• Title/Summary/Keyword: Safety manager

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Prothrombin Complex Concentrate versus Fresh Frozen Plasma in Adult Patients Undergoing Cardiac Surgery: A Systematic Review and Meta-Analysis

  • Patricia Viana;Jessica Hoffmann Relvas;Marina Persson;Thamiris Dias Delfino Cabral;Jorge Eduardo Persson;Jessica Sales de Oliveira;Paulo Bonow;Camila Veronica Souza Freire;Sara Amaral
    • Journal of Chest Surgery
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    • 제57권1호
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    • pp.25-35
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    • 2024
  • Background: Prothrombin complex concentrate (PCC) and fresh frozen plasma (FFP) are commonly used to manage bleeding in patients during cardiac surgery. However, the relative efficacy and safety of these 2 strategies remain uncertain. Methods: MEDLINE, Embase, and Cochrane were searched for studies comparing PCC and FFP in patients who underwent cardiac surgery complicated by bleeding. Review Manager (RevMan) ver. 5.4 (Nordic Cochrane Centre, The Cochrane Collaboration) was used for statistical analysis. Binary and continuous outcomes were compared using pooled risk ratios and mean differences, respectively. The meta-analysis protocol was registered in the International Prospective Register of Systematic Reviews under protocol number CRD42022379144. Results: We included 8 studies with 1,500 patients, of whom 613 (40.9%) received PCC. The mean follow-up period ranged from 28 to 90 days. The PCC group had significantly lower chest tube drainage at 24 hours (mean difference [MD], -148.50 mL; 95% CI, -253.02 to -43.99 mL; p=0.005; I2 =42%). Fewer units of red blood cells (RBCs) were transfused within the first 24 hours (MD, -1.02 units; 95% CI, -1.81 to -0.24 units; p=0.01; I2 =56%), and fewer patients required RBC transfusion within the first 24 hours (risk ratio, 0.85; 95% CI, 0.78-0.93; p<0.007; I2 =45%) in the PCC group. There were no statistically significant differences in secondary outcomes. Nonetheless, a subgroup analysis of randomized controlled trials failed to corroborate the results obtained from the main analysis. Conclusion: Our findings suggest that PCC can be effective, without increased adverse events, when compared with FFP in patients undergoing cardiac surgery complicated by bleeding.

근로자의 산업보건 지식과 태도에 관한 조사연구 (A Survey on the Knowledge and Attitude of Workers Concerning Occupational Health)

  • 박영식;조수열;남철현
    • 한국환경보건학회지
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    • 제18권2호
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    • pp.3-18
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    • 1992
  • This research was carried out on 1,017 production workers for four months from May to August, 1991, to search more effective management method of their health by grasping their knowledge and attitude on industrial health. The results of this study can be summarized as follows: 1. As for general characteristics, 74.2% were male and 25.8% were female among the 1,017 workers. The two largest age groups were 30~39, 38.7%. As for education level, graduation from high school was 58.6%, 61.2% were married, 35.9% owned their house, and workers who worked more than 1 year less than 5 years was 52.9%, workers who worked 8 hours a day was 46.7%, the largest group income level was 60~69 thousand won 21.2%, and the degree of satisfaction with work was ordinary, 45.6%. 2. The degree of recognition concerning occupational diseases was 92.5% at a very high rate. Causes of occupational diseases under the present work field were in order of noise, dust, heavy metal. The largest group of the counterplan for prevention was an improvement of working environment, 62.0%. 3. The major cause that threatens worker's health was poor working environment, 31.4%. As the best method for workers' health management, working environment management was pointed. 4. As for health examination result, the response that it is of use to health management was 53.8%. As for examination method and result, 42.7% responded that they are formal. The practice period was more than once every six months as the largest group, and the highest desire for improvement was that they wants an exact information of the result. 5. 49.3% of the respondents know about the measurement of working environment an the response that the measurement is necessary to improve working environment was 57.9%, and that the results from the measurement were reflected on improvement an management 57.5%. Appropriate period to take a measurement was more than once per six months, 40.2% and per three months, 29.1%. 6. As for safety and halth instruction, 34.5% were educated for both, 38.2% for only safety education and just 4.6% for only health education. 51.9% responded that they had never been educated out of work place. The period of its practice was more than once a month, 39.5% and every three months, 21.3%. 7. The importance of safety and health showed that the one is equal to the other, 59.8%, that the one is more important, 29.6%, and that other is more important, 7.6%. 67.7% said the necessity of a safety and health manager. 8. In spite of more or less health obstacle of work environment, 14.9% of the respondents wanted to overwork to gain an allowance for over-time work, 39.9% didn't, and 40.2% according to condition and state. 9. As the most important cause of industrial accident, 40.2% indicated unsafe behavior. As for the individual protective instrument, 66.1% of all the respondents said they have worn it to protect industrial diseases. 10. As for the degree of understanding of the contents in Industrial Safety and Health Law and Industrial Law of Accident Insurance, an affirmative response was respectively 49.3% and 50.8% and the sources of safety-health information were televisions and radios, 28.0%. Therefore, it is necessary that we do positive working environmental improvement, continuous management and health education's inforcement to increase their health and prevent occupational diseases.

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경주지역 자동차 부품 제조업의 공정별 작업환경실태에 관한 연구 (A Study on the Status of Working Environment by Type of Working Processes in Manufacturing Industry of Parts and Accessories for Motor Vehicles and its Engines)

  • 박성준;이원호;이관;문덕환
    • 한국산업보건학회지
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    • 제15권2호
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    • pp.90-103
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    • 2005
  • Objective: This study was carried out to assess the status of working environments, to improve the working environments, and to be helpful to prevent occupational disease. Methods: The authors measured the noise level, concentration of dust, heavy metals, organic solvents, and other chemicals at 95 industries (22 working processes) by type of working process in manufacturing industry of parts and accessories for motor vehicles and its engines from January to December 2003. Samples were measured and analyzed by regulations of Korea Ministry of Labor, manuals of National Institute for Occupational Safety and Health (NIOSH) and Occupational Safety and Health Administration (OSHA). Results: Results are as follows. 1. Major processes exceeding mean noise levels provided the American Conference of Governmental Industrial Hygienists (ACGIH) Threshold Limit Value (TLV) were shakeout [97.5 dB(A)]. shot-blast [94.2 dB(A)], pressing [92.9 dB(A)], crushing [91.2 dB(A)], and cleaning [90.6 dB(A)]. 2. Mean concentrations of dusts were not exceeded to the TLV. But concentration on some points of processes as like welding (6.50 mg/m3), foundry (5.24 mg/m3) were exceeded. 3. Mean concentrations of heavy metals were not exceeded to the TLV. 4. Mean concentrations of organic solvents and chemicals were not exceeded to the TLV. 5. Improving rate for working environment were significantly higher in industries with health manager than without (p<0.05), and by increasing the year of working environmental measurement (p<0.01). Conclusions: The results suggest that working processes of exceeding to the TLV will be needed rapid improvement of the working environment, and also the others will be needed positive management of the working environment. Health managers must be recommended to employ in the workplace, and further studies for relationship between working environment and health effects for the workers must be carried out.

서비스디자인 접근법을 활용한 화학테러현장 대응매뉴얼의 개선방안 연구 (A Study on the improvement for response manual of chemical terror incident using the service design analysis)

  • 함승희;박남권;이준
    • 한국재난정보학회 논문집
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    • 제14권3호
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    • pp.325-333
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    • 2018
  • 연구목적: 본 연구는 화학테러현장에서 총괄지휘권을 갖는 경찰을 중심으로 현장대응매뉴얼의 실행력을 확보하기 위해 서비스디자인 분석기법을 적용해 관찰 및 분석하고 이를 통해 문제점을 밝혀내고 개선사항을 제안하는 것을 목적으로 한다. 연구방법: 연구를 위해 경찰의 테러 대응 매뉴얼에서 화생방 테러 대응 지휘체계를 중심으로 자료를 수집하였다. 또한 분석에서 매뉴얼의 사용자 외에도 다양한 이해관계자들을 고려해야 하기 때문에 참여자들의 관계가 적용되는 방법론을 활용하여 분석하고자 서비스 디자인 분석기법을 활용하였다. 연구결과: 최종 치안서비스의 수혜자인 피해시민의 관점에서 대응매뉴얼의 서비스 프로세스를 진단하였으며, 현장대응 서비스 과정에서 발생하는 피해시민과 현장대원간, 후방대원간, 프로세스간 대기지점(Waiting Point)과 실패요소(Failure Factor)를 확인하였다. 결론: 본 연구를 통해 화학테러 현장 대응 활동을 서비스의 개념으로 파악하여 각 관계기관과 현장에 있는 시민과의 상호작용 및 비가시 영역에서의 후방지원활동과 장비 시설물의 활용성을 한 번에 검토함으로써 문제요소별 개선대안을 도출할 수 있었다.

노출감시체계 구축을 위한 작업환경측정 정보 표준화 (Standardization of work environment measurement information for constructing exposure surveillance system)

  • 최상준;정지연;임성국;임대성;고동희;박동욱;박윤경;김소연;정은교
    • 한국산업보건학회지
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    • 제29권3호
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    • pp.322-335
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    • 2019
  • Objectives: The goal of this study is to standardize industry, process, and job within work environment measurement information. Methods: We selected 180 work environment measurement reports on 30 industries from a database monitored from 2014 to 2016 by the Korea Industrial Health Association. Ten industrial hygienists, each with over five years of experience in measurement, conducted a primary standardization of 180 reports. Two professional industrial hygienists with more than 20 years of experience each reviewed and revised the results of the primary standardization. We also examined the validity on the usefulness of the standardized database by the two industrial hygienists. Results: The final standardization results were classified into eight major categories, 23 sub-major categories, 39 minor categories, 53 unit categories and 70 sub-unit categories in the Korean Standard Industrial Classification (KSIC) 10th revision. A total of 161 processes were standardized, and there were 148 processes with K2B codes. Standard job was coded into 13 job groups including operator, automobile maintenance, nurse, maintenance, manager, excavating machine operator, forklift driver, radiologist, clinical pathologist, signer, researcher, kitchen assistant, and concrete reinforcement ironworker. Conclusions: Although the standardized information in this study may be only a part of the total information, it can be useful for improvement of the K2B system. Additional research is needed for an ongoing clean-up of data in the K2B and re-calibration and reclassification of standard processes until the future national exposure monitoring system is fully established.

노후보일러 유해인자 발굴 및 사고예방에 관한 연구 (A Study on the Identification of Hazardous Factors and Prevention of Accident in Old Boilers)

  • 사민형;우인성
    • 한국가스학회지
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    • 제23권4호
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    • pp.1-9
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    • 2019
  • 큰 규모의 산업용 보일러는 고온, 고압을 이용하는 설비이며, 보유수량이 많아 폭발시 엄청난 에너지가 방출된다. 현재 산업용 보일러는 대부분이 LNG, LPG 등의 가스연료를 사용하고 있고, 연료가 설비와 같은 공간에 존재하기 때문에 보일러 사고 발생시 화재, 폭발 등 2차 피해 가능성이 높다. 뿐만 아니라 단위 사고당 2.51명의 사상자를 발생시키는 대단히 위험한 설비로 운영에 특별한 주의와 관리가 필요하다. 일정 규모 이상의 보일러는 에너지이용 합리화법, KS, 산업통상자원부 고시 등에 따라 한국에너지공단에서 검사를 실시하고 있다. 본 연구에서는 검사 결과 불합격 사항을 바탕으로 위험인자를 구성하고, 검사원, 기기 관리자, 유지보수 담당자, 제조업체 담당자에게 설문을 실시하여 보일러 안전관리에 중요하게 판단하는 기준을 AHP(계층분석방법)을 통해 분석하였다. 분석결과 공통적으로 인식하고 있는 위험인자는 관리소홀, 계측기 고장, 규격미달, 누수, 누설로 분석되었고, 접속, 용접, 스케일, 부식 등은 상대적 중요성이 낮은 것으로 분석되었다. 모든 집단과 경력에서 중요성이 높다고 인식하고 있는 위험인자는 이미 관리가 잘 되고 있다고 판단되나, 중요성이 낮게 분석된 위험인자는 관리누수가 발생되지 않도록하여 보일러를 안전하게 사용할 수 있도록 해야 한다.

해상화학사고 대응을 위한 국내 교육훈련체계 개선에 관한 연구 - 국내 체계와 외국 체계의 비교를 기반으로 - (A Study on the Improvement of the Education and Training System for Response to Marine Chemical Incidents in Korea - Based on the Comparison of Systems between Korea and Foreign Countries -)

  • 김광수;이문진
    • 해양환경안전학회지
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    • 제23권7호
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    • pp.847-857
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    • 2017
  • 해상 HNS 유출사고 대응 교육훈련체계의 국내 및 외국(미국, 캐나다, 호주, 영국) 현황을 살펴보고, 국내 체계와 외국 체계 간의 비교를 통하여 국내의 교육훈련체계 개선방안에 대한 연구를 수행하였다. 그 결과, 국내의 민간 교육훈련기관이 거의 전무한 상태에서 외국의 기관들에 비하여 활성화되지 못하였고, 국내의 해상 HNS 관련 교육훈련이 정부 주도 하에 획일적으로 이루어지고 있는 실정이었다. 또한 국내의 교육훈련기관인 해양경찰교육원과 해양환경교육원 간에는 교육대상자, 교육기간 등에서 차이가 있었다. 국내의 해상 HNS 관련 교육과정이 외국의 교육과정에 비하여 단순한 편이었고, 교육기간도 상대적으로 짧았으며, 국제해사기구 HNS 모델코스의 2가지 과정(운영 수준 및 관리자 수준)을 수용하지 않고 있었다. 국내 해상화학사고 대응 교육훈련체계를 개선하기 위한 방안을 단기적 측면과 중 장기적 측면으로 나누어 제시하였다. 단기적 측면에서, 해양경찰교육원과 해양환경교육원은 각자 독립적으로 운영하는 현행의 이원적 체계를 유지하면서 두 기관이 공동으로 참여하는 HNS교육훈련운영협의체(가칭)를 설립하는 방안을 제시하였고, 중 장기적 측면에서는, 해양경찰교육원 HNS 담당부서와 해양환경교육원 HNS 담당부서를 통합하여 국제경쟁력을 갖춘 일원적 체계인 국가해상HNS방제교육훈련기관(가칭)으로 변경 확대하는 방안을 제시하였다.

4차 산업에 적합한 미래 해기사의 직업군과 필수 교육 요소에 관한 연구 (Study on the Occupational Group and Essential Educational Elements of Future Seafarer Suitable for Industry 4.0)

  • 김상희;박한규;하민재
    • 해양환경안전학회지
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    • 제28권6호
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    • pp.1013-1022
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    • 2022
  • 최근 전세계적으로 4차산업이 발전함에 따라 스마트·친환경 선박의 기술 개발이 가속화 되고 있다. 완전 무인화 또는 최소인원이 승선하는 자율운항선박과 친환경 연료(메탄, 암모니아, 전기 등) 이용 선박이 등장하게 되면서 선박에 승선을 하고 있는 기존 해기사의 역할이 크게 변화될 것으로 예상되고 있다. 향후 해기사의 경쟁력을 향상시키기 위해서는 미래 해기사 직업군을 예측하고 그에 맞는 교육 커리큘럼 개선과 교육환경 조성이 필요할 것으로 생각된다. 본 연구에서는 선행연구 검토와 해양계 대학교 재학생, 현직 해기사, 전문가의 브레인스토밍을 통해 미래에 해기사가 가질 수 있는 8개의 직업군을 도출한 후 리커트 척도를 이용하여 설문을 실시하였고, 그 결과를 바탕으로 미래 해기사 관련 유력 직업군을 도출하였다. 분류한 8개 직업군 중 가장 유력한 직업군은 자율운항선박 육상제어사, 화물(적양하) 원격 관리자로 나타났다. 또한, 이러한 직업군들과 4차산업에 우선적으로 교육해야 할 필수 교육 요소를 도출하여 제시하였다.

결막염에 대한 한방 점안액의 효과 비교 : 체계적 문헌 고찰과 메타 분석 (Comparison of the Effectiveness of Herbal Medicine Eye Drops on Conjunctivitis : A Systematic Literature Review and Meta-Analysis)

  • 임희영;김지희;고우신;윤화정
    • 한방안이비인후피부과학회지
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    • 제35권3호
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    • pp.48-65
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    • 2022
  • Objectives : This study was conducted to find out the effectiveness and safety of herbal medicine eye drops on conjunctivitis. Methods : We searched randomized controlled trials on conjunctivitis through 10 DBs from the start to April 27, 2022. Study collection and data extraction, and evaluation of risk of bias were conducted by two independent researchers. The evaluation of the risk of bias in included RCTs was carried out by using Cochrane risk-of-bias tool. And the data synthesis was conducted by using Review Manager(RevMan, ver.5.4). Results : Total of 106 studies are researched and 7 studies of them are finally included. 1. The herbal medicine eye drops are more effective on than the western medicine eye drops, but the heterogeneity was very high. So we conducted sensitivity analysis and compared to the herbal medicine eye drops and the western medicine eye drops, the total effective rate was higher in the herbal medicine eye drops and the heterogeneity was somewhat reduced. 2. In the subgroup analysis, Fufang Xiongdan eye drops and Houttuynia cordata Thunb eye drops are more effective than the western medicine. It may represent substantial heterogeneity. 3. In the subgroup analysis, the herbal medicine eye drops are more effective than antibiotic and antiviral eye drops on acute bacterial conjunctivitis, but showed high heterogeneity. On the other hand, the herbal medicine eye drops are more effective than antibiotic and antiviral eyed drops on acute viral conjuctivitis and showed low heterogeneity. 4. In the subgroup analysis, we compared the effectiveness of herbal and western medicine eye drops according to total effectiveness rate evaluation methods. When comparing the studies calculating the total effective rate by the sum of 'Cured', 'Significantly Impaired', and 'Improved', the effective rate of the herbal medicine eye drops was higher than that of the western medicine eye drops, and the heterogeneity was very low. 5. In most studies, side effects of herbal medicine eye drops were absent or mild. Conclusions : This study shows that herbal medicine eye drops may be more effective than western medicine eye drops and have safety. But further researches are needed to resolve the heterogeneity of this study.