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Statistical analyses in an occupational health study
Jung Keun Choi(최정근),Mi A Son(손미아),Do Myung Paek(백도명) 한국통계학회 1993 응용통계연구 Vol.6 No.2
산업보건연구의 통계학적 분석은 작업환경측정에 대한 평가방법과 산업보건에 특유한 혼란변수의 통제 등 건강상태와의 연관성을 분석하는 평가방법에 있어 아른 보건통계분야와 구별되는 특성을 지니고 있다. 본 논문에서는 주물공장 근로자들의 호흡기 건강상태와 작업환경에서 폭로되는 유해물질에 대한 조사를 통하여 산업보건연구에 사용되는 통계학적 분석에 대한 기술을 하였다. 조사된 환경측정결과의 일부는 허용폭로기준을 초과하고 있었는 바, 폭로기준의 준수여부를 판정하기 위하여 작업환경측정결과와 그들의 대수변환치들로 부터 얻은 산술평균과 대수평균들이 폭로기준과 다른지에 대한 t-검정을 실시하였다.환경측정을 비롯한 위험요인들과 그들로 인한 건강상태와의 관계 분석을 위해, 범주적 건강측정 변수인 경우에는 χ-square 검정과 다변량 logistic분석을 시행하였고, 연속적 변수인 경우에는 다변량 회귀분석을 시행하였다. 작업환경내의 오염물질의 농도는 그 측정장소와 측정시점에 따라 매우 가변적이다. 이러한 작업환경의 측정결과를 평가하는데 있어 사용될 수 있는 서로 다른 여러 지수들의 장단점과 가변적 측정결과들로 인한 오차를 보정할 수 있는 통계학적 분석 방법에 대한 논의를 하였다. 본 조사의 폐기능검사 결과는 직업에서 폭로되는 정도와 아무 연관성을 보이고 있지 않은 바, 이는 건강한 근로자 효과에 기인한 것으로 추정되고 있다. 이러한 건강한 근로자 효과를 비롯한 측정시점에 따라 변화하는 혼란변수를 보정하기 위한 통계적 분석 방법이 논의 되었다. 산업보건 연구에서 기본적으로 사용될 수 있는 전국적 생정통계와 같이 광범위하며 쉽게 비교되는 외부 대조군 내지는 질병의 예측기대치에 대한 통계가 한국의 경우에는 아직 없다. 이러한 경우, 그 분석의 범위가 매우 제한되어 있으나, 문제되는 질병 내지는 임상검사결과가 다른 일반적 질환과 비교하여 차지하는 비율을 서로 다른 집단간에 비교함으로써 서로 다른 작업환경에 폭로되는 집단들에 대한 통계학적 분석을 시도할 수 있다. 현재 한국에서는 일반검진과 특수검진이 정규적으로 실시되고 있으며, 이러한 검진결과에 대한 체계적 통계학적 분석이 앞으로 필요할 것으로 기대된다. The health status of workers in a foundry was analyzed in a study which consisted of evaluations of respiratory health together with environmental measurements. The results from environmental measurements showed values exceeding permissible exposure limits. A t-test was done with log transformed and untransformed data to examine the statistical significance for the noncompliance with exposure standards. For the analysis of categorical health outcomes, χ-square test with 2×2 tables and logistic regression analysis were employed. For continuous variables, multiple linear regression was done against assessed risk factors. Pros and cons of different parameters in the compliance (or noncompliance) testing were presented. Respiratory function did not show any relation with occupational exposures, which may be due to the healthy worker effects. Strategies for controlling time dependent covariates were discussed in relation to the healthy worker effect. The scope of statistical analysis in occupational health studies is still limited in Korea without a suitable external comparison group such as credible vital statistics for the whole nation. Internal comparisons between different exposure status often result in unstable estimates of effect, and proportional morbidity study is discussed as an alternative potential research tool.
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강중구,백도명,이윤정,마효일,손미아,이홍기,최정근,Kang, Joong-Koo,Paek, Do-Myung,Lee, Young-Jung,Ma, Hyeo-Il,Son, Mi-A,Lee, Hong-Ki,Choi, Jung-Keun 대한예방의학회 1996 Journal of Preventive Medicine and Public Health Vol.29 No.3
The objectives of this study are to investigate the prevalence of occupation related carpal tunnel syndrome(CTS) among workers in a condom industry : to analyse the sensitivity and specificity of clinical signs or symptoms such as hand diagram, Tinel's sign and Phalen's sign in carpal tunnel syndrome : and to test vibration threshold test using audiometry as a technically easy and noninvasive method in the diagnosis of carpal tunnel syndrome in stead of nerve conduction velocity (NCV). The study group was divided into exposed group(39 cases) and non-exposed group(48 cases) based on whether or not excessive use of wrist movements exsist. 1. There are stastically significant differences in symptoms and signs of carpal tunnel syndrome such as hand diagram, Tinel's sign and Phalen's sign between exposed and non-exposed group(p<0.05). 2. Six cases(9 hands) were comfirmed as carpal tunnel syndrome by NCV. Five cases(7 hands) belonged to exposed group, 1 case(2 hands) to nonexposed group. As there are significant differences in prevalence of carpal tunnel syndrome between two groups(p<0.05), excessive use of wrist in occupation is a risk factor of carpal tunnel syndrome. 3. When we use NCV as a gold standard in the diagnosis of carpal tunnel syndrome, sensitivity and specificity of hand diagram, Tinel's sign and Phalen's sign is as followed; hand diagram , sensitivity 88.9%, specificity 84.2% Tinel's sign ; sensitivity 55.6%, specificity 72.8% Phalen's sign ; sensitivity 14.3%, specificity 88.4%. Among above clinical signs and symptoms, hand diagram is the best clinical screening test. 4. The differences of vibration threshold between median and ulnar nerve at the same time are useful in the diagnosis of carpal tunnel syndrome but the time change of vibration threshold of median nerve over time are not sensitive enough. It is concluded that vibration threshold between median and ulnar nerve at the same time can be used as a supplementary or alternative criterion to indicate that the nerve dysfunction is located in the carpal tunnel.
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백도명,백남원,최정근,손미아,임정기,이원진,문영한,박정선,최병순 大韓産業醫學會 1995 대한직업환경의학회지 Vol.7 No.1
Asbestos industry has been in operation over 60 years in Korea. However, the prevalence of asbestosis has not been yet reported. With rapid turn-over of workers, previous cross-sectional studies of current workers on the job could not find cases with exposures long enough for the development of asbestosis. This study was done to evaluate asbestosis prevalence of those worksites with operation history of more than 20 years. In total, 139 workers from 5 worksites were examined. Asbestos industries covered in the study include 2 asbestos textile, 1 brake lining, and 2 ship repairing worksites. Chest x-ray was taken from all workers and read by two experts familiar with pneumoconiosis classification according to 1980 ILO guidelines. Those with findings compatible with asbestosis were further ckecked with high resolution computerized tomography (HRCT). Pulmonary function tests were done according to ATS guidelines, and occupational and previous medical history was taken through a standardized interview. Air-borne asbestos was measured according to NIOSH method 7400. The air-borne asbestos concentrations ranged from 0.2-1.3 f/cc for asbestos textile, from 0.7-1.0 f/cc for brake lining, and from 6.3-7.8 f/cc during asbestos removal at ship repairing worksite. Of the 139 workers 25 had abnormal chest radiographic findings, and 10 of them had findings compatible with pneumoconiosis. When work history and current asbestos measurements were accounted, 9 workers who had more than 10 years of asbestos exposure history showed chest radiographic findings of pneumoconiosis with Finally, 4 workers showed finding of pulmonary fibrosis and/or pleural thickening at HRCT, and 2 of them had restrictive lung function changes. The study results showed that, among 139 subjects, there were 4(3%) definite asbestosis cases confirmed with HRCT. The prevalence of probable asbestosis was 7% for 10-14 years of exposure, 13% for 15-19 years of exposure, and 23% for 20 or more years of exposure. The prevalence of compensable asbestosis with abnormal lung function was 4-6% for those with 15 or more years of exposure.
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