• Child Health Nursing Research
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• 제18권3호
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• pp.95-100
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• 2012

Purpose: The purpose of this study was to facilitate home visits to assess the current rate of child abuse in order to provide an agenda for the early detection and prevention of child abuse and neglect in Korea. Methods: For this retrospective descriptive research, 20 public health centers were selected, 1,991 families were visited and 2,680 children were assessed. Results: We found 415 cases (15.5%) of potential abuse and 7 cases (0.3%) of actual abuse. The greatest risk group was to children age 4 to 6 years. According to the HOME Inventory, there were 17 infants (5.8%) presenting a potential risk for child abuse and neglect. Conclusion: Visitation screening is highly recommended for prevention in the high-risk preschool age group.

• 한국환경보건학회지
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• 제49권4호
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• pp.210-217
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• 2023

Background: N-nitrosamines are carcinogenic substances often found in rubber products. They are produced when certain additives of rubber products react with nitrite in saliva or air. Exposure assessment for the proper management and communication of N-nitrosamines in rubber balloons should be carried out. Objectives: This study was conducted to determine the concentrations of N-nitrosamines in rubber balloons in the South Korean market and assess exposure among Korean children. Methods: Forty eight rubber balloon products in the domestic market were purchased and a total of 68 balloons were analyzed for N-nitrosamines and N-nitrosatable substances. Chemical analysis was conducted by HPLC-MS/MS according to the method EN 71-12. For exposure assessment, an exposure algorithm and coefficients were obtained from previous studies. Results: Among the 68 rubber balloons, N-nitrosamines were detected in 18 (26.5%) with an average level of 60.77 ㎍/kg. N-Nitrosatable substances were detected in 44 products (64.7%) with an average level of 1353.33 ㎍/kg. As a result of the exposure evaluation, the exposure dose differed according to how exposure coefficients were applied. The median exposure (50th percentile) was higher in the age group of 6~12 years, and high exposure (95th percentile) was higher in the age group of 13~18. Conclusions: We evaluated the N-nitrosamines contained in rubber balloons purchased in the domestic market and assessed oral exposure among South Korean children. For integrated risk management of N-nitrosamines, further studies and discussion regarding exposure and risk assessment are required.

• Child Health Nursing Research
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• 제20권3호
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• pp.215-224
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• 2014

목적 본 연구는 입원 환아의 낙상위험 요인을 확인하여 낙상위험 예측도구를 개발하고 민감도와 특이도를 확인하기 위한 것이다. 방법 문헌고찰과 서울시내 1개 어린이 병원에 2006년 1월부터 2009년 8월까지 3년 8개월 동안 입원한 환아 중 낙상한 경험이 있는 환아 48명 전체와 2009년 5월 25일부터 6월 24일까지 한 달 동안 입원한 환아 중 낙상 경험이 없는 환아 149명을 비교한 자료를 바탕으로 낙상위험요인 8개를 추출하였으며, 로지스틱 회귀분석을 통해 유의한 위험요인 5개를 확인하였다. 8개 문항과 5개 문항으로 구성된 도구를 이용하여 실제 낙상을 경험한 군과 비낙상군을 비교하여 민감도, 특이도, 양성예측도, 음성예측도를 확인하였다. 결과 로지스틱 회귀분석 결과 입원 환아의 낙상 발생 위험의 유의한 예측 요인은 다음의 5가지였다. 연령은 3세 미만인 경우 3.00배, 뇌신경질환 진단이 있는 경우 2.41배, 활동 및 기능은 도움이 필요한 경우 3.18배, 신체발달은 정상인 경우에 7.09배, 위험약품 처방 수가 3개 이상인 경우 3.475배로 낙상위험이 높은 것으로 나타났다. 8개 문항의 경우 12점 이상을 고위험으로 보았을 때 민감도는 76.6%, 특이도는 30.3%였으며, 5개 문항의 경우 7점 이상을 고위험으로 보았을 때 민감도는 93.6%, 특이도는 16.2%로 나타났다. 결론 입원환아의 낙상위험예측도구로서 8개 문항과 5개 문항의 도구 모두 민감도는 높으나 특이도는 낮은 제한점을 갖고 있다. 그러나 낙상위험을 예방하기 위한 목적으로 사용됨을 감안하면 특이도는 낮지만 민감도가 높으므로 임상현장에서 사용 가능할 것으로 판단된다.

• Environmental Analysis Health and Toxicology
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• 제25권1호
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• pp.57-68
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• 2010

This study assessed the lifetime cancer and non-cancer risk of aldehydes and volatile organic compounds exposure of young children at child-care facilities and indoor playgrounds in Korea. The samples were collected at various children's facilities (40 day-care houses, 42 child-care centers, 44 kindergartens, and 42 indoor playgrounds) in summer (Jul~Sep, 2007), winter (Jan~Feb, 2008) and Spring (Mar~Apr, 2008) periods, and analyzed by GC-MS. We estimated the lifetime excess cancer risks (ECRs) of formaldehyde, acetaldehyde, benzene, chloroform, CCI4 and tetrachloroethylene, and the hazard quotients (HQs) of Non-carcinogens (toluene, xylene, benzaldehyde and formaldehyde). Formaldehyde evaluated both cancer and non-cancer risk. The average ECRs of formaldehyde for young children were $1\times10^{-4}{\sim}1\times10^{-5}$ level in all facilities. HQs of four non-carcinogens did not exceed 1.0 for all subjects in all facilities.

• 가정간호학회지
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• 제27권1호
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• pp.42-52
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• 2020

Purpose: This study aimed to find grounds for the development of a health promotion program by examining the risk factors affecting children in low-income families. Methods: This was a cross-sectional study. The subjects were 288 children under 13 years of age in We-Start, W city. The tools used included a household information questionnaire and risk assessment tools. The data were analyzed using t-test, ANOVA, and multiple regressions. Results: Risk factors like disability problems (β=.38, p<.001), residential environment (β=.37, p<.001), parenting type (β=.27, p=.003), the foster's educational level (β=.22, p=.011), and the gender of the child (β=.19, p=.030) explained 51% (p<.001) of the preschoolers in crisis. For the schooler, academic achievement (β=.39, p<.001), disability problems (β=.24, p<.001), adaptation to school (β=.23, p<.001), noise from the environment (β=.20, p<.001), and the foster's job (β=-.15, p=.007) explained 50% (p<.001) of crisis of schooler. Conclusion: The study found that children (disability, gender), family (residential environment, type of parenting), and caregivers (educational level, economic competence) had a complex impact on crisis situations. In children of a school-going age, school life appeared to be an important influencing factor. Therefore, an integrated case management approach that considers children, carers, and the home environment is necessary.

• 한국환경보건학회지
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• 제43권3호
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• pp.223-232
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• 2017

Objectives: In response to increased interest in the safety of children's products, a risk management system is being prepared through exposure assessment of hazardous chemicals. To estimate exposure levels, risk assessors are using deterministic and probabilistic approaches to statistical methodology and a commercialized Monte Carlo simulation based on tools (MCTool) to efficiently support calculation of the probability density functions. This study was conducted to analyze and discuss the usage patterns and problems associated with the results of these two approaches and MCTools used in the case of probabilistic approaches by reviewing research reports related to exposure assessment for children's products. Methods: We collected six research reports on exposure and risk assessment of children's products and summarized the deterministic results and corresponding underlying distributions for exposure dose and concentration results estimated through deterministic and probabilistic approaches. We focused on mechanisms and differences in the MCTools used for decision making with probabilistic distributions to validate the simulation adequacy in detail. Results: The estimation results of exposure dose and concentration from the deterministic approaches were 0.19-3.98 times higher than the results from the probabilistic approach. For the probabilistic approach, the use of lognormal, Student's T, and Weibull distributions had the highest frequency as underlying distributions of the input parameters. However, we could not examine the reasons for the selection of each distribution because of the absence of test-statistics. In addition, there were some cases estimating the discrete probability distribution model as the underlying distribution for continuous variables, such as weight. To find the cause of abnormal simulations, we applied two MCTools used for all reports and described the improper usage routes of MCTools. Conclusions: For transparent and realistic exposure assessment, it is necessary to 1) establish standardized guidelines for the proper use of the two statistical approaches, including notes by MCTool and 2) consider the development of a new software tool with proper configurations and features specialized for risk assessment. Such guidelines and software will make exposure assessment more user-friendly, consistent, and rapid in the future.

• 대한소아치과학회지
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• 제40권1호
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• pp.72-81
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• 2013

최근 2세에서 5세 사이 소아의 우식 발생율이 상당히 증가하고 있다. 유아기우식증(Early Childhood Caries)은 향후 영구치의 우식 발생 가능성에 대한 예측인자이며 사회 저소득층과 다문화 가정 자녀에서 특히 발생빈도가 높은데, 이는 충분히 예방과 관리가 가능하다. 만1세때부터 정기적으로 치과를 방문하고 이 때 우식위험도를 체계적으로 평가하여 환자들에게 맞춤형 예방 전략을 제시할 수 있기 때문이다. 유아기우식증의 예방을 위한 CAMBRA (Caries Management by Risk Assessment)에 대해 가장 최신의 개념과 사용법을 소개하고자 한다. 소아치과의사는 CAMBRA를 통해 개개인의 위험인자를 분석하여 연령에 따른 적절한 예방법을 수립하고 향후 우식 발생시 치료방향의 지침을 정하게 된다.

• 한국환경과학회지
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• 제23권7호
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• pp.1277-1287
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• 2014

As concerns have been raised about health effects of children's products containing hazardous chemicals on children, the Korea Ministry of Environment announced 135 environmental hazardous substances in children's products (EHSCP) which were subject to risk assessment. Therefore, it is necessary to identify the current status of EHSCP for management due to their various exposure routes and types. In this study, we investigated the exposure assessment of EHSCP as well as relevant policies implemented in domestic and foreign countries. Domestic and foreign cases of detection of EHSCP were reviewed in the literature and websites of related agencies. Due to the lack of reference values for child-specific toxicity of EHSCP, those for adults and regulatory status of EHSCP were also investigated and reviewed with literature. The related agencies of foreign countries provided 13 child-specific reference doses (RfDs), 76 RfDs, and 42 reference concentrations as toxicity reference values of the EHSCP. Among substances investigated in the studies to assess exposure of hazardous substances in children's products by the Korea Ministry of Environment, 23 substances were included in 135 EHSCP. The same studies identified 9 substances which were excluded from the 135 EHSCP. For regulatory status for hazardous substances in children's products, 44 substances (32.6 %) and 84 substances (62.2 %) of 135 EHSCP were under regulation in Korea and foreign countries, respectively. In the present study, we found that a list of 135 EHSCP should be revised to ensure children's safety.

• Toxicological Research
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• 제29권1호
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• pp.69-79
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• 2013

The purpose of this study was to investigate the current status of metal pollution in the sediment from rivers, lakes, and streams in active gold mining districts in Ghana. Two hundred and fifty surface sediment samples from 99 locations were collected and analyzed for concentrations of As, Hg, Cr, Co, Cu, Fe, Zn, Pb, Cd, Ni, and Mn using inductively coupled plasma-mass spectroscopy (ICP-MS). Metal concentrations were then used to assess the human health risks to resident children and adults in central tendency exposure (CTE) and reasonable maximum exposure (RME) scenarios. The concentrations of Pb, Cd, and As were almost twice the threshold values established by the Hong Kong Interim Sediment Quality Guidelines (ISQG). Hg, Cu, and Cr concentrations in sediment were 14, 20, and 26 times higher than the Canadian Freshwater Sediment Guidelines for these elements. Also, the concentrations of Pb, Cu, Cr, and Hg were 3, 11, 12, and 16 times more than the Australian and New Zealand Environment and Conservation Council (ANZECC) sediment guideline values. The results of the human health risk assessment indicate that for ingestion of sediment under the central tendency exposure (CTE) scenario, the cancer risks for child and adult residents from exposure to As were $4.18{\times}10^{-6}$ and $1.84{\times}10^{-7}$, respectively. This suggests that up to 4 children out of one million equally exposed children would contract cancer if exposed continuously to As over 70 years (the assumed lifetime). The hazard index for child residents following exposure to Cr(VI) in the RME scenario was 4.2. This is greater than the United States Environmental Protection Agency (USEPA) threshold of 1, indicating that adverse health effects to children from exposure to Cr(VI) are possible. This study demonstrates the urgent need to control industrial emissions and the severe heavy metal pollution in gold mining environments.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제20권2호
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• pp.71-78
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• 2017

Child obesity has become a significant health issue in Korea. Prevalence of obesity in school-age children in Korea has been alarmingly rising since 2008. Prevalence of obesity among infants and preschool-age children in Korea has doubled since 2008. Obese children may develop serious health complications. Before nutritional counseling is pursued, several points should be initially considered. The points are modifiable risk factors, assessment for child obesity, and principles of treatment. Motivational interviewing and a multidisciplinary team approach are key principles to consider in managing child obesity effectively in the short-term as well as long-term. Nutritional counseling begins with maintaining a daily log of food and drink intake, which could possibly be causing obesity in a child. Several effective tools for nutritional counseling in practice are the Traffic Light Diet plan, MyPlate, Food Balance Wheel, and 'Food Exchange Table'. Detailed nutritional counseling supported by a qualified dietitian is an art of medicine enabling insulin therapy and hypoglycemic agents to effectively manage diabetes mellitus in obese children.