우리나라의 신체장애평가법에 관한 비교연구 - 신체장해등급법, McBride법, 미국의학협회 (AMA)기준법을 중심으로 -

이창옥,최정근,손미아,문옥륜,Rhee, Chang-Ok,Choi, Jung-Keun,Son, Mi-A,Moon, Ok-Ryun 대한예방의학회 1994 예방의학회지 Vol.27 No.3

In this study, literature review was done to examine and compare the current status and problems of different evaluation approaches toward permanent impairment in Korea. Alternatives and improvements in the current approaches in Korea were suggested. Series of cases were also examined to compare different approaches applied to the real cases, using 105 cases from a hospital data and another 207 cases from a insurance company data. The main findings of the literature review are as follows; 1. The current evaluation methods of permanent impairment in Korea are grouped into two categories, grading and rating. Gradings of impairments are expressly specified in 17 various statutes. 2. In Grading methods, the rigid system of 74 different grades has been adopted uniformally for the convenience of administration, which may not be, appropriate or valid from medical and scientifical aspect. 3. The adventage of McBride method is assessment of occupational disability rate. However the classified compensable occupations are only 280 and limited to manufacturing industries in 1960s'of U.S.A., which is not appropriate to current Korean circumstances. Especially, the job list does not include managerial officers or mental workers. 4. AMA Guides is the scientific and reasonable method for the assessment of physical impairment rate. However compensation and reparation of impairment case is difficult because this method cannot assess the disability rate according to occupation, age, etc. The results of cases comparative study are as follows: 5. The physical Impairment could be compared in 167 out of total 312 cases, and for the cases of complex impairment, McBride method underestimate physical impairment rate compared with AM A method. 6. When disability late was assessed, occupation was considered the compensation of only 85 cases, and age was used in only 21 cases. This was because occupation and age compensation in McBride method are unreasonable. 7. The most Ideal alternative is to assess physical impairment according to AMA method and then to develop a compensation method appropriate for the circumstances of Korea society.

사회계급과 건강행위가 유병률에 미치는 영향

손미아,Son, Mi-A 대한예방의학회 2002 Journal of Preventive Medicine and Public Health Vol.35 No.1

Objective : To explore the relationship of social class and health behaviors with self-reported morbidity. Methods : The 1995 General Household Survey in Korea was used to investigate self-reported morbidity. Logistic regression was used to examine the relationship of social class and health behaviors with self-reported chronic disease and perceived general health. Results : For chronic disease and general perceived health, age adjusted odds ratios were higher for manual workers, lower-educated group as well as those in the lower income group; this held true for both men and women. Health behaviours had little effect or the relationship between social class and morbidity. The relationship between health behaviors and morbidity was very weak. The lower social class expressed higher levels of negative health behaviors, although this relationship appeared to be very weak in Korea. Conclusions : This study suggests that an understanding of health differentials that addresses the issue of social inequalities in Korea is required.

노동과 건강 불평등, 그 근원은 어디인가?

손미아,Son, Mi-A 대한예방의학회 2005 예방의학회지 Vol.38 No.3

There has been an enormous increasing trend of widening gap of social inequalities since economic crisis at the end of 1997 in Korea. Since then, Korean society has deteriorated in economic and social conditions; the unemployment rate, temporary or casual workers and absolute poverty have increased. This paper presents the origin of inequalities in work and health in Korea. The origin of inequalities in work begins with the relationship between the capitalist and labourers in the capitalist mode of production. The conception and execution are dissolved in the work process in the capitalist mode of production. Thus, captitalists become control over ther labour process from workers. An alienation of the work process from the workers. The distribution of work is the majour source if inequalities in many countries as well as Korea. This paper presents the increasing tendency of unhealthy states such as mortality, early death, morbidity, physical work load, workplace injury amongst the under-privileged: ordinary workers, unemployed people, casual workers and socially deprived people in Korea.

벤지딘 염료공장 노동자들의 혈뇨

손미아,백도명,최정근,박수경,박정순,오세민,박정선,박동욱,Son, Mi-A.,Paek, Do-Myung,Choi, Jung-Kun,Park, Su-Kyeong,Park, Jung-Soon,Oh, Se-Min,Park, Jung-Sun,Park, Dong-Ook 대한예방의학회 1995 Journal of Preventive Medicine and Public Health Vol.28 No.1

Benzidine Industry in Korea has started after Japan has banned its production in early 1970's, and it has been in operation in Korea for over 20 years. However, it is not known yet whether any bladder cancer has developed from benzidine exposure. This study was done to screen benzidine-exposed workers for bladder cancer, and to examine the feasibility of employing screening test at the workplace. All the workplaces that manufacture or use benzidine for more than 20 years in Korea have been covered in this study, and they include 2 benzidine manufacturing factories, 5 benzidine using factories, as well as 2 benzidine free factories as an outside control. In total, 516 workers were screened with urine stick test and urine cytology test for the evidence of hematuria and abnormal urothelial cells. Each worker was also asked about risk factors and symptoms of bladder cancer including past medical history, smoking, medication and occupational history Benzidine in the air was measured by personal and area sampling. Out of 516 screened workers, 84(16.3%) workers showed positive hematuria in urine stick test, and 7(1.4%) workers showed degenerative cells in urine cytology tests. Those workers with abnormal urine test results who have been exposed to benzidine fo more than 10 years were further screened, and, in total, 23 workers were examined with intra-venous pyelography and cystoscopy. None of those screened had any evidence of bladder cancer When workers with only past hematuria history were included in the positive hematuria group, 96(18.5%) had positive hematuria. On the multiple logistic regression analysis, positive hematuria was significantly associated with benzidine exposure, history of other occupations with elevated bladder cancer risk, pyuria and glycosuria. The association got stronger as direct benzidine exposure was accounted through individual task analysis, and as exposure duration was accounted with tenure analysis. For those with benzidine exposure with more than 10 years of tenure, the odds of having positive hematuria was elevated 2.14(95%C.I is 1.08 to 4.25) times more than for those without exposure. Even though bladder cancer was not detected for several limitations including short observation period, majority of studied workers with short latency, healthy worker effect, and low sensitivity of single screening test in a cross-sectional study, the study results suggest that hematuria screening is a feasible and very useful test for bladder cancer screening among benzidine exposed workers.

직업, 교육수준 그리고 물질적 결핍이 사망률에 미치는 영향

손미아,Son, Mi-A 대한예방의학회 2002 예방의학회지 Vol.35 No.1

Objective : To investigate the relationships of occupational class, educational level and deprivation with mortality in Korea Methods : This study used existing South Korean national data on occupation, educational level, and deprivation and death. Mortality was investigated using registered death data from 1993 to 1997 obtained from the Korean National Statistics Office (NSO) with denominators drawn from the 1995 Census. Statistical analysis consisted of poisson regression modeling and multilevel analysis. Results : The lower occupational class (manual workers) group had a higher mortality rate than the higher occupational class (non-manual workers) group Educational level, and deprivation were both inversely related withand mortality. Occupation was strongly associated with education. Area-based deprivation indicators and individual indices for social class made an independent contribution to the mortality risk. Conclusions : The findings of this study suggests that the relationships of occupational class, educational level and deprivation with mortality appears to be stronger in Korea than in European countries.

내사시에서 보툴리눔 A 독소 화학절단술의 효과

오상윤 ( O Sang Yun ),손미아 ( Son Mi A ),이주연 ( Lee Ju Yeon ),신민철 ( Sin Min Cheol ) 대한안과학회 2004 대한안과학회지 Vol.45 No.1

내사시에서 보툴리눔 A 독소 화학절단술의 효과

오상윤 ( O Sang Yun ) , 손미아 ( Son Mi A ) , 이주연 ( Lee Ju Yeon ) , 신민철 ( Sin Min Cheol ) 대한안과학회 2004 대한안과학회지 Vol.45 No.1

새로운 작업조직 시스템이 직업성 긴장수준 및 직무스트레스에 미치는 영향

장세진,선병한,강동묵,손미아,박종구,차봉석,고상백,Chang, Sei-Jin,Sun, Byeong-Hwan,Kang, Dong-Muk,Son, Mi-A,Park, Jong-Ku,Cha, Bong-Suk,Koh, Sang-Baek 대한예방의학회 2003 예방의학회지 Vol.36 No.1

Objectives : New organizational work systems, and their impact on the mental health of employees, are considered to beone of the most important topics in the area of industrial health. This study was conducted to compare job characteristics (job demand and decision latitude) levels, and psychosocial distress of workers in acompany introducing to new organizational work systems, to those of workers managed by traditional work systems. Methods ; A study sample of 627 shipbuilding workers (446the new work organizational system and 181 the traditional system) were recruited for this study. A structured-questionnaire was used to assess general characteristics, job characteristics(work demand, decision latitude), and psychosocial distress. Results : The decision latitude was not significantly higher in the new work system compared to the traditional system. However, the job demand was significantly higher in the new work system than in the traditional system. The psychosocial distress was higher within the new work system than the traditional system, but no significant relationships were found. The proportion of increased strain was significantly greater with the new system than the traditional system. Conclusion : These results suggest that increases in the decision latitude did not sufficiently compensate for higher job strain or increased work intensity. If the increase in the decision latitude was temporary, with the typical job demand remaining high, such work can be still be considered to have a job strain Futureresearch should consider psychosocial distress and fatigue as importantproblems caused by new work organizational systems, and should be performed to assess their impact through out industry.

한 콘돔공장근로자들의 수근관증후군에 관한 연구

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.

안와첨증후근을 동반한 접형골동 점액종 1 예

서철원(Chul Won Seo),손미아(Mi A. Son) 대한안과학회 1990 대한안과학회지 Vol.31 No.11