적으로 운영하여 응급의료센터 환자가 우선적으로 입원될 수 있도록 각과의 협조가 필요할 것으로 사료된다.

  • PDF

서울시(市) 대기오염(大氣汚染)이 시민보건(市民保健)에 미치는 영향(影響)에 관(關)한 조사연구(調査硏究) (Epidemiological Study of Air Pollution and Its Effects on Health of Urban Population)

  • 정규철
    • Journal of Preventive Medicine and Public Health
    • /
    • 제2권1호
    • /
    • pp.5-22
    • /
    • 1969
  • The urban population of our country is rapidly increasing due to many factors of social structure, and sociologists are predicting that the increase rate of the urban population will be over 50% in 1980's. Above all, the population of the capital city of Seoul, is at present more than four millions. Such centring of people in cities, together with the improvement of the standards of living, caused rapid increase in the amount of fuel consumption, and this consumption of fuels became one of the primary sources of the air pollution in cities. Moreover, the heavy traffic, construction of many tall buildings, and the increasing number of new factories due to the industrial development-all these are contributing to make the matter of air pollution worse and worse in the Metropolitan, whose geographical location is quite unfavorable considered from the view point of air pollution. Most homes in Seoul use briquet as fuel, while oils are used in tall buildings. The CO, $SO_2$, and smoke that come from burning of these fuels are a great threat to the health of the urban population. With the purpose of examining the influence of air pollution upon the public health, written inquiries were made upon respiratory diseases, and the carboxyhemoglobin saturation in the blood was measured to determine whether the air pollution may affect the health of the urban population. Method of Health Examination (1) Investigation of Respiratory Diseases Patients' records were examined to figure out the monthly ambulance rate of respiratory patients to the total number of patients treated. On the other hand, by using the questionnaire form approved by the Medical Research Council's Committee on Research into Chronic Bronchitis, investigators interviewed the examinees and inquired into the respiratory symptoms. (2) Measuring of Carboxyhemoglobin Saturation From the ear lobe of the examinees, with the use of the melangeur for the white blood cell counting, blood was taken, and after diluting it ten times with 0.1% $Na{2}CO_{3}$, again diulting it 20 times with 0.5% $Na_{2}\;CO_{3}$, its absorbancy was measured. The following results are obtained from the investigation. (1) It was found out that 7.7% of the total patients under treatment were suffering from upper respiratory infection, acute or chronic bronchitis, bronchial asthma, pulmonary emphysema and bronchiectasis. Of them all, patients with upper respiratory infection numbered the greatest with 4.8% and patients with acute or chronic bronchitis the next with 2.1%, and their monthly ambulance rate was high from December to February during the winter, and from April to May and from September to October during the changeable seasons. (2) The daily ambulance rate of respiratory patients, it was revealed, had a close connection with the concentration of $SO_2$ and CO in the air. (3) It was found out that men were more subject to respiratory disease than women, and both men and women were more liable to the diseases with the advancing of age. (4) People living at Choong-ku with the heavy traffic and in the industrial zones of Yeungdungpo had high frequency of respiratory symptoms. (5) Considered from the view point of occupations, high frequency was found among those without job, with jobs unknown, merchants and intdustrial workers, whose social status was rather low and traffic policemen who were always exposed to the exhaust gas of cars. As for women, the frequency was detected in the order of those from high to low, housewives who were exposed to briquet gas, women with jobs unknown, women without jobs, whose social status was low. (6) Ex-smokers rather than smokers, of both sexes, had higher frequency. As for men, heavy smokers had high frequency, while in women light smokers had rather high frequency which was presumed to be due to their average old age. (7) Men's average of carboxyhemoglobin saturation was 9.48%, while women's was 11.3%, higher than men's. (p<0.05). Age meant no difference in the case of men, but as for women, the saturation was remarkably high between the ages from 20 to 60. (8) No regional difference was detected in the carboxyhemoglobin saturation. (9) The carboxyhemoglobin saturation was found, in the case of men, in the order of office workers, traffic policemen, students, the unemployed, merchants and industrial workers, drivers; and as for women, the order was housewives, office workers, merchants and industrial workers. (10) No significant correlation was found between the carboxyhemoglobin saturation and the concentration of CO detected in kitchens, or between the carhoxyhemoglobin saturation and the passing of time after exposure to briquet gas. No difference of carboxyhemoglobin saturation was detected between smokers and non-smokers, and the degrees of smoking; only, significant negative correlation was found between the passing of time after smoking and the carboxyhemoglobin saturation. It is ture that air pollution causes or aggravates the respiratory diseases, increases the carboxyhemoglobin saturation in the blood, but what seems to be more hazardous to the health is the air polluted by the briquet gas in the kitchens and on-dol rooms rather than the atmospheric air pollution.

  • PDF

한국인 치료순응도 향상을 위한 개입 효과에 대한 메타분석 (Meta-Analysis on Effectiveness of Intervention to Improve Patient Compliance in Korean)

  • 김춘배;조희숙;현숙정;박애화
    • 보건행정학회지
    • /
    • 제12권2호
    • /
    • pp.23-42
    • /
    • 2002
  • 본 연구는 최근 20년간의 치료순응도 관련 국내연구를 수집하여 연구 동향을 파악하고, 계량적 메타분석을 통하여 순응도 향상을 위한 개입 효과를 산출하여 제시하고자 하였다. 연구 결과는 다음과 같다. 첫째, 1980년대 이후 20여년간 치료순응도와 관련된 연구는 133편에 달하였다. 이중 순응도 향상을 위한 실험연구가 11.3%, 단면연구 및 전향적 관찰연구가 88.7%에 해당하였으며, 후자의 경우 주로 순응도 향상 관련 요인에 관한 연구들이었다. 둘째, 연구대상의 상병 종류는 고혈압이 전체 연구의 24.1%로 가장 많았고, 다음으로 기타 만성질환, 당뇨병 및 결핵의 순으로 주로 이환기간이 길고 완치가 어려워서 치료순응도에 많은 노력을 기울일 필요가 있는 질환들이었다. 셋째, 133편 논문의 질적 메타분석과정을 거쳐 선별기준에 부합되는 논문은 10편으로 순응도 측정은 고혈압의 경우 혈압 조절과 같은 건강효과를, 당뇨병의 경우 뇨당, 혈당 저하와 같은 직접적인 지표 측정의 방법을 측정하였고, 이외에도 약속 이행과 환자의 주관적 보고, 약물 복용이행과 같은 객관적 지표를 측정하였다. 한편 개입방법으로는 행동변화를 적용한 1편의 연구 이외에 교육적, 행동적 및 정서적 개입의 방법을 모두 병행하여 적용하고 있었다. 넷째, 이들 중 6편의 논문에 대하여 순응도 향상에 대한 개입의 통합효과크기를 산출한 결과, 개입을 하지 않은 군에 비하여 개입이 이루어진 경우에 치료순응도 향상 효과는 4.1192여서 커지는 것으로 나타났다. 이를 다시 순응도 측정방법으로 구분하여 분석한 결과, 치료 순응도를 건강결과(혈압)로 측정한 경우 개입으로 인한 유효크기는 0.4679였고, 직접 측정지표(혈당/뇨당)에 의한 경우 개입 후 유효크기는 0.7753으로 나타나 순응도가 향상되었음을 알 수 있다. 이상의 결과에서 다양한 개입활동들이 환자의 치료순응도를 향상시키는 데 기여할 수 있음을 제시할 수 있다. 그러나 계량적 메타분석 기준에 부합되는 연구의 논문 수가 제한적이라는 한계점이 있으며, 연구에 사용되는 개입방법의 시도가 더욱 다양화될 필요성이 제시되고 있어 향후 이와 관련된 많은 연구들이 활성화되기를 기대한다.

농촌 지역 중소병원의 가정간호사업소 등록환자의 방문비용분석 (Cost Analysis of Home Nursing Care Patients in Rural Hospital)

  • 김진순;금란;황보수자
    • 농촌의학ㆍ지역보건
    • /
    • 제24권1호
    • /
    • pp.91-101
    • /
    • 1999
  • 장 노년층 인구증가에 따른 건강문제의 다양화, 주민의 건강 요구증가에 부응하기 위해서는 기존의 의료기관 중심의 진료서비스 만으로는 새로운 건강문제를 충분히 해결할 수 없으므로 새로운 보건의료 제공 체계가 도입 되기에 이르렀다. 이미 선진국에서는 오랜 역사를 갖고 있는 가정간호사제도가 우리 나라에서도 입법화되어 1994년부터 병원중심의 가정간호사업이 시범적으로 운영되고 있다. 본 연구는 농촌지역의 중소병원에서 실시하고있는 가정간호사업소에 등록되어 있는 환자의 방문비용을 분석하는 것을 목적으로 실시되었으며, 1996년 5월 - 1997년 4월(1년간)까지 등록된 102명의 진료기록부를 분석하였다. 자료 분석 방법은 수준을 파악하기 위하여 평균과 분포로 분석하였으며 변수간의 차이점 등은 t - test와 ANOVA로 분석하였다. 분석 결과는 다음과 같다. 첫째, 등록환자의 일반적 특성은 남자가 44.1%, 여자가 55.9%로서 여자가 높았으며 연령은 60세 이상이 73.5%로서 노인 환자가 많았다. 둘째, 골다공증이 등록환자의 35.3%로서 제일 높았으며 각종 암이 21.6%, 뇌졸중이 14.7%로 나타나 연령과 관계가 깊은 것으로 나타났다. 질환특성은 복합질환, 즉 한가지 이상의 증상, 혹은 질환을 함께 갖고있는 경우가 73.5%로서 단순질환 26.5% 보다 높았다. 셋째, 남자 환자의 방문당 평균비용이 47,764원으로서 여자 환자의 46,078원 보다 높았다. 연령별로는 연령이 높아질수록 방문당 평균비용이 높은 것으로 나타났다. 성별과 연령별 비용은 통계학적으로 유의한 차이가 있는 것으로 나타났다. 넷째, 질환 특성별 비용은 단순질환이 복합 질환보다 방문당비용이 약간 높았으나 통계학적으로 유의한 차이가 없었으며, 질환별로는 COPD, 각종 암, 당뇨, 골다공증의 순으로 방문비용이 높게 나타났다. 다섯째, 가정간호의 방문비용이 질환으로 병원에서 치료받을 경우 보다 적게 나타나 비용효율이 있는 것으로 나타났다. 본 연구 결과는 제한된 자료를 분석한 것이므로 결과를 일반화시키는데 신중을 기할 필요가 있다. 그러나 가정간호사제도가 향후 정착되기 위해서는 가정간호 대상질환의 선정, 서비스내용 및 질, 비용효율 및 효과에 대한 평가가 계속 실시될 것을 제안한다.

  • PDF

국제항공화물운송계약(國際航空貨物運送契約)의 법률관계(法律關係) -화주(貨主)의 권리의무(權利義務)를 중심(中心)으로- (Legal Relations of the Contract of International Carriage of Goods by Air)

  • 이강빈
    • 항공우주정책ㆍ법학회지
    • /
    • 제1권
    • /
    • pp.193-222
    • /
    • 1989
  • The purpose of this study is to review the rights and duties of cargo owners, the party to the contract of international carriage of goods by air under the Warsaw Convention System and the IATA conditions. It is generally known that air freight is the most-cost mode of transportation. However, should there be considerations of total distribution cost, the use of air freight leads exporters to be advantageous in physical distribution. The Warsaw Convention System defined and limited the rights and duties of cargo owners and air carriers paticipating in the international carriage of goods, but it does not regulate every aspect of air transportation. Therefore, the unregulated parts are governed by national laws and by individual contracts of carriage. The International Air Transport Association(lATA), a worldwide organization of airlines, has formulated model conditions of contract for the carriage of cargo. These models are not uniformly followed but they serve as a basis for many of the individual standard form of contracts prepared by air carriers. The contract of air carriage of goods is a contract of adhesion, 'the consignor recognizing and accepting the conditions laid down by the carrier'. There are consignors and carriers as the parties to the contract of international carriage of goods. In addition to his basic right, implied in Warsaw Convention Article 18 and 19, to require devery of the goods in good condition and at the date agreed upon, the consignor has the right to dispose the goods in the course of the journey up to the moment when the consignee is entitled to require delivery. If it is impossible to carry out the orders of the consignor, the carrier must so inform him forthwith. The right conferred on the consignor ceases at the moment when that of the consignee begins in accordance with Warsaw Convention Article 13. Nevertheless, if the consignee declines to accept the air waybill or the goods, or if he cannot be communicated with, the consignor resumes his right of disposition. Unless it is otherwise agreed, it is the duty of the carrier to give notice to the consignee as soon as the goods arrive. The consignee is entitled, on arrival of the goods at the place of destination, to require the carrier to hand over to him the air waybill and to deliver the goods to him, on payment of the charges due and on complying with the conditions of carriage set out in the air waybill. The air waybill is supposed to be made out by the consignor. If the carrier makes it out, he is deemed, subject to proof to the contrary, to have done so on behalf of the consignor, whether there is one air waybill or several, each must be made out in three original parts. The first is for the carrier, the second is for the consignee, and the the third is handed to the consignor when the shipment has been accepted. The consignor is responsible for the correctness of the particulars and statement concerning the cargo appearing in the air waybill. Each of the original parts of the air waybill has evidential value and possession of his part is a condition for the exercise by the consignor or consignee of his rights under the contract of carriage. Hague Protocol set forth in Article 9 that nothing in this. Convention prevents the issue of a negotiable air waybill, but Montreal Additional Protocol No. 4 deleted this article. All charges applicable to a shipment are payable in cash at the time of acceptance thereof by the carrier in case of a prepaid shipment or at the time of delivery thereof by the carrier in case of a collect shipment. The carrier shall have lien the cargo for unpaid charges and, in the event of non-payment thereof, shall have the right to dispose of the cargo at public or private sale and pay itself out of the proceeds of such sale any and all such amounts. In conclusion, the Warsaw Convention System has the character of ambiguity in various respects, not only in the part of the forms of documents but also in conditions of contract. Accordingly, the following propositions might be considered: (1) If the carrier does not obey the orders of the consignor for the disposition of the goods without proper reasons, he will be liable strictly for any damage which may be caused thereby to the cargo owner. The special agreement and carrier's conditions of carriage which limit unreasonably the consignor's right of disposition of the goods will be nullified. (2) The instrument of the Warsaw Convention System which is not yet in force(Montreal Additional Protocol No. 4) would considerably simplfy the processing and keeping of computerized records of the carriage. Until this instrument enters into force, the airlines will be faced with practical problems preventing them to substitute computerized data processing techniques for the formal issuance of the documents. Accordingly, Montreal Additional Protocol No. 4 should become effective as soon as posisble. From a practical point of view in the international trade, the issuance of negotiable air waybill should be permitted for the security of the bank.

  • PDF

2004년 경상북도 성주군에서 발생한 장병원성대장균의 유행에 관한 역학조사 (An Epidemiologic Investigation of Enteropathogenic Escherichia Coli (EPEC) Outbreak in Seongju-gun, Gyeongbuk, 2004)

  • 백달현;염석현;이관;임현술
    • 농촌의학ㆍ지역보건
    • /
    • 제30권1호
    • /
    • pp.39-50
    • /
    • 2005
  • 목적: 2004년 7월 13일 경상북도 성주군 소재 ${\bigcirc}{\bigcirc}$중 정보고등학교에서 집단 설사증 환자가 발생하여 발생 원인을 추정하고, 예방 대책을 수립하기 위하여 본 역학조사를 수행하였다. 방법: 2004년 7월 14일 전체 학생 및 교직원 및 조리원 345명 중 275명(79.7%)에 대하여 보건요원 5명이 직접 면담을 통해 설문조사를 시행하였다. 역학조사와 동시에 145명에 대해 직장도말검사를 시행하였고, 보존식, 조리기구, 식수 등의 71건의 가검물을 경상북도보건환경연구원에 검사를 의뢰하였다. 또한 식수 공급경로와 급식소 내 환경에 대하여 오염 여부를 조사하였다. 본 연구의 장병원성대장균 설사증 환례의 정의는 설사를 1회 이상 경험하고, 열, 구토, 뒤무직 중 1개 이상의 증상이 있는 설사증 의심 사례와 배양검사에서 확진된 설사증 확진자로 하였다. 통계는 SPSS 10.0을 이용하여, chi-square검사 및 chi-square 경향검사를 시행하였고, 섭취 음식별 설사증 발병의 위험도는 Taylor series를 이용하여 산출하였다. 결과: 275명 중에서 확진자는 8명이었고, 이중 3명은 불현성 감염자이었다. 확진자 8명과 설사증 의심 사례 93명을 포함하여 장병원성대장균 설사증 환례는 101명으로 발병률은 36.7%이었고, 남녀 설사증 발병률의 차이는 없었다. 고등학생이 39.1%로 중학생20.4%보다 설사증 발병률이 높았으며(p<0.05), 중학생과 고등학생 각각 학년이 증가할수록 설사증 발병률이 높았다(p<0.05). 기타 가검물에서는 균이 배양되지 않았다. 학교에 공급되는 모든 식수에서는 염소가 검출되었고, 학생들은 정수기를 이용하거나 급식소 내에 끓여놓은 보리차를 음용하였다. 설사증 환자의 발생일별 분포는 7월 9일 첫 설사증 환자가 발생 후 7월12일에 최대로 발생하였고, 설사의 평균 횟수는 $5.1{\pm}4.5$(중앙값: 4, 최소: 1, 최대: 30)회이었고, 평균 설사 기간은 $2.1{\pm}1.1$(중앙값: 2, 최소: 1, 최대: 5)일이었다. 식수 섭취별 설사증 발병률은 유의하지 않았으나, 7월 7일 제공된 급식의 경우 비섭취자에 대한 섭취자의 비교위험도가 4.12(95% 신뢰구간 1.39-12.2)로 다른 일자의 급식에 비해 매우 높았으며, 최종적으로 급식될 때 익히지 않은 상태에서 제공되는 음식들 중 유의한 음식은 샐러드로 비교위험도가 1.66(95% 신뢰구간 1.07-2.57)이었다. 7일 점심때 제공된 급식이 오염되었다고 가정하여 추정한 평균 잠복기는 $5.0{\pm}1.1$일(중앙값: 5.1, 최소: 22일, 최대 : 7.3)일이었다. 결론: 이번 장병원성대장균 유행은 물의 오염에 의한 가능성은 거의 없으며, 불현성 감염자인 조리보조원이 최종적으로 익히지 않은 상태에서 제공되는 샐러드와 다른 음식들을 조리하면서 구멍 난 조리장갑을 사용하여 여러 종류의 음식이 오염되었을 가능성이 높다.

  • PDF