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Association of Lifestyle with Blood Pressure (생활양식과 혈압의 관련성)

  • Joo, Ree;Chung, Jong-Hak
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.3 s.58
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    • pp.497-507
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    • 1997
  • This study was conducted to evaluate the association of various lifestyle with blood pressure. The data were obtained from the individuals who got routine health examination in Department of Occupational Medicine, Yeungnam University Hospital from June to September, 1996. Among these people, we selected 130 cases of hypertensives (97 males, 33 females) and 150 normotensives(70 males, 80 females) and study was conducted. The authors collected the information of the risk factors related to hypertension such as age, family history of hypertension, fasting blood sugar, serum total cholesterol, alcohol consumption(g/week), smoking history, relative amount of salt intake (low, moderate, high), the frequency' of weekly meat consumption, BMI, daily coffee consumption(cups/day) and the frequency of regular exercise(frequency/week) through questionnaire and laboratory test. By simple analysis, BMI was significantly associated with hypertension in male(p<0.05), and the frequency of weekly meat consumption was significantly associated with hypertension in female(p<0.05). Using logistic regression model, elevated odds ratio was noted for fasting blood sugar, serum total cholesterol, family history of hypertension, alcohol consumption, salt intake and BMI, and reduced odds ratio was noted for coffee consumption and exercise in male but fasting blood sugar(odds ratio=1.022, 95% CI=1.000-1.044), family history in both of parents(odds ratio=3.301, 95% CI=1.864-4.738), salt intake(odds ratio=1.690, 95% CI=1.082-2.298) and BMI(odds ratio=1.204, 95% CI=1.065-1.343) were statistically significant(p<0.05). In female, elevated odds ratio was noted in serum total choles terol, family history of hypertension, BMI and meat consumption. Of all these variables, the family history of hypertension in either of parents(odds ratio=4.981, 95% CI=3.650-6.312), family history in both of parents(odds ratio=16.864, 95% CI=14.577-19.151), BMI(odds ratio=1.167, 95% CI=1.016-1.318) and meat consumption(odds ratio=2.045, 95% CI=1.133-2.963) showed statistically significant association with hypertension in female(p<0.05).

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Evaluation of diet quality according to the eating-out patterns of preschoolers and school-aged children in South Korea: based on data from the 2016-2018 Korea National Health and Nutrition Examination Survey (우리나라 유아 및 학령기 아동의 외식패턴에 따른 식사의 질 평가: 2016-2018 국민건강영양조사 자료 활용)

  • Ju, Yu-na;Lee, Youngmi;Song, Kyunghee;Lee, Yujin
    • Journal of Nutrition and Health
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    • v.54 no.2
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    • pp.165-178
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    • 2021
  • Purpose: This study examined the eating-out patterns of Korean infants and school-aged children and compared diet quality. Methods: Data were obtained from the 2016-2018 Korea National Health and Nutrition Examination Survey. The subjects were 306 children aged 3 to 11 years old that ate dinner at restaurants. Percentage energy intakes of 24 food groups were calculated, and cluster analysis was used to identify eating-out patterns. Diet quality was assessed by calculating percentage energy and nutrient intakes using one-third of the 2015 Dietary Reference Intakes for Korean (KDRIs), nutrient adequacy ratio (NAR), mean adequacy ratio (MAR), and index of nutritional quality (INQ). Results: Cluster analysis identified 2 eating-out patterns, that is, a 'rice-centered' (53%) and a 'mixed diet' (47%) pattern. For those with the mixed diet pattern, ratios of carbohydrates, protein, and fat to total calories were 48:20:31, whereas for the rice-centered pattern, ratios were 62:15:21 (p < 0.001). Intakes of energy and most nutrients in the mixed diet pattern were excessive, but the intakes of the most nutrients in the rice-centered pattern were much lower than their KDRIs. MARs were higher for the mixed diet pattern than the rice-centered pattern (0.74 vs. 0.66) (p < 0.001), and INQs for vitamin C (p = 0.007) and calcium (p = 0.018) were lower for the rice-centered pattern, whereas INQ for iron (p = 0.003) was lower for the mixed diet pattern. Conclusion: The quality of meals for infants and school-aged children depended on eating-out patterns, but the rice-centered and mixed diet patterns both failed to provide an appropriately balanced meal pattern. The results of this study suggest that healthy menus need to be developed for children in restaurants.

The Effect of Therapeutic Listening on Occupational Performance, Auditory Problem Behavior, and Attention in Children With Sensory Modulation Disorder (감각조절 장애 아동에게 치료적 듣기가 작업수행, 청각행동문제, 주의집중에 미치는 영향)

  • Park, Mi-Young;Kim, Hee;Cha, Tae-Hyun;Kim, Soo-Kyung
    • The Journal of Korean Academy of Sensory Integration
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    • v.18 no.3
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    • pp.14-26
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    • 2020
  • Objective : The purpose of this study was to investigate the effect of therapeutic listening on task performance, auditory behavior problems, and attention in children with sensory modulation disorder. Methods : Sixteen children aged four to seven years who were classified as children with sensory modulation disorder were randomly assigned to either the experimental group (n = 8) or the control group (n = 8). From July 1 to October 18, 2017, both groups participated in sensory integration programs, while therapeutic listening training was administered only to the experimental group. Sensory integration therapy was conducted in two sessions per week for six weeks (12 sessions); each session consisted of 40 minutes of therapy and 10 minutes of parent education. Therapeutic listening was conducted in three thirty-minute sessions per week for six weeks (18 sessions). We used the Canadian Occupation Performance Measure (COPM) to evaluate changes in the participants' occupational performance between pre- and post-intervention. We used Fisher's Auditory Problems Checklist (FAPC) to observe changes in behavioral problems related to hearing. The Child Attention Scale for Teacher (CAST) was used to evaluate changes in attention. Results : No significant differences pre- and post-intervention between the two groups were observed. The participants' auditory behavioral problems improved significantly in the experimental group, but no significant difference was found between the two groups. There was no significant difference in attention between the two groups, but there was a significant difference between the two groups in the "adaptability" and "emotion" domains (p < .05). Conclusion : The results suggest that therapeutic listening training has a positive effect on reducing problematic behaviors related to hearing and improving the occupational performance of children with sensory modulation disorder. This study provides a basis for improving the sensory processing ability of children with sensory modulation disorder by applying listening training in the clinical field and at home.

Mobile Camera-Based Positioning Method by Applying Landmark Corner Extraction (랜드마크 코너 추출을 적용한 모바일 카메라 기반 위치결정 기법)

  • Yoo Jin Lee;Wansang Yoon;Sooahm Rhee
    • Korean Journal of Remote Sensing
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    • v.39 no.6_1
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    • pp.1309-1320
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    • 2023
  • The technological development and popularization of mobile devices have developed so that users can check their location anywhere and use the Internet. However, in the case of indoors, the Internet can be used smoothly, but the global positioning system (GPS) function is difficult to use. There is an increasing need to provide real-time location information in shaded areas where GPS is not received, such as department stores, museums, conference halls, schools, and tunnels, which are indoor public places. Accordingly, research on the recent indoor positioning technology based on light detection and ranging (LiDAR) equipment is increasing to build a landmark database. Focusing on the accessibility of building a landmark database, this study attempted to develop a technique for estimating the user's location by using a single image taken of a landmark based on a mobile device and the landmark database information constructed in advance. First, a landmark database was constructed. In order to estimate the user's location only with the mobile image photographing the landmark, it is essential to detect the landmark from the mobile image, and to acquire the ground coordinates of the points with fixed characteristics from the detected landmark. In the second step, by applying the bag of words (BoW) image search technology, the landmark photographed by the mobile image among the landmark database was searched up to a similar 4th place. In the third step, one of the four candidate landmarks searched through the scale invariant feature transform (SIFT) feature point extraction technique and Homography random sample consensus(RANSAC) was selected, and at this time, filtering was performed once more based on the number of matching points through threshold setting. In the fourth step, the landmark image was projected onto the mobile image through the Homography matrix between the corresponding landmark and the mobile image to detect the area of the landmark and the corner. Finally, the user's location was estimated through the location estimation technique. As a result of analyzing the performance of the technology, the landmark search performance was measured to be about 86%. As a result of comparing the location estimation result with the user's actual ground coordinate, it was confirmed that it had a horizontal location accuracy of about 0.56 m, and it was confirmed that the user's location could be estimated with a mobile image by constructing a landmark database without separate expensive equipment.

Investigation on the Safety of Biodegradable Synthetic Resins for Food (식품용 생분해성 합성수지제의 안전성 조사)

  • Hee-Jeong Yun;Jong-Sup Jeon;Young-Su Kim;Sung-Hee Park;Seo-Hyeon Song;Eun-Jung Ku;Sun-Young Chae;Myung-Jin Lee
    • Journal of Food Hygiene and Safety
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    • v.39 no.2
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    • pp.95-101
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    • 2024
  • In this study, we investigated the migration level of items specified in the Korean Standards and Specifications for Utensils, Containers, and Packages (Ministry of Food and Drug Safety Notification) for 50 utensils and hygiene products made of biodegradable resins. Our results revealed that one Polylactide (PLA) baby tableware contained 20 mg/L in consumption of potassium permanganate, exceeding the standard of 10 mg/L or less. In all other samples, formaldehyde, lead (Pb), and arsenic (As) levels could be considered very safe and remained below the standard. Moreover, we tested the PLA baby tablewares (n = 21) for migration into a food simulant (4% v/v acetic acid) upon repeated elution at 100℃ for 30 min or UV irradiation for 2 h. We detected increased formaldehyde and As amounts at the repeated 100℃ treatment for 30 min compared to those upon repeated UV irradiation. However, the migration level was markedly low under both conditions. Furthermore, the Estimated Daily Intake (EDI) calculated on an infant-to-child basis from the formaldehyde and As migration at 100℃ for 30 min in the PLA sample was at the maximum value, i.e., 6.0×10-4 mg/kg b.w./day and 1.3×10-1 ㎍/kg b.w./day, corresponding to 0.40% and 10.42% of the Tolerable Daily Intake (TDI, 0.15 mg/kg b.w./day) and Provisional Tolerable Weekly Intake (PTWI, 9.0 ㎍/kg b.w./week), respectively. Therefore, in this study, we confirmed that biodegradable synthetic resins are safe to use for food.

A Study on the Legal Proposal of Crew's Fatigue Management in the Aviation Regulations (항공법규에서의 승무원 피로관리기준 도입방안에 관한 연구 - ICAO, FAA, EASA 기준을 중심으로 -)

  • Lee, Koo-Hee;Hwang, Ho-Won
    • The Korean Journal of Air & Space Law and Policy
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    • v.27 no.1
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    • pp.29-73
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    • 2012
  • Aviation safety is the State and industry's top priority and more scientific approaches for fatigue management should be needed. There are lately various studies and regulation changes for crew fatigue management with ICAO, FAA and EASA. ICAO issued the provisions of fatigue management for flight crew since 1st edition, 1969, of Annex 6 operation of aircraft as a Standards and Recommended practice(SARPs). Unfortunately, there have been few changes and improvement to fatigue management provisions since the time they were first introduced. However the SARPs have been big changed lately. ICAO published guidance materials for development of prescriptive fatigue regulations through amendment 33A of Annex 6 Part 1 as applicable November 19th 2009. And then ICAO introduced additional amendment for using Fatigue Risk Management System (FRMS) with $35^{th}$ amendment in 2011. According to the Annex 6, the State of the operator shall establish a) regulations for flight time, flight duty period, duty period and rest period limitations and b) FRMS regulations. The Operator shall implement one of following 3 provisions a) flight time, flight duty period, duty period and rest period limitations within the prescriptive fatigue management regulations established by the State of the Operator; or b) a FRMS; or c) a combination of a) and b). U.S. FAA recently published several kinds of Advisory Circular about flightcrew fatigue. U.S. passed "Airline Safety and FAA Extension Act of 2010" into law on August 1st, 2010. This mandates all commercial air carriers to develop a FAA-acceptable Fatigue Risk Management Plan(FRMP) by October 31st, 2010. Also, on May 16, 2012, the FAA published a final rule(correction) entitled 'Flightcrew Member Duty and Rest Requirements; correction to amend its existing prescriptive regulations. The new requirements are required to implement same regulations for domestic, flag and supplemental operations from January 4, 2014. EASA introduced a Notice of Proposed Amendment (NPA) 2010-14 entitled "Draft opinion of the European Aviation Safety Agency for a Commission Regulation establishing the implementing rules on Flight and Duty Time Limitations and Rest Requirements for Commercial Air Transport with aeroplanes" on December 10, 2010. The purpose of this NPA is to develop and implement fatigue management for commercial air transport operations. Comparing with Korean and foreign regulations regarding fatigue management, the provisions of ICAO, FAA, EASA are more considering various fatigue factors and conditions. Korea regulations should be needed for some development of insufficiency points. In this thesis, I present the results of the comparative study between domestic and foreign regulations in respect of fatigue management crew member. Also, I suggest legal proposals for amendment of Korea Aviation act and Enforcement Regulations concerning fatigue management for crew members. I hope that this paper is helpful to change korea fatigue regulations, to enhance aviation safety, and to reduce the number of accidents relating to fatigue. Fatigue should be managed at all level such as regulators, experts, operators and pilots. Authority should change surveillance mind-set from regulatory auditor to expert adviser. Operators should identify various fatigue factors and consider to crew scheduling them. Crews should strongly manage both individual and duty-oriented fatigue issues.

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Relationship of Hair Copper and Mercury Contents to Personality in Chronic Schizophrenia (정신분열증 환자의 두발 중 구리 및 수은 함량과 그 인성과의 관련성)

  • Kim, Doo-Hie;Kang, Young-Woo;Park, Soon-Woo;Lee, Kuen-Hoo;Lee, Young-Sook
    • Journal of Preventive Medicine and Public Health
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    • v.23 no.3 s.31
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    • pp.296-308
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    • 1990
  • The relationship between copper and mercury contents in the scalp hair and chronic schizophrenia was investigated. The samples of scalp hair were collected from 80 male chronic schizophrenic patients at the age from 20 to 29, who were hospitalized in the National Psychiatric Hospital in Seoul. As the control group, 69 males were collected from general population. Hair samples were taken from the napes and the Minnesota Multiple Personality Inventory (MMPI) was performed also. The copper and mercury contents were determined by an atomic absorption spectrophotometer. Significantly higher T-score of MMPI was seen in patients group for Hypochondriasis Scale (Hs), Depression Scale (D), Psychopathic Deviate Scale (Pd), Paranoia Scale (Pa), Psychasthenia Scale (Pt), Schizophrenia Scale (Sc) subscales than control group, and the frequency distribution by T-score was also significantly different between the patient and the control group for above scales. The content of copper in the hair of patient group was significantly lower than the control group. In the case of mercury, the mean value of patient group was significantly higher than control group. Between the value of copper and mercury, statistically significant negative correlation (r=-0.25) was found. When grouped by the T-score of MMPI, there was no difference of copper contents between T-score subgroup at all MMPI scale. But the mercury contents showed significant difference between T-score subgroup at Pt, Sc scale. When compared between the group of above 70 T-score and the group of less than 70, the mercury contents of Pa, Pt, Sc scale of above 70 T-score group were significantly higher than the group of less than 70. In other scales, the mercury content of the above 70 group were higher than the group of less than 70 except Mf scale, although there were no statistscally significances. In D, Pa, Sc scales, as the T-score of MMPI increased, the contents of mercury also increased. When divided into the patient group and the control group, the copper contents of the patient groups were significantly lower than the control group at each T-score scale in most MMPI scales. In the case of mercury, the value of patient group were significantly higher than the control group in the less than 44 scale of D, in the $60{\sim}69$ scale of Pd, in the $45{\sim}59$ scale of Mf, in the $60{\sim}69$ scale of Ma, in the less than 44 of Si. These results suggest that the effects of the deficiency of copper or high intake of mecury on schizophrenia and personality may be of possible value. Thus further studies are necessary to determine whether schizophrenia and personality formation would be attributed to copper deficiency or mercury intake.

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A Survey on Added Sugar Intakes from Snacks and Participation Behaviors of Special Event Days Sharing Sweet Foods among Adolescents in Korea (청소년의 간식을 통한 첨가당섭취량 및 고당류식품 관련 이벤트 데이 참여행동에 대한 조사)

  • Kim, Hyun-Ju;Kim, Sun-Hyo
    • Journal of Nutrition and Health
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    • v.42 no.2
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    • pp.135-145
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    • 2009
  • This study was performed to investigate added sugar intakes from processed food-snacks and participation behaviors of special event days sharing sweet foods among adolescents in Korea. Questionnaire survey (n = 959), dietary survey (n = 71) by food record method for 3 days, and snack survey (n = 230) for 3 days were carried out, and subjects were overlapped among three surveys. As a result, middle school students (MS) preferred milks and fermented milks while high school students (HS) preferred breads and fast foods as a snack (p < 0.01). MS and HS took snacks three to six times a week, and HS took snacks more frequently than MS (p < 0.05). Most subjects participated in special event days sharing sweet foods such as friend's birthday (68.4%), Peppro's day (61.5%) and Valentine's day (42.6%). As for merits of these events, MS said ‘they could get along with their friends' and ‘relieve stress', while HS said ‘they could enjoy their own events' and ‘confess their affection to whom they like' (p < 0.01). A group of cookies, biscuits, breads and, cakes was major source of added sugars followed by beverages, sweet jellies of red bean, chocolates and candies for subjects. For MS and HS, daily total added sugar intakes from whole processed food-snacks were $30.5{\pm}23.5g/d$ (3.0-137.9 g/d) and $31.7{\pm}23.2g/d$ (1.2-126.1 g/d), and ratios of daily total energy taken from added sugars of whole processed food-snacks in proportion to daily total energy taken from diet (energy percent of added sugars from snacks) were $6.3{\pm}4.7%$ (0.6-26.1%) and $6.3{\pm}4.4%$ (0.3-23.9%), respectively. These results showed that subjects frequently participated in special event days sharing sweet foods. In addition, energy percent of added sugars from snacks was more than the UL suggested by WHO/FAO for some subjects. Therefore, it is highly critical to monitor adolescents' sugar intakes on a long-term basis and to take nutritional management on their high sugar intakes.

Study for Diagnostic Efficacy of Minibronchoalveolar Lavage in the Detection of Etiologic Agents of Ventilator-associated Pneumonia in Patients Receiving Antibiotics (항생제를 사용하고 있었던 인공호흡기 연관 폐렴환자에서의 원인균 발견을 위한 소량 기관지폐포세척술의 진단적 효용성에 관한 연구)

  • Moon, Doo-Seop;Lim, Chae-Man;Pai, Chik-Hyun;Kim, Mi-Na;Chin, Jae-Yong;Shim, Tae-Sun;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Koh, Youn-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.3
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    • pp.321-330
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    • 1999
  • Background : Early diagnosis and proper antibiotic treatment are very important in the management of ventilator-associated pneumonia (VAP) because of its high mortality. Bronchoscopy with a protected specimen brush (PSB) has been considered the standard method to isolate the causative organisms of VAP. However, this method burdens consumer economically to purchase a PSB. Another useful method for the diagnosis of VAP is quantitative cultures of aspirated specimens through bronchoscopic bronchoalveolar lavage (BAL), for which the infusion of more than 120 m1 of saline has been recommended for adequate sampling of a pulmonary segment. However, occasionally it leads to deterioration of the patient's condition. We studied the diagnostic efficacy of minibronchoalveolar lavage (miniBAL), which retrieves only 25 ml of BAL fluid, in the isolation of causative organisms of VAP. Methods: We included 38 consecutive patients (41 cases) suspected of having VAP on the basis of clinical evidence, who had received antibiotics before the bronchoscopy. The two diagnostic techniques of PSB and miniBAL, which were performed one after another at the same pulmonary segment, 'were compared prospectively. The cut-off values for quantitative cultures to define causative bacteria of VAP were more than $10^3$ colony-forming units (cfu)/ml for PSB and more than $10^4$ cfu/ml for BAL. Results: The amount of instilled normal saline required to retrieve 25 ml of BAL fluid was $93{\pm}32 ml$ (mean${\pm}$SD). The detection rate of causative agents was 46.3% (19/41) with PSB and 43.9% (18/41) with miniBAL. The concordance rate of PSB and miniBAL in the bacterial culture was 85.4% (35/41). Although arterial blood oxygen saturation dropped significantly (p<0.05) during ($92{\pm}10%$) and 10 min after ($95{\pm}3%$) miniBAL compared with the baseline ($97{\pm}3%$), all except 3 cases were within normal ranges. The significantly elevated heart rate during ($l25{\pm}24$/min, p<0.05) miniBAL compared with the baseline ($1l1{\pm}22$/min) recovered again in 10 min after ($111{\pm}26$/min) miniBAL. Transient hypotension was developed during the procedure in two cases. The procedure was stopped in one case due to atrial flutter. Conclusion: MiniBAL is a safe and effective technique to detect the causative organisms of VAP.

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The Advancement of Underwriting Skill by Selective Risk Acceptance (보험Risk 세분화를 통한 언더라이팅 기법 선진화 방안)

  • Lee, Chan-Hee
    • The Journal of the Korean life insurance medical association
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    • v.24
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    • pp.49-78
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    • 2005
  • Ⅰ. 연구(硏究) 배경(背景) 및 목적(目的) o 우리나라 보험시장의 세대가입율은 86%로 보험시장 성숙기에 진입하였으며 기존의 전통적인 전업채널에서 방카슈랑스의 도입, 온라인전문보험사의 출현, TM 영업의 성장세 等멀티채널로 진행되고 있음 o LTC(장기간병), CI(치명적질환), 실손의료보험 등(等)선 진형 건강상품의 잇따른 출시로 보험리스크 관리측면에서 언더라이팅의 대비가 절실한 시점임 o 상품과 마케팅 等언더라이팅 측면에서 매우 밀접한 영역의 변화에 발맞추어 언더라이팅의 인수기법의 선진화가 시급히 요구되는 상황하에서 위험을 적절히 분류하고 평가하는 선진적 언더라이팅 기법 구축이 필수 적임 o 궁극적으로 고객의 다양한 보장니드 충족과 상품, 마케팅, 언더라이팅의 경쟁력 강화를 통한 보험사의 종합이익 극대화에 기여할 수 있는 방안을 모색하고자 함 Ⅱ. 선진보험시장(先進保險市場)Risk 세분화사례(細分化事例) 1. 환경적위험(環境的危險)에 따른 보험료(保險料) 차등(差等) (1) 위험직업 보험료 할증 o 미국, 유럽등(等) 대부분의 선진시장에서는 가입당시 피보험자의 직업위험도에 따라 보험료를 차등 적용중(中)임 o 가입하는 보장급부에 따라 직업 분류방법 및 할증방식도 상이하며 일반사망과 재해사망,납입면제, DI에 대해서 별도의 방법을 사용함 o 할증적용은 표준위험율의 일정배수를 적용하여 할증 보험료를 산출하거나, 가입금액당 일정한 추가보험료를 적용하고 있음 - 광부의 경우 재해사망 가입시 표준위험율의 300% 적용하며, 일반사망 가입시 $1,000당 $2.95 할증보험료 부가 (2) 위험취미 보험료 할증 o 취미와 관련 사고의 지속적 다발로 취미활동도 위험요소로 인식되어 보험료를 차등 적용중(中)임 o 할증보험료는 보험가입금액당 일정비율로 부가(가입 금액과 무관)하며, 신종레포츠 등(等)일부 위험취미는 통계의 부족으로 언더라이터가 할증율 결정하여 적용함 - 패러글라이딩 년(年)$26{\sim}50$회(回) 취미생활의 경우 가입금액 $1,000당 재해사망 $2, DI보험 8$ 할증보험료 부가 o 보험료 할증과는 별도로 위험취미에 대한 부담보를 적용함. 위험취미 활동으로 인한 보험사고 발생시 사망을 포함한 모든 급부에 대한 보장을 부(不)담보로 인수함. (3) 위험지역 거주/ 여행 보험료 할증 o 피보험자가 거주하고 있는 특정국가의 임시 혹은 영구적 거주시 기후위험, 거주지역의 위생과 의료수준, 여행위험, 전쟁과 폭동위험 등(等)을 고려하여 평가 o 일반사망, 재해사망 등(等)보장급부별로 할증보험료 부가 또는 거절 o 할증보험료는 보험全기간에 대해 동일하게 적용 - 러시아의 경우 가입금액 $1,000당 일반사망은 2$의 할증보험료 부가, 재해사망은 거절 (4) 기타 위험도에 대한 보험료 차등 o 비행관련 위험은 세가지로 분류(항공운송기, 개인비행, 군사비행), 청약서, 추가질문서, 진단서, 비행이력 정보를 바탕으로 할증보험료를 부가함 - 농약살포비행기조종사의 경우 가입금액 $1,000당 일반사망 6$의 할증보험료 부가, 재해사망은 거절 o 미국, 일본등(等)서는 교통사고나 교통위반 관련 기록을 활용하여 무(無)사고운전자에 대해 보험료 할인(우량체 위험요소로 활용) 2. 신체적위험도(身體的危險度)에 따른 보험료차등(保險料差等) (1) 표준미달체 보험료 할증 1) 총위험지수 500(초과위험지수 400)까지 인수 o 300이하는 25점단위, 300점 초과는 50점 단위로 13단계로 구분하여 할증보험료를 적용중(中)임 2) 삭감법과 할증법을 동시 적용 o 보험금 삭감부분만큼 할증보험료가 감소하는 효과가 있어 청약자에게 선택의 기회를 제공할수 있으며 고(高)위험 피보험자에게 유용함 3) 특정암에 대한 기왕력자에 대해 단기(Temporary)할증 적용 o 질병성향에 따라 가입후 $1{\sim}5$년간 할증보험료를 부가하고 보험료 할증 기간이 경과한 후에는 표준체보험료를 부가함 4) 할증보험료 반환옵션(Return of the extra premium)의 적용 o 보험계약이 유지중(中)이며, 일정기간 생존시 할증보험료가 반환됨 (2) 표준미달체 급부증액(Enhanced annuity) o 영국에서는 표준미달체를 대상으로 연금급부를 증가시킨 증액형 연금(Enhanced annuity) 상품을 개발 판매중(中)임 o 흡연, 직업, 병력 등(等)다양한 신체적, 환경적 위험도에 따라 표준체에 비해 증액연금을 차등 지급함 (3) 우량 피보험체 가격 세분화 o 미국시장에서는 $8{\sim}14$개 의적, 비(非)의적 위험요소에 대한 평가기준에 따라 표준체를 최대 8개 Class로 분류하여 할인보험료를 차등 적용 - 기왕력, 혈압, 가족력, 흡연, BMI, 콜레스테롤, 운전, 위험취미, 거주지, 비행력, 음주/마약 등(等) o 할인율은 회사, Class, 가입기준에 따라 상이(최대75%)하며, 가입연령은 최저 $16{\sim}20$세, 최대 $65{\sim}75$세, 최저보험금액은 10만달러(HIV검사가 필요한 최저 금액) o 일본시장에서는 $3{\sim}4$개 위험요소에 따라 $3{\sim}4$개 Class로 분류 우량체 할인중(中)임 o 유럽시장에서는 영국 등(等)일부시장에서만 비(非)흡연할인 또는 우량체할인 적용 Ⅲ. 국내보험시장(國內保險市場) 현황(現況)및 문제점(問題點) 1. 환경적위험도(環境的危險度)에 따른 가입한도제한(加入限度制限) (1) 위험직업 보험가입 제한 o 업계공동의 직업별 표준위험등급에 따라 각 보험사 자체적으로 위험등급별 가입한도를 설정 운영중(中)임. 비(非)위험직과의 형평성, 고(高)위험직업 보장 한계, 수익구조 불안정화 등(等)문제점을 내포하고 있음 - 광부의 경우 위험1급 적용으로 사망 최대 1억(億), 입원 1일(日) 2만원까지 제한 o 금융감독원이 2002년(年)7월(月)위험등급별 위험지수를 참조 위험율로 인가하였으나, 비위험직은 70%, 위험직은 200% 수준으로 산정되어 현실적 적용이 어려움 (2) 위험취미 보험가입 제한 o 해당취미의 직업종사자에 준(準)하여 직업위험등급을 적용하여 가입 한도를 제한하고 있음. 추가질문서를 활용하여 자격증 유무, 동호회 가입등(等)에 대한 세부정보를 입수하지 않음 - 패러글라이딩의 경우 위험2급을 적용, 사망보장 최대 2 억(億)까지 제한 (3) 거주지역/ 해외여행 보험가입 제한 o 각(各)보험사별로 지역적 특성상 사고재해 다발 지역에 대해 보험가입을 제한하고 있음 - 강원, 충청 일부지역 상해보험 가입불가 - 전북, 태백 일부지역 입원급여금 1일(日)2만원이내 o 해외여행을 포함한 해외체류에 대해서는 일정한 가입 요건을 정하여 운영중(中)이며, 가입한도 설정 보험가입을 제한하거나 재해집중보장 상품에 대해 거절함 - 러시아의 경우 단기체류는 위험1급 및 상해보험 가입 불가, 장기 체류는 거절처리함 2. 신체적위험도(身體的危險度)에 따른 인수차별화(引受差別化) (1) 표준미달체 인수방법 o 체증성, 항상성 위험에 대한 초과위험지수를 보험금삭감법으로 전환 사망보험에 적용(최대 5년(年))하여 5년(年)이후 보험 Risk노출 심각 o 보험료 할증은 일부 회사에서 주(主)보험 중심으로 사용중(中)이며, 총위험지수 300(8단계)까지 인수 - 주(主)보험 할증시 특약은 가입 불가하며, 암 기왕력자는 대부분 거절 o 신체부위 39가지, 질병 5가지에 대해 부담보 적용(입원, 수술 등(等)생존급부에 부담보) (2) 비(非)흡연/ 우량체 보험료 할인 o 1999년(年)최초 도입 이래 $3{\sim}4$개의 위험요소로 1개 Class 운영중(中)임 S생보사의 경우 비(非)흡연우량체, 비(非)흡연표준체의 2개 Class 운영 o 보험료 할인율은 회사, 상품에 따라 상이하며 최대 22%(영업보험료기준)임. 흡연여부는 뇨스틱을 활용 코티닌테스트를 실시함 o 우량체 판매는 신계약의 $2{\sim}15%$수준(회사의 정책에 따라 상이) Ⅳ. 언더라이팅 기법(技法) 선진화(先進化) 방안(方案) 1. 직업위험도별 보험료 차등 적용 o 생 손보 직업위험등급 일원화와 연계하여 3개등급으로 위험지수개편, 비위험직 기준으로 보험요율 차별적용 2. 위험취미에 대한 부담보 적용 o 해당취미를 원인으로 보험사고(사망포함) 발생시 부담보 제도 도입 3. 표준미달체 인수기법 선진화를 통한 인수범위 대폭 확대 o 보험료 할증법 적용 확대를 통한 Risk 헷지로 총위험지수 $300{\rightarrow}500$으로 확대(거절건 최소화) 4. 보험료 할증법 보험금 삭감 병행 적용 o 삭감기간을 적용한 보험료 할증방식 개발, 고객에게 선택권 제공 5. 기한부 보험료할증 부가 o 위암, 갑상선암 등(等)특정암의 성향에 따라 위험도가 높은 가입초기에 평준할증보험료를 적용하여 인수 6. 보험료 할증법 부가특약 확대 적용, 부담보 병행 사용 o 정기특약 등(等)사망관련 특약에 할증법 확대, 생존급부 특약은 부담보 7. 표준체 고객 세분화 확대 o 콜레스테롤, HDL 등(等)위험평가요소 확대를 통한 Class 세분화 Ⅴ. 기대효과(期待效果) 1. 고(高)위험직종사자, 위험취미자, 표준미달체에 대한 보험가입 문호개방 2. 보험계약자간 형평성 제고 및 다양한 고객의 보장니드에 부응 3. 상품판매 확대 및 Risk헷지를 통한 수입보험료 증대 및 사차익 개선 4. 본격적인 가격경쟁에 대비한 보험사 체질 개선 5. 회사 이미지 제고 및 진단 거부감 해소, 포트폴리오 약화 방지 Ⅵ. 결론(結論) o 종래의 소극적이고 일률적인 인수기법에서 탈피하여 피보험자를 다양한 측면에서 위험평가하여 적정 보험료 부가와 합리적 가입조건을 제시하는 적절한 위험평가 수단을 도입하고, o 언더라이팅 인수기법의 선진화와 함께 언더라이팅 인력의 전문화, 정보입수 및 시스템 인프라의 구축 등이 병행함으로써, o 보험사의 사차손익 관리측면에서 뿐만 아니라 보험시장 개방 및 급변하는 보험환경에 대비한 한국 생보언더라이팅 경쟁력 강화 및 언더라이터의 글로벌화에도 크게 기여할 것임.

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