• 한국환경보건학회지
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• 제43권6호
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• pp.532-544
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• 2017

Objectives: Because the amount of medical waste (i.e., health-care waste) generated in Korea is rapidly increasing and social concern against its safety is widespread, a number of issues related with medical wastes are being discussed. The purpose of this study is to compare diverse medical waste management systems worldwide and propose future directions of a medical waste management system in Korea. Methods: Literature review was conducted mainly on the WHO, and developed countries such as the European Union (Germany, Belgium and UK), Japan and the United States. For these countries, the data with respect to their systems for medical waste management ranging from the definition of medical waste to the whole processes of collection, transportation and disposal were summarized and compared. Results: The terminology and classification of medical wastes were not consistent for WHO recommendation, EU, Japan, US and Korea. Comparison of the collection, storage, transportation and disposal of medical waste showed that Korea had rather stronger regulations for medical waste management compared to developed countries including Belgium (Flanders region), Germany, Japan and the US. Considering that developed countries adopt rather flexible disposal system especially for general medical wastes which pose lower possibility of infection, Korean government could consider diversifying disposal methods other than incineration. It may also be very important to try to reduce the amount of medical wastes and enough capacity for off-site incineration are secured. Conclusion: Our study of international comparisons suggests that it is necessary to continue to identify advantages and disadvantages of the current medical waste management systems and establish more effective one in Korea.

• Environmental Engineering Research
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• 제24권2호
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• pp.211-219
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• 2019

Since improper management practices of solid medical waste (SMW) could potentially result in serious health risks and environmental problems, it is very important to properly treat and dispose of the medical wastes. In this study, current practices of SMW management from storage to final disposal stage in 12 health care facilities (HCFs) of Burundi were investigated using the official government reports. The results showed that 75% and 92% of HCFs used uncovered wheelbarrows and trucks for on-site or off-site SMW transportation, respectively, indicating that most transportation equipment and waste workers are not safely protected. The results also showed that 92.8% of SMW (15,736.4 ton) from all 12 HCFs were inappropriately disposed of through uncontrolled land disposal and incineration. If pharmaceutical wastes and discarded medical plastics (29.5% of SMW) can be separated and treated properly, the treatment costs can be reduced and resource savings can be achieved. Raising awareness of healthcare workers and general public about potential health effects arising from improper SMW management, sufficient financial and human resources for the treatment facilities (especially incinerators), and effective regulations and guidelines for transportation and treatment of SWM are some of the major tasks for safe and sustainable medical waste management in Burundi.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제27권3호
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• pp.39-49
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• 2021

Purpose: The negative pressure isolation ward is a key facility in preparedness and response to infectious diseases. For the sustainable operation of the facility, appropriate facility improvement is required. The experience of medical staff responding to infectious diseases in the COVID-19 pandemic provides effective informations for facility planning. Methods: The post occupancy evaluation (POE) was conducted by interviewing medical staff who is working on Nationally designated negative pressure isolation ward in general hospital. Floor plan analysis was conducted before field surveys for identifying facility characteristic and spatial composition. After that, field surveys were conducted at 3 hospitals, and interviews and fieldwork were conducted together. Results: It is necessary to increase the standard size of ward area from 15m² to 20m². The size of the doffing room has to be planned for accommodation of two or more people. Equipment storage, clean storage and waste storage also should be properly planned. There were almost no problems with the circulation in the ward. There was not enough space for medical staff. Implications: For a sustainable and safe negative pressure isolation ward planning, it is necessary to exploit learning from the medical staffs who have many experiences of coping with infectious diseases.

• 한국방사선학회논문지
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• 제9권6호
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• pp.409-416
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• 2015

본 연구는 대구 및 경북의 치과위생사들을 대상으로 치과 감염관리의 인식과 실천도를 조사하였으며, 이전의 연구를 참조하여 수정 및 보완 후 설문 조사하였다. 근무지 유형에 따라 치과의원보다는 치과병원에서, 치과 감염관리 담당자 및 감염관리 교육의 프로그램의 여부에 따라 다르게 나타남이 나타났다. 또한 치과 감염관리의 인지도와 실천도는 근무지 유형에 따라 개인방어, 무균술식법, 방사선 장비를 포함한 치과 장비, 감염성 폐기물과 세탁물 관리에서 유의하게 차이를 보였으며, 즉 치과 의원보다 치과병원이 감염관리 인지도 및 실천도가 높았다. 따라서 치과병원에서 감염 예방을 최소화하기 위해, 감염관리 및 감염관리의 정규 교육 및 가이드라인이 필요하며, 치과의 특성을 반영하는 지표 및 프로그램 개발 등이 빨리 도입 되어야 하며, 향후 치과의원(의원급 소형병원)에서의 감염 방지 및 평가 프로그램에 대한 연구 및 정부의 제도도 필요하다.

• Safety and Health at Work
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• 제14권4호
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• pp.347-357
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• 2023

Introduction: The COVID-19 pandemic turned biological hazards in the working environment into a global concern. This systematized review of published reviews aimed to provide a comprehensive overview of the specific jobs and categories of workers exposed to biological hazards with the related prevention. Methods: We extracted reviews published in English and French in PubMed, Embase, and Web of Science. Two authors, working independently, subsequently screened the potentially relevant titles and abstracts recovered (step 1) and then examined relevant full texts (step 2). Disagreements were resolved by consensus. We built tables summarizing populations of exposed workers, types of hazards, types of outcomes (types of health issues, means of prevention), and routes of transmission. Results: Of 1426 studies initially identified, 79 studies by authors from every continent were selected, mostly published after 2010 (n = 63, 79.7%). About half of the reviews dealt with infectious hazards alone (n = 38, 48.1%). The industrial sectors identified involved healthcare alone (n = 16), laboratories (n = 10), agriculture (including the animal, vegetable, and grain sectors, n = 32), waste (n = 10), in addition of 11 studies without specific sectors. The results also highlighted a range of hazards (infectious and noninfectious agents, endotoxins, bioaerosols, organic dust, and emerging agents). Conclusion: This systematized overview allowed to list the populations of workers exposed to biological hazards and underlined how prevention measures in the healthcare and laboratory sectors were usually well defined and controlled, although this was not the case in the agriculture and waste sectors. Further studies are necessary to quantify these risks and implement prevention measures that can be applied in every country.

• 적정기술학회지
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• 제6권1호
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• pp.37-44
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• 2020

의료폐기물은 감염성물질을 함유하고 있는 모든 종류의 폐기물을 가리키며 전염을 예방하기 위해 운송에 신중을 기해야 한다. 처리 수단으로의 소각은 부피 감소, 악취 제거, 위해성 측면에서 매립이나 투기보다 장점을 갖고 있다. 야외 소각이나 바람직하지 않은 환경에서의 소각은 환경오염 물질의 대기 중 배출을, 생물학적 폐기물의 매립은 토양과 수질오염을 야기시킨다. 피지의 대부분의 2차 병원은 의료 폐기물을 세 군데에 있는 3차 병원으로 차량 또는 배로 이송하여 소각 처리한다. 어떤 의료폐기물은 일반폐기물로 간주되어 현장에서 야외 소각되거나 출산 시 발생한 생물학적 의료폐기물은 매립되기도 하였다. 이런 측면에서 의료폐기물 처리 관련 인력들에 대한 인식 증진을 위한 교육이 시급하다. 피지에서의 의료폐기물 처리는 단일 도로를 따르는 차량운송, 배를 이용한 도서간 운송보다 소형 소각로를 이용한 현장소각이 권장되며, 가이드라인 제정, 관련 인력 훈련, 정부의 법률적 제정 등 의료 폐기물 처리를 위한 기반 조성이 필요하다.

• 한국응급구조학회지
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• 제12권3호
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• pp.99-113
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• 2008

In order to protect Rescue 119 workers exposed on the spot from potential infection, this study identified their awareness and practices of infection control so that it could help preventing them from infection and also provide basic materials necessary for pre-hospital infection control. This study applied questionnaire survey to total 215 Rescue 119 workers at fire stations in Jeonbuk province, Jeonnam province and Gwangju city from July 14 to Sept. 14, 2006 for the benefit of data collection. The questionnaire about possible associations between awareness and practices of infection control consisted of total 46 times across 6 categories such as washing hands during emergency activities ; fluid therapy and injection ; respirator maintenance; individual hygienics ; disinfectant supplies and equipments maintenance ; and control of infectious wastes. And collected data were processed using SPSS statistic program to analyze frequency and percentage, mean and standard deviation, Pearson's correlation coefficient, t-test and one-way ANOVA. As a result, this study came to the following conclusions : In terms of awareness about infection control, our respondents showed highest awareness about infectious waste control, and also showed highest level of practices in washing hands during emergency activities. Throughout all domains, awareness means were higher than practice means. In particular, infectious waste control was the domain of significant differences between awareness and practices. In terms of associations between awareness and individual characteristics, it was found that female rescue worker group and hospital/general hospital career group (before joining the Rescue 119) showed significantly higher awareness on statistic level. In regard to associations between individual characteristics and practices, it was found that female rescue worker group showed higher level of practices than male group on statistic level. This study also analyzed correlations between rescue workers' awareness and practice of infection control. As a result, it was found that the higher awareness was in correlations with the higher practices across all 6 domains including washing hands. In addition, the higher awareness of a questionnaire item was in significantly positive correlations with the higher practice of other items. However, our respondents showed high awareness about anti-infection, but low practices in reality. This indicates necessity of devising possible solutions to improve the practices as much as awareness. Especially, it was noted that major reasons for insufficient practices of infection control guideline come from unhabituated practices and lack of supports for infection-preventing supplies and protective device (mask, etc). Hence, it is necessary to provide more infection-preventing supplies for local rescue workers sufficiently, in parallel with steady habituation of infection control. Furthermore, it is required to manage and study infection control policies even at pre-hospital step in efforts for effective infection control, education and activities.

• 한국전산구조공학회논문집
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• 제34권6호
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• pp.409-415
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• 2021

COVID-19 대유행으로 인해 병원, 진료소, 검역소 및 의료 연구 기관을 포함한 의료 시설에서 매일 수많은 의료 폐기물이 발생함에 따라 의료폐기물 처리가 심각한 문제가 되고 있다. 이전에는 전통적인 소각방법이 사용되었지만 매립지 부족 및 관련 환경 문제로 인해 공중 보건이 위험에 처해 있다. 이런 문제를 극복하기 위해 멸균분쇄용 파쇄기를 개발하였다. 본 연구에서는 유해 및 감염성 의료폐기물에 대한 작동 성능을 결정하기 위해 분쇄용 파쇄 시스템의 설계 및 수치해석을 수행하였다. 파쇄기의 부품은 CAD 소프트웨어를 이용하여 모델링하였으며, ABAQUS를 사용하여 유한요소해석을 수행하였다. 정적, 동적 및 피로하중 조건 하에서 파쇄기 절단 날의 해석을 수행하였으며, 의료 폐기물을 분쇄하는데 필요한 절단력을 기반으로 절단 날의 형상이 효과적임을 입증하였다. 모달 해석을 통해 구조물의 동적 안정성을 검증하였다. 또한, 절단 날의 수명을 예측하기 위해 고주기 피로해석을 통해 S-N 선도를 생성하였다. 이를 통해 적절한 분쇄용 파쇄 시스템이 멸균 장치와 통합되도록 설계하여 의료 폐기물의 양과 처리 시간을 줄임으로써 환경 문제와 잠재적인 건강 위험을 극복하는 방안을 제시하였다.

• 한국산학기술학회논문지
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• 제8권6호
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• pp.1572-1578
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• 2007

지정폐기물은 폐산, 폐알칼리, 폐유, 폐유기용제, 폐합성수지, 먼지, 슬러지, 감염성폐기물 등이며, 이 중에서 많은 부분이 폐산, 폐알칼리, 폐유, 폐유기용제, 폐합성수지 등 액상지정폐기물이다. 이와 같은 액상지정폐기물을 적절히 분해하기 위해 먼저 액상지정폐기물에 대하여 밀도, 삼성분, 원소분석, 발열량 등 물리화학적 특성을 분석하고 0.3톤/일급의 고온고압시스템을 설계하였으며, 반응온도는 $1,200^{\circ}C$ 이상, 압력은 최대 4 $kg_f/cm^2(g)$ 조건에서 실험을 수행하였다. 폐유의 평균 밀도값은 0.93 g/mL. 폐유기용제는 0.93 g/mL, 폐합성수지는 0.91 g/mL이었으며, 삼성분과 원소분석 결과 폐유기용제는 수분 54.34%, 회분 3.35%, 가연분 42.31%이었고, 탄소 29.73%, 수소 3.82%, 산소 5.94%, 질소 2.31%, 황 0.51%이었다. 폐유의 평균 저위발열량은 8,294 kcal/kg, 폐유기용제의 경우 7,462 kcal/kg, 그리고 례합성수지는 5,809 kcal/kg으로 나타났다. 액상례기물 중 유해물질의 분해 특성을 보기 위해 대상 폐기물에 혼합한 톨루엔, TCE 그리고 톨루엔이 고온에서 분해될 때 발생하는 벤젠 3가지 물질에 대해 고온 고압 처리 전후의 양으로 각물질의 DRE를 비교한 결과, 상압조건에서 벤젠 99.73%, 톨루엔 99.73%, TCE가 99.95% 이었으며 가압조건에서 벤젠99.97%, 톨루엔 99.82%, TCE가 99.99%으로 나타나 가압조건이 상압조건보다 유해물질의 분해율이 향상된 결과를 보였다. 본 실험결과 TCE/톨루엔 혼합물의 DRE는 99.73% 이상으로 매우 높게 나타나 유해물질이 적절히 분해됨을 확인할 수 있었다.nes., CWT+35‰＋Anes., NWT＋15‰+Anes. 및 CWT+15‰＋Anes.의 8개 실험구를 2반복으로 설정하여 경북울진∼부산까지 약 400 km (6시간)를 차량수송하였다. 수송용기는 스티로폼상자(66×42×20 cnn)로서, 여기에 해수 3 L와 액화산소를 넣은 비닐봉지에 넙치 8마리씩 수용하여 수송하였다. 혈액의 성상 및 분석항목은 수송전ㆍ후에 채혈하여 비교하였다. 수송전 hematocrit는 22.2±3.8%에서 수송후 NWT＋35‰에서 15.3＋3.9%, CWT＋35‰은 16.7±3.0%, NWT+15‰구에서는 19.2±1.8%로 낮아졌으며, CWT+15‰구는 20.9±3.6%로 수송전과 차이가 없었다. 한편 NWT＋15‰＋Anes.구는 17.8±0.9%, CWT＋15‰＋Anes.구는 14.5±1.5%로 낮아졌다. Cortisol은 수송전 2.4±0.1 ng/ml로부터 CWT＋35‰구는 16.7±12.8 ng/ml, NWT＋35‰구는 47.9＋19.8 ng/ml, NWT＋15‰구는 43.5±13.9 ng/ml, CWT＋15‰구는 26.1±8.3 ng/ml, NWT＋15‰+Anes.구는 61.7±3.3 ng/ml, CWT+15‰+Anes.구는 86.1±19.0 ng/ml로 높아졌다. Glucose는 수송전 74.2±32.6 mg/dl로부터 NWT＋35‰구는 197.9±27.5 mg/dl, CWT＋35‰구도 272.1±29.9 mg/dl로 유의하게 높아졌다. Na/sup +/의 수송전 농도는 163.5±0.6 mEq/L로부터 NWT＋35‰구와 CWT＋35‰구는 각각 175.3±1.2 mEq/L, 190.0±5.0 mEq/L로 높아졌으며, 다른 실험구에서는 차이가 없었다. 본 연구 결과, cortisol과 glucose에서 수송전보다는 모든 실험구에서 높게

• 환경위생공학
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• 제6권1호
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• pp.7-25
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• 1991

Until now, pure drinking water grnerally menas the water without taste, odor, general bacteria, coliform, and other exotic substance. Such a definition has been changing recently due to the finding of numerous other inorganic and organic substances unknown to us. 10 years ago, major causes of death were infectious agents and parasites contained in water, but recently, it has become apparent that some substances contained in drinking water cause cancer and heart diseases. We must drink about 2L of water everyday in order to maintain healthy condition. Waters used for drinking include tap water, well water, spring water, filtered water, etc., but the quality of drinking water has more polluted due to the industrial development and population increase. For example, industrial waste waters from industrial plants pollute the water supply sources ; toxic substances contained in the waste waters pollute the ground water sources by penetrating the geological strata, and municipal, livestock, public building waste waters also pollute the water supply sources. Sometimes, the polluted surface waters were announced to be polluted by various kinds of orgainc substance, and it is reported that the pollution of ground water by orga nic substances has few in number but high in its concectration comparing with those of surface water. As the water quality pollution level increases, so the amount of disinfectant also increase. For example, chlorine solution, one of widely used disinfectants, creates trihalomethane(THM), a carcinogen, and halogen compounds. According to Oliver, through chlorine disinfection process, humine substance and chlorine create bolatile organic halide and nonvolatile organic halide by chemical reaction. There are tens or hundreds filtering devices, but filtering principles and maintenance metjhods are different, so their efficiency tests are needed. According to Smith, the effeciency tests aginst over 30 Ameican filtering devices show that 10 devices can remove 85% of volatile organics and further studies on filtered waters are underway. In consideration of important impacts of polluted drinking water on national health, authors studied the state of water quality pollution against tap water used as drinking water, filtration device passed water, ground water, and conserved drinking water ; tested the efficiency of filtration devices for tap water ; tried to sep up the detection method by using ion chromatography based on negative ion and positive ion by using single column, and attemped the simple filtration method for general households.