한 사업장 부속의원의 비용-편익 분석

유인근(Inkeun Yoo),원종욱(Jonguk Won),송재석(Jaeseok Song),노재훈(Jaehoon Roh) 대한직업환경의학회 2001 대한직업환경의학회지 Vol.13 No.2

석유화학 공장 사무실 공기질과 근로자 자각 증상과의 연관성에 관한 연구

김기연(Kiyoun Kim),김혜정(Hyejung Kim),김현수(Hyunsoo Kim),김치년(Chinyon Kim),원종욱(Jonguk Won),노영만(Youngman Roh),노재훈(Jaehoon Roh) 한국실내환경학회 2006 한국실내환경학회지 Vol.3 No.3

This research was performed with the subject of 111 offices in a chemical plant of Korea. Airborne concentration level of carbon dioxide, carbon monoxide, formaldehyde and total suspended particulates in the office rooms were measured along with temperature and relative humidity. Simultaneously, general characteristics and subjective health symptoms of 500 office workers were investigated through a questionnaire consisting of the five point weighting method : 0 = not at all, 1 = a little bit, 2 = moderately, 3 = quite a bit and 4 = extremely. Results showed that the mean values for temperature and relative humidity in investigated office rooms were 22.2℃ and 34.3%, respectively. The concentrations of formaldehyde, PM10, carbon dioxide and carbon monoxide were 0.17 ppb, 28.8 ㎍/㎥, 0.95 ppm and 424 ppm, respectively. 56.4% of all the workers investigated replied with a sense of fatigue or weariness (mean=2.23), drowsiness or languidness (mean=2.22), sneezing (mean=2.11) and ophthalmia oreye fatigue (mean=2.07). Female workers, non-smokers, non-drinkers, workers who do shift more than nine hours a day, and workers in poor health experienced more subjective symptoms than other workers (p<0.05). Subjective symptoms of office workers were significantly associated with the following items of office characteristics: the purchase date of office equipment, the change of office furniture, the use of paint, smoking in the office, ventilation condition, the use of an individual air-conditioner, the use of a fax machine, the degree of office repair, the proportion of workers per office, the degree of satisfaction in office environment, and the operation hours of the air-conditioner. Also, subjective symptoms were positively correlated with indoor environmental factors such as relative humidity, carbon dioxide level, level of PM10, and formaldehyde (p<0.05). In conclusion, office characteristics and air quality in a chemical plant affected subjective health symptoms of office workers. Thus, in order to improve the health of workers, to enhance work efficiency, and to establish a better office environment, air quality control in office rooms by optimal ventilation, adequately occupied number of workers in one office, and maintenance of office equipment should be fulfilled thoroughly.

한 사업장 부속의원의 비용-편익 분석

유인근, 원종욱, 송재석, 노재훈 대한산업의학회 2001 대한직업환경의학회지 Vol.13 No.2

목적 : 이 연구는 부속의원의 비용-편익 부문을 화폐가치로 계량화하여 분석함으로써 대상 사업장 부속의원의 비용-편익 상태의 변동 및 특성을 파악하여 경제성을 검토하여 사업에 대한 합리적인 의사 결정을 할 수 있는 근거를 제공하기 위하여 비용-편익 분석을 시행하였다. 방법 : 연구방법으로는 사업장 부속의원 중 의료 행위에 필요한 적정의료인력을 갖춘 인천 지역의 근로자수 약 700여명을 보유한 사업장 부속의원을 설정하여 부속의원의 회계 및 진료와 관련된 자료를 기초로 하여 1995∼1997년까지 3년간에 발생된 직 · 간접 비용과 직 · 간접편익부분을 산출하였다. 각각의 비용과 편익은 할인율을 5 %로 하여 현재가치로 환산한 후 3년간의 평균액으로 계산하여 비교 ·분석하였다. 그러나 일부 간접편익 즉, 사업장 부속의원의 건강진단 및 진료사업을 통한 건강증진, 생명 연장, 정신 편익 및 외부효과에 관한 부분은 제외 시켰다. 민감도 분석을 통해 할인율 4 %, 6 %일 때, 부속의원이 존재하지 않을 경우에 타 의료기판 이용시 발생되는 소요시간을 2시간, 4시간으로 하고, 교통비 산출에 있어 일반버스, 택시 비용을 적용하였다. 결과 : 1. 연구 대상 사업장 부속의원에 투입되는 연간 평균 비용은 약 2억8백만원이었으며, 이로 인한 편익액은 약 1억3천5백만원이었다. 2. 순편익은 -7천3백만원 정도의 값을 보였다. 3. 편익/비용비는 0.65이었다. 4. 본 연구의 민감도 분석에서는 해당연도의 가치를 현재 가치로 전환하는 과정에서 발생되는 할인율을 4%, 6 %인 경우의 편익/비용비가 0.654∼0.648로 약간의 변화를 보였으며, 타 병원 이용시 발생되는 소요 시간은 2시간과 4시간을 적용하여 비용∼편익 분석을 실시했을 때 편익/비용비가 0.532∼0.769로 비교적 큰 변화를 보였다. 또한, 타 의료기관 이용 수단으로 일반버스와 택시를 비교 하였으나, 0.632∼ 0.724로 거의 변화가 없었다. 그리고 위의 경우가 동시에 최대 · 최저치의 상황에서 편익/비용비는 0.52∼0.84이었다. 결론 : 본 연구 결과 부속의원 사업이 현 상태의 규모로 운영된다면 사업주 측면에서 효율성이 없기때문에 폐쇄 결정을 내릴 수도 있겠으나, 이는 간접편익 일부를 제외시킨 상태로 분석한 결과이므로 단순히 이 결과 만을 놓고 볼 때 경제성이 없다고 단정지울 수는 없다. 다만, 사업주 측면에서 인정할 수 있는 부분까지 고려했을 경우에는 인접 사업장 근로자들과 연계하여 일반건강진단 및 외래 진료 범위를 기존 시설과 인력에서 간호사 1명을 감원시켜 최소한 근로자수 1,100명 이상으로 확대 운영하여 부속의원 이용 회수를 증가시킨다면 경제성이 있는 사업이며 나아가 근로자들의 신속한 의료 혜택으로 심각한 질병의 진행을 예방할 수 있는 효과를 기대할 수 있다. Objectives : We performed cost-benefit analysis to investigate the benefit of companies dispensary. Methods : We measured the cost and benefit of running a factory dispensary. This study focused on a factory with well arranged professional health-care staff. The study was carried out during 1995-1997. All the past values of cost and benefit were converted into present value. We used net benefit and cost/benefit ratio as determinants. Results : The net benefit of the object factory dispensary was -73,000,000 Won, and cost/benefit ratio was about 0.65. This result showed no profitability. Conclusion : There would be limitation of generalization because this study included only one factory dispensary. As we did not consider many indirect benefits. the benefit portion might be underestimated. We should also think about the possibility of profitability. If one dispensary takes charge of two or more factories. then it can produce sufficient profit. With all of those efforts we dream the days of healthy workers will come.

흡입성 화상후 발생한 음성장애에 대한 평가

김은서,도윤정,원종욱,노재훈 大韓産業醫學會 1999 대한직업환경의학회지 Vol.11 No.4

Objective : Injury to the airway, found in 25 % to 35 % of patients admitted to major burn center, is now the leading cause of death in burn patients. Significant inhalation injury can increase the patient mortality rates by up to 20 %. Toxic compounds in smoke can include phosgene, ammonia, sulfur dioxide, and chlorine from plastics and various oxides and aldehydes from burning wood. These compound directly injure airway epithelial cells, causing an intense inflammatory response with significant edema. After the critical problem is controlled with intensive care in inhalation burn patients, less critical but significant laryngeal function such as protection, phonation and deglutition may often be overlooked. Method & Result : We have experienced a male patient who was injured by inhalation of toxic compound in ship under construction. He have suffered from pulmonary problem, bronchiolitis obliterans. Voice disorder was assessed and managed by otolaryngologists after resolving the pulmonary lesion. Conclusion : Evaluation and treatment of patients suspected of inhalation injury should include anatomical and functional aspects of the larynx as well as critical problem of the airway.

산재의료원 일부 입원 환자들의 직장 복귀 의사에 영향을 주는 요인

고덕기,유송희,송재석,원종욱,노재훈 大韓産業醫學會 1998 대한직업환경의학회지 Vol.10 No.3

The purpose of this study is to identify the various factor associated with the patients' return-to-work. For conducting the study, 511 samples are selected from nine industrial accident hospitals. Questionnaire are patient's general characteristics, injury characteristics and job characteristics. These results can be summarized as follow. When industrial accident patients get older, have family members to be supported, are hospitalized for less than six months, have accidents caused by their mistakes, have worked in the construction and manufacturing industry, have worked a company with more than 300 workers, and have worked for six months∼ two years or over two years, they tend to express stronger willingness of return-to-work. In face with the current drastic increase of economic loss from industrial accidents, it is required to be dealt with these factors in planning and managing the health care of industrial accident patients.

보건관리 대행사업 평가 지표 및 척도개발에 관한 연구

박정일,조병희,구정완,김광종,김현욱,원종욱,이명숙,이원철,정문희 가톨릭대학교 산업의학센터 2000 韓國의 産業醫學 Vol.39 No.3

This study was carried out to develop the index and the scales for the evaluation of the group occupational health services(GOHS). The possible variables of each step, firstly, based on an evaluation model composed of four steps, input, throughout, output and outcome, were selected through several meetings of professional committee. And five types of questionnaire(for doctor, nurse, industrial hygienist, employer, and employee) were developed based on the selected variables. A pilot survey for four GOHS institutions and 12 enterprises was conducted using the questionnaires and correlation analysis for extracting variables was done. The results were as follows: 1.The evaluation scale was composed of three areas(evaluation on workers' health and work environment, evaluation by institution and employer, and evaluation by employee)which were devided into ten subscales. 2.Among firstly selected ninety-six variables, forty-three variables (11 for input, 14 for throughout, and 18 for output indices) were extracted by correlation analysis. 3.Based on the extracted variables, the questionnaires were simplified as five items for doctor, thirty-six items for nurse, nine items for industrial hygienist, and twenty-six items for employer and employee. 4.The total score of evaluation model was defined on the basis of four-hundred points as sum of four indices (input, throughout, output and outcome) given one-hundred points each.