우리나라 지역 직업성질환 감시체계의 현황과 전망

임종한,장성실,김성아,문재동,채창호,홍윤철,김수영,김진석,김영욱,한상환,이혜숙,원종욱,송동빈,하은희,강성규 대한산업의학회 2001 대한직업환경의학회지 Vol.13 No.2

기존의 특수건강진단과 작업환경측정을 통한 직업병 관리가 진폐증, 소음성난청 등의 소수 특정질환에 국한되고 실제 직업병 발생 규모 파악이나 신종 직업병의 발견에 한계를 보인다는 사실은 산업의학전문가들 사이에서도 공감을 이루고 있다. 미국과 영국 등에서의 직업성질환 감시체계에 대한 경험은 우리 나라의 직업성질환 감시체계 구축에도 새로운 자극제가 되면서, 1998년이후 인천, 대전, 여천, 구미, 부울경 지역에서 지역 직업성질환감시체계를 산업보건관리의 중요한 시스템으로 구축하려는 노력이 확산되고 있다. 새로이 구축되어지는 이들 지역 직업성질환 감시체계는 감시하고자 하는 대상질환, 활용 가능한 인적자원 및 자료원, 지역 의료체계의 특수성 등에 따라서 목적과 방법을 달리하면서 독특한 형태로 발전을 하고 있다. 각 지역단위 감시체계들이 그 상황에 맞게 독특한 목적과 전략들을 발전 시키면서도, 향후 발전할 국가적인 차원의 직업성질환 감시체계 구축을 위하여 직업성질환 감시의 기본 전략 등을 공유하는 등의 노력이 필요하다. 환례 정의 및 기본적인 등록 서식의 공유, 직업성질환 감시 자료원의 발굴, 공동의 정보 네트워크 및 직업성질환 감시 데이터베이스 구축 등 직업성질환 감시활동을 지원하기 위한 여러 기초 인프라 구축에 힘을 모아야 할 것이다. 우리 나라에서 직업성질환 감시체계를 성공적으로 구축하기 위해서는 수집된 자료의 질 관리를 위한 직업성질환 감시의 원칙 제정과 감시 전략의 공유 등이 필요하며, 전국적인 직업성질환 감시체계의 하부구조라고 할 수 있는 지역감시체계의 기초 토대 마련과 강화작업이 절실하게 필요하다.

일부 청소년들에서 흡연노출량에 따른 혈중 카드뮴 농도

장성실,권윤형,배진순,노영만,한진구 韓國學校保健學會 2001 韓國學校保健學會誌 Vol.14 No.2

Objectives: We surveyed the prevalence of smoking among the adolescent population and analysed the correlation of the two exposure biomarkers-concentration of blood cadmium and urinary cotinine-to the smoking status. Methods: Subjects were 193 middle and high school students in Chungnam province. Blood cadmium and urinary cotinine were compared by sex and smoking status. Smoking status were classified by either the concentration of urinary cotinine or subjective answering as a smoker in the questionnaire. Results: Smoking prevalence was 24.6%, 36.2% and 6.7% among all subjects, male and female subjects, respectively. Average smoking amount was 17.5 and 1.5 cigarettes per month among the male subjects and female subjects, respectively Mean concentration of urinary cotinine among the male subjects was 135.57 ㎍/ℓ, and that of female subjects was 116.59 ㎍/. Direct smokers showed higher concentration of urinary cotinine than those of indirect smokers, and subjects with higher urinary concentration showed higher prevalence of smoking, too. Mean concentration of blood cadmium was 0.0572 ㎍/㎗ among the male subjects, and 0.0693 ㎍/㎗ among the female subjects. Among the male subjects, both exposure biumarkers showed significant correlation to the smoking status, but among the female subjects urinary cotinine did not show significant correlation to the smoking status. Conclusion: Concentrations of these two biomarkers suggested that this population had significantly high evironmental tobacco smoking(ETS) and efficient stop-smoking programs to reduce ETS should be directed to this population. Key words : environmental tobacco smoking, urinary cotinine, blood cadmium

춘천 지역 주부들의 제례음식 준비에 관한 연구

김은실,함승시 동아시아식생활학회 2001 동아시아식생활학회지 Vol.11 No.4

The survey on the practice of the memorial ceremonial food in Chuncheon area showed it varied according to social position of officiator, location(inland or seaside town), and personal condition. The study included the foods prepared for the memorial services on the memorial day, New Year's Day and Chusok. 1. 40,4% of the subjects were in the thirties at their age, 46.6% were high school graduates, 57.3% were the first daughter-in-law, 40.4% had no religion, 30,9% were working at public administration and earned less than 1 to 1,5 million won monthly, 2. 71.7% of the subjects who replied that the ancestor worship service had to be kept were Buddhists, 55.4% of them were high school graduates, and 58.8% of them ran independent businesses. They learned how to practice the ancestor worship service from their mother before marriage or from their parents-in-law after marriage. 3. The older the officiators, the better they wanted to keep the traditional format of the service, but the Christians and Catholics wanted to change the format to western style in the future. 4. 92.7% of them served cooked milled rice. They prepared the soup in the order of beef soup, radish soup and dried Alaskan Pollack soup, 5. Among cooked vegetable dishes, bracken was used the most and balloonflower root, mung bean sprout and spinach followed, Among jeon(pan-fried foods), frozen Alaskan Pollack was used the most and buckwheat, mung bean and meatball followed. 6. They served san-juk(beef kebab) mostly on the ceremony. Among the grilled foods, tofu was the favorite, and croaker followed. 7. Among the fried foods, squid was the favorite, and sweet-potato and shrimp followed. Among the dried foods, they used in the order of dried Alaskan pollack, dried beef and squid. 8. Among the rice cake and traditional confectionery, they used in the order of Yak-sik(sweet rice cake), Gang-jeong(fried glutinous rice cookie), Jeol-pyun and In-jeol-mee. Among a beverage, they served Sik-hye(fermented rice drink) mostly. 9. Among fruits, apples, jujube, chestnut and dried persimmon were served. Among a liquor, Cheongju was served mostly. 10. Soy sauce, salt and salted fermented fish were served, too.

만성 승모판폐쇄부전증 이환견의 치료 1례

김영실,박정희,신영지,박성준,이영원,최호정,송근호 忠南大學校 獸醫科大學 動物醫科學硏究所 2005 動物醫科學硏究誌 Vol.13 No.-

A 8 years old intact male Shih-tzu dog with respiratory distress was referred to the Veterinary Medical Teaching Hospital of Chungnam National University. The dog also had a history of several episodes of syncope prior to visit. Physical examination revealed tachypnea, panting, mucous membrane of pale and cyanosis. Holosystolic murmur at the left apex region by auscultation, left sided cardiac enlargement by thoracic radiography and mitral regurgitated flow by echocardiography were detected. Clinical signs were improved by treatment of diuretics, ACE inhibitor, bronchodilator and oxygen therapy.

노후아파트단지 개량화 방안에 관한 연구 (I)

오덕성,권성실,박천보 忠南大學校 産業技術硏究所 1994 산업기술연구논문집 Vol.9 No.2

This study aims to review the problems of deteriorated or declined apartment estates and to suggest the ways of their improvement. It is divided into four parts. The first part reviews the need of the improvement methods to deal with these apartment estates. The second part analyzes the conditions of these apartment estates and the experiences of the improvements with reference to the site, public facilities, buildings and dwelling units. The last part considers the findings from the analysis and put forward some suggestions for future development.

대전지역 접촉성 피부염에 대한 감시체계 : 대전1, 2 공단지역 용제 및 특화물 취급자에서 수시건강진단체계 구축 시도를 통한 접촉성 피부염 유병조사

장성실,김수영 대한산업의학회 2000 대한직업환경의학회지 Vol.12 No.2

Objectives : We tried to establish a Regional Occupational Surveillance System (ROSS) for estimating the prevalence and monitoring the trend of occupational dermatitis among 718 manufacturing workers exposed to organic solvents and nonmetallic chemicals in small and medium sized businesses of 1,2 industrial complex area of taejon City. Methods : Through the report from the nurses of Group Occupational Health Management System, we made a case referral and immediate health examination system with occupational medical clinics. We also performed a survey for detecting occupational dermatitis by a self-administered questionnaire. Case must meet 3 criteria; 1) He/she must have one or more significant cutaneous signs and symptoms. 2) The symptom should be changed by the work condition or caused by risk chemicals. 3) Dermatitis should be diagnosed by a doctor. Results : Among the 131 workers(17.7 %) with significant symptoms screened by the questionnaire, 4 workers(0.6 %) met the case definition criteria. And among the 45 workers (6.3 %) referred to the immediate diagnosed system, 14 workers (1.9 %) were strongly suspected to have occupational dermatitis. Conclusions : These prevalence rates were quite underestimated because of deficient recognition of the disease severity among the workers, reversibility of the target diseases, and life-threathening mood due to nationwide economic crisis and the socioeconomic withdrawal of each business. Ultimately, harmonized activities of government, industry, labor unions, volunteer organization and academy relating to occupational health in a community should be encouraged to do creative, consistent efforts for evolution and development of this first trial of ROSS.

高等學校에서의 英語敎育

李成實 한국강원영어영문학회 1981 영어영문학 Vol.- No.2

초등학교 치아우식 아동의 구강검진 후 관리 실태와 어머니의 구강건강신념과의 관계

배진순,장성실 韓國學校保健學會 1999 韓國學校保健學會誌 Vol.12 No.2

The objective of this study were to evaluate the relation between post-examination management states of dental caries in elementary school students and a mother's dental health beliefs. We systematically chose 10 elementary schools in urban and rural areas of Chungnam Province and determined the first class students of 5 and 6 grade in each school as study subjects. Among 837 participants, 669 students were diagnosed with dental caries after a 1998 periodic dental health examination was answered completely and analysed. The contents of the questionnaire for students were general characteristics, dental health behaviors, notification factors, treatment factors. Their mothers were surveyed by another questionnaire. The contents of the questionnaire for mothers were also general characteristics, dental health behaviors, and dental health beliefs. The result of this study were as follows" 1.The prevalence of dental caries was 65.0% and there was no significant difference between urban and rural areas. 2. Meanwhile, 63.8% of students in urban areas knew the examination result through a doctor's explanation, 52.4% of students in rural areas learned through a school notification letter. 82.9% of all the students let their parents know of their dental caries. 3. Among the dental caries group, 36.3% of the students were treated as for treatment, most students in urban areas visited a dental clinic, but those in rural areas visited the dental dept of a public health center as for the treatment time, 35.9% of the students were treated immediately after the examination. 4.449% of those treated answered that they considered the treatment as a bother and unnecessary due to no pain. 5. Overall, the scores in the dental health beliefs in mothers were low. Especially among the 5 items of susceptibility and seriousness, the scored were very low but the benefit was high. Logistic regression analysis showed that the treatment of a child's dental caries was significantly associated with low scores of benefit in those untreated and high scores among those treated. Considering these results, health education to stimalate a mother's susceptibility and seriousness in health beliefs and for students to learn the need for treatment, including a more detailed post exam management system at the school level should be considered for a higher treatment rate.

대전시 일부 지하상가 공기중 포름알데히드 농도 및 종사자들의 자각증상에 관한 연구

양태웅,장성실 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.1

This study was performed to get the fundamental data establishing environmental formaldehyde threshold limit as well as to contribute the health promotion of merchants and customers in two underground shopping-centers in Taejon from Dec. 1997 to Jan. 1998. Formaldehyde concentration and three climate factors-air current, humidity, and temperature-were measured at exit., hallway and inside shops in underground environment, and questionnaire about 15 subjective symptoms among 120 merchants in the inside shops were also surveyed by means of the questionnaire for screening workers exposed formaldehyde in Korea. The results were as follows ; 1. The average formaldehyde concentration in whole area was 0.0299 ppm ; Exit, Hallway and Inside shop were 0.0205 ppm, 0.0325 ppm and 0.0366 ppm, respectively(p<0.000). 2. According to simple regresson analysis, air current(r=-0.2517, p<0.05) and temperature(r=0. 5871, p<0.001) were significantly related to formaldehyde concentration. 3. More than 80% of the merchants have 5 subjective symptoms such as easy fatigahility, headache, throat discomfort, conjunctival injection, and nasal congestion. With all above the results, it can be suggested that environmental formaldehyde threshold limit at underground in Korea be reestablished, regarding related climate factor-air current and temperature-, and the questionnaire for screening subjective symptoms should be developed again for evaluating the evironmental effect of formaldehyde.

Aldehyde dehydrogenase2(ALDH2) 유전자형이 톨루엔의 생물학적 폭로지표인 요중 마뇨산배설에 미치는 영향

박정일,장성실,이강숙,노영만 大韓産業醫學會 1996 대한직업환경의학회지 Vol.8 No.3

We investigated toluene exposure level, urinary hippuric acid concentration, subjective symptoms and genotype of ALDH2 DNA in 134 exposed workers and 53 nonexposed workers for evaluating the effect of ALDH2 polymorphism on toluene metabolism and urinary hippuric acid concentration as biological exposure indices(BEI) of toluene. The results were as follows; 1. The percentage of inactive genotype of ALDH2 in exposed workers was lower than that of exposed(P=0.081). 2. The percentages of exposed workers with inactive genotype did not have any significant difference by the increase of toluene exposure level or work duration. 3. The frequency of drinking, monthly and maximum amount of alcohol intake in workers with normal genotype were significantly higher, than those with inactive genotype. 4. The urinary hippuric acid concentration of nonexposed workers with inactive genotype was significantly lower than that with normal genotype. Under 100 ppm of toluene, similar but statistically insignificant trends were found, while above that concentration of toluene, reverse but statistically insignificant trends were found. 5. The number of acute and chronic subjective symptoms were increased positively with the concentration of toluene in workers with normal genotype, but no such trends were found in workers with inactive genotype. 6. The result of simple linear regression between toluene and urinary hippuric acid concentration showed a very significant positive linear relation-ship. The mean hippuric acid concentration of nonoccupational exposure was 0.289±0.227(0.062-0.516)g/l. Toluene exposure level unable to discriminate with nonoccupational exposure estimated from regression equation, it range from 7.29 to 9.87 ppm. Considering above all things, it was useful to estimate the exposure level of toluene by means of analysing urinary hippuric acid concentration in both genotype workers, but the biological exposure indices(BEI) of both genotypes were different from each other. The BEI of the total exposed workers was 2.76g/l, which was lower than current criteria 3.0g/l (2.5 g/g Cr), and it also suggest that the BEI for the exposed workers in our country be lowered to the appropriate level after further study.