Objective : Subdural hygroma (SDG) is a complication occurring after head trauma that may occur secondary to decompressive craniectomy (DC). However, the mechanism underlying SDG formation is not fully understood. Also, the relationship between the operative technique of DC or the decompressive effect and the occurrence and pathophysiology of SDG has not been clarified. Purpose of this study was to investigate the risk factors of SDG after DC in our series. Methods : From January 2004 to December 2008, DC was performed in 85 patients who suffered from traumatic brain injury. We retrospectively reviewed the clinical and radiological features. For comparative analysis, we divided the patients into 2 groups : one group with SDG after craniectomy (19 patients; 28.4% of the total sample), the other group without SDG (48 patients; 71.6%). The risk factors for developing SDG were then analyzed. Results : The mean Glasgow Outcome Scale (GOS) scores at discharge of the groups with and without SDG were 2.8 and 3.1, respectively (p<0.0001). Analysis of radiological factors showed that a midline shift in excess of 5 mm on CT scans was present in 19 patients (100%) in the group with SDG and in 32 patients (66.7%) in the group without SDG (p<0.05). An accompanying subarachnoid hemorrhage (SAH) was seen in 17 patients (89.5%) in the group with SDG and in 29 patients (60.4%) in the group without SDG (p<0.05). Delayed hydrocephalus accompanied these findings in 10 patients (52.6%) in the group with SDG, versus 5 patients (10.4%) in the group without SDG (p<0.05). On CT, compression of basal cisterns was observed in 14 members (73.7%) in the group with SDG and in 18 members of the group without SDG (37.5%) (p<0.007). Furthermore, tearing of the arachnoid membrane, as observed on CT, was more common in all patients in the group with SDG (100%) than in the group without SDG (31 patients; 64.6%) (p<0.05). Conclusion : GOS showed statistically significant difference in the clinical risk factors for SDG between the group with SDG and the group without SDG. Analysis of radiological factors indicated that a midline shifting exceeding 5 mm, SAH, delayed hydrocephalus, compression of basal cisterns, and tearing of the arachnoid membrane were significantly more common in patients with SDG.
Hyperlipemia is the most leading risk factor of cardiovascular disease which is the main cause of death in Korea. However, there is a tendency to neglect the prevention and treatment since it has no specific symptoms. It has been reported that the level of serum-lipid can be lowered by the improvement of eating habits. Therefore, it is highly likely that the development of programs on the improvement of eating habits through behavioral theory is required to the community nursing practice. The theory of planned behavior, which assumes that human behaviors are determined by one's intention to carry out the behavior, can be characterized by the point that behaviors are not only individual factors but also social behaviors relating to subjective norms. It is widely recognized that this theory has a high predictability on health behavior due to it's simplicity clearness, and measurability as well as high quality of being general. Thus, the theory of planned behavior could be useful in developing a model of a health promotion program to the change of behaviors of the risk group of cardiovascular disease. Consequently, based on the theory of planned behavior, the purpose of this study is to develop an intention promotion program of the diet, and then to testify the effects. The sample of this study consisted of 26 industrial workers who had proved hyperlipemia from a medical examination in 1996 (experimental group 13, control group 13). The intention promotion program, which includes education, monitoring, pressure, counselling on the level of individuals, families and organizations, was conducted for 10 weeks The purpose of this program was to promoting intention of the diet through changes of the prerequisite factors of intention such as behavioral belief, outcome evaluation, normative belief and control belief. When it came to data analysis, the ${\chi}^2$-test and Fisher's Exact test were used to compare the general characteristics between the experimental and the control group, an independent t-test for the other variables. ANOVA was used to the test hypothesis, and the Pearson correlation test for variable's correlation. The results of this study can be summarized as follows ; 1) There was a significant increase in the intention(F=18.51, p=.00) of diet in the experimental group. 2) Diets(F=32.51, p=.001) in the experimental group were better carried out than in the control group. 5) There was a moderate correlation between the intention of diet and performance (r=.587. p=.003). From the results, it can be concluded that the intention promotion program is very effective, leading to the change of health promotion behavior. Above all, it is really valuable that the intention promotion program in this study regards health promotion behavior as a social behavior and that intervention was done on the level of family and organization. Consequently, when performing a health promotion program, social approach elevating the intention should go hand in hand in order to make the program effective.
Journal of Korean Society of Occupational and Environmental Hygiene
/
v.29
no.3
/
pp.298-309
/
2019
Objectives: This study aimed to investigate stages of safety and health culture change through a reflection on 40 years of hearing conservation history at a multinational company. Methods: The target workplaces were multinational companies with more than 1,000 employees. The research used the clinical case study and system analysis methods based on direct observation of the research from 1994 to 2009. The latter method performed an analysis of the equilibrium state of the cross-section in the given period and the longitudinal profile of the change during the given period. Results: The stages of cultural change are divided into five stages and summarized as follows. In the first stage, workplace noise was not widely recognized as a hazard, while in the second stage, the measurement of noise levels and audiometric testing were conducted under the Korean Occupational Safety and Health Act (KOSHA). The driving force for change in the second stage was the amendment of the KOSHA. In the third stage, noise came to be recognized as a hazard factor through awareness training. The driving force of change during the third stage was the strong executive power exerted by the audit of the industrial hygiene program from the US head office. In the fourth step, there was a change to actually reduce noise. The driving force in this stage was a change in company executives' risk perception resulting from lawsuits over noise-induced hearing loss and the task force team activities for culture change based on the action learning protocol. At the fifth stage, a 'buy quiet policy' was institutionalized. The management's experience that noise reduction was difficult was the motivation to manage noise from the time of purchase of equipment. Conclusions: The activities of a hearing conservation program are determined by the improvement of the legal system and by the way it is enforced. Noise control activities to reduce noise areas may be possible through the shared risk perception of noise-induced hearing loss and by a change agent role as a facilitator to implement noise control.
This study aims to improve the safety inspection awareness of occupational exposure and help radiation safety management by analyzing radiation exposure doses by occupational type of radiation related-workers and radiation workers. Radiation-related workers and radiation workers were classified into three occupations (radiological technologist, doctors, and nurses). A nominal risk coefficient based on ICRP 103 was used to calculate the probability of causing side effects of the lungs due to exposure doses. As a result of analyzing the exposure dose of all workers for one year, the exposure dose of radiological technologist among radiation-related workers was 1.63 ± 2.84 mSv, doctors 0.12 ± 0.22 mSv, and nurses 0.59 ± 1.08 mSv. The one-year deep dose for radiation workers was 2.44 ± 3.30 mSv for radiological technologists, 0.19 ± 0.26 mSv for doctors, and 0.12 ± 0.00 mSv for nurses. Due to this dose, the probability of causing side effects in the lungs was 1.2 per 100,000 radiological technologist, 0.096 doctors, and 0.06 nurses. In this study, it is believed that the probability of side effects on lungs by occupation of radiation exposure dose will be studied and used as useful data for radiation safety management in relation to probabilistic effects in the future.
Mei-Fang Cheng;Yue Leon Guo;Ruoh-Fang Yen;Yen-Wen Wu;Hsiu-Po Wang
Korean Journal of Radiology
/
v.24
no.6
/
pp.590-598
/
2023
Objective: To investigate whether the levels of inflammation detected by 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) can predict disease relapse in immunoglobulin G4-related disease (IgG4-RD) patients receiving standard induction steroid therapy. Materials and Methods: This prospective study analyzed pretherapy FDG PET/CT images from 48 patients (mean age, 63 ± 12.9 years; 45 males and 3 females) diagnosed with IgG4-RD between September 2008 and February 2018, who subsequently received standard induction steroid therapy as the first-line treatment. Multivariable Cox proportional hazards models were used to identify the potential prognostic factors associated with relapse-free survival (RFS). Results: The median follow-up time for the entire cohort was 1913 days (interquartile range [IQR], 803-2929 days). Relapse occurred in 81.3% (39/48) patients during the follow-up period. The median time to relapse was 210 days (IQR, 140-308 days) after completion of standardized induction steroid therapy. Among the 17 parameters analyzed, Cox proportional hazard analysis identified whole-body total lesion glycolysis (WTLG) > 600 on FDG-PET as an independent risk factor for disease relapse (median RFS, 175 vs. 308 days; adjusted hazard ratio, 2.196 [95% confidence interval: 1.080-4.374]; P = 0.030). Conclusion: WTLG on pretherapy FDG PET/CT was the only significant factor associated with RFS in IgG-RD patients receiving standard steroid induction therapy.
Kim, Jong Bum;Kim, Kyung Hwan;Choi, Byung-Gil;Song, Kyung Seuk;Bae, Gwi-Nam
Journal of Environmental Science International
/
v.25
no.4
/
pp.505-516
/
2016
With the development of nanotechnology, nanomaterials are used in various fields. Therefore, the interest regarding the safety of nanomaterial use is increasing and much effort is diverted toward establishment of exposure assessment and management methods. Occupational exposure limits (OELs) are effectively used to protect the health of workers in various industrial workplaces. This study aimed to propose an OEL for domestic multi-walled carbon nanotubes (MWCNTs) based on animal inhalation toxicity test. Basic procedure for development of OELs was examined. For OEL estimation, epidemiological study and quantitative risk assessment are generally performed based on toxicity data. In addition, inhalation toxicity data-based no observed adverse effect level (NOAEL) and benchmark dose (BMD) are estimated to obtain the OEL. Three different estimation processes (NEDO in Japan, NIOSH in USA, and Baytubes in Germany) of OELs for carbon nanotubes (CNTs) were intensively reviewed. From the rat inhalation toxicity test for MWCNTs manufactured in Korea, a NOAEL of $0.98mg/m^3$ was derived. Using the simple equation for estimation of OEL suggested by NEDO, the OEL of $142{\mu}g/m^3$ was estimated for the MWCNT manufacturing workplace. Here, we used test rat and Korean human data and adopted 36 as an uncertainty factor. The OEL for MWCNT estimated in this work is higher than those ($2-80{\mu}g/m^3$) suggested by previous investigators. It may be greatly caused by different physicochemical properties of MWCNT and their dispersion method and test rat data. For setting of regulatory OELs in CNT workplaces, further epidemiological studies in addition to animal studies are needed. More advanced technical methods such as CNT dispersion in air and liquid should be also developed.
Journal of the Korea Society of Computer and Information
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v.26
no.8
/
pp.83-90
/
2021
In this paper, effects on industrial accident prevention based on better safety and health environment by utilizing ergonomics expert were studied. This study was mainly based on the data from 'the survey for occupational safety and health trend' conducted by Occupational Safety and Health Research Institute. The number of industries participated in the survey was 2,084. Main results of the study were as follows; 1) Only 22.9% of the industries participated in the survey utilized ergonomics expert. The rest of the industries have never had an ergonomics expert due to the reasons such as lack of knowledge for the field of ergonomics, etc. 2) Specific activities done by the industries with ergonomics expert in order to have better safety & health were 'providing work orders'(94.8%), 'providing monitoring guidelines'(85.5%), 'providing information for dangerous work'(95.8%), 'providing safety education'(96.6%), and 'other safety management'(94.1%). 3) When the odds ratio for the levels of communication and the levels of environmental stability regarding safety & health for the different groups(with experts and without experts), it was found that the group with ergonomics experts had a significant higher ORs(2.391, 95% confidence interval(1.949-2.932) and 2.128, 95% confidence interval(1.786-2.537)) respectively than those of the industries without ergonomics expert. The results suggested that ergonomics expert has been unique in most of time in terms of his/her contributions in the field of industrial safety and health.
Journal of the Korea Institute of Building Construction
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v.19
no.2
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pp.185-192
/
2019
Construction has been well known as the industry in which accidents occur more often than other industries. The efforts to eliminate the accidents at construction sites need to be continuously conducted because they tend to cause the social problems such as massive loss of life and property. According to the Korea Occupational Safety and Health Agency (KOSHA), 26,570 (29.3 percent) out of 90,656 workers in total industrial accidents have been occurred in the construction industry in 2016. Particularly, the falling victims are the largest number, which is about 8,699. This number is increasing due to the increase of the large scale, high-rise, and complex construction structures and the various construction methods. In reality, there is a lack of analysis on the risk factors of safety accidents and preventive measures. Therefore, in this study, we have selected risk factors by analyzing the accident cases at construction sites. Based on the results, we conducted a safety practitioner-focused survey and had an interview with safety managers. In analyzing the cases, we have categorized them into three groups such as upper, middle, and lower and compared their statistical results. This study are expected to provide safety management guidelines with workers and safety managers to prevent previously fall accidents at construction site.
You, Are-Sun;Hong, Soonsung;Lee, Je Bong;Lee, Seungdon;Ihm, Yangbin
The Korean Journal of Pesticide Science
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v.18
no.4
/
pp.342-349
/
2014
Methods of establishment of AOEL (Acceptable Operator Exposure Level), application of oral absorption by country, and calculation of exposure dose for operator risk assessment in USA, EU and Korea were investigated. Oral absorption of 141 active substances for pesticides was also investigated, then operator risk assessment was conducted with AOEL including oral absorption and Korean AOEL. Internal dose converted to external dose with oral or dermal absorption in USA and EU, but external dose to which oral absorption was not applied was used for establishment of AOEL in Korea. Oral absorption of 50 active substances among 141 were below 80%. In case of application of oral absorption as a correction factor in below 80%, AOELs of about 36% active substances were considered to be lower than the current Korean AOELs. Operator risk assessment of 28 active substances among 50 active substances with oral absorption below 80% was conducted with EU AOELs. TER (Toxicity Exposure Ratio) of 12 plant protection products including chlorothalonil WG (Water-dispersible Granule) was less than 1 and the risk was high. Operator risk assessment of 24 active substances among 50 active substances with oral absorption below 80% was conducted with Korean AOELs. TER of 6 plant protection products including chlorothalonil WG were less than 1 and the risk was high. Operator risk assessment of 4 plant protection products not having Korean AOEL was conducted with converted EU AOEL into AOEL not including oral absorption. The results indicated TER of 4 products including daminozide WP (Wettable Powder) was over 1 and risk was low. 22 products except 6 products such as oxadiagyl SC (Suspension Concentration) were shown the same results of risk assessment between EU AOELs and Korean AOELs. As a result, it was considered that AOELs including oral absorption was possible to be used for operator risk assessment. It was considered operator risk assessment with AOEL including oral absorption was more like real assessment method, and improvement of assessment was needed for application to evaluate pesticides in registration.
Pesticide risk assessment for pesticide operators as well as for consumers has become one of the pesticide regulatory tools to reduce any unreasonable adverse health effects from pesticide use. The risk for pesticide operators can be quantified by comparing the acceptable operator exposure level(AOEL) with exposure level during pesticide application. This study is to evaluate the risk of benzimidazole fungicides application worker. The exposure level of pesticide applicators were calculated using Japanese operator exposure study tested with EPN 45% EC. The AOELs for pesticides were obtained dividing relevant lowest no observed abuse effect levels(NOAELs) for the exposure scenario into uncertainty factor, 100. For the non-cancer and cancer occupational risk assessment, $Q_1^*$ produced by US/EPA and life time average daily dose(LADD) calculated from average daily dose(ADD), treatment days per year, worked years for life time were used. Operator exposure for benzimidazole fungicides application were benomyl 0.2, carbendazim 0.36 and thiophanate-methyl 0.42 mg/kg/day. Short-term AOELs for benomyl, carbendazim and thiophanate-methyl were 0.3, 0.1, and 0.2 mg/kg/day, and long-term AOEL were 0.025, 0.025, 0.08 mg/kg/day, respectively. LADDs were benomyl 0.0038, carbendazim 0.0067, thiophanate-methyl 0.0081 mg/kg/day. The ratios of exposure to AOEL were $0.28{\sim}1.5$ for short-term and $3.73{\sim}9.88$ for long-term. Cancer risk for operator were $9.12{\times}10^{-6}$ for benomyl, $1.61{\times}10^{-5}$ for carbendazim and $1.13{\times}10^{-4}$ for thiophanate-methyl by the standard application scenario. The result showed 3 fungicides exceed the risk criteria, $1.0{\times}10^{-6}$. The above risk assessments were based upon conservative assumptions and therefore are believed to be protective of the applicator. To refine the risk at the more actual conditions, further risk assessment with more realistic data would be needed.
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