• 대한예방의학회:학술대회논문집
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• 1994.02a
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• pp.23-56
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• 1994

Recent criticisms of the conduct and use of risk assessment by regulatory agencies have led to a wide range of proposed remedies, including changes in regulatory statutes and the development of new methods for assessing risk. The mandate to this Committee was more limited. Our objective was to examine whether alterations in institutional arrangements or procedures, particularly the organizational separation of risk assessment from regulatory decision-making and the use of uniform guidelines for inferring risk from available scientific information, can improve federal risk assessment activities. Before undertaking to determine whether organizational and procedural reforms could improve the performance and use of risk assessment in the federal government, the Committee examined the state of risk assessment and the regulatory environment in which it is performed. In this chapter, we define risk assessment and differentiate it from other elements in the regulatory process, analyze the types of judgments made in risk assessment, and examine its current government context. Because one chronic health hazard, cancer, was highlighted in the Committee's congressional mandate and has dominated public concern about public health risks in recent years, most of our report focuses on it. Furthermore, because activities in four agencies--the Environmental Protection Agency (EPA), the Food and Drug Administration (FDA), the Occupational Safety and Health Administration (OSHA), and the Consumer Product Safety Commission (CPSC)--have given rise to many of the proposals for changes in risk assessment practices, our review focuses on these four agencies. The conclusions of this report, although directed primarily at risk assessment of potential carcinogens as performed by these four agencies, may be applicable to other federal programs to reduce health risks.

• Safety and Health at Work
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• v.1 no.1
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• pp.11-18
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• 2010

In the UK, a person or organisation that creates risk is required to manage and control that risk so that it is reduced 'So Far As Is Reasonably Practicable (SFAIRP).' How the risk is managed is to be determined by those who create the risk. They have a duty to demonstrate that they have taken action to ensure all risk is reduced SFAIRP and must have documentary evidence, for example a risk assessment or safety case, to prove that they manage the risks their activities create. The UK Health and Safety Executive (HSE) does not tell organisations how to manage the risks they create but does inspect the quality of risk identification and management. This paper gives a brief overview of where responsibility for occupational health and safety lies in the UK, and how risk should be managed through risk assessment. The focus of the paper is three recent major UK incidents, all involving fatalities, and all of which were wholly avoidable if risks had been properly assessed and managed. The paper concludes with an analysis of the common failings of risk assessments and key actions for improvement.

• Quality Improvement in Health Care
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• v.17 no.1
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• pp.5-20
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• 2011

• Health Policy and Management
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• v.31 no.3
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• pp.261-271
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• 2021

Background: In 2018, the government increased the fee for the magnetic resonance imaging (MRI) image deciphering services of the external hospital to discourage the redundant MRI scan and to induce appropriate use of the MRI services. It is important to evaluate the effect of the policy to provide the basis for establishing other MRI-related policies. Methods: The healthcare data of the patients who had brain MRI scans were organized by episode and analyzed using the panel study in order to find out the effect of the MRI-related policy on the substitution effect and the medical expenses. Results: As a result of the increase in the fee of deciphering the MRI image, there has been an uplift in deciphering the MRI scan of the external hospital. It implies that more hospitals chose to use the MRI scan taken by other clinics or hospitals, rather than the MRI scan taken at their own facilities. Conclusion: The research results imply that a policy that facilitates the exchange of the medical image data between the hospitals is needed in order to establish an efficient management system of the healthcare resources. Such improvement is expected to reduce the social cost and contribute to the stability in the finance of national health insurance.

• Korean Parent-Child Health Journal
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• v.13 no.2
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• pp.63-77
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• 2010

Purpose: The purpose of this study was to develop child's health assessment tools and tailored home visiting nursing service model in a community. Methods: Based on the literature review and several types of workshops participated with the child health nursing professors and visiting nurses in public health centers from May to December 2009, the standards of child health assessment tools, service model and education materials for visiting nurses were developed. Results: Some record forms were newly developed, including neonatal assessment, breast feeding, mother-infant interaction, oral care, vaccination and safety, and appropriate developmental screening tests in the community were selected. For systematic health care management in the community, problem list, problem criteria, health care plan, outcome criteria were also developed. Conclusion: On the demand of growing need for health promotion and early intervention for children and their association with parenting and socioeconomic status, assessment and control measures are indispensable to the promotion of child health for vulnerable population. Children's health and developmental problems, and safe circumstances can be assessed using this assessment tools, and can be used for tailored home visiting nursing care for children.

• Quality Improvement in Health Care
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• v.27 no.2
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• pp.73-82
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• 2021

Purpose: This study aims to examine the quality of tuberculosis (TB) care after the 1st to 3rd national quality assessment (QA) program for TB healthcare service in Korea was conducted. Methods: We analyzed Health Insurance Review & Assessment Service (HIRA) claims data of new TB patients during the period of January to June from 2018-2020. The new TB patients were defined as TB patients reported to Korea Centers for Disease Control and Prevention Agency (KCDA). The unit of analysis was the patient. Chi-square tests were used to analyze the differences in indicator value according to the types of medical facilities. The QA indicators of TB care were divided into 3 areas consisting of the following 7 quality indicators: 4 indicators of diagnosis test (the rate of acid-fast bacilli smear, the rate of acid-fast bacilli culture, the rate of Mycobacterium tuberculosis-polymerase chain reaction, drug susceptibility test), 1 compliance of treatment guideline, and 2 indicators of care management of TB patients (encounter rate, day of therapy). Results: The QA program for TB care was conducted among 8,246 patients from 534 facilities in 2020. The value of the 7 quality indicators was shown to increase as a result of the QA program. The indicators of the diagnostic test were all higher than 95%, with the exception of the drug susceptibility test which was 84.8%. Both indicators for care management of TB patients were 88.5%. Conclusion: The quality of TB care has been improving with the implementation of the QA program. In order to continue to improve the quality of TB care, it will be necessary to disclose the results of the QA program in medical facilities in the future.

• Journal of Environmental Impact Assessment
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• v.16 no.6
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• pp.511-524
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• 2007

Korea has 30 years of experiences in environmental impact assessment (EIA). Although EIA includes sanitation-public health factor, considering health impacts, among 74 unit projects of 17 sections, health impacts haven't been properly considered or have been ignored in many cases. The increasing awareness on the importance of health impacts has triggered this study to seek an optimal introduction scheme of health impact assessment (HIA). The processes of EIA already include screening, scoping, analysis, impact assessment, consultation, document review, decision making and monitoring, in which they would be the essential parts of HIA. In this context, integrating HIA into the existing EIA process could be the most effective way to use the benefits in both legal and procedural processes existed and to avoid the confusion and overlapping since the close relationships between environment and health impacts might be. Furthermore, it is desirable that the existing sanitation-public health factor should be substituted by and extended to environment-health factor with sufficient determinants to properly consider health impacts. When considering the first step of HIA, the prospective and qualitative approach is suitable more than the retrospective and quantitative one due to the lack of database accumulated. Similarly, an approach based on epidemiology and toxicology could analyze the limited evidences and impacts related to human disease, whereas one based on socio-science and psychology could provide the effective means available for predicting how the people and community will act by the change of surroundings. Checklist approach with various and comprehensive health determinants focused on prospective and qualitative methods will be very useful for more convenient and progressive dissemination of HIA. Various checklist approaches of toolkits could be found from HIA documents elsewhere, for example Westminster Toolkit, and they would be helpful to figure out how to develop common procedures and health determinants for checklist, in which the unique characteristics on korean cultural and political context compared to abroad should be carefully considered since checklist would be the most basic and essential part of HIA. After the establishment of checklist and procedural processes, the pilot projects should be conducted. Main purpose of pilot projects is to apparently prove the effectiveness and profitability of HIA. Pilot projects should be implemented to decide the effectiveness and suitability of HIA for future projects, programs and policies, and should be provided as the positive cases that can be achieved through the proper implementation and progress.

• Journal of Environmental Impact Assessment
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• v.3 no.2
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• pp.69-75
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• 1994

Environmental Impact Assessment is composed of screening, scoping, inventory survey, prediction, assessment, alternative assessment, mitigation measure, and post management. Environmental monitoring data is applied to EIA process such as prediction and post management. It must he collected and managed systematically for effective applying in EIA process. This article explains factors such as air quality, water quality, soil, ocean, odor, noise & vibration, ecosystem, etc. and organizations of environmental monitoring managed by Ministry of Environment.

• Journal of Environmental Impact Assessment
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• v.4 no.1
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• pp.59-64
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• 1995

Environmental Impact Assesment(EIA) is composed of various procedures, such as screening, scoping, inventory survey, prediction, assessment, mitigation measure, alternative assessment, and post management. Remote sensing introduced lately begins to be applied ecosystem and land use in inventory survey and assessment of EIA. This study explains on land use classification, buffering analysis of residential area, and overlaying analysis of odor predictive data with residential area for application to EIA with remote sensing data. Residential area extracted from land use classification of remote sensing provides effectively buffering analysis of residential area in selection of landfill site with GIS. It could assess also residential effect to an offensive odor by overlaying analysis. Application methods in EIA should be enlarged to assess effectively.

• Journal of Microbiology and Biotechnology
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• v.22 no.2
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• pp.256-263
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• 2012

A strain of bacterium producing antifungal antibiotic was isolated and identification of the strain was attempted. We could identify the bacterium as being a Bacillus sp., based on morphological observation, physiological characteristics, and 16S rDNA sequence analysis, thus leading us to designate the strain as Bacillus sp. AH-E-1. The strain showed potent antibiotic activity against phytopathogenic and human pathogenic fungi by inducing mycelial distortion and swelling and inhibiting spore germination. The antibiotic metabolite produced by the strain demonstrated excellent thermal and pH (2-11) stability, but was labile to autoclaving. From these results, we could find a broader antifungal activity of Bacillus genus. Isolation and characterization of the active agent produced by the strain are under progress.