직업적 디메틸아세트아미드(Dimethylacetamide) 노출에 의해 집단적으로 발생한 독성간염

최태성,우극현,김진석,박완섭,함정오,정상재,유재영 대한산업의학회 2001 대한직업환경의학회지 Vol.13 No.2

목적 : DMAC에 노출된 후 집단적으로 발생한 독성 간염 7례보고. 방법 : 2000년 2월 신설된 스판덱스 섬유제조 공장에 근무하는 생산직 근로자 178명중 2000년 2월 부터 8월까지 7명이 간장질환이 발생하였다. 환례들의 나이는 23∼47세였고, 남자 5명, 여자 2명이었다. 이들에 대해 혈액검사, 간 초음파 검사 등의 임상검사와 작업장 조사를 실시하였다. 결과 : 근무 부서는 중합 1명, 방사 1명, 권취 4명, 그리고 포장 1명이며 평균근무기간은 10주였다. 주 호소 증상은 심한 피로감, 어지럼증 및 황달이었고, 검사실 소견상 독성간염의 소견을 보였다. A, B 및 C형 간염 표지자 검사는 모두 음성이었고, 간초음파 소견상 특이 소견이 없었다. 문진 상 알코올 성 간염을 일으킬 정도의 음주력이나 최근 약물 복용력을 가지고 있는 환례는 없었다. 입원 후 보존적인 치료로 모두 급속히 호전되었다. 초기에 발생했던 환례에서 퇴원후 DMAC에 재 노출되어 독성 간염이 재발되었다. 이후 모든 환례들은 퇴원 후 DMAC 비노출 부서로 전환하였고, 퇴원후 지속적인 추적검사에서 간 효소 수치가 완전히 정상화되었고, 정상화되는 기간은 1∼2개월 정도 소요되었다. 결론 : 환례들의 임상증상, 검사결파, 노출력 및 과거력상 DMAC에 의한 독성간염으로 추정된다. Dimethylacetamide is widely used in the production of plasics, resins, synthetic fibers, and gums and in purification and crystallization processes. Inhalation of the vapor or skin absorption of the liquid of dimethylacetamide (DMAC) can cause liver damage. Toxic hepatitis possibly attributable to DMAC exposure occurred in seven works among 178 employees who had worked on a new spandex-fiber production line. A large amount of DMAC is used as a spinning solvent for synthetic fibers in the factory. The patients were aged 23-47 years old and composed of five males and two females. They were involved in the process of polymerization(1 patient), spinning(1), take-up(4) and packaging(1). The mean duration of exposure was 10 weeks. They experienced fatigue, dizziness and jaundice. The patients showed elavated total bilirubln, alanlne aminotransferase (ALT), and aspartate aminotransferase (AST) levels. The serologic test for viral hepatitis A, B and C were negative, as were the abdominal ultrasonographic scans. Based on the presumptive diagnosis of DMAC-induced toxic hepatitis, they were removed from the workplaces. One or two months after removal from the work, the transaminase levels returned to normal. The patients had no history of significant alcohol use, blood transfusion, recent medication, and drug abuse. As a result, authors could not find any attributable cause of toxic hepatitis but the toxicity by DMAC exposure.

일부 인쇄회로기판 납땜근로자들의 눈, 호흡기, 피부의 증상에 대한 조사연구

유재영,우극현,김진석,함정오,최태성,하봉구,정상재,박신구,김일룡 大韓産業醫學會 2001 대한직업환경의학회지 Vol.13 No.4

목적 : 이 연구는 납점작업자를 대상으로 납점작업으로 유발될 가능성이 높은 눈, 호흡기, 피부 등의 증상호소율 및 노출강도에 따른 관련성을 파악하기위해 수행되었다. 방법 : 연구참가자 146명중 연구목적에 적합한 20명을 제외한 126명을 대상으로 '눈이 가렵고 충혈됨', '코가 가렵거나 파가움', '재채기', '콧물'. '코막힘' , '목이 따끔거림' , '목에 무언가가 걸려있는것 같음' , '갑자기 연속적인 기침을 함' , '운동 시에 다른 사람에 비해 숨이 가쁨', '숨을 쉴 때 쌕쌕하는 소리가 남', '가래가 끓음', '손이나 안면에 가려움을 느낌' , '안면에 여드름이 날' '손이나 안면에 붉은 반점이 남' 등 14가지 증상에 대한 경험유무와 혈중연농도, 납점작업의 건강위험요인에 대한 지식상태 등을 조사하였다. 결과 : 조사된 14가지의 증상 중, '갑자기 연속적인 기침을 함'이 하루 납점시간 4시간 이상인 군아서 4시간 미만인 군보다 유의하게 증상호소율이 높았으며, 다른 증상의 경우 하루 납땜시간에 따라 유의한 결과를 보이지 않았다. 납땜작업의 건강위험요인에 대한 질문에 12.8 %가 플럭스에 의한 건강위험을 지적하였다. 전체 대상자의 평균 혈중연농도는6.05 rg/dL였으며, 히고치는 15.50 rg/dL이었다.결론 : 납땜작업자에게 호흡기 증상의 위험이 높을 가능성이 있으며, 납땜작업의 건강위험에 대한추가적인 연구와 납점작업자들을 대상으로 납점작업에 의해 유발될 수 있는 건강장해에 대한 적극적인교육 및 홍보활동을 필요로 한다. Objectives : This study was conducted to evaluate the prevalence of ocular, respiratory and skin symptoms among solderers and to investigate the relationship between symptom prevalence and exposure intensity. Methods : We analyzed 126 eligible participants out of a population of 146 male solder-ers who completed the symptom questionnaires. Fourteen symptoms including 'itchy and red eyes', 'itchy or prickly nose', 'sneezing', 'rhinorrhea', 'blocked nose', 'prickly throat', 'foreign body sensation in throat', 'sudden bouts of coughing', 'exertional breathlessness', 'wheezing', 'sputum production', 'itchy face or hands', 'acneiform erup-tions on the face' and 'red spots on the face or hands' were contained. Blood lead levels of all the 126 participants were tested and the participants' own assessments of the health risk of soldering were collected. Results : Of the 14 investigated symptoms, 'sudden bouts of coughing' was significantly more prevalent in solderers who worked 4 hours or more a day than those who worked less than 4 hours a day, as for the other symptoms, there were no significant differences in the prevalences related to daily soldering hours. 2.8% of the solderers considered the risk of flux exposure to be serious. The mean blood lead bevel was 6.05 μg/dL (maximum 15.50 μg/dL). Conclusions : Soldering may increase the risk of respiratory symptoms. Further invert tigations on the hazards of soldering processes are warranted and solderers should be educarted on these hazards.

소음 노출 남성 근로자의 고음영역 청력손실과 관련 요인

정상재,우극현,박완섭,유재영,최태성,김상우,김진석 대한산업의학회 2000 대한직업환경의학회지 Vol.12 No.2

Objectives : The purpose of the study was to assess the risk factors assumed to be related to the high frequency hearing loss in the noise-exposed male workers. Methods : 712 occupationally noise-exposed male workers were included in this cross sectional study. The subjects filled out a questionnaire on the history of noise exposure, hearing protection, otologic diseases, tobacco smoking, and were tested on height, weight, hematocrit, serum total cholesterol level, fasting plasma glucose level and arterial blood pressure level. Pure tone audiometry and otoscopy were conducted and the subjects were allocated into two groups according to whether they had 4000 Hz hearing loss or not. Results : The multiple logistic regression analysis showed that military noise exposure, poor wearing status of the hearing protection devices, increased age, long noise exposure duration, mean arterial pressure less than 80mmHg, high fasting plasma sugar are the factors significantly related to high frequency hearing loss (P〈0.05). On the contrary, there was no significant relationship between noise intensity, body mass index, serum total cholesterol level, smelling and high frequency hearing loss. Low hematocrit was shown to be a significant factor with a p-value less than 0.1. Conclusions : High frequency hearing loss in the noise-exposed male workers is related to military noise exposure, use of hearing protection devices, age, noise exposure length, fasting glucose level and mean arterial pressure, in this order. Appropriate use of the hearing protection devices has a great impact on the prevention of the noise-induced hearing loss.

남성 근로자의 건강관련 행태와 건강수준과의 관련성

함정오,김화성,이성수,우극현,안규동,이병국 순천향대학교 산업의학연구소 2001 순천향산업의학 Vol.7 No.1

This study was conducted to evaluate the health related behaviors associated with blood pressure, results of liver function and renal function, and anemia indices. Study subjects were 499 male workers who visited to General Health Screening Center of A hospital located in Chonan. Data were collected from March to December 1996. By the questionnaire, the informations of health related behaviors such as, age, smoking and drinking habits, food intake habit, sleeping time, stress were obtained. Height, weight and blood pressure were measured by a trained nurse. The level of total Cholesterol, HDL Cholesterol, triglyceride, fasting blood sugar, glutamate oxaloacetate transaminase(GOT), glutamate pyruvate transaminase (GPT), r-glutamyl transferase(rGTP), blood urea nitrogen(BUN), serum creatinine(Cr), hemoglobin(Hb), hematocrit(Hct), hepatitis B surface antigen were selected as biometric test variables. Statistical analysis, such as t-test, Chi square-test, stepwise multiple regression, multiple logistic regression were performed using SAS package program. There were significant differences in age, systolic blood pressure, total cholesterol, GOT, GGT, BUN, Hb, and Hct between drinkers and non-drinkers, and significant differences in age, body mass index(BMI), systolic blood pressure, diastolic blood pressure, rGTP, BUN, and Hb between smokers and non-smokers . Triglyceride, age, BMI, and HDL cholesterol were found to be positivc independent predictors of blood pressure, but drinking habit(mild drinking group vs. non-drinking group) and pack-year of smoking were negative predictors of blood pressure. Logistic analysis of systolic hypertensive related condition indicated that triglyceride(OR=1.003, 95% CI; 1.000-1.006), total cholesterol(OR=1.008, 95% CI; 1.000-1.016), and pack-years of smoking (OR=0.972, 95% CI; 0.952-0.994) were significantly contribution to dependent variable, Logistic analysis of diastolic hypertensive related condition revealed that age3(≥50 years vs. <40 years) (OR=4.702 (95% CI; 1.919-11.521), age2(40-49 years vs. <40 years) (OR=4.702 (955 CI; 1.919-11.521), triglyceride (OR=1.005, 95% CI; 1.002-1.008), pack-years of smoking(OR=0.972, 95% CI; 0.951-0.993), and meal regularity (yes vs. no) (OR=0.618, 95% CI; 0.383-0.991) were significantly contribution to dependent variable. Triglyceride, total cholesterol, fasting blood sugar, and animal food intake(yea vs. no) were found to be positive independent predictors to BMI, but HDL and stress(yes vs. no) were negative predictors. Logistic analysis of abnormal BMI condition indicated that total cholesterol(OR= 1.013, 95% CI; 1.007-1.020) and HDL cholesterol (OR=0.943, 95% CI; 0.916-0.972) were significantly contribution to dependent variable. BMI, HBs Ag, and the frequency of drinking were found to be positive independent predictors to GOT, but meal regularity(yes vs. no) were negative predictors. Logistic analysis of abnormal GOT condition indicated that HBs Ag(yes vs. no)(OR-6.666, 95% CI; 1.724-25.779), BMI(OR=1.199, 95% CI;1.015-1.416), and meal regularity(yes vs. no)(OR=0.248, 95% CI; 0.096-0.639) were significantly contribution to dependent variable. BMI, and HBs Ag were found to be positive independent predictors to GPT, but meal regularity(yes vs. no) were negative predictors. Logistic analysis of abnormal GPT condition showed that only BMI (OR=1.301, 95% CI; 1.301(1.176-1.440) was significantly contribution to dependent variable. BMI and the frequency of drinking were found to be positive independent predictors to rGTP, but meal regularity(yes vs. no) were negative predictors. Logistic analysis of abnormal rGTP conditionindicated that BMI(OR=1.340, 95% CI; 1.197-1.499), Alc5(abovc 5 times/week vs. non-drinking) (OR=21.733, 95% CI; 3.671-128.684), Alc4(3-4 times/week vs. non-drinking) (OR=4.533, 95% CI; 1.463-14.049), Alc3(1-2 times/week vs. non-drinking) (OR=3.918, 95% CI; 1.406-10.916), and meal regularity(yes vs. no) (OR=0.405, 95% CI; 0.221-0.740) were significantly contribution to dependent variable. BMI and age were found to be positive independent predictors to BUN, but stress(yes vs. no) and pack-year of smoking were negative predictors. Logistic analysis of abnormal BUN condition indicated that only age3(≥50 years vs. <40 years) (OR=4.808 (95% CI; 1.307-17.676) was significantly contribution to dependent variable. BMI was found to be positive independent predictors to Hb and Hct, respectively, but regular exercise(yes vs. no) was negative predictors to Hb and Hct, respectively. With above results, it was found that age, BMI, level of serum triglyceride, and level of serum total cholesterol were significantly associated with hypertension and that BMI was significantly associated with abnormal results of liver function tests and especially the frequency of drinking was associated with abnormal rGTP. Also the workers with meal regularity habits, compared to those with meal irregularity habits, were lower prevalence of hypertension and abnormal liver function tests, therefore the meal regularity habits seem to be reflected good health related behaviors.

산업 근로자의 구강건강실태 및 구강질환 관련요인에 관한 연구

김혜진,박천만,우극현,이은숙,이종렬,하은경 대한보건협회 2002 대한보건연구 Vol.28 No.2

To maintain and improve workers' oral health, I investigated and analyzed the oral health status of workers, who are working at companies located in Koomi City. The results of the investigation and analysis are as follows. 1. Regarding the general properties of investigated objects, the male ratio of whole objects(1299 persons) occupied 86.6% the larger percentage, the persons from 20ages to 29ages in terms of age distribution occupied 35.6%, and the high school graduators in the respect of education occupied 75.3%. As for the property of duties, technical workers occupied 83.6% the larger percentage. In the drinking frequency of habits, one or two times drinking per week occupied 34.1% in case of male, and no drinking occupied 62.9% in case of female. 2. In the existence and nonexistence of oral disease depends on the general property of each objects, many females have an oral disease in comparison with males(p<.05), many persons with low education level have an oral disease(p<.001), and lots of self-boarding persons have an oral disease compared to the persons stayed at own home or dormitory(p<.05). In the existence and nonexistence of oral disease depends on living habits, the more male has a drinking capacity, the more has an oral disease(p<.05). And, the more male is smoking, the more has an oral disease(p<.05). When examine oral disease in accordance with cubjective healthy condition, there were many respondents answered that I have a decayed tooth or periodontitis in comparison with respondents did that I' m healthy(p<.001). In the existence and nonexistence of oral disease depends on oral health control practices and recognition, the persons received scaling for the latest one year had show a few of oral diseases significantly(p<.001). 3. As a result of Logistics Regression Analysis by putting oral disease as a dependent variable, the person who does not receive scaling, does smoking, has a low education level, does work at company for a short time, experiences lots of subjective symptoms, and does drinking, has a possibility that he/she can be infected easily with oral disease. As a whole of the above results, regular oral checkup every year shall be strengthen in its quality and quantity. In particular, the activation of oral health education to prevent oral disease may make workers' oral health and their life quality to be improved. Accordingly, in oral health education for workers, the more systematic and effective program shall be developed and the supports in government policy shall be needed.

유기용제 폭로 근로자의 자각증상에 관한 연구

엄영익,신혜련,우극현,안규동,이병국 순천향대학교 산업의학연구소 1997 순천향산업의학 Vol.3 No.1

To investigate the relationship of subjective symptoms of organic solvent exposed workers with their exposure level and urinary excretion of hippuric acid, 61 male workers who worked in 5 organic solvent using industries were studied. 89 workers were randomly selected from workers group for detailed health examination who visited hospital and had no exposure history to organic solvent as a control group. Personal air concentrations of organic solvent were checked for all organic solvent workers and urinary concentration of hippuric acid for both exposed and control group were also measured. Subjective symptom questionnaire of 31 organic solvent related item were provided to all workers and filled up by themselves and rechecked by medical doctor. The results obtained were as follows: 1. The overall prevalence rate of symptoms were significantly higher in exposed group than control group with statistical difference of 13 symptoms. 2. The overall prevalence rate of symptoms seemed to be increased by the exposure level of organic solvent. 3. The excretion of hippuric acid was more closely related to the level of toluene exposure than the level of mixed organic solvent exposure. 4. In the analysis of multiple stepwise regression using hippuric acid concentration as dependent variable and the concentration of each organic solvents as independent variables, only toluene had significant relationship with hippuric acid and none of other solvent did not affect on the concentration of hippuric acid. 5. In the analysis of multiple stepwise regression using symptom prevalence as dependent variable and the concentration of each organic solvents as independent variables, toluene had most significant effect to the symptom prevalence and the contribution of other solvents was minimal.

뇌 심혈관계 관련질환 유소견 근로자들의 의료이용에 관한 연구

최태성,유재영,김진석,장은철,박주언,우극현 순천향의학연구소 2006 Journal of Soonchunhyang Medical Science Vol.12 No.2

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산업근로자의 보건복지사업 활성화 방안

우극현 慶山大學校 保健福祉硏究所 1997 保健福祉硏究 Vol.1 No.-

산업근로자들의 보건복지 활성화를 위해서는 관련전문기관과 사업주, 근로자들간의 팀웍과 자발적인 참여를 토대로 하는 포괄적인 관리프로그램이 필수적이다. 과거 수십년 동안 우리나라는 경제성장위주의 국가시책에 힘입어 신흥공업국가로 급성장하게 되었다. 그러나 70년대 후반에 들어서면서 그 부산물로 산업재해 다발과 대형화를 수반하게 되었고, 또한 유해 작업환경으로 인한 각종 직업병이 사회문제로 크게 대두되었다. 이와 때를 같이하여 근로자들 스스로가 누려야 할 권리에 대한 인식이 노동운동으로 발전하게 되었으며, 정부는 1981년에 직업병과 산업재해에 대한 예방대책을 세워 나가고자 산업안전보건법을 제정 공포하였다. 그러나 초창기의 노동운동은 근본적인 문제해결 보다는 임금인상의 도구로 활용되었으며, 사업주의 인식부족과 근로자들의 무관심 및 정부차원의 지원이 미흡하였을뿐 아니라, 산업보건분야 전문인력이 모자라는 등으로 근로자 건강관리가 형식적인 면을 크게 벗어나지 못하였다. 최근에 우리나라도 여러 선진국들의 영향을 받아 대기업을 중심으로 근로자들의 보건복지를 위해 상당한 투자를 하고 있으나 중소기업의 실정은 많은 차이가 있다. 특히, 노동부 통계 자료에 의하면 1987년말 우리나라 전체 근로자 중 300인 이하 사업장에 근무하는 근로자가 64.4%나 되며, 1992년 4월 현재 5인이상의 사업장 근로자 588만 3천명 가운데 67.7%가 300인 이하의 중소 영세사업장에 근무하는데, 이들의 근로조건과 작업환경은 대기업에 비해 더욱 열악하고 사업주들의 경제적 여건이나 작업관리의 효율성에 대한 인식도가 부족할 뿐 아니라 근로자들의 학력수준 및 건강에 대한 관심도가 낮아 각종 산업재해와 직업성 질환의 온상이 되고 있으며 또한 중고령화로 인한 각 종 만성퇴행성 질환의 유병율이 급격하게 증가하는 추세에 있다. 따라서 본 연구는 미국, 일본 등 선진국에서의 근로자 보건복지 추진현황을 살펴보고 우리나라 대기업 중심의 보건복지 실태와 향후 전략에 관한 의견을 제시하고자 시도되었다. For the maintenance and promotion of all workers' health and welfare, it is essential that comprehensive occupational health care program is based on the team-work approach and spontaneous particpation of employers and employees. During the past several decades, industrialization of our country was achieved very rapidly because the first order of the governmental policy was economic growth. As a by-product, many kinds of occupational diseases and injuries were developed and became a social problem. And so, Occupational safety and health law and regulation was made by Korean government in 1981 and revised in 1990. But, it was not fit in with the reality. Organization and financing of government was not appropriate to carry out occupational health services and well-trained occupational health professionals also were much lower than what is needed to prevent and treat occupational health problems. Moreover, employers and employees' ignorance and indifference toward their occupational health problems has made it difficult to improve these problems. Recently, interests in health promotion and welfare have been stimulated from most large industries in Korea, and their employers began to spend the large amount of money on this field. But, workers' condition in medium and small sized factories is not similar. Especially, proportion of workers who were engaged in factories with less than 300 was 67.7% among total 5,890,000 manufactuaring workers in April, 1992. Their working environment and work condition is relatively worse than large enterprises. Accordingly the rate of occupational injuries and illnesses is higher, too. From now, I'd like to introduce characteristics and prospect of the Korean occupational health and welfare condition and suggest strategy for promoting their health and welfare.

도시영세지역(都市零細地域) 주민(住民)의 상병(傷病)및 의료이용(醫療利用) 양상(樣相) -대구직할시를 중심으로-

우극현,Woo, Kuck-Hyeun 대한예방의학회 1985 예방의학회지 Vol.18 No.1

도시 영세지역 주민의 이환 및 의료이용 양상을 파악하기 위하여 1984년 7월 한 달 동안에 대구시 중구 남산 4동 영세지역 468가구의 가구원 2,002명과 대조지역 374가구의 가구원 1,709명을 대상으로 가구원의 일반적 특성, 질병이환 및 의료이용 양상 등을 면담조사 하였다. 영세지역과 대조지역의 성별, 연령별 분포는 비슷하였으나, 경제수준, 교육수준, 주거밀집도, 의료보장 종류별 분포는 유의한 차이를 보였다. 15일간의 상병 이환율은 영세지역이 1,000명당 131로 대조지역의 71보다 유의하게 높았고, 연령이 증가함에 따라 이환율도 증가하는 경향을 보였으나 65세이상의 노인층에서는 오히려 감소하였다. 년간 만성병 이환율도 영세지역이 1,000명당 134로 대조지역의 89보다 유의하게 높았고 나이가 증가함에 따라 이환율이 증가하였다. 15일간의 상병은 영세지역과 대조지역 모두 호흡기계 질환이 각각 24.0%, 29.8%로 가장 많았고 그 다음은 소화기계 질환으로 21.0%, 20.6%였으며 손상 및 중독은 영세지역이 10.3%인데 비해 대조지역은 3.3%였다. 만성병은 영세지역과 대조지역 모두 소화기계질환이 22.1%, 21.7%로 가장 많았고 그 다음으로 영세지역은 근골격계 질환으로 12.3%, 대조지역은 신경통으로 14.5%였으며, 순환기계 질환은 대조지역이 11.8%로 영세지역의 5.6% 보다 더 많은데 비해 손상 및 중독은 영세지역이 10.8%로 대조지역의 4.6%보다 더 많았다. 15일간의 상병으로 활동제한을 받은 일수는 영세지역이 평균 4.0일로 대조지역의 평균 2.2일보다 유의하게 높았다. 15일간의 상병이나 만성병을 치료받기 위해 영세지역은 약국을 더 많이 이용하고 대조지역은 병의원 외래를 더 많이 이용하였으며, 특히 의료보장 종류별로는 의료보험 가입자는 병의원 외래를, 그리고 일반환자는 약국을 더 많이 이용하였으며, 미치료율은 의료보장 종류에 관계없이 15일 이환의 경우 영세지역이 17.9%, 대조지역은 11.6%, 그리고 만성병은 영세지역이 15.2%, 대조지역은 9.2%로 영세지역의 미치료율이 대조지역보다 더 높았다. 15일간의 상병이나 만성병 모두 경제적인 이유로 치료받지 않은 경우가 가장 많았다. 영세지역의 이환율이 대조지역보다 높은 것은 경제수준, 교육정도, 주거밀집도 등 여러가지 사회 경제적인 요소가 관련된 것으로 나타났으므로, 영세민을 위한 보건사업 계획에는 이러한 사회 경제적인 요소들을 개선하는 노력을 병행해야 효과적인 보건사업이 추진될 것으로 생각된다. This study was conducted to assess the morbidity and medical facilities utilization patterns of the residents in urban low income area. Study population included 2,002 family members of 468 households in the low income area (LA) of Nam-san 4 Dong, Jung Gu of Taegu city and 1,709 family members of 374 households in surrounding neighbourhood control area (CA). Well trained nursing school students interviewed mainly with housewives according to the pretested questionaire between July 1 and July 30, 1984. Age-sex distribution of the study population in LA was similar to that in CA. The average monthly income of a household in LA was 236,000 won and 356,000 won in CA. Educational level of the residents in LA was lower than that in CA; average years of school education of the 20 years old or above in LA was 6.9 years compared with 8.5 years in CA. The average family members per room in LA was 2.6 and 2.2 in CA, and proportion of Medicaid program beneficiary was 29.4% in LA and 1.9% in CA. Prevalence rate of illness during 15-day period was 131 per 1,000 population in LA and 71 in CA(p<0.01) and that of the chronic illness for 1 year was 134 per 1,000 population in LA and 89 in CA(p<0.01). The most common illness experienced during 15 days was respiratory disease(24.0% in LA ana 29.8% in CA) and followed by gastro-intestinal disorders(21.0% in LA, 20.6% in CA). Injury or poisoning was 10.3% in LA and 3.3% in CA. Castro-intestinal disorder was the most common chronic illness in both LA (22.7%) and CA (21.7%), and followed by musculoskeletal disease in LA and neuralgia in CA. Mean activity restricted days among the persons with illness during 15-day period was 4.0 days in LA and 2.2 days in CA. Among persons with illness during 15 days, 17.9% in LA and 11.6% in CA did not seek any medical treatment and the most frequently utilized medical facility was pharmacy in LA (35.5%) and local clinic or hospital OPD in CA (42.1%). Among persons with chronic illness, 15.2% in LA and 9.2% in CA did not seek for medical treatment, and residents in LA as well as residents in CA utilized local clinic or hospital OPD more frequently than pharmacy or drugstores, especially those who have medical insurance. The most common reason for not treating illness experienced during 15-day period and chronic illness was economical constraint in both LA and CA. The higher prevalence rate of illness during 15-day period and chronic illness in LA than that in CA seems to be highly correlated with their lower economic status and educational level and crowded living condition. The utilization pattern of medical facilities was associated with the medical security status. A program to improve the economic status and living condition should be integrated with the health program to promote the health of the population in low income area.

참여형 개선기법(PAOT)의 원리를 적용한 대사증후군 관리 프로그램 효과분석

윤성용(Seong-Yong Yoon),우극현(Kuck-Hyeun Woo),김화성(Hwa-Sung Kim),김용배(Yong-Bae Kim),김진석(Jin-Seok Kim),조성용(Seong-Yong Jo),이성수(Sung-Soo Lee) 한국보건교육건강증진학회 2014 보건교육건강증진학회지 Vol.31 No.5