• 핵의학기술
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• 제13권3호
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• pp.110-122
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• 2009

목적: 최근 의료기관평가제도는 의료의 질에 대한 병원들의 관심을 높게 하고 그것을 향상시키기 위한 활동을 활발히 전개하고 있다. 또한 추가된 항목인 환자의 위험관리에 대해서도 많은 관심을 보이고 있다. 의정부성모병원 핵의학과는 2008년도 PET/CT도입으로 시작된 부서내 리모델링은 과내 구조 및 업무 프로세스에 많은 변화를 가져왔다. 따라서 변경된 구조와 기존의 업무 처리방식은 미처 알지 못하는 위험요인을 내포하게 되었다. 그러므로 영상 검사 과정에서 발생할 수 있는 위험요인을 다각도로 찾고 분석하여, 부서의 특수한 환경에 맞는 위험관리 프로세스와 위험요인 제거업무를 포함한 개선 활동을 목적으로 한다. 실험재료 및 방법: 핵의학과의 새로워진 프로세스를 다각도로 분석하여 첫째, 위험관리 응대메뉴얼을 제작하여 교육후 실제 업무에 적용한다. 결과분석은 전년도 위험사고 발생건수와 개선활동 후 위험사고 발생건수를 비교하였다. 둘째, 위험관리 홍보동영상은 제작 후 검사전 해당 환자에게 상영하였고 그 후 자체 제작된 설문지로 해당 환자 100명에게 만족도 조사를 하였다. 셋째, 위험요소를 개선할 수 있는 시설물 참여형 개선활동을 통해서 위험요소를 제거하였다. 결과: 안전사고 발생건수는 개선활동이후 PET/CT와 감마카메라 영상 검사 모두 검사건수대비 투약오류, 낙상, 충돌 등의 안전사고가 0건으로 조사되었다. 설문조사 결과는 동영상 상영 후 검사진행과정 이해 74%, 불안감해소 81%로 "만족한다"는 결과가 조사되었다. "위험요소에 대해 주의했습니까?" 라는 물음의 경우 PET/CT는 94%, 감마카메라는 89%가 주의했다는 결과로 조사되었다. 개선활동을 통해서 핵의학과내에서의 고객위험관리를 효과적으로 수행할 수 있었다. 결론: 본 개선활동을 통하여 영상 검사 시 산재된 위험요소를 체계적으로 나열하고 분석하는 계기가 되었다. 또한 안전사고에 대처하는 방사선사의 업무방법에서도 기준이 되는 응대메뉴얼을 적용시킨다면 안전사고의 최소화와 안전사고시 체계적인 피드백이 가능함을 알 수 있었다. 위험요소를 알려주는 방법론적인 부분에서도 일상생활에서 쉽게 접할 수 있는 시청각자료로 제공 되었을 때 보다 효과적이였다. 따라서 이런 활동이 지속적이고 세부화 된 업그레이드 작업을 통해서 환자들에게 제작되어 제공된다면 핵의학 검사 이용의 안전성과 편리성에 도움을 줄 수 있으리라 생각된다.

• 한국학교보건학회지
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• 제9권1호
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• pp.55-67
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• 1996

This research has incorporated a postal survey from the principals, nurse-charging teachers and nurse-teachers of the fiftyfive elementary, middle and high school in Yang-pyeong county area where its supplementary rate of nurse-teachers is less than adequate. It is to analyse the current status of the school health service in the area and to come out with a plan to improve the school health program through the participations of the health related experts of the local community. The survey was done in the two months of period of April to May of 1994. The result of the survey follows. The student population in the Yang-pyeong county area is 13,998 and the school employee population is 904 which counts for about 19.2% of the whole population of the area. However, the supplementary rate of nurse-teachers is only 10.8% (4 in 55 schools) which is very low in terms of relativity. School health committee only exist in 17% of the whole number of schools in the area and 50 of school health committee answered that their activity do not meet the adequate level. Only 54. 3% of the whole school numbers has included the school health finance in their financial plans and the amount set for the school health finance is about 500,000 wons (100,000-1,600,000 wons). 64.9% of the schools in the Yang-pyeong county area have the permanent nursing room established in the school. But, often than the equipment for a simple physical examinations, their supply of the health related equipments are less than adequate. Particitations of school doctor in the school health service is at only 67.6% which pretty much include only the physical examinations. Nurse-charging teachers consider their utmost important role is to teach health education but, they answered that they spent most of their times and efforts on physical examinations & immunizations. The average number of students visition to the nursing room is 2.5 persons and complains for basic discomfort as headache, concussion, stomachache and indigestion problems and usual pills used are the analgesics and digestives. Physical examination is done in the most schools every year but, 51.4% of nurse-charging teachers answered the physical examination does not really help. About the emergency treatment ability, 75.7% reports that both manpower & equipment are short. The school food services are present in only 8 schools (21.6%) but, 89.2% of nurse-charging teachers answer that there is a definite need of the food service. The survey says that the utmost important environmental health and safety factors are the traffic accidents followed by improper heat system, lighting, the stools and desks that do not consider the student physical status The overall evaluation of school health program reports that there are adequate physical examination, immunization, environmental hygiene, and management of safety but, on the other hand, health education, health councelling & management of nursing room are not managed properly. The principals of the survey pool report shortage of public agency support, lack of understanding of school health, shortage of nursing equipments and school health finance as the barrier factors of school health. The nurse-charging teachers report on the same questions as their less than qualitifying expertise, extraload of work upon the nursing affairs, shortage of nursing equipments & school health finance. The head masters & nurse-charging teachers answered that they are desperate for the meetings of nurse-charging teachers, construction of school health councelling system & training education in order to improve school health and if these are available, they will actively participate in them. After the careful analysis of the survey result, it is apparent that through the relations of the manpowers, establishment of community-oriented school health is definitely in need in rural area where there is low supplementary rate of nurse-teachers and poor school health environment.

• Korean Chemical Engineering Research
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• 제55권2호
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• pp.190-194
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• 2017

사업장에서 화재 및 폭발을 예방하기 위해서는 연소특성치로 인화점, 폭발한계, 최소자연발화온도 등을 들 수 있다. 화학공정의 안전을 위해서 취급 물질의 정확한 물질보건안전자료(MSDS)의 연소특성치 사용은 매우 중요하다. 화학산업에서 다양하게 사용되고 있는 벤질알코올의 안전한 취급을 위해서 인화점과 최소자연발화온도를 측정하였다. 벤질알코올의 폭발하한계는 실험에서 얻어진 하부인화점을 이용하여 계산하였다. 벤질알코올의 Setaflash 밀폐식은 $90^{\circ}C$, Pensky-Martens 밀폐식에서는 $93^{\circ}C$ 그리고 Tag 개방식에서는 $97^{\circ}C$, Cleveland 개방식에서는 $100^{\circ}C$로 측정되었다. ASTM E659 장치에 의한 측정된 벤질알코올의 최소자연발화온도는 $408^{\circ}C$로 측정되었다. Setaflash 밀폐식에 의해 측정된 벤질알코올의 하부인화점 $90^{\circ}C$의 폭발하한계는 1.17 vol%로 계산되었다. 본 연구에서는 Setaflash 밀폐식에 의해 측정된 벤질알코올의 하부인화점을 이용하여 폭발하한계의 예측이 가능하였다.

• 한국산업융합학회 논문집
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• 제26권5호
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• pp.757-763
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• 2023

Major industrial accidents in which workers die due to fires or explosions while working at chemical substance handling workplaces continue to occur. Among the major industrial accidents that occurred between 2005 and 2021, the accident status by work situation and equipment was analyzed. Through analysis, it was confirmed that storage, reaction, and piping facilities were the main causes of the accident, and a self-checklist for each facility was developed. Verification was conducted through the supply and use groups to evaluate the suitability of the use, duties, and items of the self-checklist. The user group showed higher satisfaction than the supplier group for all three suitability of use, job, and item. In particular, since the inspection items of the self-checklist were organized around the cause of the accident derived through the analysis of actual accident cases, the satisfaction level was high in all groups. It is expected that the self-checklist developed through this study will be useful not only for large companies but also for small and medium-sized chemical industries that lack professional manpower.

• 한국지역사회생활과학회지
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• 제18권1호
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• pp.87-95
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• 2007

This study was to determine the effect of cooling parts of the limbs without harm to health. The results provide basic data for the development of clothing which could increase work efficiency and reduce body strain in hot environments. Five male adults took part in the study, conducted in a climate chamber with an ambient temperature of $37^{\circ}C$ and a relative humidity of 50%. The limbs were divided into six areas to be cooled: upper arm, forearm, thigh, calf, hand, and foot. According to preceding studies, permissible cooling safety limits of skin temperature for each part of the body for one-hour were $20^{\circ}C$ on the upper arm, forearm, thigh, and calf, and $23^{\circ}C$ on the hand and foot. For this reason, cooling the skin of each region was carried out at the above mentioned temperatures. In conclusion, cooling the hand and foot reduced perspiration, rectal temperature and heart rate. Therefore, the heat stress of workers exposed to hot environments would be reduced by decreased subjective sensations of heat and increased comfort. The effectiveness of cooling was better on the arm than on the leg.

• 대한임상검사과학회지
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• 제55권3호
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• pp.159-166
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• 2023

본 연구에서는 진단검사를 수행하기 위해 가장 중요하다고 할 수 있는 채혈 업무에 대한 임상병리사의 현 상황을 알아보고, 이를 통해 채혈 업무에 대한 행위료의 보험 수가 산정 및 상대 가치점수 부여를 통한 임상병리사의 권익을 향상시키고자 하였다. 부산·울산·경남 지역의 병원에서 근무하고 있는 임상병리사를 대상으로 설문조사를 실시하였고, 총 650명의 임상병리사를 대상으로 연구를 수행하였다. 연구결과 1명의 임상병리사가 약 100명의 피검자를 대상으로 채혈 업무를 수행하는 것을 확인할 수 있었다. 채혈 실패 건수는 하루에 1건 이상 실패하는 것을 확인할 수 있었고, 통증 호소 환자 및 이를 통한 민원 발생은 1년간 1건 이상 발생하여 검사자의 부담감이 높은 것을 확인할 수 있었다. 사용한 바늘에 채혈자가 찔리는 경우도 1년간 1건 이상 발생되고 있고, 자상으로 인한 감염관리 진료 및 치료를 받은 경우도 약 15% 발생되고 있음을 확인하였다. 채혈 업무로 인한 근골격계 질환 발생 및 정신적 스트레스를 받는 비율은 절반 이상의 인원이 받는 것을 확인할 수 있었다. 현재 같은 주사침을 이용한 정맥 및 근육 주사와는 달리 채혈 업무에 대한 행위료는 없는 상황이기 때문에, 이러한 연구 결과를 기반으로 채혈 업무에 대한 행위료 산정 및 상대 가치점수 부여를 통해 임상병리사의 안전 및 권익을 향상시킬 수 있을 것으로 사료된다.

• 대한수사과학회지
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• 제1권2호
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• pp.44-56
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• 2006

The reform necessity of medicolegal death investigation system is continuously issued. The problems from the current death investigation system are discussed, specially on the professionalism of the involved personnel such as policemen, doctors, prosecutors. Death investigation exists not only to prosecute the criminals but also primarily to protect the general public's health, safety, and welfare. The reform proposals of death investigation system are followed as below. Statutes require that the prosecutor be notified of certain deaths. All deaths that may reasonably result from anything other than natural disease should be investigated. A death certificate is a legal document which authenticate a death, therefore it is issued by the doctor. The postmortem examination must be rearranged on the university base and performed by the qualified doctors who are trained at least in pathology. The police officer specified in death investigation and forensic identification should be encouraged to keep doing their special work in many ways.

• Journal of Trauma and Injury
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• 제36권4호
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• pp.385-392
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• 2023

Purpose: This study investigated the epidemiology, management, outcomes, and postoperative disabilities of degloving soft tissue injuries (DSTIs) treated at a tertiary care center in northern India. Methods: A prospective study of patients with DSTIs was conducted over 15 months. The type of degloving injury, the mechanism of injury, and any associated injuries were analyzed using the World Health Organization Disability Assessment Schedule (WHODAS) 2.0 along with the management, outcomes, and disabilities at a 3-month follow-up. Results: Among 75 patients with DSTIs, the average age was 27.5 years, 80.0% were male, and 76.0% had been injured in traffic accidents. The majority (93.3%) were open degloving injuries. Lower limbs were affected most often (62.7%), followed by upper limbs (32.0%). Fractures were the most commonly associated injuries (72.0%). Most patients required more than two procedures, including secondary debridement (41.3%), split skin grafting (80.0%), flap coverage (12.0%), or vacuum-assisted closure (24.0%), while five patients underwent conservative management for closed degloving injuries. Postoperative complications included surgical site infections (14.7%) and skin necrosis (10.7%). Two patients died due to septic shock and multiple organ dysfunction syndrome. The mean length of hospital stay was 11.5±8.1 days, with injuries affecting the lower limbs and perineum requiring longer hospital stays. The mean WHODAS 2.0 disability score at 3 months was 19. Most patients had mild disabilities. Time away from work depended largely upon the site and severity of the injury. Approximately 75% of patients resumed their previous job or study, 14% changed their job, and 8% stopped working completely due to residual disability. Conclusions: DSTIs are common injuries in trauma and management is challenging. Although open DSTI are clinically evident at secondary survey, closed degloving injuries may be missed in the primary survey, necessitating a high index of suspicion, thorough clinical examination, and protocol-based management. Primary preventive strategies (e.g., road safety protocols, preplacement training, and proper protective equipment in industries) are also needed to reduce the incidence of these injuries.

• 지역사회간호학회지
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• 제1권1호
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• pp.299-317
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• 1989

This study was attempted to find out the distribution of industrial nurses, analyze job performance by function and utilization state of medical dispensary among workers. The subjects for this study were 32 nurses working at industry located in Kyungpook and Taegu area. The data was collected through questionaire during the period of August 5-31, 1986, and analysed by the method of frequency and percentage. The following is the main findings of the study; 1. 72.2% of respondents was engaged in manufacturing industry, 33.3% in workplace whose regular workers was more than 2,000 workers. 67.7% in occupational health physicians was part-time system. 2. 93.1% of respondents was 20-29 years age group, 93.1% was graduates of junior nursing college, 96.6% was unmarried. 448% had 1-4 years of total working experiences. 3. For the motives which made them becomes industrial health nurse, 'good employment condition' was 62.1%. For the job satisfaction, 'moderate' was 586%. For the interest about the industrial health, 'moderate' was most frequent (58.6%). In the inservice education, 86.2% of the subjects was received education. 4. For the attitude of the dispensary and industrial nursing of employer, 'necessary' was most frequent (72.4%, 62.6%). 5. All establishment had dispensary facilities, 65.5% of them had independent dispensary. 6. In duty shift, 93.1% of respondents was working in one shift system. 41.4% of respondents was received from 250,000 won to 290,000 Won and 41.4% was belong to personnel section and 24.1% was direct controlled by general business section chief. 7. In the main health problem of their factories, 48.3% of respondents was work-environmental state, 24.1% was health education. 8. In the Dispensary budget, 60% of respondents was under 3,000 won per worker. 9. In the job performance rate by function, nursing service 73.1%, industrial health and nursing management 63.7%, environmental hygiene and safety management 54.5%, medical insurance 44.9%, welfare 38.4%. 10. Main health complaints among workers utilizing medical dispensary was 35.9% of respiratory system, 21.5% of gastro-intestinal system, 11.0% of skeletomuscular system.

• Journal of Preventive Medicine and Public Health
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• 제28권1호
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• pp.103-121
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• 1995

교대작업이 근로자의 육체적, 정신적 및 사회적 건강에 미치는 영향을 조사하고자 1993년 5월 한 달간 경상남도 울산시 소재 모 자동차 공장 생산직 근로자 659명(교대작업자 : 544, 주간작업자 : 115)을 대상으로 설문조사 및 면접조사를 실시하였다. 조사시점에서 현재 교대작업을 하고 있으며 자신의 근무기간 중 80% 이상을 교대작업에 참여한 근로자를 지속적인 교대작업자로 간주하였으며, 조사 당시 교대작업에 참여하고 있지 않고 과거에도 교대 작업에 참여한 경험이 전혀 없었던 근로자룰 주간작업자로 하였다. 교대작업군과 대조군의 일반적인 특성 및 작업과 관련된 특성은 자기기입식 설문지를 이용하여 조사하였으며, 교대작업에 관련된 내용은 면접을 통한 자기기입식 설문지를 이용하여 조사하였다. 근로자의 수면양상과 식사형태에 관한 설문은 National Institute for Occupational Safety and Health에서 개발된 항목을 이용하여 조사하였으며, 위장관계질환의 자각증상에 관하여서도 자기기입식 설문지를 이용하여 조사하였다. 근로자의 일반적인 안녕 상태와 장해는 미국의 Health and Nutrition Examination Survey에서 개발된 자기기입식 설문인 General Well-Being Schedule(GWB)에 의해 측정되었다. 교대작업자에서 자신이 원하는 수면시간보다 1시간 이상 수면이 모자란다고 호소한 근로자가 56.8%로 주간작업군의 50.0%보다 높았으며, 수면 중 2회 이상 잠을 깨는 근로자의 비율, 잠에서 깨었다 다시 잠들기가 힘들다고 호소한 근로자의 비율, 일주일에 2일 이상 작업 중 피곤하거나 졸리다고 호소한 근로자의 비율, 일주일에 2일 이상 작업이 끝난 후에도 피곤하거나 졸리다고 호소한 근로자의 비율은 주간 작업자보다 교대작업자에서 현저하게 높았으며(p<0.01), 교대작업자에서 자고 일어난 후에도 피로감을 호소하는 율도 교대작업군에서 53.1%로 주간작업자의 40.0%보다 높았다(p<0.05). 수면의 형태를 보면 교대작업자에서는 각 교대작업 때마다 다른 형태의 수면을 취하는 근로자가 35.9%로 가장 많은 비율을 차지하였으며, 잠을 잘 못 잔다고 호소하는 근로자도 12.3%로 주간작업자의 6.1%보다 훨씬 많은 비율을 차지하였다. 잠을 자기 위해 약물을 상습적으로 복용하는 근로자도 주간작업자에서 1.7%, 교대작업자에서 2.8%를 차지하였다. 교대작업자들과 주간작업자는 다른 형태의 식사형태를 보였으나 유의한 차이는 없었으며, 식욕은 주간작업자의 13.0%에서 아주 좋다라고 응답한 반면 교대작업자에서는 6.6%만이 식욕이 아주 좋다라고 응답하였으며, 식욕이 매우 나쁘다라고 응답한 비율도 5.0%로 주간작업자의 2.5%보다 높았다. 교대작업자와 주간작업자의 위장관계 자각증상 호소율은 교대작업군에서 높았으며(p<0.01), 배변습관의 변화와 체중감소 호소율도 교대작업자에서 주간작업자에 비해 유의하게 높았다(p<0.05). 근로자의 일반적인 안녕 상태와 장해는 HANES I에서 개발된 General Well-Being Schedule(GWB)에 의해 측정되었는데 불안척도, 우울척도, positive well-being척도, 활력척도에서는 교대작업군에서 통계적으로 유의하게 낮았으며(p<0.05). 자기제어력척도, 일반건강척도도 교대 작업자에서 낮았으나 유의한 수준은 아니었다. 이상의 결과를 종합해 볼 때, 교대작업자에서 생체리듬의 부조화로 인한 수면, 식사, 위장관계장해 등의 일련의 자각증상에 대한 호소율이 주간작업자에 비해 전반적으로 높았으며, 일반적인 건강 장해 호소율도 교대작업자에서 높았다.