우리나라의 B형 간염 조절 정책의 변화에 대한 조사

A Survey for Changed Control Policies of Hepatitis B in Republic of Korea

  • 한지윤 (가톨릭대학교 의과대학 소아과학교실) ;
  • 정태웅 (가톨릭대학교 의과대학 소아과학교실) ;
  • 고대균 (가톨릭대학교 의과대학 소아과학교실) ;
  • 김종현 (가톨릭대학교 의과대학 소아과학교실)
  • Han, Ji Yoon (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Jung, Tae Woong (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Koh, Dae Kyun (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Kim, Jong Hyun (Department of Pediatrics, College of Medicine, The Catholic University of Korea)
  • 투고 : 2011.10.10
  • 심사 : 2011.10.20
  • 발행 : 2011.12.25

초록

목 적:우리나라의 B형 간염 조절을 위한 초창기 예방접종 정책과 1회용 주사기를 포함한 혈액매개질환의 감염원이 될 수 있는 기구 사용 정책에 관한 자료를 수집, 정리하여 향후 정책 수립 및 평가에 활용할 수 있도록 하였다. 방 법:국내 학회지 또는 논문, 정부 웹사이트, 전산화된 주요 일간신문 등을 검색하여 수집된 자료들의 내용을 확인하였다. 자료의 내용에 따라 정부의 B형 간염 조절 정책, 학교에서의 B형 간염 단체 예방접종 사업, B형 간염 백신 사용 상황, 1회용 주사기를 포함 혈액매개질환의 전파 가능성이 있는 기구 사용에 관한 정책 등 네 가지 주제로 나누어 각각에 대해 시기별 정책 변화를 정리하였다. 결 과: 1980년대 초 B형 간염에 대한 사회적 관심이 컸기 때문에 B형 간염 백신이 신속히 도입, 개발되었으며, 1983년 말에 'B형 간염 퇴치를 위한 5개년 계획'이 수립되어 1984-5년 2년간에만 B형 간염 백신을 접종한 사람은 약 600만명이었다. 그러나 접종 대상이 신생아가 아닌 성인에 초점을 맞추었기에 전문가들의 반론에 따라 2년만에 계획은 백지화되었다. 이후 학교 단체 예방접종 사업이 진행되고, 1995년에는 국가 필수예방접종에 포함되는 등 신생아 중심의 예방접종 정책이 유지되었다. 1회용 주사기의 사용은 1980년대 초부터 권고 되었으나 1985년이 돼서야 법제화되었다. 결 론:우리나라에서의 B형 간염 감염 관리에 대한 성공 요인은 B형 간염 백신의 조기 도입 및 대량 접종, 높은 접종률, 1회용 주사기 사용 등이 종합적으로 작용하여 이루어진 것이라 생각된다. 그러나 이를 뒷받침할만한 공식적 자료가 너무 부족하다. 따라서 정부가 보유하고 있는 모든 감염 관련 자료들의 정리와 전산화 작업이 매우 시급하다고 여겨진다.

Purpose : We have tried to search all concerning data on the policies of hepatitis B vaccination or surveillance of medical equipments that can transmit blood mediated diseases, including disposable syringe, in Republic of Korea, to propose references to other medical professionals. Methods : Data from domestic journals, government websites, computerized newspapers, etc. were reviewed. The data were arranged into four categories (governmental policies on hepatitis B control, hepatitis B mass immunization program in school, using process of hepatitis B vaccine, and policies on medical equipments surveillance, including disposable syringes, which is considered as source of blood mediated infection), and the periodic changes on each subjects in policies were reviewed. Results : Due to growing social concerns on hepatitis B in early 1980s, swift introduction and production of hepatitis B vaccine was made. After establishment of "5 year project for eradication of hepatitis B" in late 1983, number of vaccinated population jumped up to 6 million within 2 years (1984-85). However, since the immunization targets were mainly adult, not infant, this project was annulled in late 1985. Following this project, hepatitis B mass immunization program in school was carried out. In year 1995, hepatitis B vaccine was included in national immunization program. The use of disposable syringe was recommended from year 1980 but legislated in year 1985, finally. Conclusion : The mainstay in controlling hepatitis B in Republic of Korea was coordination of prompt introduction of vaccine, mass immunization, high vaccination coverage rate, or use of disposable syringes. However, since there is lack of official data available, it is urgent to arrange and computerize all government data related to infectious diseases.

키워드

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