• Title/Summary/Keyword: 예방적 유지

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Assessment of Refuge Safety in Accomodations According to Awareness and Usability of Descending Life Lines and Simple Descending Life Lines (완강기 및 간이완강기의 인지·사용능력에 따른 숙박시설의 피난안전성 평가)

  • Han, Dong-Gew;Kong, Ha-Sung
    • The Journal of the Convergence on Culture Technology
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    • v.5 no.4
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    • pp.11-21
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    • 2019
  • The purpose of this study is to evaluate the awareness and usability of descending life lines and simple descending life lines for fire situations in the accommodation of the public officials who are responsible for supervising the installation and maintenance of descending life lines and simple descending life lines. The main results of the study are summarized as follows. First, in comparison of the ability to distinguish between descending life lines and simple descending life lines, the majority of female public officers in general administrative services do not have the ability to distinguish between descending lifelines and simple descending life lines, so they should be able to improve their ability to distinguish descending life lines. Also, institutional strategies are needed to regularly receive education through the Safety Experience Center in order to prevent safety accidents such as falling in emergency situations. Second, as a result of verifying reusability of simple descending life lines by gender and occupation, most public officers with the exception of half of the firefighting officers were analyzed as having no ability to reuse the simple descending life lines. Therefore, it is necessary to change the relevant laws so that only the installation of descending life lines which can be used continuously is permitted, except for the simple descending life lines among the evacuation instruments to be additionally installed in each room of the accommodation. Third, in terms of the ability to perceive the maximum load of the descending life lines according to occupation, the perception ability of the rescuers was the highest and the perception ability of the fire service personnel was the lowest. In order to improve the perception abilities of the fire service personnel, it is necessary to strengthen the theoretical and practical education of descending life lines in collective education such as the command-enhancing training which is regularly carried out in fire service academy. Lastly, it is believed that it is more effective to conduct the experience training of the descending life lines by imagining the fire in accomodations rather than other facilities, because it is the location where fires are actually seen the most.

Therapeutic Endoscopy-related Gastrointestinal Bleeding and Thromboembolic Events in Patients Using Warfarin or Direct Oral Anticoagulant (와파린 및 새로운 경구용 항응고제를 복용하는 환자에서의 치료 내시경과 관련된 위장관 출혈 및 혈전색전증의 위험)

  • Na, Hee Kyong
    • The Korean Journal of Gastroenterology
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    • v.72 no.5
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    • pp.271-273
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    • 2018
  • 내시경 시술 전 일시적으로 항응고제를 중단하는 것은 위장관 출혈의 위험과 혈전색전증의 위험 사이에 적절한 균형을 잡기 어렵기 때문에 논란의 여지가 많다. 와파린은 새로운 경구용 항응고제(direct oral anticoagulant agent, DOAC)보다 임상의에게 더 친숙하고, 효과를 쉽고 빠르게 전환시킬 수 있다는 장점이 있지만 복잡한 약역동학 특징과 좁은 치료적 범위 때문에 관리가 어렵다. 반면, DOAC는 약물의 모니터링 및 용량 조절 없이 정해진 용량으로 처방이 가능하며, 빠르게 작용하고, 반감기가 짧아 관리가 쉽지만 해독제가 없다는 단점이 있다. 이전 연구들에서 DOAC를 복용한 환자들은 와파린을 복용한 환자들보다 시술과 관련되지 않은 위장관 출혈의 위험이 높았다고 보고한 바 있다. 하지만 시술과 관련된 위장관 출혈 위험에 대하여는 알려진 바가 없는 실정이다. 미국이나 유럽 내시경 가이드라인들에서는 저위험 내시경 시술을 받는 환자들에서는 와파린과 DOAC를 유지하도록 권고하고 있으며, 고위험 시술의 경우에는 와파린를 사용하는 환자들에서 헤파린 교량 요법(heparin bridging)을 시행하도록 권고하고 있다. 임상적으로 DOAC를 사용하는 환자들 또한 혈전색전증을 예방하기 위하여 헤파린 교량 요법을 시행해볼 수 있는데, 와파린 및 DOAC의 헤파린 교량 요법과 관련된 출혈 및 혈전색전증 위험의 차이 또한 명확하지 않다. 따라서 저자들은 1) 와파린과 DOAC 치료를 받는 환자들에서의 출혈, 혈전색전증 및 사망의 위험을 비교하고자 하였으며, 2) 13종류의 고위험 내시경 시술 중에서 시술별 위험을 비교하고, 3) 헤파린 교량 요법이 합병증의 발생을 증가시키지 않는지 확인하고자 본 연구를 진행하였다. 일본 대규모 국가 입원 환자 데이터베이스를 이용하여 2014년 4월부터 2015년 5월까지 시술 전 와파린 또는 DOAC(rivaroxaban, apixaban, dabigatran, edoxaban)를 복용하고, 13종류의 고위험 내시경 시술을 시행받은 20세 이상의 성인 환자 총 16,977명을 확인하였다. 고위험 시술은 용종 절제술, 내시경 점막절제술, 내시경 점막하박리술, 협착 부위의 풍선확장술, 내시경 지혈술, 내시경 정맥결찰술, 내시경 주사 경화요법, 내시경 괄약근절개술, 내시경 초음파 유도하 미세침 흡인 검사, 경피적 위루술을 포함하였다. 일대일 성향 점수 매칭 분석(propensity score matching, 나이, 성별, 체질량 지수, 기저 질환, 병원의 규모, 시술의 종류, 약물의 종류를 매칭)을 시행하여 와파린군과 DOAC군에서 시술 위장관 출혈 및 혈전색전증, 사망의 발생을 비교하였다. 또한 경구항혈전제와 헤파린 교량 치료 시행 유무에 따라, DOAC 단독군, 와파린 단독군, DOAC와 헤파린 교량 요법군, 와파린과 헤파린 교량요법군으로 나누어, 하위군(subgroup) 분석을 시행하였다. 5,046쌍이 성향 점수 매칭 분석에 포함되었으며, 와파린군에서 DOAC군보다 통계적으로 의미 있게 위장관 출혈의 비율이 높았다(12.0% vs. 9.9% p=0.02). 혈전색전증 발생률(5.4% vs. 4.7%)과 입원중 사망률(5.4% vs. 4.7%)은 양 군에서 의미 있는 차이는 없었다. DOAC 종류별로 나누어 하위군 분석을 시행하였을 때, 와파린군은 rivaroxaban군에 비하여 위장관 출혈의 비율이 높았으며, rivaroxaban군, dabigatran군에 비하여 혈전색전증의 비율이 높았고, 입원 중 사망률에서는 의미 있는 차이는 없었다. 내시경 시술의 종류로 보정하였을 때 위장관 출혈 및 혈전색전증, 사망률은 DOAC 단독으로 치료한 환자에서보다 와파린과 헤파린 교량 요법(bridging) 또는 DOAC과 헤파린 교량 요법을 시행한 환자에서 높았다. 시술 종류 중에서는 위루관 삽입술에 비하여 내시경 점막하박리술, 내시경 점막절제술 및 내시경 정맥류결찰술, 내시경 주사경화요법을 시행한 환자에서 위장관 출혈의 위험이 가장 높았으며, 하부 내시경 점막절제술, 하부 용종 절제술, 내시경적 유두괄약근절제술 또는 내시경 초음파 유도하 미세침 흡인 검사는 중등도 위험을 보였다.

A Proposal for Simplified Velocity Estimation for Practical Applicability (실무 적용성이 용이한 간편 유속 산정식 제안)

  • Tai-Ho Choo;Jong-Cheol Seo; Hyeon-Gu Choi;Kun-Hak Chun
    • Journal of Wetlands Research
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    • v.25 no.2
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    • pp.75-82
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    • 2023
  • Data for measuring the flow rate of streams are used as important basic data for the development and maintenance of water resources, and many experts are conducting research to make more accurate measurements. Especially, in Korea, monsoon rains and heavy rains are concentrated in summer due to the nature of the climate, so floods occur frequently. Therefore, it is necessary to measure the flow rate most accurately during a flood to predict and prevent flooding. Thus, the U.S. Geological Survey (USGS) introduces 1, 2, 3 point method using a flow meter as one way to measure the average flow rate. However, it is difficult to calculate the average flow rate with the existing 1, 2, 3 point method alone.This paper proposes a new 1, 2, 3 point method formula, which is more accurate, utilizing one probabilistic entropy concept. This is considered to be a highly empirical study that can supplement the limitations of existing measurement methods. Data and Flume data were used in the number of holesman to demonstrate the utility of the proposed formula. As a result of the analysis, in the case of Flume Data, the existing USGS 1 point method compared to the measured value was 7.6% on average, 8.6% on the 2 point method, and 8.1% on the 3 point method. In the case of Coleman Data, the 1 point method showed an average error rate of 5%, the 2 point method 5.6% and the 3 point method 5.3%. On the other hand, the proposed formula using the concept of entropy reduced the error rate by about 60% compared to the existing method, with the Flume Data averaging 4.7% for the 1 point method, 5.7% for the 2 point method, and 5.2% for the 3 point method. In addition, Coleman Data showed an average error of 2.5% in the 1 point method, 3.1% in the 2 point method, and 2.8% in the 3 point method, reducing the error rate by about 50% compared to the existing method.This study can calculate the average flow rate more accurately than the existing 1, 2, 3 point method, which can be useful in many ways, including future river disaster management, design and administration.

Development of a smart cane concept for guiding the visually impaired - focused on design thinking learning practices for students - (시각장애인을 위한 길 안내용 스마트 지팡이 콘셉트 개발)

  • Park, Hae Rim;Lee, Min Sun;Yang, Ho Jung
    • Journal of Service Research and Studies
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    • v.13 no.1
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    • pp.186-200
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    • 2023
  • This study aims to improve the usability of the white cane, which is walking equipment that most local visually impaired people use and carry when going out, and to contribute to the prevention of safety accidents and the walking rights of visually impaired people by providing improvement and resolution measures for the problems identified. Also, this study is a study on the visually impaired, primarily targeting the 1st to 2nd degree visually impaired people, who cannot go out on their own without walking equipment such as a white cane, corresponding to 20% among approximately 250,000 blind and low vision people in the Korean population. In the study process, the concept has been developed from the user's point of view in order that the white cane becomes a real help in the walking step of the visually impaired and the improvement of usability of the white cane, the main walking equipment for the visually impaired, are done by problem identification through the Double Diamond Model of Design Thinking (Empathize → Define → Ideate → Prototype → Test (verify)). As a result of the investigation in the process of Empathy, a total of five issues was synthesized, including an increase in the proportion of the visually impaired people, an insufficient workforce situation to help all the visually impaired, an improvement and advancement of assistive devices essential for the visually impaired, problems of damage, illegal occupation, demolition, maintenance about braille blocks, making braille block paradigms for the visually impaired and for everyone. In Ideate and Prototype steps, situations derived from brainstorming were grouped and the relationship were made through the KJ method, and specific situations and major causes were organized to establish the direction of the concept. The derived solutions and major functions are defined in four categories, and representative situations requiring solutions and major functions are organized into two user scenarios. Ideas were visualized by arranging the virtual Persona and Customer Journey Map according to the situation and producing a prototype through 3D modeling. Finally, in the evaluation, the final concept derived is a device such a smart cane for guidance for the visually impaired as ① a smart cane emphasizing portability + ② compatibility with other electronic devices + ③ a product with safety and convenience.

Suggestions on Expanding Admission Number of Medical School (의과대학 정원 확대에 대한 제언)

  • Eun-Cheol Park
    • Health Policy and Management
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    • v.34 no.2
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    • pp.120-128
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    • 2024
  • From February to now 2024, there continues to be controversy over the expansion of admission number to medical school. Some of the controversy arises from a mix of present and future time points. In the present time point, the controversy over whether physicians are some shortages or not has various aspects. Some aspects are presented as evidence of the physician shortage and others as non-shortage. Also, the presenting evidence of shortage is being disputed, and so is the evidence of the contrary. This controversy over whether there is a shortage or not in the present time point makes it difficult to reach a consensus. In 10 years, the shortage of doctors will increase due to the rapid increase in the elderly population, so the admission number of medical schools will need to be increased. However, the increase must be such that there is minimal deterioration in the quality of medical education. More admission numbers should be allocated to medical schools with a high quality of medical education. This study suggests that large-scale medical schools increase the admission number by 20%-30%, and small-scale medical schools increase the admission number by 40%-50%, if so, the total increasing number is 760 to 1,066. If the 2,000-person increase is enforced, the quality of medical education must be carefully evaluated and the results should be reflected in adjusting the admission number of medical schools. In 20 years later, the admission number of medical schools will have to be reduced. This is because the physician supply is changing to a linear function and the physician demand (medical care demand) is changing to a quadratic function. Even if the current number is maintained, there will be an excess of doctors from 2048, so the medical school admission number must be reduced and its size will be reduced to about 2,000, a 30% reduction from the current number. Because the same reduction rate for all medical schools will result in many small-scale medical schools, the M&A (mergers and acquisitions) strategy should be considered with 40 medical schools and 12 Korean medical schools. In Korea, the main contributor to estimating physician demand is the change in population structure. Due to the rapid decrease in the total fertility rate, future population projections are uncertain. The recent rapid increase in healthcare utilization should be reexamined in the forecasting of physician demand. Since the various factors that affect the estimate of doctor supply and demand are unclear, the estimate of physician supply and demand must be continuously conducted every five years, and the Health Care Workforce Committee must be established and operated. The effects of increasing the admission number of medical schools should be evaluated and adjusted annually.

The Effect of VDT Work on Vision and Eye Symptoms among Workers in a TV Manufacturing Plant (텔레비젼(TV)생산업체 근로자들의 영상단말기(VDT)작업이 시력과 안증상에 미치는 영향)

  • Woo, Kuck-Hyeun;Choi, Gwang-Seo;Jung, Young-Yeon;Han, Gu-Wung;Park, Jung-Han;Lee, Jong-Hyeob
    • Journal of Preventive Medicine and Public Health
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    • v.25 no.3 s.39
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    • pp.247-268
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    • 1992
  • This study was conducted to evaluate the effect of VDT work on eyes and vision among workers in a TV manufacturing plant. The study subjects consisted of 264 screen workers and 74 non-screen workers who were less than 40 years old male and had no history of opthalmic diseases such as corneal opacities, trauma, keratitis, etc and whose visual acuity on pre-employment health examination by Han's test chart was 1.0 or above. The screen workers were divided into two groups by actual time for screen work in a day : Group I, 60 workers, lesser than 4 hours a day and group II, 204 workers, more than 4 hours a day. From July to October 1992 a questionnaire was administered to all the study subjects for the general charateristics and subjective eye symptoms after which the opthalmologic tests such as visual acuity, spherical equivalent, lacrimal function, ocular pressure, slit lamp test, fundoscopy were conducted by one opthalmologist. The proportion of workers whose present visual acuity was decreased more than 0.15 in comparison with that on the pre-employment health examination by Han's test chart was 20.6% in Group II. 15.0% in Group I and 14.9% in non-screen workers. However, the differences in proportion were not statistically significant. The proportion of workers with decreased visual acuity was not associated with the age, working duration, use of magnifying glass and type of shift work (independent variables) in all of the three groups. However, screen workers working under poor illumination had a higher proportion of persons with decreased visual acuity than those working under adequate illumination (P<0.05) . The proportion of workers whose near vision was decreased was 27.5% in Group II, 18.3% in Group I, and 28.4% in non-screen workers and these differences in proportion were not statistically significant. Changes of near vision were not associated with 4 independent variables in all of the three groups. Six out of seven subjective eye symptoms except tearing were more common in Group I than in non-screen workers and more common in Group II than in Group I (P<0.01). Mean of the total scores for seven subjective symptoms of each worker(2 points for always, 1 point for sometimes, 0 point for never) was not significantly different between workers with decreased visual acuity and workers with no vision change. However, mean of the total scores for Group II was higher than those for the Group I and non-screen workers (P<0.01). Total eye symptom scores were significantly correlated with the grade of screen work, use of magnifying glass, and type of shift work. There was no independent variable which was correlated with the difference in visual acuity between the pre-employment health examination and the present state, the difference between far and near visions, lacrimal function, ocular pressure, and spherical equivalent. Multiple linear regression analysis for the subjective eye symptom scores revealed a positive linear relationship with actual time for screen work and shift work(P<0.01). In this study it was not observed that the VDT work decreased visual acuity but it induces subjective eye symptoms such as eye fatigue, blurred vision, ocular discomfort, etc. Maintenance of adequate illumination in the work place and control of excessive VDT work are recommended to prevent such eye symptoms.

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Prevalence of Metabolic Syndrome and Assessment of Food·Nutrient Intakes among Adult Visitors of a Public Health Center in Korea (일부 보건소 내원자의 대사증후군 발현과 식품 및 영양소 섭취 실태)

  • Jeong, Won-Hoon;Jin, Bok-Hee;Hwang, Eun-Hee
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.41 no.2
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    • pp.205-212
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    • 2012
  • This study was performed to investigate the prevalence of metabolic syndrome (MS) and assess nutrient intake levels for the purpose of improving MS risk factors. The participants in this study were 512 adults consisting of 271 men and 241 women aged 30 and over, who visited a public health center for a medical check up. The diagnosis of MS subjects was adapted from the NCEP-ATPIII guidelines and the WHO Asia-Pacific Area criteria for obesity. The MS group was defined as subjects displaying three or more risk factors, and the non MS group was defined as those displaying two or less risk factors. A dietary survey was conducted using the 24-hour recall method. The number of subjects displaying MS syndrome factors was 158 (30.9%), broken down into, 89 men and 69 women. Regarding risk factors in the MS group, the prevalence of waist circumference was 40.5%, hypertension 34.2%, hyperglycemia 31.0%, low HDL-cholesterol 24.7%, and hypertriglycemia 19.6%. BMI, sistolic blood pressure, blood glocose, blood triglyceride, and blood HCL-cholesterol of the MS group were significantly higher compared to the non MS group. Male subjects in the MS group reported high intakes of cereals, sugar, fruits, meat and poultry, oil and fats, and beverages and total food intake was significantly higher compared to the non MS group. Women in the MS group reported high intakes of meat and poultry, milk and dairy products, beverages, and seasonings, and total food intake was higher compared to the non MS group. Dietary diversity score (DDS) was 3.82~4.04, which was not significant among the groups. In men, dietary variety score (DVS) was 16.3 in the MS group and 19.4 in the non MS group, whereas in women, the DVS was 15.2 in the non MS group and 17.0 in the MS group. In GMVDF pattern, 11111 pattern was 30.7%, followed by 01111 for men and 11101 for women. Calorie, fat, and cholesterol intakes in men as well as, calorie, fat, and folate intakes in women in the MS group were higher compared to the non MS group. Intakes of protein, P, Fe, Na, vitamin $B_1$, vitamin $B_2$, niacin, vitamin E, and Zn were higher than the KDRIs. On the other hand, intakes of Ca, K, fiber, vitamin $B_2$, and vitamin C were below the KDRIs. Intakes of lipids, animal food, Na, and cholesterol in the MS group were higher compared to the non MS group, whereas intake of dietary fiber was lower. Our results indicate that continuous, systematic nutritional education program must implemented to reduce the risk factors associated with MS.

Primary Culture of Chicken Tracheal Epithelial Cells and Study on Those Characters for Recombinant Virus Infection (닭 기도 상피세포의 1차 배양과 유전자 재조합 바이러스의 감염 특성 연구)

  • Park, Mi Na;Jang, Hyun-Jun;Keum, Dae Ho;Choi, Jin Ae;Yoo, Jae Gyu;Byun, Sung June;Park, Jong Ju;Ji, Ju Young;Lee, Kyung-Tai;Kim, Tae-Hun;Lee, Hyun-Jeong
    • Korean Journal of Poultry Science
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    • v.40 no.4
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    • pp.299-304
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    • 2013
  • Tracheal epithelial cells (TECs) are an important tool for studies of viral respiratory diseases. Primary TECs have been cultured from human, mouse and hamster. It is also necessary to diagnose viral respiratory disease and reveal infection mechanisms in chicken. In this study, we isolated tracheal epithelial layers from tracheal of 20-day-old chicks and cultured primary TECs from the isolated layers. Ciliated cells which were a typical morphology of TECs were observed in cultured primary TECs and maintained until cell passage 5 (15 to 20 days). When we analyzed expression patterns of epithelial marker genes (retinoic acid responder, FGF-binding protein, virus activating protease (VAP) in TECs compared to immortalized chicken embryonic fibroblast cell line (DF-1), all the marker genes are highly expressed in TECs than in DF-1. When TECs were cultured with 0.1 and 1 MOI of ND virus (rNDV-GFP strain) to test the susceptibility of TECs for ND virus, 12.6% and 48.2% of the incubated TECs were infected respectively. In addition, when DF-1 was incubated with 1 MOI of ND virus, the virus infection rate of DF-1 was three times lower than the virus infection rate of TECs. These data could contribute to study infection mechanisms of viral respiratory diseases and control them in chicken.

An Analysis on the Current Status of Daily Outdoor Play Parents Recognize (Focused on Gyeonggi-do) (부모가 인식하고 있는 일상적 바깥놀이 실태 분석 (경기도를 중심으로))

  • Kim, Yong-Sook;Yoon, Hee-Bong;Yoo, Ji-Eun
    • The Journal of the Korea Contents Association
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    • v.17 no.12
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    • pp.461-472
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    • 2017
  • The purpose of this study is to analyze the current status and condition of children's playgrounds in K which parents recognize as in Gyeonggi-do and provide basic data for the qualitative environment for daily outdoor play of young Children. To do so, a survey of 269 parents living in Gyeonggi-do was conducted and reconstructed based on the advanced research related to outdoor play. Also it was evaluated and revised after consultation with 3 children education specialists. The repossessed questionaries were frequency-analyzed with SPSS 20.0 program. The result of the analysis on outdoor playgrounds is in the following. First of all, it was analyzed that parents required 1 or 2 hours for their children to play outdoors in a type of "forest playgrounds." Moreover, they said that it was really important for the children to feel "interesting and funny" during the outdoor play, and they recognized that the play would be helpful for the children's socialization. However, they felt that a risk factor of the outdoor play was "a vehicle risk in streets." Secondly, the study suggested that there were outdoor playgrounds around parents' houses, and a type of the outdoor play was "a playground installed in the apartment complex." Furthermore, most of the parents weren't satisfied with the outdoor play because the apartment neglected the management of the playgrounds, and there were no playing facilities that were good enough to derive children's curiosity and adventurous spirit. The result also showed that most of the children played outdoors with "their mothers," and they participated in indoor activities, especially playing a game or watching TV rather than outdoor activities after attending a children educational institute. Lastly, when it comes to areas of outdoor play to be improved, it was necessary to "expand playgrounds that children can use for each season," build "safe playgrounds" for a type of the outdoor play," provide "playing spaces" for a spatial type, and "control vehicles around the playgrounds and deal with dangerous things" to prevent safety accidents. The result can expand the understanding of outdoor play for Young Children and offer discussions about the relevant organizations and studies.

The Accidents Analysis for Safety Training in The Container Terminal (컨테이너터미널에서 안전교육이 사고에 미치는 영향 분석)

  • Cha, Sang-Hyun;Noh, Chang-Kyun
    • Journal of Navigation and Port Research
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    • v.40 no.4
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    • pp.197-205
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    • 2016
  • Our country, which relies on maritime transport a majority of import and export trade volume and faced with unexpected accidents, it is difficult to operate the normal function of container terminal. It also caused by reliability issue raised is likely to be given a blow to the new volumes to attract and maintain existing volumes. Under this views, the container terminal is a situation that highlights the role of the harbor workers and cope with aggressive work to provide the best quality services to customers 365 days. On these grounds, the heavy work burden is passed on to the harbor workers and caused accidents every year. The study was analyzed the safety status of the container terminal under the real following the conditions as disaster status analysis, insufficient safety training circumstances and safety training from 2012 year to 2015 in the target current K.Y terminal. As a result of equipments safety training analysis, it shows that 2012 year happened 45 cases and 31 cases in 2013 year until not practicing the training over the Gantry Crane equipment. One hand 23 cases took place in 2014 while preparation training and the other intensive training period of 2015, 8 cases occurred. it shows that 2012 year happened 13 cases and 19 cases in 2013 year until not practicing the training over the Transfer Crane equipment. One hand 12 cases took place in 2014 while preparation training and the other intensive training period of 2015, 8 cases occurred. it shows that 2012 year happened 9 cases and 9 cases in 2013 year until not practicing the training over the Yard Tractor equipment. One hand 9 cases took place in 2014 while preparation training and the other intensive training period of 2015, 4 cases occurred. Because safety training of the container terminal was given to greatly impact on the mandatory safety training, self-educational enforcement and specified equipments safety training, hence the container terminal is to strengthen the safety education to prevent accidents in advance.