모 제약회사 근로자들의 직업성 천식 유병률과 약제 분말 노출수준

오성수,최용휴,김은아,이영목,장재길,유장진,박승현,김태균,정수영,김규상,강성규 大韓産業醫學會 2006 대한직업환경의학회지 Vol.18 No.2

목적: 제약회사에서 직업상 천식의 유병 규모를 파악하고 작업공정에 대한 작업환경 측정을 통해 제약회사의 약제 분말에 대한 노출수준을 평가하고자 하였다. 방법: 제약회사에서 약제 분말에 노출되는 근로자를 대상으로 천식을 선별하기 위하여 설문조사 및 진찰, 혈액검사, 폐기능 검사 그리고 피부단자시험을 실시하였고, 각 부서별 공정에 따라서 총분진과 항생제 또는 효소제 분말에 대한 작업환경 측정을 실시하였다. 직업상 천식이 의심되는 근로자에 대하여 기관지과민성에 대한 검사(메타콜린을 이용한 비특이 기관지유발시험)와 약제 분말 기관지유발시험을 실시하여 확진하였다. 결과: 설문조사 및 진찰에서 작업 관련 천식 증상이 있는 근로자는 11명(34.4%)이었고, 약제 분말을 이용한 피부단자시험에서 1+ 이상 반응을 보인 근로자 10명(31.2%)이었다. 비특이 기관지유발시험 결과 8명(25.0%)이 양성(PC20 ≤16 mg/ml)이었다. 약제 분말 기관지유발시험을 통해 직업상 천식으로 확진된 근로자는 5명(15.6%)이었다. 작업환경 측정에서 원료를 충진하거나 투입하는 작업 그리고 정립작업에서 약제 분말에 대한 노출이 많았다. 결론: 제약회사에서 직업상 천식은 주로 제조공정 중 약제 분말에 노출된 근로자에서 발생하여, 증상 및 직업성 천식의 유병률이 높았다. 따라서 원료를 충진 또는 투입하는 작업과 정립작업 등 제조과적에서 약제 분말 노출을 줄이기 위한 세심한 주의가 필요하여, 약제 분말을 취급하는 근로자에 대해서는 천식 증상 조사뿐 아니라 정기적으로 피부단자시험, 비특이 기관지유발시험 등을 실시하여야 할 것이다. Objectives: After the investigation of one worker with occupational asthma, we surveyed the preva- lence of occupational asthma and the exposure level of pharmaceutical dust of 32 workers in a pharmaceutical company. Methods: Thirty-two of the 90 employees participated in the survey which consisted of questionnaire, blood sampling, spirometry and skin prick tests with 8 common allergens as well as 9 antibiotics and 2 enzymes. Various indices of the working environment were also measured. Subjects who had a symptom suggestive of work-related asthma or positive skin prick test were further investigated by PC20 methacholine. Nine subjects who had a PC20 result of 16 mg/ml or less (n=7) or had work-related symptoms and positive skin prick test (n=2) were referred to undergo a specific bronchial provocation test to phar- maceutical dust in an academic allergic disease center. Results: Eleven of 32 workers (34.4%) had a work-related symptom suggestive of occupational asthma. Ten (31.2%) showed positive skin prick test. 8 (25.0%) had a PC20 result of 16 mg/ml or less (indicative of significant bronchial hyperresponsiveness), and 5 (15.6%) had a positive result on the specific bronchial provocation test. Exposure levels of stuffing, input of raw materials and screening process were relatively high. Conclusions: This survey showed that pharmaceutical workers have an increased risk of occupational asthma. Although pharmaceutical factories maintain a relatively good working environment, careful control of respiratory tract exposures, especially during stuffing, input or raw materials and screening process, is important to prevent occupational asthma. Pharmaceutical workers need to undergo regular skin prick and methacholine bronchial provocation tests, as well as asthmatic symptom survey, to ensure the early detection and prevention of occupational asthma.

한 사업장 근로자들의 스트레스, 생활습관 및 건강수준간의 관계

오장균 大韓産業醫學會 2000 대한직업환경의학회지 Vol.12 No.1

목적 : 이 연구는 사회인구학적 특성, 스트레스, 생활습관 및 건강수준과의 관계를 파악하여, 건강 검진시 수진자들에게 포괄적이고 양질의 임상 예방 진료서비스를 제공하고, 효율적인 사후관리 대책을 수립하는데 도움이 되고자 실시하였다. 방법 : 한 사업장 근로자 463명을 대상으로 하였고, SAS(Statistical Analysis System) version 6.11과 LISREL (Linear Strcutural Relationship) version 8.12I(1998)와 PRELIS 2.12i를 사용하여 분석한 결과는 다음과 같다. 결과 : 사회인구학적 특성과 스트레스는 유의한 관계가 없었으며, 연령이 높을수록, 기혼인 군이, 교육 수준이 높은 군이, 월 수입이 많을수록, 종교를 가진 군이, 연구직이 그리고 근무 연수가 높은 군 즉 인구 사회학적 특성이 좋은 군일수록 생활습관이 좋았다. 스트레스가 많을수록 음주량과 흡연량이 많았고, 운동은 적게 하였으며, 수면 상태가 불충분하였다. 사회인구학적 특성, 스트레스 정도 및 생활습관에 따른 건강수준과의 관계를 밝히기 위하여 카이제곱 및 분산분석을 한 결론은 결혼군의 고지혈증의 빈도가 높았다. 스ㅡ레스와 건강수준과의 직접적인 관계는 없는 것으로 나타났으며, 생활습관 중 음주 군, 운동량이 적은 군, 비만인 경우 간 질환이 많았고, 음주군, 흡연군, 운동랴이 적은군, 수면 상태가 불충분한 군, 비만인 경우 고지혈증이 많았다. 사회인구학적 변수를 고려하고 스트레스 정도, 생활습관 및 건강수준간의 관게모델을 구축하기 위하여 LISREL을 실시하여 얻은 결론은 다음과 같다. 사회인구학적 특성을 고려한 후 스테레스가 많을수록 음주, 흡연량이 많고, 운동량은 적으며, 수면상태는 불충분하는 등 생활습관이 나빴고, 생활습관이 나쁠수록 간 질환 및 고지혈증의 건강 수준이 낮았다. 비만인 경우 스트레스와는 독립적으로 간 질환 및 고지혈증의 건강 수준이 낮았다. 결론 : 생활습관 특히 적절한 음주 습관과 금연, 규칙적인 운동, 수면 습관 그리고 비만 관리가 만성 퇴행성 질환이 예방과 관리에 중요한 요인으로 판단된다. 이를 위하여 근로자 개인, 직장 및 사회적 차원에서의 스트레스 관리가 선행 되어야할 것으로 사료된다. Objectives The purpose of this study was to examine stress affecting the life style (suchas alcohol consumption, smoking, exercise, sleep disturbance, obesity) , and to determine the relationships among the stress, life style and health status of in industrial employees. Methods : This study utilized the data from health survey and laboratory test (suchas lived· enzymes and lipid profiles) in 463 Industrial Employees. Psycho-social wellbeing index was used in stress scales. The data were analyzed using SAS version 6.11, LISREL version 8.12i and PRELIS 2,12i. The analytic methods for study were chi-square analysis, anova and covariance structural analysis Results : There was no significant relationship between socio-demographic characteris-tics and stress. The older person, married, higher education level, higher economic status and researcher group included the good life style. The higher stress groups included the more alcohol consumption, more smoking, less exercise and more sleep disturbance. There was no significant relationship between stress and health status (liver enzymes and lipid profiles) Alcohol consumption, less exert·cine and obesity had a significant relationship with abnormal liver enzymes. Alcohol consumption, smoking, less exercise, sleep disturbance and obesity had a significant relationship with abnormal lipid profiles. Based on the find-ings, the structural model of stress, life style and health status was established and then consider to socio-demographic characteristics the covariance structural analysis was used. The higher stress scores included the bad life style. The bad life style included the lower health status. Regardless stress, obesity was significant relationship wish health status. Conclusions : Control of stress was initiative clues in health-promotive behaviors. Less alcohol consumption, no smoking, regular exercise, no sleep disturbance and not obese were health-promotive behaviors. Stress influenced the life style, and then life style influenced the health status.

교통사고 발생에 관한 조사연구

이장근,심운택,오장균 충남대학교 의과대학 지역사회의학연구소 1991 충남의대잡지 Vol.18 No.2

To investigate epidemiologic characteristics of traffic accident incidence, the author analyzed randomezed sampled 541 accident victims for 1 year from Jan. 1990 and Dec. 1990. The results were as follows: 1. Kind of vehicles were sedan(53.6%), truck(17.4%), microbus(14.4%), bus(9.1%) and autobicycle (5.5%) in decending order. 2. The proportion of TA ownes to disobey of safety duty was high among the groups of age forties, middle school educated, 4-5yrs carrier, in spring, on monday, at 12-19 hours time, at domestic area, truck, car to others, snowy or rainy weather, at cross road and at curve road. 3. The proportion of TA ownes to over speed was high among the groups of age forties, elementary school educated, 6-10yrs carrier, in summer, on sunday, at 04- 11 hours time, at agricultural area, microbus, car to man, cloudy weather, at cross way and at straight road. 4. The proportion of TA ownes to drinking was high among the groups of age thirties, high school educated, 6-l0hrs carrier, in winter, on saturday, at 20-03 hours time, at agricultural area, microbus, car to car, cloudy weather, at cross walk way & at curve road. 5. Head trauma & multiple organ injuries were high in drnking induced TA & fracture was high in the groups of disobey of safety walking. 6. Head trauma, multiple organ injuries & fracture were high in the group of over speed 60km/hr more over. 7. Head trauma & fracture were high in the group of bicycle rider & multiple organ injuries was high in the group of autobyicycle rider. 8. Average treatment periods was signigicantly long among the group of drinking or overspeed induced TA & autobyicycle rider.

충남지역 나환자에 대한 사회의학적 조사연구

박연우,오장균,이태용,심운택 충남대학교 의과대학 지역사회의학연구소 1990 충남의대잡지 Vol.17 No.2

We studied through February 1989 to August 1989 to investigate the demographic characteristics, disease status and deformity of leprosy patients registered at Chungnam provincial area on December 31, 1988. The results were as follows: 1. Older than 40 years of age occupied 83.3%, and most patients lived at his or her own home as farmer or stock breeder. 2. The infection source was more the extrafamilial than the intrafamilial source and the most common initial symptoms and signs by body site were sensory paralysis on extremities and infiltration on face and macule on trunk. 3. The deformity was higher in male than female, older the age and much more the deformity. 4. The deformity was higher in T type than L type, and more recent onset of disease and shorter the duration between the onset and the register of disease, more lighter the deformity. The settlement villiger than domiciliary and the group of patientnts being treated at health center than leprosy association, the deformity was heavier.

입원중인 환자들의 권리인식과 만족도

김선민,이태용,오장균,박암 충남대학교 의과대학 지역사회의학연구소 1992 충남의대잡지 Vol.19 No.1

The author studied the recognition of patient's right and the degree of one's satisfaction to help set the index of doctor-patient relationship. The data was collected from 423 patients who were admitted to the hospital in Taejeon for fifteen days from Aug. 10, 1991 to Aug. 25, 1991. The results were as the follows: 1. The recognition of the patient's right and the degree of satisfaction were 4.46±0.734, 3.20±0.884 of total 5.0 score in each mean level. 2. "I believe a patient has a right to be treated equal.", "I believe a patient has a right to be compensated in medical accident." and "A patient should be told his diagnosis, treatment, prognosis about the disease by the doctor." were high mean level among each question. Their mean levels were 4.73, 4.69, 4.66 in sequence. 3. The recognition of patient's right by the age was the highest in teenager. It was lowest in above fifty years old. It was lower as age increase. There were statistically significant difference(P<0.05). The recognition of patient's right by the level of education was highest in college level and lowest in primary school level, but the degree of satisfaction was highest in primary school level and lowest in high school. The higher the education level was, the higher the recognition of patient's right was, but the lower it was, the higher the degree of satisfaction was. There was statistically significant difference(P<0.01). The recognition of patient's right be family income was highest in high income level but the degree of satisfaction was lowest. There was statistically significant difference in the recognition of patient's right(P<0.01). 4. Correlation between the recognition of patient's right and the degree of its satisfaction: "To be advised if the hospital proposes to engage in human experimentation affecting his care to patient one has the right to refuse to participate in such research projects was positive correlation with the degree of its satisfaction(r=0.1153). There was statistically significant difference(P<0.01). There were no correlation in other questions. 5. Correlation among each questions for the recognition of patient's right was highest between "…to expect that all communications and records pertaining to his care should be treated as confidential" and "…the right to know what hospital rules and regulations apply to his conduct as a patient"(r=.6314). 6. Correlation among each questions for the degree of satisfaction was highest between "…to considerate and respectful care" and "…to expect that within its capacity a hospital must make reasonable response to the request of a patient for services"(r=.6314).

Acidic primer를 이용한 교정용 브라켓 접착의 전단결합강도

김진희,진훈희,오장균 대한치과교정학회 2001 대한치과교정학회지 Vol.31 No.1

Acidic primer는 하나의 용액으로 conditioning과 priming을 동시에 시행하는 새로운 접착 시스템으로 치질의 손상이 적고 처리 과정이 간단한 특징을 지닌다. 본 실험은 acidic primer를 이용하여 치면처리를 시행한 후 기존의 접착제로 브라켓을 접착할 때 적절한 결합강도를 지니는지 평가하기 위하여 고안되었다. 50개의 사람 소구치를 5개군으로 나누어 4개군은 acidic primer로 법랑질을 처리한 후 Clearfil Liner bond 2R(1군), Transbond XTR(2군), Panavia 21R(3군), Fuji Ortho LCR(4군)로 브라켓을 접착하였고 1개군은 Transbond XTR를 통상적인 산부식 방법을 이용하여 접착(5군)한 후 전단 결합 강도를 측정하고 접착 파절의 양상을 평가하여 다음과 같은 결론을 얻었다. Acidic primer로 처리한 4개의 군 가운데 광중합형 글래스 아이오노머를 사용한 군(4군)의 전단결합강도(9.72 ± 3.16 MPa)와 Panavia 21R을 사용한 군(3군)의 전단 결합 강도(8.69 ± 2.72 MPa)는 37% 인산으로 처리한 후 광중합형 레진(Transbond XTR)을 사용한 군(5군)의 전단결합강도(10.48 ± 2.60 Mpa)와 유의성있는 차이를 보이지 않았다 (P〉0.05). 2. Acidic primer로 처리한 4개의 군 가운데 광중합형 글래스 아이오노머를 사용한 군(4군)과 Panavia 21R을 사용한 군(3군)의 전단 결합 강도는 Clearfil Liner bond 2R를 사용한 군(1군)의 전단 결합 강도(1.09 ± 0.53Mpa)와 광중합형 레진(Transbond XTR)을 사용한 군(2군)의 전단 결합 강도(2.70 ± 1.46Mpa)에 비해 유의하게 큰 강도를 보였다 (P〈0.05). 3. 접착제 잔류지수 측정 결과 4군(2.1 ± 1.1)과 5군(2.9 ± 0.3)의 경우 1군(0,2 ± 0.4), 2군(0.3 ± 0.9), 3군(0.2 ± 0.4)에 비해 접착제 잔류지수가 유의하게 높았다 (P〈0.05). 4. 4군과 5군의 접착제 잔류 지수간에는 유의한 차이가 없었다 (P〉0.05). 따라서 acidic primer로 치면을 처리하는 방법은 시용되는 접착제에 따라 기존의 산부식 접착법과 유사한 결합강도를 얻을 수 있어 교정용 브라켓 접착시 산부식 단계를 생략할 수 있는 가능성을 보여준다. Acidic primer is the bonding agent which combines the conditioning and priming agent into the single solution and was originally developed for the dentin bonding system. It is less harmful to the tooth structure and more convenient to manipulate than the traditional etching procedure. The purpose of this study is to evaluate the shear bond strength of various bonding materials when the enamel is treated with acidic primer for the bracket bonding procedure. Fifty recently extracted human premolars were randomly separated into five groups : Group I using Clearfil Liner Bond 2 adhesive system to the enamel treated with acidic primer, Group II using Transbond XT adhesive system to the enamel treated with acidic primer, Group III using panavia 21 adhesive system to the enamel treated with acidic primer, Group IV using Fuji-Ortho LC adhesive system to the enamel treated with acidic primer, Group V using Transbond XT adhesive system to the enamel treated with 37% phosphoric acid. The shear bond strength was measured with Instron universal testing machine after storing in 37℃ water bath for 48 hours. After debonding, the teeth and brackets were examined under scanning electron microscope (SEM) and assessed with the adhesive remnant index (ARI). The results were as follows : 1. There were no significant differences in shear bond strength between group III (8.69 ± 2.72 MPa), group IV (9.7 ± 3.16 MPa), and group V (10.48 ± 2.60 Mpa) (p〉0.05). 2. The shear bond strength of group III and group IV was significantly higher than that of group I (1.09 ± 0.53 Mpa), and Group II (2.70 ± 1.46Mpa) (p〈0.05). 3. The ARI of group IV (2.1 ± 1.1) and group V (2.9 ± 0.3) was significantly higher than that of group I (0.2 ± 0.4), group II (0.3 ± 0.9) and group III (0.2 ± 0.4) (p〈0.05). 4. There were no significant difference between the ARI of group IV and group V (p〉0.05). This result suggests that the combination of acidic primer and some bonding adhesive can provide sufficient shear bond strength for clinical orthodontics.

택시 운전기사들의 유병상태에 관한 조사 연구

심운택,이종연,오장균,조영채 충남대학교 의과대학 지역사회의학연구소 1991 충남의대잡지 Vol.18 No.1

A questionnaire survey was conducted on 572 taxi drivers in Taejeon City to investigate the prevalence rate which was derived from the subjective symptoms of respondents according to the working condition and daily life effected on health. The disease were classified the cardiovascular disease, gastrointestinal disease, neurotic disease and musculoskeletal disease according to the subjetive symptoms. The results obtained were as follows : 1. Among the subjective symptoms. the complaint rate of latigability, eye strain, loss of appetite, irritability, dizziness on standing, stiffness on shoulder. and low back pain became decreased in that order. 2. The prevalence rates of cardiopulmonary and gastrointestinal disease were low in the old aged group, and the prevalence rates of all disease was proportional to the frequencies of accident experience. but no evident trend in job conditions. 3. The groups having regular meal time and rest after meal showed low prevalence rate in all disease. The sleeping time and smoking habit were related to the neurotic and cardiopulmonary disease. 4. The group of usual drug intake occupied 68% of all studied subjects, the age group of 40 or more and the group of having G-1 disease showed high rats of usual drug intake.

택시운전기사의 요통에 관한 조사

최인수,이동배,오장균,이영수 충남대학교 의과대학 지역사회의학연구소 1991 충남의대잡지 Vol.18 No.2

This study was conducted to obtain the information on the low back pain of taxi drivers from June 15, 1990 to June 30, 1990. The target population was 414 taxi drivers in Seoul city. The results were as follows; 1. Mean age of studied drivers was 36.0 years old. 2. The prevalence rate of LBP during past one year was 54.3%, and that of sciatic pain was 19.8%. and that of recent 2 weeks was 30.7% 3. The prevalence rate of low back pain was increasing with the increasing age, and that of sciatic pain was increasing with increasing work times per 1 shift. The drivers of small taxi had lower prevalence rate of low back pain than that of medium sized taxi. 4. The prevalence rate of low back pain was high in the group of unsatisfying for his job, high score of anxiety and driving car having not-comfortable chair. 5. The variables of having significant relation with the low back pain of past one year were kinds of taxi, satisfaction for job, comfortability of chair and score of anxiety. Those with sicatic pain were work times per 1 shift, satisfaction for job, comfortability of chair and anxiety score and those of recent 2 weeks were work times per 1 shift and anxiety score.

일부 농촌지역 노인들의 인식기능에 관한 조사 연구

심운택,배일훈,오장균,조영채 충남대학교 의과대학 지역사회의학연구소 1991 충남의대잡지 Vol.18 No.1

For the purpose of promotion of mental health in the rural elderlies, we surveyed 506 elderlies by means of Mini-Mental State Examination(MMSE) for evaluation of cognitive functions. We assesed degree of cognitive function impairments and association between cognitive function and socio-environmental conditions. The results were as follows : 1. Proportion of severe and mild cognitive function impairments were increased as incresing age, and mean scores of MMSE became decreased significantly among them(P<0.001). 2. In female, rates of severe and mild cognitive function impairment were high and mean scores of MMSE were significantly lower than male(P<0.001). 3. In widow group, proportion of severe and mild cognitive function impairment were high and mean scores of MMSE were significantly low(P<0.001). 4. As decreasing familly numbers, proportion of severe and mild cognitive function impairment became high and mean scores of MMSE were significantly low(P<0.01). 5. In physical handicaped group, proportions of severe and mild cognitive function impairment were high and mean scores of MMSE were significantly low(P<0.001). 6. In low scores of physical ability group, proportions of severe and mild cognitive function impairment were high and mean scores of MMES were significantly low(P<0.001). 7. Most item-scores of MMSE were significantly correlated. 8. In stepwised multiple regression analysis, age, existence of physical disorder, sex and scores of physical ability were selected highly correlated variables and power of explanation was 0.1528.

혈액투석 환자에게서 발생한 재생불량성 빈혈 1예

정지용,윤나라,강대웅,오종찬,장재현,선길홍,박경희,정종훈,김현리 朝鮮大學校 附設 醫學硏究所 2005 The Medical Journal of Chosun University Vol.30 No.1

Aplastic anemia is a disease characterized by pancytopenia in the peripheral blood and hypocellular bone marrow with the fatty infiltration. The causes of the acquired aplastic anemia were usually related to drugs and immune-related diseases. A 34-years old man was admitted due to general weakness. He has been going hemodialysis for 2 years because of end stage renal disease (ESRD) due to chronic glomerulonephritis. At admission, laboratory tests showed hemoglobin 6.2 g/dL, hematocrit 18.0 %, WBC 5,710mm (neutrophil 71.8%, lymphocyte 19.1%, monocyte 5.9%), reticulocyte 1.9%, platelet 93,000/mm, Fe 12.8 ug/dL, TIBC 204 ug/dL, ferritin 941.47 ng /ml, haptoglobin 0.72 g/L, vitamin B12 508.17 pmol/L, folate 24 ng/mL, total protein 6.54 g/dL, albumin 3.76 g/dL, Alk. pohsphatase 79 IU/L, AST 30.0 IU/L, ALT 39.7 IU/L, total bilirubin 0.57 mg/dl, BUN 79.4 mg/dl and creatinine 10.18 mg/dl. Peripheral blood smear showed the normocytic normochromic anemia with anisocytosis. Anemia was diagnosed but it was irresponsive to the recombinant human erythropoietin (EPO) and blood transfusion. In the bone marrow aspiration smear were there the hypoplastic myeloid and erythroid precursors. The bone marrow biopsy section showed the hypoplasia of all components (10-20%) and the fatty infiltration. We have experienced one case of the idiopathic aplastic anemia in a patient going through hemodialysis and we just report it with documentary records. 저자들은 혈액 투석 중인 환자에서 약물, 면역계 이상등의 원인을 발견할 수 없었음에도 재생 불량성 빈혈이 발생한 1예를 경험하여 문헌 고찰과 함께 보고하는 바이다.