• Safety and Health at Work
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• 제14권4호
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• pp.390-397
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• 2023

Introduction: Biological risks are a major global problem in the workplace. The recent COVID-19 pandemic has highlighted the need for a more comprehensive understanding of the biological risks at work. This study presents data on both communicable infectious biological agents and noncommunicable factors leading to death and disability for the year 2021. Methods: We followed the methodology established by the International Labour Organization (ILO) in their past global estimates on occupational accidents and work-related diseases. We used relevant ILO estimates for hazardous substances and related population attributable fractions derived from literature, which were then applied to World Health Organization mortality data. The communicable diseases included in the estimates were tuberculosis, pneumococcal diseases, malaria, diarrheal diseases, other infectious diseases, neglected tropical diseases, influenza associated respiratory diseases and COVID-19. Noncommunicable diseases and injuries considered were Chronic Obstructive Diseases (COPD) due to organic dusts, asthma, allergic reactions and risks related to animal contact. We estimated death attributable to biological risk at work and disability in terms of disability adjusted life years (DALYs). Results: We estimated that in 2022, 550,819 deaths were caused by biological risk factors, with 476,000 deaths attributed to communicable infectious diseases and 74,000 deaths caused by noncommunicable factors. Among these, there were 223,650 deaths attributed to COVID-19 at work. We calculated the rate of 584 DALYs per 100,000 workers, representing an 11% increase from the previous estimate of the global burden of work-related disabilities measured by DALYs. Conclusion: This is a first update since previous 2007 ILO estimates, which has now increased by 74% and covers most biological risks factors. However, it is important to note that there may be other diseases and deaths are missing from the data, which need to be included when new information becomes available. It is also worth mentioning that while deaths caused by major communicable diseases including COVID-19 are relatively rare within the working population, absences from work due to these diseases are likely to be very common within the active workforce.

• Annals of Occupational and Environmental Medicine
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• 제34권
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• pp.38.1-38.9
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• 2022

Background: This study investigated the risk perceptions, prevalence of environmental diseases (EDs) and associated factors with the prevalence of environmental disease among the population living near an incinerator Methods: Study area were divided into 3 local areas near the incinerator by distance (A, B, C) and control area (D) by distance and geographic isolation. A Questionnaire was conducted with 1,380 in local residents (A, B, C) and 390 in control area (D), gathered information of demographic characteristics, lifestyle, perception of damage by incinerators, experience of EDs (atopic dermatitis, allergic rhinitis, asthma) diagnosed by physician. Analysis of variance, χ² test, and Kruskal Wallis test was applied to determine the difference by area. Logistic regression analysis was performed to identify factors associated with the prevalence of allergic rhinitis. Results: Residents residing closer to the incinerator had negative perception in most items in questionnaire compared with control. The prevalence of allergic rhinitis was higher as they lived nearby the incinerator (p = 0.008). The associated factors with the prevalence of allergic rhinitis were carpet (odds ratio [OR]: 1.79, p = 0.001), residential area (marginally significant), duration of residence (OR: 1.09, p < 0.001). The perception of environmental pollution around the residential area was inversely associated with the prevalence of allergic rhinitis: perceived as very dissatisfied (OR: 4.21, p = 0.02) compared with very satisfied. Conclusions: As closer to the incinerator, the risk perception tend to negative and prevalence of EDs were increased. Carpet, residential area, duration of residence and perception of environmental air pollution around the residential area were associated with prevalence of allergic rhinitis. These results may be useful for the communication with residents to discuss the environmental problems caused by the incinerator.

• 대한예방한의학회지
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• 제19권1호
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• pp.95-107
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• 2015

Objective : To use and its affecting factors of patients' outpatient treatment that have single and multiple chronic illnesses Method : We used the 2011 study by the Ministry of Health and Welfare, "Report on Usage and Consumption of Korean Medicine." This report was conducted on outpatients and inpatients that visited Korean traditional medicine, from August 25th, 2011, to September 30th, 2011. Our research was based on 1729 patients with chronic diseases aged 30 and over who received outpatient treatment during the last three months. Results : There were 1365 patients with non-complex chronic diseases, while there were 364 patients with complex chronis diseases. Patients had 1 - 8 chronic diseases, and the average number (standard deviation) was 1.26 (0.59). There were statistically significant differences by sex(P<0.0001), age(p=0.0045), marriage (p=0.0060), education level(p<0.0001), income level(P=0.0063), and types of health insurance(p=0.0023). The diseases most common among patients with non-complex chronic diseases were: low back pain, arthritis, gastrointestinal disorder, frozen shoulder, side effects from motor accidents, high blood pressure, fracture, stroke, diabetes, cancer, atopic dermatitis, and asthma. The diseases most common among patients with non-complex chronic diseases were: arthritis+low back pain, low back pain+gastrointestinal disorder, low back pain+side effects from motor accidents, low back pain+frozen shoulder, arthritis+gastrointestinal disease, gastrointestinal disease+frozen shoulder, arthritis+low back pain+gastrointestinal disease, high blood pressure+arthritis, arthritis+low back pain+frozen shoulder, arthritis+fracture, and arthritis+side effects from motor accidents. There were statistically significant differences among the usage of medical clinics by: frequently used clinic (p<0.0001), number of treatment (p<0.0001), the cost of outpatient treatment (p=0.0073), the satisfaction rate (p=0.0171), whether the clinic is the preferred clinic (p=0.0040). In model 1, men than women, people who had local benefits instead of type 1 medical aid, and patients with complex chronic diseases were more likely to use Korean medical clinics. In model 2, men than women, people who had local benefits than people with types 1 and 2 medical aids, people who went to pharmacies and Korean medicine pharmacies than people who went to hospitals, people who went to get treatment 1-10 times than people who visited 11-20 times and more than 41 times, and people who spent less than ten thousand Korean won than people who spent 1 to 2 million Korean won, and people without complex chronic diseases were more likely to use Korean medical treatment. Conclusion : There were differences in sociodemographic characteristics and the usage of medical clinics between patients with non-complex chronic diseases and patients with complex chronic diseases. Among patients with complex chronic diseases, women, patients with types 1 and 2 medical aid, patients who used Korean medical clinics, patients who were treated 11-20 times and more than 41 times, and patients who spent 1 million to 2 million Korean won on outpatient treatment used less treatment than patients with non-complex chronic diseases. However, patients with complex chronic diseases used pharmacies and Korean medicine pharmacies more.

• Clinical and Experimental Pediatrics
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• 제48권4호
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• pp.376-379
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• 2005

목 적 : 학동기에 많은 감염을 보이며 진단이 용이하고, 기관지 천식의 중요한 인자로 작용하는 M. pneumoniae 폐렴군과 숙주 방어에 중요하게 작용하는 SP-A를 중심으로 폐렴군과 대조군의 SP-A 유전자 대립 형질을 비교하여 M. pneumoniae 폐렴에 관여하는 유전자 대립 형질을 밝히고자 본 연구를 시행하였다. 방 법 : 2003년 5월부터 2003년 10월까지 순천향대학교 천안병원 소아과에 진찰 소견과 방사선 소견 상 폐렴으로 진단되어 입원한 환아 중, 최근 6개월간 폐렴의 병력이 없으며, M. pneumoniae 특이 항체 검사 상 항체가가 1 : 5,120 이상이거나, 회복기 항체가가 4배 이상 증가된 49례를 대상으로 하였으며, 순천향대학교 천안병원 신생아실에 입원한 정상 신생아 50명을 대조군으로 하여 아미노산 염기 서열의 차이에 의해 SP-A의 유전자형을 밝혔다. 결 과 : 1) 대조군에서 SP-A1 중 $6A^3$ 44.5%, $6A^2$ 28.7%, $6A^4$ 21.8%, 6A 1.1%의 분포를 보였고, SP-A2 중 $1A^0$ 40.7%, 1A 13.1%, $1A^5$ 11.4%, $1A^2$ 10%, $1A^1$ 9.3%의 분포를 보였다. 2) 폐렴군의 SP-A1 유전자 대립 형질은 대조군과 비교하여 통계적으로 유의한 차이가 없었다. 3) 폐렴군의 SP-A2 유전자 대립 형질 중 $1A^0$, $1A^1$ 그리고 $1A^5$는 대조군과 비교하여 낮은 빈도를 보였으나 통계적 의미는 없었으며, $1A^2$는 폐렴군에서 통계적으로 유의하게 높은 분포를 보였다. 결 론 : M. pneumoniae 폐렴에 대해 $1A^2$는 유발 인자로 작용할 것으로 추정할 수 있으며, $1A^2$에 대한 단백질의 정량, 정성분석을 통하여 M. pneumoniae의 예방이나 치료에 어떻게 적용할 것인지 연구되어야 한다고 생각된다.

• Clinical and Experimental Pediatrics
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• 제52권11호
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• pp.1267-1272
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• 2009

목 적:국내 학동 전기 소아를 대상으로 폐활량 측정법을 시행하여 기존에 제시된 여러 지표를 기준으로 검사 결과의 적정성을 평가함으로써 이 연령대에서의 폐기능 검사의 성공률을 알아보고자 하였다. 방 법:만성 기침이나 천식이 의심되어 내원한 2세 이상 6세 이하의 176명을 대상으로 폐활량 측정법을 시도하여 총 155 명에서 측정 결과를 얻을 수 있었다. ATS/ERS 에서 제시한 기준에 따라 후외삽용적(Vbe)이 80 mL 미만이고 FVC의 12.5% 미만일 때를 시작 기준에 적합하다고 정의하였다. 검사의 반복성을 확인하기 위해 선별한 두개의 유량-용적 곡선에서 FVC, FEV1의 차이를 구하여 FVC와 $FEV_1$의 절대적 차이값이 100 mL 또는 10% 미만인 경우를 적합하다고 정하였다. 검사의 종료에 대한 기준은 학동 전기 연령에서 수치적으로 정의되어 있지 않지만 유량-용적 곡선이 초기에 급격하게 증가해서 후기에 완만하게 감소하는 것을 합당하다고 보았다. 또한 유량-용적 곡선이 적절하게 나온 대상자(107명)를 선별하여 다른 문헌에 발표된 여러 정도 관리 기준에 맞추어 각 항목별로 성공률을 비교하였다. 결 과:전체 폐기능 검사의 성공률은 59% 이었고 연령이 증가할수록 폐활량 측정법의 성공률이 증가하였으며, 특히 3세부터 급격하게 성공률이 증가하였다(2세 14.3%, 3세 53.7%, 4세 65.1%, 5세 69.7%, 6세 70.8%). 폐활량 측정법의 실패 원인으로는 시작 기준에 맞지 않는 경우가 전체의 6.5%, 반복성 기준에 맞지 않는 경우가 12.3% 또 최대 호기량의 부족, 조기 종료 등으로 인해 검사 종료 기준에 맞지 않는 경우가 전체의 31% 로 가장 높았다. 폐활량 측정법 성공군와 실패군을 비교하였을 때 나이에서만 유의한 차이가 있었다(P<0.01). 정도 관리에 대한 몇몇 연구결과에 따라 각 항목별로 성공률을 보았을 때 연령이 증가할수록 성공률도 증가하였다. 결 론:학동 전기 소아에서도 약 60% 정도 폐활량 측정법을 성공적으로 수행하였다. 성공률은 연령에 따라 급격히 변화하므로 각 연령에 적합한 정도 관리 기준을 개발하여 이용한다면 검사의 성공률을 높일 수 있을 것으로 사료된다.

• 대한한방내과학회지
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• 제33권4호
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• pp.418-428
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• 2012

Objectives : Ojeok-san, a traditional herbal formula, has been used for the treatment of cold illness and its related symptoms such as headache, nausea and indigestion. This study was performed to compare effects of water (OJSW) and 70% ethanol extracts (OJSE) of Ojeok-san on inflammation and its related diseases atopy, asthma and obesity in vitro. Methods : We performed HPLC to investigate contents of index components of OJSW and OJSE. We investigated the effects of OJSW and OJSE with an in vitro model, using 5 cell lines, specifically RAW 264. 7, HaCaT, MC/9, BEAS-2B and 3T3-L1. Results : HPLC analysis displayed that the contents of index components were higher in OJSE than OJSW. In lipopolysaccharide (LPS)-treated RAW 264.7 macrophages, OJSE significantly inhibited productions of interleukin (IL)-6, nitrite and prostaglandin $E_2$ ($PEG_2$). In TNF-${\alpha}$/IFN-${\gamma}$-treated HaCaT keratinocytes, OJSE significantly lowered levels of macrophage-derived chemokine (MDC) as well as regulated and normal T cell expressed and secreted (RANTES). OJSE also had a protective effect on inflammatory response by decreasing RANTES secretion in TNF-${\alpha}$-stimulated BEAS-2B cells. Conclusions : We conclude that OJSE could be more appropriate to enhance the biological activities against inflammation and its related diseases, and could be applied as a bioactive material for developing the potent anti-inflammatory agents.

• 치위생과학회지
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• 제12권4호
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• pp.443-450
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• 2012

본 연구는 일부 대학생의 구취자각에 따른 건강상태 및 건강행동을 알아보기 위하여 천안시 남서울대학교에 재학중인 학생 1,490명을 대상으로 설문조사를 실시한 결과 다음과 같은 결과를 얻었다. 1. 성별에 따른 구취 관련 특성을 분석한 결과 구취에 대한 인식은 여자 보다 남자가 구취가 있다고 생각하는 경우가 더 많았으며, 남녀 모두 구취를 스스로 인식하게 된 경우가 많았고 타인에 의해 인식한 경우는 여자 보다는 남자가 더 많았다(p<.01). 구취가 가장 심한 시기는 '기상직후'가 67.4%로 가장 많았으며, '공복 시'는 여자가 17.5%, 남자는 11.4%로 여자가 공복 시에 구취가 가장 심하다고 느끼는 경우가 많았다(p< .01). 2. 구취 및 전신질환 유무에 대한 자각을 확인한 결과 자신에게 구취가 없다고 생각하는 사람 보다 구취가 있다고 생각하는 사람에서 축농증과 만성비염, 천식, 위장질환, 구강건조증이 있다고 자각하는 경우가 많았다(p<.05). 3. 구취 유무 자각에 따른 주관적 구강건강상태를 확인한 결과 구취가 있다고 자각하는 사람이 구취가 없다고 생각하는 사람 보다 치료받을 치아가 있다고 생각하는 경우가 더 많으며, 음식물이 잘 끼고, 흔들리는 치아가 있다고 생각하는 경우도 더 많았다(p<.05). 또한 잇몸이 자주 붓고, 이를 닦을 때 출혈이 있다고 응답한 경우도 구취가 없는 사람과 비교하여 더 많은 것으로 나타났다(p<.05). 4. 구취 유무 자각에 따른 구강건강행동을 확인한 결과 구취가 없다고 생각하는 사람이 구취가 있다고 자각하는 사람보다 매일 이를 닦는 경우가 더 많았으며, 하루에 3번 이상 이를 닦는 경우도 더 많았다(p<.05). 또한 아침 식후와 점심 식후에 이를 닦는 경우가 더 많은 것으로 나타났으며, 매일 치실을 사용하는 경우와 매일 혀를 닦는 경우도 구취가 없다고 생각하는 사람에서 더 높게 나타났다(p<.01). 5. 구취유무 자각에 관련된 요인을 확인한 결과 성별, 만성비염, 위장질환, 구강건조증 자각 유무가 구취 유무 자각에 영향을 주며, 음식물 잘 낌, 이 닦을 때 출혈, 건강 잘 챙김, 매일 이 닦음, 아침 식후 이 닦음, 매일 치실 사용이 구취유무 자각에 영향을 미치는 것으로 나타났다(p<.05).

• 한국환경보건학회지
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• 제46권3호
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• pp.285-296
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• 2020

Objective: The objective of this study was to describe the characteristics of exposure to humidifier disinfectants (HDs) and their association with the presence of a person who experienced the adverse health effects in general households in Korea. Methods: During the month of December 2016, a nationwide online survey was conducted on adults over 20 years of age who had experience of using HDs. It provided information on exposure characteristics and the experience of health effects. The final survey respondents consisted of 1,555 people who provided information on themselves and their household members during the use of HD. Exposure characteristics at the household level included average days of HD use per week, average hours of HD use per day, the duration within which one bottle of HD was emptied, average input frequency of HD, amount of HD (cc) per one time used, and active ingredients of HD products (PHMG, CMIT/MIT, PGH, or others). The risk of the presence of a person who experienced adverse health effects in the household was evaluated by estimating odds ratios (ORs) and 95% confidence intervals (CIs) adjusted for monthly income and region using a multiple logistic regression model. Subgroup analyses were conducted for households with a child (≤7 years) and households with a newborn infant during HD use. Results: The level of exposure to HD tended to be higher for households with a child or newborn infant for several variables including average days of HD use per week (P<0.0001) and average hours of HD use per day (P<0.0001). The proportion of households in which there was at least one person who experienced adverse health effects such as rhinitis, asthma, pneumonia, atopy/skin disease, etc. was 20.6% for all households, 25.3% for households with children, and 29.9% for households with newborn infants. The presence of a person who experienced adverse health effects in the household was significantly associated with average hours of HD use per day (P_trend<0.001), duration within which one bottle of HD was emptied (P_trend<0.001), average input frequency of HD (P_trend<0.001), amount of HD per one use (P_trend=0.01), and use of HDs containing PHMG (OR=2.23, 95% CI=1.45-3.43). Similar results were observed in subgroup analyses. Conclusion: Our results suggest that level of exposure to HD tended to be higher for households with a child or newborn infant and that exposure to HD is significantly associated with the presence of a person who experienced adverse health effects in the household.

• 한국환경보건학회지
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• 제43권1호
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• pp.1-22
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• 2017

'The worstest environment disaster', 'World's first biocide massacre', 'Home-based Sewol ferry disaster' are all phrases attached to the recent humidifier disinfectant disaster. In the spring of 2011, four of 8 pregnant women including 1 adult man passed away at a university hospital in Seoul due to breathing failure. Epidemiologic investigation conducted by the Korean CDC soon revealed the inhalation of humidifier disinfectant, which had been widely used in Korea during the winter, to be responsible for the disease. As well as lung fibrosis hardening of the lungs, other diseases including asthma, rhinitis, skin disease, liver disease, fetal disease or cancers have been researched for their relation with exposure to the products. By February 9, 2017, 5,342 cases had registered for health problems and 1,131 of them were already dead (20.8% mortality rate). Based on studies by government agencies and a telephone survey of the general population by Seoul National University and civic groups, around 20% of the general public of Korea has used these products. Since the market release of the first product by SK Chemical in 1994, over 7.1 million items from around 20 brands were sold up to 2011. Most of the products were manufactured by well-known large conglomerates such as SK, Lotte, Samsung, Shinsegye, LG, and GS, as well as some European companies including UK-based Reckitt Benckiser and TESCO, the German firm Henkel, the Danish firm KeTox, and an Irish company. Even though this disaster was unveiled in 2011 by the Korean government, the issue of the victims was neglected for over five years. In 2016, an unexpected but intensive investigation by prosecutors found that Reckitt Benckiser manipulated and concealed animal tests for its own brand and brought several university experts and company employees to court. The matter was an intense social issue in Korea from May to June with a surge in media coverage. The prosecutor's investigation and a nationwide boycott campaign organized by victims and environmental groups against Reckitt Benckiser, whose product had been used by more than 70% of victims, led to the producer's official apology and a compensation scheme. A legislative investigation organized after the April 2016 national election revealed the producers' faults and the government's responsibility, but failed to meet expectations. A special law for the victims passed the National Assembly in January 2017 and a punitive system together with a massive environmental epidemiology investigation are expected to be the only solutions for this tragedy. Sciences of medicine, toxicology and environmental health have provided decisive evidence so far, but for the remaining problems the perspectives of social sciences such as sociology and jurisprudence are highly necessary, similar to with the Minamata disease and Wonjin Rayon events. It may not be easy to follow this issue using unfamiliar terminology from medical and chemical science and the long, complicated history of the event. For these reasons the author has attempted to write this article in a question and answer format to render it easier to follow. The 17 questions are: Q1 What is humidifier disinfectant? Q2 What kind of health problems are caused by humidifier disinfectant? Q3 How many victims are there? Q4 What is the analysis of the 1,112 cases of death? Q5 What is the problem with the government's diagnostic criteria and the solution? Q6 Who made what brands? Q7 Has there been a recall? What is still on sale? Q8 Was safety not checked by any producers? Q9 What are the government's responsibilities? Q10 Is it true that these products were sold only in Korea? Q11 Why and how was it unveiled only in 2011 after 17 years of sales? Q12 What delayed the resolution of the victim issue? Q13 What is the background of the prosecutor's investigation in early 2016? Q14 Is it possible to report new victim cases without evidence of product purchase? Q15 What is happening with the victim issue? Q16 How does it compare with the cases of Minamata disease and Wonjin Rayon? Q17 Are there prevention measures and lessons?

• Clinical and Experimental Pediatrics
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• 제45권7호
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• pp.875-883
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• 2002

목 적 : 기관지 천식은 Th2 반응 우세로 인한 기도의 호산구증과 IgE 증가를 특징으로 하는 질환이다. 박테리아 DNA 혹은 합성 ODNs인 unmethylated CpG motifs(CpG)은 Th1 사이토카인인 $INF-{\gamma}$와 IL-12 유도와 Th2 사이토카인을 하강 조절하여 기도 내의 호산구증 및 전신적 IgE 생성을 억제하며, 메타콜린 흡입에 의한 기관지 과민성을 방지한다. 저자들은 기도 염증을 유발한 생쥐의 비강내에 합성 CpG ODNs의 점적 투여로 기도의 호산구증과 그 외 면역학적 기전에 대한 영향을 연구하고자 한다. 방 법 : BALB/c 생쥐에 주당 2번씩 면역보강제 없이 OVA를 $10{\mu}g$을 피하 주사하여 감작 시켰다. 10주째에 $50{\mu}g$ OVA를 백서의 비강내로 주입하여 기도 염증을 유도한 후, 4주 뒤인 14주째 다시 생쥐의 비강내에 OVA＋CpG ODNs과 OVA를 점적 흡입 주입하였다. 마지막 항원 유발(14주) 후 4일째에 기관지 폐포 세척액을 추출하여 세포를 염색한 후 호산구를 측정하였고 동시에 비장 세포를 배양하여 사이토카인 측정을 하였다. 비장 세포에서 OVA에 의해 생성된 사이토카인 즉 Th1($INF-{\gamma}$, IL-12), Th2(IL-4, IL-5, IL-13) 사이토카인을 ELISA에 의해 측정하였다. 혈청 항원 특이 IgE, IgG2a 또한 ELISA에 의해 측정하였다. 결 과 : 1) 기관지폐포 세척액의 호중구수 : CpG ODNs을 투여한 군이 7.6[5.8-9.4]%, CpG ODNs을 투여하지 않은 군이 42.0[38.2-44.6]%로 기도 염증 세포내의 호산구증을 현저히 억제시켰다(P<0.01). 2) 혈청 OVA-specific IgE와 IgG2a : CpG ODNs으로 투여한 군과 투여하지 않은 군에서 측정한 혈청 OVA-specific IgE와 IgG2a는 음성 대조군에 비해 현저히 증가하였고, CpG ODNs을 비강내 투여 후 4일째 측정한 혈청 OVA-specific IgE와 IgG2a 수치는 CpG ODNs 투여군과 비투여군 사이에 유의한 차이가 없었다. 3) 사이토카인 분석 : CpG ODNs으로 투여한 군은 투여하지 않은 군에 비해 IL-4, IL-5, IL-13의 생성이 감소하였고 IL-12 생성은 증가하였으나, $INF-{\gamma}$의 상향조절은 보여주지 못하였다. 결 론: CpG ODNs의 백신 접종은 면역반응을 조절하여 기도 염증이 형성된 생쥐에서 기도 호산구증을 감소시키는데 매우 효과적이며 천식 치료에 유용할 수 있을 것으로 사료된다.