• 한국직업건강간호학회지
• /
• 제11권1호
• /
• pp.44-51
• /
• 2002

Purpose: Surgical Site Infection(SSI) is the third most common cause of nosocomial infection, so that it results in serious socioeconomic impact such as extra hospitalization, mortality and health care cost. The aim of this study was to analyses the SSI that based on the degree of wound contamination and patient risk index after general surgery and to generate a reference data for the effective management and reducing SSI. Method: From July, 1999 to June, 2000, 1080 cases which presented with surgical site infection after general surgery at S hospital in chunchon city were included in this study. The data were collected by review of the medical records retrospectively. The collected data, in accordance with the test purpose, is analyzed by SPSS/PC+ program, using real numbers, percentage, $X^2$ test, Pearson's correlation and stepwise logistic regression. Result: The overall wound infection rate was 4.7%(51 cases out of 1,080). The infection rate of clean wounds was 1.4%. Surgical site infection rate for patient risk index scores of 0, 1, 2 and 3 was 1.9%, 8.0%, 13.1% and 20.0%, respectively and increased significantly according to patient risk index(p=.000). Sixteen of the fifty one(31.4%) surgical site infections were found during an outpatient visit after discharge. Multivariate analysis, identified two independent variables : duration of postoperation stay(p=.000), age(p=.037). The most frequent isolated organisms were Pseudomonas aeruginosa(21%) and Staphylococcus aureus(21%). Also Staphylococcus aureus were all MRSA(Methicillin Resistant S. aureus). Conclusion: In this study, SSI was analysed according to the degree of wound contamination and patient risk index after general surgery. The data that obtained from this study is expected that it would be available for surveillance and control of SSI.

• 문화기술의 융합
• /
• 제6권4호
• /
• pp.253-258
• /
• 2020

우울증은 전 세계적으로 유병율이 증가하고 있으며, 고혈압과 같은 여러 질병들뿐만 아니라 사망률과도 연관성이 높은 질병이다. 본 연구의 목적은 한국인 성인 중 단순노무종사자 직업군에서 우울증과 연관성이 있는 임상학적 위험지표를 발굴하는 것이다. 이러한 연구를 위한 데이터로는 질병관리본부 국민건강영양조사 7기 (2016-2018) 데이터가 사용되었다. 우울증과 인구학적 정보와의 연관성에서는 나이, 성별, 스트레스 인지정도, 스트레스 인지율 지표들이 우울증과 매우 높은 통계적 연관성이 나타났고, 교육과 결혼유무도 우울증과 연관성이 있는 것으로 나타났다. 복부둘레 및 체질량지수와 같은 비만 지표들은 우울증과 연관성이 없는 것으로 나타났다. 혈액정보 중 hemoglobin과 hematocrit은 우울증과 연관성이 매우 높은 것으로 나타났으며, 성별과 나이로 보정한 분석에서도 통계적 유의성이 유지되었다. 본 연구결과는 향후 단순노무종사자 직업군의 우울증 예방 및 치료를 위한 정보로 활용가능할 것이다.

• 한국산업보건학회지
• /
• 제29권1호
• /
• pp.1-12
• /
• 2019

Objective: Significant concerns have been raised over chemical exposure and potential health risks such as increased cancer mortality among laboratory workers. The aim of this study was to investigate the overall exposure and unit task exposure levels of researchers in organic synthesis laboratories at universities. Methods: Seventy-seven personal Time-weighted average(TWA) samples and 139 task-based samples from four organic synthesis laboratories at two universities were collected over three days. The concentrations of acetone, chloroform, dichloromethane(DCM), diethyl ether, ethyl acetate, n-hexane, tetrahydrofuran(THF), benzene, toluene, and xylene were determined using the GC-FID. Results: The most frequently used chemicals in the laboratories were acetone, DCM, n-hexane, methanol, and THF. Carcinogens such as benzene, chloroform, and DCM were used in one or more laboratories. The TWA full-shift exposures of researchers to acetone was the highest(ND-59.3 ppm). Benzene was observed above the occupational exposure limit in 18-40% of the samples. The levels of exposure to organic solvents were statistically different by task(p<0.05), while washing task was the highest. Washing was not perceived as a part of the real lab tasks. Rather it was considered as simple dish-washing or experimental preparation and performed in an open sink where exposure to organic solvents was unavoidable. TWAs and task-based concentrations were compared by substance, which suggests that TWA-based assessment could not reflect short-term and high concentration exposures. Conclusions: Laboratory workers may be exposed to various organic solvents at levels of concern. TWA-based measurement alone cannot guarantee holistic exposure assessment among lab workers as their exposures are very dependent on their tasks. Further investigation and characterization for specific tasks and overall chronic exposures will help protect lab workers from unnecessary exposure to chemicals while they perform research.

• Journal of Chest Surgery
• /
• 제32권6호
• /
• pp.549-555
• /
• 1999

배경: 폐암을 비롯한 각종 폐질환에 있어서 중요한 외과적 치료방법인 폐절제술시 일반적으로 수술전에 폐기능 검사 및 기타 임상적 평가를 시행하여 수술후에 이환율과 사망율에 영향을 주는 위험 인자를 확인하고 있으나 아직까지 가장 확실하고 정확한 단일 검사방법과 검사치에 대한 기준 설정에는 논란의 여지가 있다. 대상 및 방법: 본 연구는 1994년 6월부터 1998년 2월까지 3년 8개월 동안 아주대학교 병원 흉부외과학 교실에서 폐암, 기관지 확장증, 그리고 폐결핵 등으로 주요 폐 절제술을 시행받은 167명의 환자를 대상으로 25개의 수술전 또는 수술중 위험인자와 19개의 수술후 합병증을 분석하여 그 관련성을 연구하였다. 19개의 수술후 합병증은 사망율 및 호흡기, 순환기, 그리고 기타 합병증 네 가지로 분류하였고 수술전 또는 수술중 위험 인자와의 연관성을 확인하기 위하여 로지스틱 회귀분석과 $\chi$2검정을 사용하였다. 결과: 합병증을 예견하는 인자로 술후 예측 폐확산능백분율(ppoDLCO%)이 호흡기(p<0.009), 순환기(p<0.003), 전체 이환율(p<0.004)에 가장 유의한 영향을 주는 것으로 평가되었다. 결론: 폐기능 검사중 폐확산능(Diffusing Capacity for Carbon Monoxide, DLCO)이 일반적으로 사용되는 페활량측정법(Spirometry) 보다 술후 합병증을 예견하는데 있어서 통계학적으로 유의성있는 인자로 평가되었다. 따라서, 주요 폐절제술의 적응증이 되는 환자들은 폐확산능 검사를 통상적으로 시행하여 술전 정확한 평가에 의하여 유용한 치료의 지침으로 삼아야 될 것으로 판단된다.

• Journal of Preventive Medicine and Public Health
• /
• 제34권2호
• /
• pp.103-108
• /
• 2001

대기분진의 영향을 분석한 역학적 연구들은 분석방법의 오류, 생물학적인 타당성, 혼란변수의 통제 등 여러 가지 제한점들을 갖고 있기 때문에 이를 해석할 때 주의를 요한다. 그러나 대기분진역학연구들이 여러 가지 다른 연구방법과 자료원, 그리고 분석기법 등을 적용하였는데도 불구하고 연구결과간에 일치성이 매우높기 때문에 대기분진의 인체효과에 대한 연구결과가 일정한 방법론적인 또는 분석상의 오류에 의해서 나타났을 가능성은 거의 없다. 역학적 연구들이 생물학적인 타당성에 대한 상세한 근거를 제시하기는 어렵지만 서로 다른 연구들의 결과가 호흡기질환 및 심혈관계질환에 대한 건강영향을 나타내고 있으나 기타 질환에 대해서는 의미있는 결과들이 거의 없다는 것은 대기분진이 호흡기질환 및 심혈관계질환에 미치는 생물학적인 기전의 근거를 강하게 나타낸다고 할 수 있다. 대기분진 역학연구의 또 다른 중요한 관심사는 혼란변수의 통제 문제이다. 혼란변수란 노출과 질병에 서로 연관되어 있는 다른 위험인자가 분석에서 적절하게 통제되지 못하였을 때 이로 인하여 대기분진과 건강영향의 관련성이 잘못 나타나는 것을 말한다. 그러나 역시 서로 다른 연구들에서 여러 가지 혼란변수가 관련성에 영향을 미쳤다면 여러 지역의 다양한 연구에서 일정한 결과를 제시하기는 어려웠을 것이므로 대기분진과 건강영향의 관련성이 혼란변수의 부적절한 처리 때문에 나타난 것이라고 보기는 어렵다. 물론 대기분진 이외의 가스상 오염 물질이 같이 존재하고 또 서로간의 상관성이 매우 높기 때문에 이러한 대기오염 물질의 영향을 완전히 통제한 상태에서 대기분진만의 영향을 관찰한다는 것은 매우 어려운 일이다. 따라서 다중 공선성의 문제나 교차효과의 문제 등이 앞으로 대기분진 역학연구의 과제일 것이다. 결론적으로, 대기분진이 사망률 및 병원 내원율 등에 미치는 영향은 확립되었다고 보아도 될 것이다. 또한 우리나라의 연구들을 통하여 대기분진의 건강영향은 예외 없이 우리에게도 나타나는 문제라는 것을 확인하였다. 그러나 이러한 역학적 관련성에 대한 성과에도 불구하고 발생기전의 평가, 감수성 인구집단의 확인, 예방 및 관리 대책 마련 등 앞으로 해야 할 과제가 많이 남아있다.

• Journal of Preventive Medicine and Public Health
• /
• 제38권4호
• /
• pp.425-430
• /
• 2005

Objectives : To investigate the prevalence of Clonorchis Sinensis infestation and to determine the associated risk factors among a population in a part of the rural area of Gyeongsangnam-do, Korea, which is an area known to have a high mortality from liver cancer and a high infection of C. sinensis. Methods : The study populat ion consisted of those people who have lived in rural areas and who were over 40 years old. This study was performed in 5 areas during the period from 1999 to 200 3. Informed consents were obtained from the 2,381 study participants, and these people were interviewed about their life style habits with using the structured questionnaire that was administered by trained staff members. The subjects underwent blood sampling and their stool specimens were examined by using the Formalin-ether sedimentation technique. Results : Among the study subjects (N=2,381), the positivity for C. sinensis in the stool was 34.4% (95% CI=36.3-42.5); it was 39.4% (95% CI=36.3-42.5) in the males and 30.9% (95% CI=28.5-33.3) in the females . The positivity for C. sinensis was associated with current alcohol drinking (odds ratio=1.8, 95% CI: 1.5-2.1) and raw fish consumption (odds ratio 1.2, 95% CI: 0.9-1.6). Conclusion : The present study confirmed the high prevalence of C. sinensis in the study subjects. It is necessary to establish consistent medical management and education programs for the treatment and prevention of C. sinensis infestation in the rural inhabitants of Korea.

• 한국환경보건학회지
• /
• 제40권5호
• /
• pp.385-396
• /
• 2014

Objectives: By conducting a meta-analysis of cohort studies reporting standardized mortality ratios (SMRs) for workers exposed to trichloroethylene, we attempted to adjust for healthy hired effect by applying the same methods as described in a recent report from the Agricultural Health Study. Methods: Among all cohort studies that evaluated the association between all cancer, non-Hodgkin's lymphoma (NHL), kidney cancer, liver cancer and occupational exposure to trichloroethylene, a total of 10 studies reporting SMR values were selected. A random-effects model was used to estimate the summary SMRs or rSMRs and 95% confidence intervals. Relative SMR ($rSMR=SMR_x/SMR_{not\;x}$) was calculated comparing observed and expected counts for all cancer, NHL, kidney cancer, and liver cancer with an independent referent set of values consisting of the observed and expected counts for other causes. Results: The SMR values for all causes ranged from 0.68 to 1.03, suggesting moderate to weak healthy worker effect for the selected studies. When the healthy worker hire effect was taken into account, the summarized risk became statistically significant; the summary SMR of all cancer was 0.95 (0.91-1.00) and the summary rSMR of all cancer was 1.10 (1.04-1.15). The summary SMR of NHL was 1.04 (0.93-1.14) and the summary rSMR of NHL was 1.23 (1.04-1.46). The summary SMR of kidney cancer was 1.08 (0.88-1.33) and the summary rSMR of kidney cancer was 1.23 (1.02-1.49). The summary SMR of liver cancer was 0.88 (0.78-0.99), and the summary rSMR of liver cancer was 0.95 (0.84-1.07). Conclusion: The rSMR method is useful to determine summary risk adjusted for healthy worker effect through meta-analysis.

• Asian Pacific Journal of Cancer Prevention
• /
• 제13권2호
• /
• pp.533-538
• /
• 2012

Background: Tobacco cessation would provide the most immediate benefits of tobacco control to prevent tobacco related disease morbidity and mortality. Methods: A tobacco cessation program involving individual and group behavior therapy was implemented in three stages at a worksite. Tobacco quit rates were assessed at the end of each contact session. Results: Out of the 291 tobacco users identified, 224 participated in the tobacco cessation interventions. At the end of three interventions, 38 (17%) users had successfully quit tobacco use. Presence of clinical oral pre-cancer lesion was found to be associated with quitting (p=0.02). Also tobacco users with oral pre-cancer lesions were around three times more likely to quit than those with no lesions (OR= 2.70 95% C.I= 1.20 - 6.05). Conclusion: Cost effective multi-pronged tobacco cessation approaches, inbuilt into other occupational health and welfare activities, are acceptable and feasible to achieve long term sustainable tobacco cessation programs at worksites.

• 대한임상독성학회지
• /
• 제5권1호
• /
• pp.74-78
• /
• 2007

The carbamates are a group of insecticides derived from carbamic acid, with a broad spectrum of uses as agricultural and household garden insecticides. Carbamate insecticides are reversible cholinesterase inhibitors. Their inhibitory action is mediated by reversible carbamylation of acetylcholine, as with the organophosphate insecticides. Carbamates are absorbed by the body through multiple routes, including inhalation, ingestion, and dermal absorption. Although poisoning can result from occupational exposure or accidental ingestion, in most cases there is suicidal intent. This is particularly true in developing countries, where the highest incidence of morbidity and mortality from this cause occurs. Cardiac complications often accompany poisoning by carbamate compounds, which may be serious and often fatal. The extent, frequency, and pathogenesis of cardiac toxicity from carbamate compounds has not been clearly defined. Possible mechanismsinclude sympathetic and parasymphatetic overactivity, hypoxemia, acidosis, electrolyte derangements, and a direct toxic effect of the compounds on the myocardium. Patients with carbamate poisoning should immediately be transferred to an intensive or coronary care unit where appropriate monitoring and resuscitative facilities are available. We here report a case of acute coronary syndrome resulting from acute carbamate ingestionthat resulted in a healthy discharge.

• 대한치과의사협회지
• /
• 제53권4호
• /
• pp.249-258
• /
• 2015

Snoring and obstructive sleep apnea are the representative sleep disordered breathings, caused by the temporary and repetitive constriction or obstruction of upper airway during sleep. They present with excessively vibratory noise and repetitive cease of respiration. These disorders commonly result in sleep disturbance and the subsequent daytime sleepiness, chronic fatigue. Furthermore, they can cause the serious and extensive complications including increased risk of hypertension, cardiac arrhythmia, cardiovascular disease, cerebrovascular accident, neurocognitive disturbance, traffic and occupational accidents, type II diabetes, childhood growth interruption, awakening headache and finally, relatively increased mortality rate. Because appropriate therapeutic intervention is best way for patients to relieve their symptoms and prevent their possible complications, it is very important for dentists to recognize their own role and responsibility in diagnosis and treatment of these disorders. For this, the present article provides the understanding of the clinical features, possible complications, various treatment modalities, and suitable treatment strategies for snoring and obstructive sleep apnea.