• 농촌의학ㆍ지역보건
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• 제27권2호
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• pp.35-54
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• 2002

보건기관에 근무하는 치과위생사의 직무실태, 직무만족도, 그리고 향후 직무개선 방안을 알아보기 위하여 경상북도 보건소 및 보건지소에 근무하고 있는 치과위생사 전원(203명) 대상으로 2002년 4월에 설문조사를 실시하였다. 타부서에 비해 업무량이 많다고 응답한 대상자는 52.2%였고, 보수 수준에 대하여는 61.6%가 보통, 36.5%는 만족한다고 하였다. 대상자의 73.9%가 업무에 대해 긍지와 보람을 느낀다고 하였고, 32.0%가 전직의사가 있다고 응답하였는데, 전직의사 이유로는 승진기회의 부족이 가장 높았다. 대상 치과위생사의 47.3%가 직무교육에 참여한 경험이 있었고, 19.2%가 특수사업에 참여한 경험이 있었다. 치과위생사가 공무원계급에 6급직이 없는 이유에 대해서는 60.6%가 타직렬의 견제 때문이라고 응답하였다. 보건기관에서 타업무에 종사하는 치과위생사에 대해서는 53.7%가 구강업무에 종사하도록 해야 한다고 하였고, 치과의사가 배치되어 있지 않은 지역의 치과위생사에 대해서는 61.9%가 치과질료실을 구강보건실로 전환하여 구장질환 예방사업에 종사하도록 하여야 한다고 하였다. 보건기관의 유휴 치과장비에 대해서는 89.1%가 지역실정에 맞게 치면세마사업에 활용하야야 한다고 하였다. 보건기관 근무 치과위생사외 구강보건업무 담당시간은 전체 업무시간의 57.8%를 차지하였고, 투입시간 비율은 치과실내에서의 치과진료업무가 41.6%로 가장 많았다. 구강보건업무 중 가장 중요하게 다루어야 할 업무로는 구강보건실 내에서의 구강보건업무 학교구강보건사업, 수직적 구강보건사업 순이었다. 보건기관에서의 구강보건 업무를 수행하는데 문제점으로는 공중보건치과의사의 부족으로 치과위생사 고유 업무에 종사 하지 못함, 구강보건사업에 대한 관심부족, 예산 및 인력부족 순이었다. 개선방안으로는 보건복지부와 도에 치과위생사 배치, 인력 및 예산확보 등이었다. 이상의 결과, 보건기관 근무 치과위생사의 효율적인 활용방안이 강구되어야 하겠는데, 타업무에 종사하고 있는 치과위생사의 재배치를 통해 구강보건업무에 종사하도록 하여야 하겠고, 치과위생사의 업무를 치과진료실 내에서의 진료보조 업무에서 구강보건교육과 예방진료 등으로 전환하는 것이 필요하겠으며, 공중보건 치과의사 미배치지역에 대해서는 지역설정에 맞게 치과 진료실을 구강보건실로 전환하여 구강보건사업에 활용하도록 하여야 하겠다. 또한 치과위생사익 전문성 제고를 위하여 직무교육, 연구사업, 특수사업 등의 참여 기회를 확대 부여하도록 하여야 하겠고, 치과위생사에 대한 6급 승진 기회 부여와 시 도에 구강보건 담당부서 설치 및 치과위생사 배치도 고려되어야 할 것이다.

• 한국직업건강간호학회지
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• 제6권1호
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• pp.23-43
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• 1997

The work-related diseases due to continuous overwork are mainly cerebro- and cardio-vascular ones, which is commonly called 'Karoshi', death from overwork. Many factors are capable for Karoshi : occupational stress in relation to technological renovation and industrial rationalization, competitive social structure, and accumulated fatigue accured to long time or irregular working. And its occurence is on the rise. The World Labor Report 1993 released by ILO, pointed out the diseases related to overwork and stress as one of the most important occupational health problem. In Korea, social awareness of Karoshi is at an infant stage, and reliable statistics for its occurence are not compiled in a convenient manner. Despite the rising Karoshi, there are no reliable clauses in workmen's compensation enough to settle down the disputes. Therefore, it is not uncommon that the Labour Ministry and Civil Court find difficulties in reaching an agreement. This study was intended to provide proper compensation and prevention program for workers by suggesting reasonable compensation clauses for the death from overwork. This study consists of two comparative reviews on the compensaton clauses for the death from overwork. One is to review legal standards of Karoshi among three countries, such as Korea, Japan and Taiwan. The other is to investigate the cases of Karoshi in Korea, 121 cases identified at the Labor Welfare Corperation and the Labour Ministrial process of examination and reexamination, and 73 leading cases at the High Court of Justice. The main findings of the study are as follows : 1. Comparisons of comperative review on compensation clauses for the death from overwork among three countries. 1) All of three countries have the same kinds of disease for compensation, which were cerebro-and cardiao-vascular diseases, while for cardiac disease group, Korea has the smaller number of diseases for compensation than Japan. 2) As for the definition of overwork, the three countries share equally that overload for one week prior to collapse is considered as an important factor, but accumulated chronic fatigue is disregarded. 3) As the basis of overwork, in Japan, there is a tendency to move from the conditions of an ordinary healthy adult to those of the individual concerned in Japan, whereas there is no such concern yet in Korea. 4) All the three countries use a common standard of medical judgement in demonstrating causal relationship between a job and a disease. However, Korea is progressive in the sense that in the case of CVA at worksite, the worker himself has no obligation to prove the cause. 2. The results of a comparative review on excutive decisions by Labor Ministry and judicial decisions by the Court in Korea : A judicial decision is based on the legalistic probability, but a excutive decision is not. Therefore, excutive decisions have such restrictions that : 1) TIA (transitory ischemic cerebral attack) and myocarditis are excluded from compensation, and there is little consistency of decision in the case of cause-unknown death. 2) There is a tendency not to compensate for the death from overwork since the work terms such as repeated long-time working, shift work or night-shift work are not considered as overloading. 3) There is a tendency to regard the conditions of a ordinary healthy adult rather than those of the individual concerned(age, existing diseases, health state, etc.) as the comparative basis of overload. 4) There remains a tendency not to compensate for the death from overwork in the case of collapse occuring out of workplace, on the ground of 'on the course of working' and 'in the cause of accident'. Through the study, the fact manifests itself that Korea's compensation clauses for work-related diseases due to overwork are very restrictive. So, it is necessary to extend the Labor Ministry's clauses of compensation for the death from overwork following to the recent changes of other countries and internal judicial decisions. This is very important in the perspective of occupational health that aims at health promotion of workers including prevention of the Karoshi.

• 한국산업보건학회지
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• 제9권1호
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• pp.56-72
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• 1999

Airborne concentrations of welding fumes in which 13 different metals such as Al, Cd, Cr, Cu, Fe, Mn, Mo, Ni, Pb, Si, Sn, Ti, and Zn were analyzed were measured at 18 factories including automobile assembly and manufactures, steel heavy industries and shipyards. Air samples were collected by personal sampler at each worker's worksite(n=339). Blood levels of Cd, Cu, Fe, Mn, Pb and Zn were also measured from samples taken from 447 welders by atomic absorption spectrometry and compared with control values obtained from 127 non-exposed workers. The results were as follows ; 1. Among various welding types, $CO_2$ welding 70.2 % were widely used, shielded metal arc welding(SMAW) 22.1 % came next, and rest of them were metal inert gas(MIG) welding, submerged arc welding(SAW), spot welding(SPOT) and tungsten inert gas(TIG) welding. 2. Welding fume concentration was $0.92mg/m^3$($0.02{\sim}15.33mg/m^3$) at automobile assembly and manufactures, $4.10mg/m^3$($0.02{\sim}70.75mg/m^3$) at steel heavy industries and $5.59mg/m^3$($0.30{\sim}91.16mg/m^3$) at shipyards, respectively, showing significant difference among industry types. Workers exposed to high concentration of welding fumes above Korean Permissible Exposure Limit(KPEL) amounted to 7.9 % and 12.5 %, in $CO_2$ welding and in SMAW at automobile assembly and manufactures and 62.7 % in $CO_2$ welding, and 12.5 % in SMAW at shipyards, and 66.2 % in $CO_2$ welding and 70.6 % in SMAW at steel heavy industries. 3. Geometric mean of airborne concentration of each metal released from welding fumes was below one 10th of KPEL in all welding types. Percentage of workers, however, exposed to airborne concentration of metals above KPEL amounted to 16.8 % in Mn and 7.6 % in Fe in $CO_2$ welding; 37.5 % in Cu in SAW, 30 % in Cu in TIG; and 25 % in Pb in SPOT welding. As a whole, 76 Workers(22.4%) were exposed to high concentration of any of the metals above KPEL. 4. There were differences in airborne concentration of metals such as Al, Cd, Cr, Cu. Fe. Mn, Mo, Ni, Pb, Si, Sn, Ti and Zn by industry types. These concentrations were higher in shipyards and steel heavy industries than in automobile assembly and manufactures. Workers exposed to higher concentration of Pb above KPEI amounted to 7.4 % of workers(7/94) in automobile assembly and manufactures. In shipyards, 19.2 % of workers(19/99) were over-exposed to Mn and 7.1 % (7/99) to Fe above KPEL. In steel heavy industries, 14.4 %(21/146), 7.5 %(11/146) and 13 %(19/146) were over-exposed to Mn, Fe and Cu, respectively. As a whole, 76 out of 339 workers(22.4%) were exposed to any of the metals above KPEL. 5. Blood levels of Cd, Cu, Fe, Mn, Pb, and Zn in welders were $0.11{\mu}g/100m{\ell}$, $0.84{\mu}g/m{\ell}$, $424.4{\mu}g/m{\ell}$, $1.26{\mu}g/100m{\ell}$, $5.01{\mu}g/100m{\ell}$ and $5.68{\mu}g/m{\ell}$, respectively, in contrast to $0.09{\mu}g/100m{\ell}$, $0.70{\mu}g/m{\ell}$, $477.2{\mu}g/m{\ell}$, $0.73{\mu}g/100m{\ell}$, $3.14{\mu}g/100m{\ell}$ and $6.15{\mu}g/m{\ell}$ in non-exposed control groups, showing significantly higher values in welders but Fe and Zn.

• Journal of Preventive Medicine and Public Health
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• 제29권4호
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• pp.733-746
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• 1996

연 업종별 보건관리 대행기관에 의해 근로자의 보건 관리를 하고 있는 5개 연 축전지 회사의 전체 근로자들 중 1995년에 일반 건강진단 및 특수 건강진단을 동시에 시행한 전체 1,919명의 근로자 중에서 C(건강관리 상 계속 관찰이 필요한자)와 D(유소견자)의 판정을 받은 365명의 근로자들을 대상으로 하여 이들 중 퇴직자 35명, 조사 기간중 출장, 휴직 및 야간 근무자 8명, 그리고 조사에 응하지 않은 근로자 29명 등 총 72명을 제외한 293명을 대상으로 설문 및 1995년도 일반 및 특수 건강진단 결과표를 통하여 건강진단 결과에 따른 사후관리 조치실태 및 관련 요인들을 조사하였다. 결과를 요약하면 다음과 같다. 1. 요주의자 이상근로자의 86%가 건강진단결과표를 받았으나 이에 대한 교육설명이 제대로 이루어지지 않았고, 자신의 건강진단 결과를 잘 알고 있지 못하였다. 2. 사후관리 조치가 있었던 근로자는 23%로 낮았으며, 사후관리조치의 내용은 단순한 추적관찰이 가장 많았다. 3. 조사대상 근로자들은 현재의 건강진단은 필요하지만 형식적이라고 하였다. 4.사후관리 조치의 유무를 피설명변수로 한 로지스틱 회귀분석에서 유의한 설명 변수는 건강진단 결과에 대한 설명의 유무뿐이었다.