• 제목/요약/키워드: hygienic management

검색결과 136건 처리시간 0.028초

Characterisation of fungal contamination sources for use in quality management of cheese production farms in Korea

  • Kandasamy, Sujatha;Park, Won Seo;Yoo, Jayeon;Yun, Jeonghee;Kang, Han Byul;Seol, Kuk-Hwan;Oh, Mi-Hwa;Ham, Jun Sang
    • Asian-Australasian Journal of Animal Sciences
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    • 제33권6호
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    • pp.1002-1011
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    • 2020
  • Objective: This study was conducted to determine the composition and diversity of the fungal flora at various control points in cheese ripening rooms of 10 dairy farms from six different provinces in the Republic of Korea. Methods: Floor, wall, cheese board, room air, cheese rind and core were sampled from cheese ripening rooms of ten different dairy farms. The molds were enumerated using YM petrifilm, while isolation was done on yeast extract glucose chloramphenicol agar plates. Morphologically distinct isolates were identified using sequencing of internal transcribed spacer region. Results: The fungal counts in 8 out of 10 dairy farms were out of acceptable range, as per hazard analysis critical control point regulation. A total of 986 fungal isolates identified and assigned to the phyla Ascomycota (14 genera) and Basidiomycota (3 genera). Of these Penicillium, Aspergillus, and Cladosporium were the most diverse and predominant. The cheese ripening rooms was overrepresented in 9 farms by Penicillium (76%), while Aspergillus in a single farm. Among 39 species, the prominent members were Penicillium commune, P. oxalicum, P. echinulatum, and Aspergillus versicolor. Most of the mold species detected on surfaces were the same found in the indoor air of cheese ripening rooms. Conclusion: The environment of cheese ripening rooms persuades a favourable niche for mold growth. The fungal diversity in the dairy farms were greatly influenced by several factors (exterior atmosphere, working personnel etc.,) and their proportion varied from one to another. Proper management of hygienic and production practices and air filtration system would be effective to eradicate contamination in cheese processing industries.

사망 원인별 유형 분석을 통한 사망자의 위생 관리에 대한 연구 (Study on Sanitary Management of Deceased Bodies through Categorical Analysis of Cause of Death)

  • 최정목
    • 한국콘텐츠학회논문지
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    • 제17권7호
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    • pp.265-275
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    • 2017
  • 본 연구는 장례식장에서 사망자를 위생적으로 관리하기 위해 사망의 장소, 종류 및 원인 등 사망자들의 유형에 따라 체액 분출 등 사후 어떤 변화가 있는지 알아보고자 하였다. 사망자 858명을 대상으로 조사한 결과 평균 연령은 68.6세이며, 주요 사망의 원인은 83.0%가 병사이며, 사망 장소는 79.5%가 의료기관에서 발생되었다. 사망자에서 발생되는 체액 분출율은 전체 사망자의 46.2%에서 조사되었고, 사망의 종류에 따라서는 사고사가 78.8%로 가장 높고, 노화사는 10.8%로 가장 낮았다. 사망의 장소에 따른 의료기관 사망자는 46.3%, 주택 사망자는 38.6%인데 반해 기타 장소는 77.4%로 높았다. 사망의 원인으로 직접, 중간 및 선행 사인이 기록된 사망자 수는 크게 다르지만 체액 분출 비율은 비슷하였다. 장기 및 계통별 사망자 수는 직접, 중간 및 선행 사인 모두 호흡기질환과 심장질환 사망자 수가 가장 많고, 체액 분출은 직접 사인은 간질환 사망자가 가장 높고 소화기 및 혈액순환계 순이며, 중간 및 선행 사인에서는 기타 및 사고사가 가장 높은 비율을 보였다. 사망의 원인에 기록된 질병을 기준으로 한 사망자 수는 직접 사인은 심폐부전이 96명으로 가장 많고 폐렴 및 패혈증 순이며, 체액 분출은 사망자 수가 15명 이상 기준으로 담관암(73.3%)이 가장 높고, 췌장암, 중증뇌손상 및 간암 순으로 많았다. 따라서 사망자의 위생적 관리를 위해서는 보다 정확한 질병명과 발병기간을 명시하도록 하여야 하고, 사망자 이송과정에서는 관련 정보가 문서화 되고 체계적인 전달 시스템이 될 수 있도록 제도화 하여야 할 것이다.

소규모 베이커리에서의 HACCP적용을 위한 미생물학적 위해도 평가 (Microbiological Quality Evaluation for Application of the HACCP System to the Bakery Products at Small Scale Bakeries)

  • 엄애선;권성희;정덕화;오상석;이헌옥
    • 한국식품조리과학회지
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    • 제19권4호
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    • pp.454-462
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    • 2003
  • 본 연구는 서울시에 위치한 소규모 베이커리 2곳을 대상으로 제빵류(단팥빵, 크림빵, 케익류)의 원료 및 공정별, 제빵기구$.$용기, 제빵종사자와 작업장환경에 대한 일반세균, 대장균군 및 급식소에서 위해세균으로 정의되어 있는 E. coli, Salmonella, Yersinia, Staphylococcus와 같은 식중독균에 대한 미생물 검색을 실시함으로써 소규모 베이커리에서의 HACCP적용을 위한 기초자료를 제공하고자 하였으며, 그 결과는 다음과 같았다. 1. 채취한 시료의 일반세균수 및 대장균군수는 대부분의 시료에서 안전성 수준을 초과하였다. 2. 대장균은 A점포의 혼합기, 수도꼭지, 쓰레기통, 작업장 바닥과 손잡이, 단팥빵 및 크림 빵 성형단계의 시료에서 균이 분리되었다. 3. 살모넬라균은 A점포의 원재료인 마가린과 단팥빵 성형단계의 시료에서 검출되었다. 4. 황색포도상구균은 A점포의 계란과 빵자르는 기계 및 B점포의 크림빵 성형단계의 시료에서 검출되었고, 독소형은 enterotoxin A인 것으로 확인되었다. 5. PCR분석 결과 E. coli O157은 음성인 반면, Salmonella균은 양성임이 판명되었다. 이상의 결과가 소규모 베이커리에서의 HACCP적용을 위한 미생물학적 위해도 평가의 전반적인 면을 대표할 수 없는 연구의 제한성을 가지고는 있으나 이연구를 기초로 더욱더 체계적인 연구들이 실시되리라 기대한다.

지속가능성 측면에서 재난 임시대피소의 특성 연구 -쓰촨성(四川省) 원촨(汶川) 지진 사례를 중심으로- (A Study on the Characteristics of Disaster Temporary Sheltering in Terms of Sustainable Design -Focused on the Case of the Wenchuan Earthquake in Sichuan Province-)

  • 티엔휘;윤지영;왕단
    • 한국콘텐츠학회논문지
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    • 제21권5호
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    • pp.877-888
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    • 2021
  • 본 연구는 2008년 원촨(汶川) 지진 이후 중국 정부가 이재민들을 위해 제공한 임시 집중 안치소와 텐트와 이동식 판자가옥 등 3가지의 임시대피소를 대상으로 그 특성에 대해 연구하였다. 문헌조사를 통해 지속가능성 측면에서 사회적, 경제적, 환경적 요소 중 12개 평가항목을 선정해 임시대피소를 분석하고 평가함으로써 각각의 특성과 문제점을 도출하였다. 분석 결과 임시 집중 안치소와 텐트는 기반시설이 미비하고 위생상태가 나쁘며, 주거공간이 협소하고 개인 공간이 없어 기본 생활조차 불편하다는 문제가 있었다. 이동식 판자가옥은 건축비가 비싸고 건축자재가 친환경적이지 않고 농경지를 차지하며 자재가 재활용률이 낮으며 폐기물이 환경을 오염시키는 등의 문제가 있었다. 3가지 임시대피소의 공통적인 문제점은 우선 정부가 대피소 건설과 배치를 주도하고 이재민들은 정부의 지원을 받는 바람에 임시 커뮤니티의 건설과 관리에 대한 참여 의욕이 떨어진다는 점이었다. 다음으로 3가지 임시대피소가 모두 설계상 이재민들의 심리적 수요를 충분히 고려하지 못했으며, 특히 안전하고 위생적인 개인 공간에 대한 기본 요구를 전혀 충족하지 못하고 있었다. 마지막으로 본 연구는 3가지 임시 대피소의 지속가능한 디자인과 임시 커뮤니티의 건설 및 관리 문제에 대한 개선 방안을 제안하였다.

20대 구강보건지식과 구강위생관리능력이 치주건강상태평가에 미치는 영향 (The Effect of Dental Health Knowledge and Oral Hygiene Management Skills on Periodontal Health Status Assessment in Their Twenties)

  • 복혜정;이은주;최정미
    • 치위생과학회지
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    • 제13권1호
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    • pp.36-44
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    • 2013
  • 본 연구는 치주질환을 조기에 발견하고 예방하기 위해 20대의 구강보건지식과 구강위생관리능력이 치주건강상태평가에 미치는 영향을 비교 분석함으로써 국민의 구강보건관심도를 높일 뿐 아니라 치주건강증진활동에 지식과 정보를 제공하여 건강하고 효율적인 구강관리를 하는 데 기초자료를 제공할 목적으로 조사되었다. 포괄 치위생 관리 및 처치를 위하여 치위생과 실습실을 방문한 20대의 성인 130명을 대상으로 설문조사를 실시하고, 치주건강상태를 평가하였다. 일반적 특성, 구강보건지식, 구강위생관리능력과 치주건강상태평가의 연관성을 조사 분석하여 다음과 같은 결과를 얻었다. 1. 성별에 따른 잇솔질(p=0.030)과 구강위생용품(p=0.047)에 대한 구강보건지식은 통계적으로 유의하였고, 여성이 구강보건에 대한 지식이 높게 나타났다. 2. 성별에 따른 잇솔질(p=0.030)과 구강위생용품(p=0.047)에 대한 구강보건지식은 통계적으로 유의하였고 여성이 구강건강에 대한 지식이 높게 나타났다. 3. 성별에 따른 유두변연부착 치은염지수(p=0.047)와 지역사회치주지수(p=0.028)는 통계적으로 유의하였다. 남자의 유두변연부착 치은염지수, 지역사회치주지수는 여자보다 높았다. 학력에 따른 출혈지수(p=0.042)는 통계적으로 유의하였고, 고졸 이하가 가장 높았다. 4. 잇솔질(p=0.030), 치주질환(p=0.024)에 대한 구강보건지식이 치면세균막지수에 미치는 영향이 통계적으로 유의하게 나타났다. 잇솔질에 대한 구강보건지식($\beta$=-0.137)이 증가하면 치면세균막지수가 감소하고, 치주질환에 대한 구강보건지식($\beta$=-0.144)이 증가하면 치면세균막지수가 감소한다. 5. 잇솔질 총 횟수에 따른 유두변연부착 치은염지수는 2회가 가장 높았다. 잇솔질 방법에 따른 치면세균막지수는 묘원법이 가장 높았으며, 횡마법, 회전법 순으로 나타났다. 구강위생용품을 사용하지 않는 경우의 지역사회치주지수와 출혈지수가 구강위생용품을 사용하는 경우보다 높았다. 흡연의 경우 유두변연부착 치은염지수, 지역사회치주지수, 출혈지수가 흡연을 하지 않는 경우보다 높았다. 주 당 음주 횟수에 따른 지역사회치주지수와 출혈지수는 3회 이상이 가장 높았다. 구강보건교육을 경험하지 못한 경우의 유두변연부착 치은염지수가 구강보건교육을 경험한 경우보다 높았다.

식수인원에 따른 보육시설 급식소 위생관리 수준 평가 (Assessment of Food Service Management at Childcare Facilities According to the Number of People Eating Meals)

  • 김동수;권혁성;김평원;이자영;김상구;이상윤
    • 한국식품위생안전성학회지
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    • 제39권1호
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    • pp.26-34
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    • 2024
  • 본 연구에서는 보육시설 내 식수인원 및 조리 종사자 근무현황에 따른 급식소 위생 관리수준을 평가하였다. 2021년부터 2022년까지 풀무원푸드머스를 통해 식자재를 공급받는 전국 199개 보육시설을 대상으로 61개 점검문항 중 평가결과에서 유의미한 일부 분석결과를 바탕으로 작성하였다. 분석결과 식수인원이 적고, 조리 종사자가 적을수록 검수기록이 미 실시(P<0.05)되는 평가되었으며, 식수인원이 적을수록 조리 종사자의 건강상태 확인이 미흡하고, 조리 종사자가 적을수록 복장착용(P<0.05)이 미흡하였다. 또한, 식수인원이 적은 보육시설일수록 소비기한 경과 식재료 보관이 확인(P<0.05)되는 빈도 수가 높아 관리가 요구되었으며, 가열조리 시 심부온도 측정기록은 미 실시(P<0.05)되는 것으로 확인되었다. 그리고 식수인원이 적은 보육시설일수록 조리시설의 유지관리가 미흡(P<0.05)하였다. ATP 측정결과에서는 식수인원이 적은 조리시설 종사자의 손과 도마에서 유의적으로 높은 ATP 수치가 검출(P<0.05)되었으며, 조리종사자가 적을수록 근무 급식소의 도마에서 높은 ATP 수치(P<0.05)가 측정되었다. 분석결과를 종합해 볼 때 식수인원이 적은 보육시설일수록 조리운영을 위한 시설기반 관리가 부족하고, 위생관리가 미흡한 것으로 확인되었다. 따라서 본 연구결과를 통해 식수인원 및 조리 종사자 수에 따른 보육시설 급식소의 위생 관리수준을 판단하였으며, 향후 보육시설에 대한 국가 지원사업 선정 시 해당 연구결과가 기초자료로써 활용될 수 있을 것으로 사료된다.

젖소 유방염 관리에 따른 세균 및 체세포수 등급 실태 조사 분석 (Analytical studies of bovine mastitis management by standard plate counts(SPC) and somatic cell counts(SCC))

  • 허정호;정명호;박영호;조명희;이주홍
    • 한국동물위생학회지
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    • 제21권3호
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    • pp.285-300
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    • 1998
  • 1. The number of average milking cows, clinical forms of mastitis, mastitis-developing cows, and cows killed by mastitis a year were 25.7, 1.8(7%), 6.3(26%), and 2.7(10.1%)heads, respectively. The annual grade changes of standard plate counts(SPC) and somatic cell counts(SCC) showed the grade 1A of SPC diminished sharply from April to August, we think it was due to the lack of proper management in farming season and the grade 3 of SCC indirectly influenced increased in huge during August. 2. The average number of parturitions of farms was 2.3, but 50% of below 1 parturition were 22 farms(31%), 50% of above 3 parturitions were 16(23%) out of 71 farms. According to grades of the number of parturitions of milking cows per each farm, the farms' grades recording 3 parturitions and 50% were little bit excellent. 3. The actual situation research of foremilking CMT revealed 35 out of 74 farmer didn't do CMT Among them(35 out of 74 farmers), 80% did not test thanks to the troublesome process of the CMT. SCC grade 3, among farms who did foremilking CMT once or twice a month and who did not were 29% and 40% respectively and SPC grade 1A were 55% and 9%, respectively. 4. The research of actual situation on milking management let us know 29 farms(39%) did not do lastmilking, 37 farms(49%) usually did overmilking, and 34 farms(46%) did milking for 4 or 5 minutes. Grades according to average requiring times of milking showed SCC grade 1 of farms milking within 7 minutes was 11% and SPC grade 1A was 34%, on the other side, farms milking more than 7 minutes were 0% in SCC grade 1 and 13% in SPC grade 1A. Grades according to the starting time of milking after rubbing teats showed SPC grade 1A of farms starting milking at about 1 minute and over 2 minutes were 50% and 20%, respectively. 5. The research of actual situation on hygienic milking management uncovered 65 farms(88%) were using one towel which was used in washing teats and udders to wash more than 3 to 4 cows, and 53 farms(72%) were using one dried towel to dry udders not for each cow but for more than 3 to 4 cows after washing. Also, on milking turns disclosed 30 farms(40%) were milking cows in the order of incoming without isolation of a dominant group. According to grades of towels used in washing teats and udders, farms using a towel for each cow were 56% and a towel for over 3 cows were 31% in SPC grade 1A. According to using-or-not grades of dried towels after washing udders, farms using a towel for each cow were 79% and a towel for over 3 cows were 21% in SPC grade 1A. 6. Farms doing teat-dipping before milking were 7(10%), not doing teat-dipping after milking, or doing sometimes were 9(12%), and doing right after milking were 57(77%). And farms doing teat-dipping after dry cows and before delivery were 21(28a ). Farms using bethadine as an antiseptic solution were 70(95%), 40 farms(59%) diluted it with water as weak as 5 to 10 times, and on drying cows 64 farms(87%) slowly did it more than 2 days. Grade 1A of SPC of farms doing teat-dipping at every milking was 38%, farms doing occasionally or not was 33%, and farms doing it right after milking was 37% and doing after milking more than 5 cows was 20%. Grade 1A of SPC among farms diluting bethadine 5 times and diluting 5 to 10 times with water were 36% and 33%, respectively, and Grade 3 of SCC were 35% and 32%, respectively. 7. Studies on nonlactating period medical treatment, as the cows were on dry, 54 farms treated with their own hands.73 farms(98%) had bovine mastitis treated for themselves. And on applying medicines against mastitis, 55 farmers chose them on the basis of their own experience, 42 farms(57%) were treated more than 3 days. 41 farms(55%) dumped away the mastitis infected milk separately, 24 farms(32%) were feeding and milking at the same time. 8. Fifty-six farms(76%) always washed and disinfected milking machines after milking. Farms using the milking machines at low, or variable vacuum pressures, or at the vacuum pressure, set at the moment of its installation were 31(42%), and farms that did not know pulsation ratio were 27(37%). Farms changing liners when they were torn 8(11%), 58 farms(78%) said they checked milking system when there were wrong with them, 31 farms(42%) changed milking hoses when they found out problems, and 42 farms(57%) cleaned vacuum and milking systems when they felt dirty. The SPC grade 1A of farms washing and sterilizing milking machines was 38% and farms only washing was 28%.

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호주인과 호주 교민의 주거문화 비교를 위한 기초 연구(I) -호주 교민의 주생활 분석을 중심으로 - (A Baseline Study on Housing Cultures for Cross-Cultural Comparison between Korean- Australians and Australians(I) : An Analysis of Housing Cultures of Korean- Australian Families.)

  • 이영심;이상해
    • 가정과삶의질연구
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    • 제23권2호
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    • pp.107-125
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    • 2005
  • Each ethnic group has a different cultural background and has developed its own culture in the name of a tradition. The interaction between different cultures is ever increasing through the process of acculturation or culture contact The purpose of this study is to provide baseline information about domestic living of Korean immigrants in Australia and Australians for a larger cross-cultural study project. As the first step, the usage of domestic space and seating styles of 52 Korean households in Melbourne were analyzed. Ethnographic research was conducted, utilizing a questionnaire. The findings of this research are as follows: 1. The most popular type of Living-Dining-Kitchen arrangement was the one which the kitchen is separated from the living and dining area. The level of satisfaction was the highest when the living room, dining room, and kitchen were all separated. 2. A laundry room was indispensable for Koreans in Australia, and they wanted to dry laundry and do ironing in there. Most people were satisfied with the toilet separated from the bathroom A drain hole on the floor of the bathroom was not indispensable for most Korean-Australians. 3. Korean-Australians tend to engage in various activities in their individual rooms, and they estimated that the size of most rooms were small. They also wanted to renovate the house to expand the rooms. 4. The seating style of Korean-Australians was mostly chair-seating. Yet, they often made beds on the floor for guests, and made kimchi sitting on the floor. Also, when they were relaxing, they were using both chair-seating and floor-seating. 5. Korean-Australians were not very satisfied with the use of floor carpets because of the dust collected on the carpets, and the difficulty to clean. It may be related to their preferred floor seating style, as well. 6. Almost all Korean-Australians take off their shoes inside of the house for hygienic reasons. They had a shoes cabinet at the entrance inside of the house. 7. The most popular heating system was ducted heating. The level of satisfaction about this was moderate because hot air contains lots of dust and it makes rooms very dry. Many were using electric blankets and their desired heating system was Ondol (heated floor). 8. Korean-Australians thought that the living room was the most important place for the family, and believed it should be decorated well to entertain guests. They also pointed out that the lighting was not bright enough in general.

Public Health Risks: Chemical and Antibiotic Residues - Review -

  • Lee, M.H.;Lee, H.J.;Ryu, P.D.
    • Asian-Australasian Journal of Animal Sciences
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    • 제14권3호
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    • pp.402-413
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    • 2001
  • Food safety is a term broadly applied to food quality that may adversely affect human health. These include zoonotic diseases and acute and chronic effects of ingesting natural and human-made xenobiotics. There are two major areas of concern over the presence of residues of antibiotics in animal-derived foodstuffs with regard to human health. The first is allergic reactions. Some antibiotics, such as penicillins can evoke allergic reactions even though small amounts of them are ingested or exposed by parenteral routes. The second is development of antibiotic resistance in gut bacteria of human. Recently multi-resistant pneumococcal, glycopeptide-resistant enterococci and gram negative bacteria with extended-spectrum $\beta$-lactamases have spread all over the world, and are now a serious therapeutic problem in human. Although it is evident that drugs are required in the efficient production of meat, milk and eggs, their indiscriminate use should never be substituted for hygienic management of farm. Drug should be used only when they are required. In addition to veterinary drugs, environmental contaminants that were contaminated in feed, water and air can make residues in animal products. Mycotoxins, heavy metals, pesticides, herbicides and other chemicals derived from industries can be harmful both to animal and human health. Most of organic contaminants, such as dioxin, PCBs and DDT, and metals are persistent in environment and biological organisms and can be accumulated in fat and hard tissues. Some of them are suspected to have endocrine disrupting, carcinogenic, teratogenic, immunodepressive and nervous effects. The governmental agencies concerned make efforts to prevent residue problems; approval of drugs including withdrawal times of each preparation of drugs, establishment of tolerances, guidelines regarding drug use and sanitation enforcement of livestock products. National residue program is conducted to audit the status of the chemical residues in foods. Recently HACCP has been introduced to promote food safety from farm to table by reducing hazardous biological, chemical and physical factors. Animal Production Food Safety Program, Quality Assurance Programs, Food Animal Residue Avoidance Databank are para- or non-governmental activities ensuring food safety. This topic will cover classification and usage or sources of chemical residues, their adverse effects, and chemical residue status of some countries. Issues are expanded to residue detection methodologies, toxicological and pharmacokinetic backgrounds of MRL and withdrawal time establishments, and the importance of non-governmental activities with regard to reducing chemical residues in food.

고위험가족 선별을 위한 위험요인 분석 (The factors to identify high risk family)

  • 방숙명
    • 대한간호학회지
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    • 제25권2호
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    • pp.351-361
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    • 1995
  • The main purpose of the study is to identify critical risk factors for development of a family assessment tool to screen high risk family. This study used a conceptual framework of family diagnosis developed by Eui-sook Kim's (1993) and analyzed risk factors to identify the high risk family. As employing a explorative and methodological study design, this study has four stages. 1. In the first stage, 34 family risk factors were identified by doing intensive literature review on conceptual framework of family diagnoses. 2. In the second stage, above risk factors were tested for content validity by consultation with 29 persons in community health nursing, nursing education, family theory, and social work. 3. In the third stage, existing survey data was used for actual application of the identified risk factors. The survey data used for this purpose was previously collected for the community diagnosis in a region of Seoul. At the final stage, through the comparison between high risk and low risk families, initially identified 34 risk factors decreased to 25 risk factors. Among 34 risk factors, six factors did not agree with content of questionnaries sand two factors were not significant in differentiating the high risk family Also, two risk factors showed high correlation between themselves, so only one of those two factors was chosen. As a result, twenty-five risk factors chosen to identify the high risk family are following ; 1. A single parent family due to divorce or death of a partner, or unweded single mother 2. A family with an unrelated household members 3. A family with a working mother with a young child 4. A family with no regular income 5. A family with no rule in family or too strict rules 6. A family with little or no support from other lam-ily members 7. A family with little or no support from friends or relatives 8. A family with little or no time to share with each other 9. A family with family history of hypertension, diabetus, cancer 10. A family with a sick person 11. A family with a mentally ill person 12. A family with a disabled person 13. A family with an alcoholic person 14. A family with a excessive smoker who smokes more than 1 pack / day 15. A family with too much salt intake in their diet. 16. A family with inappropriate management skills for family health 17. A family with high utilization of drug store than hospital to solve the health problems of the family 18. A family with disharmony between husband and wife 19. A family with conflicts among the family members 20. A family with unequal division of labor among family members 21. An authoritative family structure 22. A socially isolated family 23. The location of house is not residential area 24. A family with high risk of accidents 25. The drinking water and sewage systems are not hygienic. The main implication of the results of this study is clinical use. The high risk factors can be used to identify the high risk family effectively and efficiently. The use of high risk factors woule contribute to develop a conceptual framework of family diagnosis in Korea and the list of risk factors need to be revised continuously. Further researches are needed to develop an index of weight of each risk factor and to validate the risk factors.

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