• 한국산업보건학회지
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• 제31권1호
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• pp.38-49
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• 2021

Objectives: This study was conducted to analyze the impact of safety/health managers' experience of trauma case on their post traumatic stress disorder and the mediation effects of job stress and the moderated mediation effects of social support. Method: Using a structured questionnaire, data were collected from 241 workplace safety/health managers with experience in trauma case. The collected data were analyzed using SPSS(IBM. Ver.26.0) and verified through SPSS PROCESS Macro (Ver. 3.4). Results: The trauma case experience and the job stress, which is a mediation variable, had a statistically significant positive effect on post-traumatic stress disorder, and the job stress had a positive mediation effect in the relationship between the trauma case experience and post-traumatic stress disorder. Social support had a statistically significant negative moderation effect in the relationship between the trauma case experience and job stress; social support had a moderated mediation effect on the indirect effect of a job stress on the post-traumatic effect through a trauma case experience. Conclusion: The above findings suggest that work-related job stress management is important in order to reduce safety/health managers' post-traumatic stress disorder caused by the experience of trauma case, and that social support is essential to reduce the job stress, which can later be used as a basis for further studies.

• 한국산업보건학회지
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• 제31권4호
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• pp.451-460
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• 2021

Objectives: The purpose of this study is to examine occupational risk factors that affect the mental health (depression, anxiety, anger, insomnia, self-esteem, trauma) of hospital facility workers. Methods: A survey was conducted from November 17, 2020 to December 1, 2020 for 700 non-medical workers (Temporary and contract workers: cleaning, security, information, office workers, etc.) working at a general hospital in Seoul. Results: As a result of the study, the risk of musculoskeletal disorders was found to have a significant effect on depression, anxiety, insomnia, and trauma. Noise had a significant effect on depression and anger, dust hazard had an effect on depression and self-esteem, and high temperature had a significant effect on anxiety and insomnia. Conclusions: Based on these results, it is necessary to examine the influence of occupational risk factors to improve the mental health of non-medical hospital facility workers.

• Journal of Trauma and Injury
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• 제25권4호
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• pp.178-187
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• 2012

Purpose: In Korea, the nation's medical expenses were 12 billion won in 2010. The medical costs for individuals can also be overwhelming. If a patient has sustained severe trauma, his/her insurance company responsible may pay only part of the medical bills. In Korean, there are diverse types of medical insurance, such as health insurance, automobile insurance, and industrial accident compensation insurance. And each insurance system has a different type of payment system. Our study will be essential for establishing the optimal medical expense payment system. Methods: From January to December 2011, we retrospectively reviewed the medical charts of 161 patients who were admitted to our hospital's emergency room after having undergone severe trauma. Of those 161 patients, 125 were retrospectively reviewed. Written permission was obtained from all of the patients. We analysed the demographic characteristics, clinical outcomes, data of the trauma, type of the patient's insurance, and the entire bill when the patient was discharged. Results: Seventy-one patients had health insurance, 48 automobile insurance, and six industrial accident compensation insurance. High-deductible insurance included health insurance and industrial accident compensation insurance, with the deductibles up to 20.6% and 19.1%, respectively. We attempted to analyze the cause of the high deductible rate. In patients with health insurance, medicines, primarily sedatives, pain killers, antibiotics, and fluids. comprised a large proportion. On the other hand, industrial accident compensation insurance deducted for a high-grade hospital room charge. Conclusion: We found that medical expenses were diverse according to the type of insurance. In particular, health insurance forced patients to pay too much of the medical expenses. Therefore, in Korea we should try to identify the insurance problems and improve the wage system.

• Journal of Chest Surgery
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• 제11권4호
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• pp.488-500
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• 1978

The purpose of this communication is to review the 390 cases of chest trauma, treated at Department of Thoracic and Cardiovascular Surgery, School of Medicine Kyungpook National University from 1960 to 1977. Patients were grouped into two: group `60s [1960-1969] of 103 cases and group `70s [1970-1977] of 257 cases. As the number of cases of each group showed, chest trauma cases increased three times in `70s . The main causes of trauma were auto accident, falling down, industrial injury and stab wound in that order for both groups. Eighty per cent of cases of `60s were between 20 and 59 years and 73.8% of same age range for `70s. Rib fracture of fourth to eighth rib was the most common lesion in both `60s and `70s group. The incidence of hemothorax or hemopnemothorax significantly increased among `70s group than `60s. Clinical manifestations of chest pain and dyspnea remained most frequent symptoms for both groups. The pertinent principles of treatment for the chest trauma were conservative therapy, closed thoracotomy and open thoracotomy. Closed thoracotomy was performed more freely during the period of 1970-1977, with encouraging clinical results. Very few cases of complications other than pneumothorax or hemopneumothorax occurred. Those are fibrothorax, asphyxia, atelectasis and mediastinitis. The overall mortality was 3.9% for the `60s and 2.1% for the `70s group. The possible causes of death of 14 cases of chest trauma whom died on arrival during 1970-1977 were analyzed.

• Journal of Trauma and Injury
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• 제28권1호
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• pp.15-20
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• 2015

Purpose: Vascular injuries caused by traffic, industrial accidents and by outside activities have increased in Korea. Especially, vascular injuries to the extremities can lead to limb loss and even mortality if they are not appropriately treated. The aim of the study was to evaluate the surgical outcomes of femoropopliteal vascular management after trauma. Methods: The medical records of 12 patients with femoropopliteal vascular injuries who were treated at Dankook University Hospital from 2011 to 2013 were reviewed. Iatrogenic vascular injuries were excluded. The clinical data including the causes of injury, associated injuries and surgical outcomes were analyzed retrospectively. Results: All patients were male, with a mean age of $46.8{\pm}16.3years$ (range: 26~69 years). The causes of vascular injuries were four traffic accidents, three industrial accidents, two iron plates, one outside activity, one glass injury and one knife injury. The average transit time between the place of the accident place and the emergency department was $3.0{\pm}2.1$ (0.5~12.5) hours, and the average preparation time for surgery was $8.0{\pm}6.7$ (1.7~23.3) hours. The anatomic injuries included the popliteal vessel in seven cases and the femoral vessel in five cases. The average Injury Severity Score (ISS) was $12.0{\pm}5.0$ (5~17), and the average Mangled Extremity Severity Score (MESS) was $5.7{\pm}2.1$ (2~9). The operation methods were four interposition grafts, three end-to-end anastomoses, two direct repairs and three patch angioplasties. One case required amputation of the injured extremity. Conclusion: Early recognition and revascularization of the injured vessel are mandatory to reduce limb loss and to obtain satisfactory outcomes. Therefore, careful/rapid evaluation of the vascular injuries and timely/successful surgical treatment are the keys to salvaging an injured limb.

• 대한불안의학회지
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• 제6권1호
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• pp.65-70
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• 2010

Objectives : Indirect contact with trauma may occur when a person empathically listens to detailed descriptions, exposing the person to intense emotional pain from trauma victims. Although less severe than direct trauma, indirectly traumatized persons may experience the same fear, rage, and despair as direct trauma victims. This phenomenon has been variously termed vicarious trauma, traumatic countertransference, burnout, compassion fatigue, and secondary traumatic stress. Using a psychiatric symptoms questionnaires, this study investigated the effects of indirect exposure to co-worker's trauma on the mental health of firefighters who had not directly experienced traumatic events in the previous year. Methods : We administered self-report questionnaires, such as the Impact of Event Scale-Revised (IESR) and Alcohol Use Disorder Identification Test (AUDIT), to firefighters working at two fire stations in a metropolitan city. We analyzed 188 of 232 collected surveys, after excluding falsely entered data (28 cases) and questionnaires by directly-traumatized victims (16 cases). Results : Alcohol consumption and posttraumatic stress disorder (PTSD) symptoms, as determined by the AUDIT and IES-R, were significantly higher in the indirectly-traumatized group. The ratio of high-risk members scoring higher than 23 in IES-R was larger in the indirectly traumatized group, although this was not statistically significant. Conclusion : Alcohol consumption was significantly higher in the indirectly traumatized group. This group also included more members at high risk for PTSD. Further research, with a larger group of indirectly traumatized firefighters and ongoing investigation of PTSD development and other psychiatric symptoms, is needed.

• 한국산학기술학회논문지
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• 제20권1호
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• pp.371-375
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• 2019

혈역학적으로 불안정한 췌장손상의 치료에서 Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA)의 역할은 아직 불명확하다. 저자들은 출혈을 동반한 췌장손상에서 REBOA와 경도관 동맥색전술을 시행하여 출혈을 먼저 제어한 후 수술을 시행한 증례를 보고하고자 한다. 65세 남자가 20 m 높이에서 추락하면서 발생한 복통과 흉통을 호소하며 본원 응급실을 통하여 내원하였다. 전산화단층촬영에서 췌장 미부에 grade III 손상이 의심되고 비장동맥으로부터 조영제 누출이 관찰되었다. 전산화단층촬영 시행 후 수축기혈압이 60 mmHg까지 하강하여 혈역학적 안정을 위해 REBOA를 시행하였다. REBOA 시행 후 수축기혈압이 130 mmHg로 상승하였으며, 비장동맥에 대해 색전술을 시행하였다. 혈관조영술에서 더 이상 출혈이 없는 것을 확인하고, REBOA 제거 후 응급 개복 및 췌장미부절제술을 시행하였다. 수술 소견에서 췌장미부의 주췌관 손상을 동반한 열상이 관찰되었으며, 수술 중 큰 출혈은 관찰되지 않았고 주 췌관의 손상이 확인되었다. 술 후 환자는 합병증 없이 회복하였다. 본 증례에서 저자들은 혈역학적으로 불안정한 출혈을 동반한 췌장손상 환자에서 REBOA와 동맥색전술 시행 후 췌장미부절제술을 안전하고 효과적으로 진행할 수 있었다.

• Journal of Chest Surgery
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• 제11권4호
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• pp.501-515
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• 1978

The purpose of this communication is to review the 390 cases of chest trauma, treated at Department of Thoracic and Cardiovascular Surgery, School of Medicine Kyungpook National University from 1960 to 1977. Patients were grouped into two: group `60s [1960-1969] of 103 cases and group `70s [1970-1977] of 257 cases. As the number of cases of each group showed, chest trauma cases increased three times in `70s . The main causes of trauma were auto accident, falling down, industrial injury and stab wound in that order for both groups. Eighty per cent of cases of `60s were between 20 and 59 years and 73.8% of same age range for `70s. Rib fracture of fourth to eighth rib was the most common lesion in both `60s and `70s group. The incidence of hemothorax or hemopnemothorax significantly increased among `70s group than `60s. Clinical manifestations of chest pain and dyspnea remained most frequent symptoms for both groups. The pertinent principles of treatment for the chest trauma were conservative therapy, closed thoracotomy and open thoracotomy. Closed thoracotomy was performed more freely during the period of 1970-1977, with encouraging clinical results. Very few cases of complications other than pneumothorax or hemopneumothorax occurred. Those are fibrothorax, asphyxia, atelectasis and mediastinitis. The overall mortality was 3.9% for the `60s and 2.1% for the `70s group. The possible causes of death of 14 cases of chest trauma whom died on arrival during 1970-1977 were analyzed.

• 한국산업보건학회지
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• 제8권1호
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• pp.36-49
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• 1998

The purpose of this study is to investigate the relationship between the work postures and upper extremity cumulative trauma disorders(CTDs) in female medical insurance bill reviewers(n=448). This study included diagnosis for CTDs, anthropometry and job analysis (workstations and posture). The characteristics of subject were 33.6 years of average age and 8.7 years of average work duration. The results were as fallows. Ergonomic conditions of workstation were unsuitable compared with anthropometry result. The height of work surface(79.5 cm) and chair(43.0 cm)were high. work space was small, and legs space under the table was limited. Work postures were awkward compared with recommended neutral postures. Neck flexion($21.0-36.0^{\circ}$), elbow elevation, shoulder abduction ($46.0-47.0^{\circ}$). wrist radial and ulnar deviation, forearm supination and pronation, and wrist repeated motion(12.7-21.5 freq./min) were analyzed as hazardous risk factors by job analysis. The prevalence of CTDs was 32.8 % by medical diagnosis. The prevalence rate of CTDs in hazardous work posture group was significantly greater than safe work posture group both neck-shoulder (relative prevalence = 5.2, p<0.001) and wrist-hand (relative prevalence = 2.5, p<0.05).

• 한국산업정보학회논문지
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• 제6권3호
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• pp.79-86
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• 2001

신종 직업병 중 누적외상성질환(Cumulative Trauma Disorders)은 고도로 분업화된 현대 산업환경에서 주로 수작업을 수행하는 종사자에게 발생된다. 본 연구는 단순반복근로자의 누적외상성질환에 노출되는 정도를 EMG시스템을 이용하여 분석한 결과는 다음과 같다. AEMG에서는 작업경과에 따라 근피로도는 증가하다가 작업 완료시에는 근피로도가 내화벽돌을 들기 전보다 감소하였다. MF와 MPF에에서는 천극근, 다열근의 근피로도가 많은 것으로 나타났다. ZCR에서는 모든 내화벽돌의 무게에서 작업전과 작업후의 근피로도가 가장 낮게 나타났다. 종합적으로 작업진행이 계속됨에 따라 근육피로도는 증가하고 있었고, 단순반복운반작업시에 천극근과 다열관에 대한 근피로도가 큰 것으로 나타났다.