유기용제 사용 소규모사업장의 체계적 건강관리 프로그램 개발에 관한 연구1) : 신경행동학적 검사법의 적용 가능성 Application of Neurobehavioral Core Test Battery(NCTB)

한상환,하미나,권호장,윤덕로,조수헌 大韓産業醫學會 1995 대한직업환경의학회지 Vol.7 No.2

It is known that there appear some nonspecific and delicate changes in neuropsychiatric aspect on the workers when they are exposed for a long period to low concentrated organic solvents in the work places. Therefore, it gives rise to the necessity of developing a program for the health supervisor stationed in the work place to supervise these neurobehavioral health affection. In addition to the questionnaire posed to the workers exposed to organic solvents, the study team conducted NCTB(Neurobehavioral Core Test Battery) respectively on an exposed group and a non-exposed group to organic solvents. The study team compared the results and decided whether or not to apply the results to the evaluation program of health affection. The study team divided 132 workers in 6 car repairing factories and 2 textile printing factories into exposed group and non-exposed group, pairing them off into 66 research objects according to their age, sex, and job. Neurobehavioral test was conducted on 6 items, except the POMS test, of NCTB developed by the World Health Organization(WHO). The study team conducted examinations of working environment on the exposed and non-exposed groups of each work place. The analysis of the collected materials for examinations were conducted with GC-MS. The concentration of the mixture in the air, relative to their respective threshold limit values(TLV) was calculated according to the formula of the ACGIH and the Korean threshold limits. The results indicated that for two of eight factories samples the recommended concentration limits for mixtures was exceeded. Of the six tests, the 'digit span forward', 'digit span backward' and 'digit symbol' produced conspicuous statistical differences between the two groups(p<0.1) as a result of compairing the test values by means of paired t-test. The results of respective analysis of the car repairing factories and textile printing factories revealed that the textile printing factories had greater differences between the exposed and the non-exposed than in the car repairing factories. It is presumably because the textile printing workers are continuously exposed to the organic solvents during working hours, whereas the car repairing workers are exposed only when they are doing painting works, The NCTB is assessed very useful in examining the neurobehavioral health affection under the exposure to organic solvents, and, therefore, the study team expects that the NCTB will play an important part in the course of developing a health program for the workers exposed to organic solvents.

특수건강진단 자료를 이용한 소음성난청 판정기준의 비교

한상환,조수헌,주영수,하미나,윤덕로,권호장,강대희,성주헌 大韓産業醫學會 1996 대한직업환경의학회지 Vol.8 No.3

Although noise-induced hearing loss (NIHL) is the most prevalent occupational disease in Korea, only 10% of the diagnosed cases are compensated. Old (1989-94) and current diagnostic criteria, criteria for workers' compensation of NIHL in Korea, compensation formulas of American Medical Association/American association of Ophthalmology and Otolaryngology (AMA/AAOO), the Committee on Hearing, Bio-Acoustics, Biomechanics (CHABA), American Academy of Otolaryngology (AAO) recommendation were compared. Each criterion was applied on the audiomety data of 4044 workers (8023 ears), who had received the second line screening test of Special Periodic Health Examination Program for noise-exposed workers during 1991-2. First, the resulting proportions of NIHL cases by employing each criterion were compared and strength of agreement was measured using kappa value. Temporary Threshold Shift (TTS) was corrected by noise free interval, and the reduction ratio of NIHL cases was calculated. Theoretical progression model of NIHL was reconstructed from previous studies on the natural course of NIHL to evaluate the change of diagnosis result of each criterion in the model. The kappa value between old and current criteria was 0.19, 0.55 for current criteria and workers' com. criteria, ranging from 0.08 to 0.78, highest coincidence was observed between current criteria and CHABA formula. The current criteria produce most similar results with CHABA formula. If TTS is corrected for NFI, there is about 14% reduction of NIHL cases. The results of applying on NIHL progression model divided the formulas roughly into 3 groups, of which compensation criteria was the most, old criteria and AAO the least conservative. In conclusion, the result of 4 ㎑ audiometry should be excluded in evaluation of hearing level and a new hearing conservation program should be set out. Current diagnostic criteria has an ambiguity in that managerial concept for prevention and purpose of compensation is mixed up. The current diagnostic criteria and compensation criteria could be incorporated into a new formula which is based on the state of the art test for estimating everyday hearing disability.

사업장 소음 폭로에 의한 일과성 역치 상승과 회복

조수헌,하미나,한상환,주영수,성주헌,강종원,윤덕로,송동빈,이명학,김선태 大韓産業醫學會 1996 대한직업환경의학회지 Vol.8 No.2

To determine the recovery time from noise-induced temporary threshold shift(TTS), a prospective field study was conducted at three worksites where workers are known to be exposed high level of noise. Subjects were selected according to answers on a questionnaire which inquired about otological history and previous noise exposure, including avocational, military and occupational exposures. After excluding employee with past otologic problems, recent exposure to high level noise, and under medications, total 92 employees participated in the study. Among 92 participants, complete consecutive audiometric examinations were carried out at 0∼2 hours, 5∼7 hours, 14∼16 hours after worktime noise exposure on 26 participants wearing hearing protectors and 22 participants wearing no protective devices. The difference between the hearing level 0∼2 hours after noise exposure and 5∼7 hours is statistically significant by paired t-test(p<0.01). The median recovery times calculated from the data of 22 participants wearing no protective hearing devices are 15.6 hours at 4000Hz, and 7.7 hours, 10.3 hours, 8.4 hours at 1000Hz, 2000Hz and 8000Hz respectively. These data suggest that when measuring the pure tone audiometry for noise exposed workers, at least 16 hours noise-free interval is required.

VDT작업자에서 업무로 인한 정신사회적 스트레스에 대한 인지가 근골격계장애에 미치는 영향

백남종,하미나,조수헌,강대희,백도명,주영수,윤덕로,권호장 大韓産業醫學會 1996 대한직업환경의학회지 Vol.8 No.3

업무에 의한 정신사회적 스트레스가 근골격계 질환의 유병에 미치는 영향을 파악하기 위하여 전화안내원을 대상으로 단면적 조사연구를 수행하였다. 연구 결과 나이, 교육정도, 근무연한, 가사부담 등의 인구학적 변수는 근골격계질환의 유병에 영향을 미치지 않는 것으로 분석되었다. 정신사회적 스트레스 중 업무요구도가 높다고 느끼는 집단에서 그렇지 않은 집단에 비해 근골격계 질환의 유병률이 통계적으로 유의하게 높게 나타났으나 업무재량도나 사회적지지도는 근골격계질환과 유의한 상관관계를 발견할 수 없었다. 그러나 업무요구도는 높고 업무재량도는 낮다고 느끼는 '근무긴장도가 가장 높은 군'은 업무요구도는 낮고 업무재량도는 높다고 느끼는 '근무긴장도가 낮은 군'에 비해 근골격계 질환의 발생위험이 통계적으로 유의하게 높은 것으로 나타났다. 본 연구의 결과는 업무로 인한 정신사회적 스트레스에 대한 인지 정도에 따라 근골격계질환의 유병률이 달라짐을 시사하고 있다. 따라서 작업관련성 근골격계질환의 예방을 위해서는 기존의 인간공학적 접근 이외에 스트레스를 감소시키려는 노력이 동시에 진행되어야 할 것으로 생각한다. A cross-sectional study was conducted to assess the association between perceived occupational psychosocial stress at work and the work-related musculoskeletal disorder(WRMSD) among employees using video display terminals. The study included 111 female telecommunication employees from three companies at ChungBuk province. Cases of WRMSD were defined using symptom questionnaire and physical examination conducted by rehabilitation specialist. Information on demographics, individual factors, and perceived psychosocial stress, were obtained by self-administered questionnaire. For assessing perceived psychosocial stress, we used variables from 'job strain model' proposed by Karasek. Associations between perceived psychosocial stress and WRMSD were assessed by multiple logistic regression models. Forty nine(44% to the total) subjects met our operational definition for WRMSD. Age, seniority, housing load were not associated with WRMSD. Perceived psychosocial stress was associated with WRMSD[odds ratio=3.28, 95% confidence interval: 1.05-10.19]. This study suggests that perceived occupational psychosocial stress is related to the prevalence of WRMSD.

一酸化炭素 中毒

尹德老 대한의학협회 1970 대한의학협회지 Vol.13 No.11

유해가스중독

윤덕로 대한의학협회 1974 대한의학협회지 Vol.17 No.5

煉炭가스中毒의 發生 및 診療實態에 關한 調査硏究

尹德老,趙秀憲 대한의학협회 1977 대한의학협회지 Vol.20 No.8

CO中毒時 Aconite 復合製劑와 Sodium Succinate의 ?行療法에 關한 實驗的 硏究

尹德老 中央醫學社 1976 中央醫學 Vol.30 No.5

This experiment is to ascertain the theropeutic effectiveness, of the administ?ration of Aconite Compound & Sodium succinate in the treatment of acute Cal poisoning. The results are summarized as follows; 1. The administration of Aconite Compound & Sodium succinate by stomach. catheterization to the rat poisoned by 1% CO for 30 Minutes ensued in the ?rapid recovery, quick disappearance of the convulsion & lower fatality rate Compared to control group. 2. In the experimental group administered above mentioned two. drugs before ex?posure to 1% CO environment, significantly longer survival time was observed. 3. More experimental & clinical studies have to be done to attain definite conc?lusion on the threapeutic effectiveness of Aconite compound & Sodium succinate in the combined administration to CO poisoning?

CO 중독 치료에 있어 고압산소요법의 이론과 실제

윤덕로 중앙대부설한국의과학연구소 1969 한국의과학 Vol.1 No.11

우리 나라 주택의 대기오염문제

윤덕로 대한의학협회 1971 대한의학협회지 Vol.14 No.10