직업성 긴장과 근로자 결근

차봉석,장세진,최홍렬,김형식,고상백,Cha, Bong-Suk,Chang, Sei-Jin,Choi, Hong-Ryul,Kim, Hyong-Sik,Koh, Sang-Baek 대한예방의학회 1999 Journal of Preventive Medicine and Public Health Vol.32 No.4

Objectives : The purpose of this study was to assess the relationship between job strains and absenteeism from work. Methods : The study design was cross-sectional, and the study subjects consisted of 1,166 workers who were employed in the small-sized industries. A self administered questionnaire was used to measure the general characteristics, job characteristics(job demand, job control), and social support(coworker support, supervisor support) at work. The Job Content Questionnaire(JCQ) was used to assess job demand(2 items) and decision lattitude(10 items). Social support at work (10 items) was measured using JCQ. Sick absence was collected using self-report and were rechecked by the attendance record of their company. Odds ratios and 95% confidence intervals for the association between job strain and sick absence were estimated. The modifying effect of social support was evaluated by stratification. Logistic regression was used to estimate the relationship between job strain and sick absence. Results : In the bivariate analysis, the variables related to sick absence were age, marital status, occupation, job demand. Four distinctly different kinds of level of job strain were generated by the combination of job demand and job control: low strain group, high strain group, active group, and passive group. The crude odds ratio of high job strain was 1.78(95% CI: 1.26-2.53), and those of active group and passive group were 1.33(95% CI: 1.07-1.66) and 1.13 (95% CI: 0.88-1.47), respectively. The odds ratio of high job strain after adjusting for age and occupation were still significant The odds ratio of high job strain in low social support was 5.96(95% CI: 2.45-14.51), but that in high social support was 0.73(95% CI: 0.26-2.01). Conclusions : Job strain was associated with increased risk of absenteeism from work, and social support at work modified the association between job strain and sick absence.

쯔쯔가무시병 환자에서 Soluble ICAM - 1 농도의 변화

이흥범(Heung Bum Lee),고현우(Hyeon Woo Koh),김형식(Hyong Sik Kim),문성기(Sung Gi Moon),오상미(Sang Mi Oh),이용철(Yong Chul Lee),이양근(Yang Keun Rhee) 대한내과학회 1998 대한내과학회지 Vol.54 No.1

N/A Objectives: ICAM-1 has been shown to be required for leukocyte migration into inflammed area and plays a significant role in inflammatory disease including bronchial asthma, and various infectious disease such as tuberculosis and malaria, Although, the significance of soluble ICAM-1 (sICAM-1) in rickettial disease has not beet recognized. The present investigation was designed to evaluate the sICAM-1 levels in patients with tsutsugamushi disease, and the correlation factors between sICAM-1 level and subject characteristics including clinical and 1aboratory indices. Methods: Eight normal controls and thirteen patients with tsutsugamushi disease underwent serum sampling for sICAM-1 level, which was measured by using ELISA kit. Results: 1) sICAM-1 level is significantly elevated in patients group. 2) sICAM-1 level is a significantly correlation with AST level, titer of anti-tsutsugamushi antiboby, and leukocyte counts, but other factors such as age, sex, differential fraction of leukocyte, ALT, duration of fever, and total hospital day etc, are not. Conclusion: These results show that sICAM-1 may he a role in the pathogenesis of tsutsugamushi disease.

일부 조선업 근로자의 직업성 요통 발생실태 및 위험요인에 관한 연구

고상백,김형식,최홍렬,김지희,송인혁,박준한,박종구,장세진,차봉석 大韓産業醫學會 2000 대한직업환경의학회지 Vol.12 No.1

목적 : 이 연구에서는 한 사업장의 동일한 코호트내에서 직업성 요통의 발생 및 발생원인에 대해 조사하고자 하였다. 방법 : 연구대상은 1995년 12월 현재 한 조선업체에 종사하는 근로자 중에서 1995년 12월 31일 까지 요통이 이미 발생한 근로자와 1995년 당시 검진 미수검자를 제외한 9,784명을 연구대상으로 하였다. 요통 발생군은 1996년부터 1998년까지 3년간 추적 관찰하여 요통으로 4일 이상 통원 또는 입원치료를 받은 근로자로 하였다. 발생률은 요통발생 당시 연도를 기준으로 하여 해당 연도의 4일 이상 신규치료를 받은 중등도 이상의 요통근로자를 분자로 하였고, 해당년도 사업장의 종사하는 근로자 총수(과거 요통자 제외)를 분모로 간주하였다. 요통 발생군은 외상성 요통과 직업관련성 요통으로 대별하였으며, 위험요인과 질병 발생간의 관련성을 보기 위한 Cox모형에서 그 위험도를 파악하고자 할 때에는 직업성 요통만을 환자군으로 선정하였다. 결과 및 결론 . 요통 발생률은 근로자 천명당 1998년 3.1명, 1997년 8.8명, 1996년 7.8명이었다. 요통점유율의 범위는 10.99∼25.66이었다. 연령별 요통 발생률은 30대, 40대에서 높은 발생률을 보였다. 진단명에 따른 발생률은 추간판 탈출증, 염좌, 척추골절, 척추분리증, 척추협착증 순이었다 직업성 요통 발생자들의 직업적 요인을 알아보기 위하여 요통 발생 당시 작업형태를 알아본 결과, 물건을 들다가 66명(35.3%)이 발생하여 가장 큰 빈도를 차지하였고, 물건을 옮기는 과정에서 19명(10.2%)이 발생하여 2위를 차지하였고, 넘어지거나(8.6%), 물건을 당기는 자세(8.0%), 값자기 일어서다(7.5%) 순으로 요통이 발생하였다. 직업성 요통에 영향을 주는 일반적 특성 및 직업적 특성에 판한 상대위험도 및 95% 신뢰구간를 구한 결과, 요통발생에 영향을 주는 유의한 변수로는 체질량 지수(비만도), 교대여부, 중량물 취급여부였다. Objectives : This study was conducted to estimate the incidence rate, and to identify the risk factors for the occupational low back pain among shipyard workers. Methods : The study subjects consisted of 9,784 workers who were employed in a ship-building industry (excluded workers who had a history of low pack pain before 1995 or did not take periodic health examination in 1995) . The cases were 220 people who experienced back pain from January 1, 1996 to December 31, 1998. To assess risk factors for occupational low back pain, Cox propotional hazard model was used. Results : During the recent three years from 1996 to 1998, the incidence rate per 1,000 persons was 7.8 in 1996, 8.8 in 1997, and 3.1 in 1998. The main causes of work-related low back pawn were sprain, strain and disc herniation. Lifting was the most common cause of back pain (35.3%) , and carrying (10.2%) and pulling (8.0%) were followed. In Cox proportional harzard model, independent risk factors for back pain were body mass index(R.R. ; 1.54, 95% C.1. : 1.06-2.25), shift work(R.R. ; 1.65, 95% C.1. : 1.19-2.28), and lifting heavy material(R. R., 3.95, 95% C.1. : 2.29-6.82). Conclusions . This study suggests that the risk factors of back pawn In shipyard work-ers were body mass index, shift work and lifting.

조선소 근로자에서의 국소진동장해 진단방법에 대한 평가

손 홍,전순자,주영수,조성일,최홍렬,김미경,김형식 大韓産業醫學會 1998 대한직업환경의학회지 Vol.10 No.4

A hand-arm vibration syndrome, local vibration illness, occurs in some workers who use hand held vibration tools. It consists of white fingers, diffusely distributed finger neuropathy, pain in the hand and arm, and a small excess risk of osteoarthritis. This study is aimed to identify effective methods to confirm local vibration illness among various health exams, which are mentioned in worker's special health exam regulation. In addition, this study is aimed to quantitatively assess the daily vibration exposure level as a major determinant of vibration illness. The subjects, 46 vibration workers, were selected according to the results of the first special health exam about vibration hazards at shipbuilding industry in 1997. They all had experiences of work related blanching of fingers. Fifteen controls, who had no vibration exposure at all, were also recruited to compare their test results with the results of vibration workers. We adopted I subjective and 6 objective tests to evaluate the effectiveness and feasibility for confirming local vibration illness. These tests were history taking of subjective symptoms according to the Stockholm classification, checking blood pressure of finger, checking grasp power, checking finger skin temperature, nail-bed pressing test, vibration perceptional threshold test, and skin prick test for pain perception. Among these, checking skin temperature, nail-bed pressing test, and vibration perception test included cold water provocations. We also estimated some vibration exposure levels of hand held vibration tools by using previously published data from one automobile company. In conclusion, history taking of subjective symptoms according to the Stockholm classification, nail-bed pressing test, and vibration perceptional threshold test were discovered to be effective to diagnose local vibration illness. Furthermore, vibration perceptional threshold on right fingers showed a dose-response relationship to daily vibration exposure levels. The parameter β was 0.0005(±0.0002), and statistically significant by REM(random effects model).