• 제목/요약/키워드: Health Risk Assessment

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Meta-analysis of the Diagnostic Test Accuracy of Pediatric Inpatient Fall Risk Assessment Scales

  • Kim, Eun Joo;Lim, Ji Young;Kim, Geun Myun;Lee, Mi Kyung
    • Child Health Nursing Research
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    • v.25 no.1
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    • pp.56-64
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    • 2019
  • Purpose: This study was conducted to obtain data for the development of an effective fall risk assessment tool for pediatric inpatients through a systematic review and meta-analysis of the diagnostic test accuracy of existing scales. Methods: A literature search using Medline, Science Direct, CINAHL, EMBASE, and the Cochrane Library was performed between March 1 and 31, 2018. Of 890 identified papers, 10 were selected for review. Nine were used in the meta-analysis. Stata version 14.0 was used to create forest plots of sensitivity and specificity. A summary receiver operating characteristic curve was used to compare all diagnostic test accuracies. Results: Four studies used the Humpty Dumpty Falls Scale. The most common items included the patient's diagnoses, use of sedative medications, and mobility. The pooled sensitivity and specificity of the nine studies were .79 and .36, respectively. Conclusion: Considering the low specificity of the pediatric fall risk assessment scales currently available, there is a need to subdivide scoring categories and to minimize items that are evaluated using nurses' subjective judgment alone. Fall risk assessment scales should be incorporated into the electronic medical record system and an automated scoring system should be developed.

A Study on Activation of Vulnerable Worker Participation for Risk Assessment in Construction (건설업 위험성 평가 시 취약 근로자 참여 활성화 방안에 대한 연구)

  • Hyunjin Wi;Taekeun Oh
    • The Journal of the Convergence on Culture Technology
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    • v.10 no.1
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    • pp.533-538
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    • 2024
  • The risk assessment under the Occupational Safety and Health Act was implemented in 2013, but since it is not mandatory, companies are operating it as a formality. Although legal obligations have been strengthened, such as the recent comprehensive revision of the Occupational Safety and Health Act and the enforcement of the Act on Punishment for Serious Accidents, the death rate has remained stagnant. Even if a risk assessment plan is properly established in order for employers to prevent industrial accidents through necessary measures, it is necessary to involve relevant workers so that they can understand and implement the contents of the risk assessment. In this regard, this study proposed applying efficient worker participation measures through on-site surveys to activate the participation of vulnerable workers in risk assessments. Key words : risk assessment, accident prevention, vulnerable class, worker participation

A Proposal of Hazard/Risk Assessment Criteria and an Asbestos Management Method for Asbestos-containing Building Materials

  • Park, Wha-Me;Kim, Yoon-Shin
    • Journal of Environmental Health Sciences
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    • v.38 no.1
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    • pp.66-72
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    • 2012
  • Objectives: The AHERA method by the US EPA, ASTM E2356-04, and HSG264 by the UK HSE, all of which are hazard/risk assessment methods for asbestos-containing building materials, were reviewed and compared based on 231 homogeneous areas. In addition, the current Act on Asbestos Safety Management (enforcement: April 29, 2012) was reviewed and analyzed. This trial provided fundamental data for improving the current asbestos hazard/risk assessment method. Methods: For the hazard/risk assessment of 77 asbestos-containing public buildings including schools, 231 homogeneous areas were selected, each of which was assessed using AHERA, ASTM E2356-04, and HSG264. Results: The matching rate of the hazard/risk assessment stood at 20.4 percent between AHERA and ASTM, at 71.4 percent between AHERA and HSG264 and at 17.8 percent between ASTM and HSG264. The AHERA method includes a seven-category rating scale. There were three categories, two of which have three subcategories. ASTM provides two decision-making charts consisting of ten rating scales for current condition estimation and for potential for disturbance estimation. In addition, the HSG264 method has a total of 20 scores with four items, and then provides four grades. This HSG264 method cannot clearly separate current condition and potential for disturbance. Conclusions: In the Korean Act on Asbestos Safety Management, the hazard/risk assessment method for asbestos-containing building materials should consider balance between current condition estimation and the potential for disturbance estimation.

The Effects of the Systemic Follow up Health Care Program on the Health Promotion and the Risk Reduction in Premature Infants and Their Mothers (체계적 건강관리프로그램이 모성과 미숙아의 건강증진 및 질병예방에 미치는 영향에 관한 연구)

  • Ahn Young-Mee
    • Journal of Korean Academy of Nursing
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    • v.34 no.6
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    • pp.1129-1142
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    • 2004
  • Purpose: This research was conducted to evaluate the effects of asystemic follow-up care program on health promotion and risk reduction in 64 high-risk infants(HRI) including premature infants and their mothers. Method: The intervention consisted of systemic NICU education, tele-counseling and 3 home visits in 6 months. The subjects were divided into either the intervention group or the control group receiving the conventional NICU education without the tele-counseling and home visiting. Infant health promotion was measured using physical assessment, types of health problems, reflexes, OPD visiting history, DDST, immunization, feeding assessment, Infant death rate, etc. Maternal self-esteem, postpartum depression and family function were measured using the maternal self-report inventory(MRI), EPDS, and family apgar score(Fapgar), retrospectively. Result: All premature infants in the intervention group were in the normal range of growth and development, and the regular vaccination schedule. The health problems in the intervention group were addressed early so not to develop into adverse effects. The follow-up program for 6 months showed beneficial effects on MRI, EPDS, and Fapgar. Conclusion: A systemic follow-up health care program is beneficial on health promotion and risk reduction in 64 HRI including premature infants and their mothers.

Nanotechnology and Occupational Health Addressing Potential Health Risks

  • Maynard Andrew
    • Proceedings of the Korea Environmental Mutagen Society Conference
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    • 2005.05a
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    • pp.21-26
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    • 2005
  • [ $\cdot$ ] Occupational safety and health is a key component of responsible nanotechnology $\cdot$ Nanotechnology challenges conventional approaches to addressing occupational safety and health risk $\cdot$ Nanomaterials and devices of concern include those capable of entering the body and causing harm as a result of their nanostructure $\cdot$ Proactive risk assessment and management requires extensive strategic research $\cdot$ Current knowledge provides a staring point for addressing risk

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A Study on the Improvement of Risk Assessment Method in Laboratory (연구실 위험성평가방법 개선에 관한 연구)

  • Kim, Soo-Tae
    • Journal of the Society of Disaster Information
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    • v.18 no.3
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    • pp.444-456
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    • 2022
  • Purpose: Laboratories require Preliminary Risk Analysis of Hazard Factors, but there are many laboratories that do not. For the purpose of securing the safety of the laboratory, it is intended to find improvements so that the Risk Assessment can be easily applied. Method: Research papers and data from the Laboratory Safety Management Survey Report by the Ministry of Science and ICT were used. The study was conducted by comparing Preliminary Risk Analysis of Hazard Factors and Risk Assessment under the Occopational Safety and Health Act. Result: A technique for Risk Assessment of a laboratory was proposed. When Risk Assessment of the laboratory, a method was proposed to estimate the size of the possibility(frequency) and severity(intensity). Conclusion: For easy application in the laboratory, a checklist-type Risk Assessment technique was presented and actual evaluation was conducted. It is expected that the laboratory will improve through Risk Assessment to help prevent safety accidents.

The Analysis of Geriatric Nutritional Risk Index (GNRI) for Nutritional Assessment and Health Care in Elderly Women (여자노인의 영양상태 평가 및 건강관리를 위한 Nutritional Risk Index (NRI) 비교 분석)

  • Yang, Eun-Ju
    • Journal of Nutrition and Health
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    • v.42 no.3
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    • pp.234-245
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    • 2009
  • Nutritional assessment for the elderly can identify health status and morbidity. However, development of Nutritional Risk Index (NRI) remains limited for elderly because of difficulties in understanding physiological mechanism of elderly. This study was performed to analyze and develop Nutritional Risk Index for Korean elderly Women (Geriatric Nutritional Risk Index, GNRI). Based on literature review, factors for NRI were identified and indices were assessed by a cross-sectional survey. The survey involved Korean elderly women (${\geq}$60, n = 94) in Gwangju area, and sociodemographics, lifestyle characteristics, health conditions, dietary intakes based on 24h- recall, anthropometric measures (wt, ht, BMI, waist, hip, WHR, body protein, body fat, abdominal fat, and triceps skinfold thickness), and clinical biochemistry parameters (systolic blood pressure, diastolic blood pressure, cholesterol, HDL-cholesterol, triglyceride, total protein, albumin, prealbumin, hemoglobin, hematocrit, fasting blood glucose, HbAlc, ferritin, Zn, Ca, Na, K, Vit E, Vit $B_{12}$, folate, C-reactive protein) were examined relation to nutritional risk index. Based on literature review and data analyses, three NRIs were categorized (NRI I, NRI II, NRI III) and used for further analysis. NRI I was related to having metabolic syndrome, NRI II was related to serum albumin and body weight, and NRI III was related to food habit and health concerns. Abdominal fat (%) of elderly was correlated with each NRIs. NRI II was correlated with nutritional deficiency and higher tendency of inflammatory response, and NRI III was correlated with nutritional status which tend to be lower on aging (protein, folate, Vit $B_{12}$). NRI can serve as a useful tools in assessing health risk and nutritional status. Some modification of items in NRI and validity study are need to apply to Korean elderly.

Does performing high- or low-risk coronary artery bypass graft surgery bias the assessment of risk-adjusted mortality rates of hospitals? (관상동맥우회로술의 위험 수준이 병원내사망률 평가 결과에 미친 영향 분석)

  • Lee, Kwang-Soo;Lee, Sang-Il;Lee, Jung-Soo
    • Health Policy and Management
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    • v.17 no.3
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    • pp.87-105
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    • 2007
  • The purpose of this study was to analyze whether nonemergency, isolated coronary artery bypass graft (CABG) surgery for high- or low-risk patients biases the assessment of the risk-adjusted mortality rates of hospitals. This study used 2002 National Health Insurance claims data for tertiary hospitals in Korea. The study sample consisted of 1,959 patients from 23 tertiary hospitals. The risk-adjustment model used the patients' biological, admission, and comorbidity data identified in the claims. The subjects were classified into high- and low-risk groups based on predicted surgical risk. The crude mortality rates and risk-adjusted mortality rates for low-risk, high-risk, and all patients in a hospital were compared based on the rank and the four intervals defined by quartile. Also, the crude mortality rates of the three groups were compared with their 95% confidence intervals of predicted mortality rates. The C-statistic (0.83) and Hosmer-Lemeshow test ($X^2$=11.47, p=0.18) indicated that the risk-adjustment model performed well. Presenting crude mortality rates with their 95% confidence intervals of predicted rates showed higher agreements among the three groups than using the rank or intervals of mortality rates defined by quartile in the hospital performance assessment. The crude mortality rates for the low-risk patients in 21 of the 23 hospitals were located on the same side of their 95% confidence intervals compared to that for all patients. High-risk patients and all patients differed at only one hospital. In conclusion, the impact of risk selection by hospital on the assessment results was the smallest when comparing the crude inpatient mortality rates of CABG patients with the 95% confidence intervals of predicted mortality rates. Given the increasing importance of quality improvements in Korean health policy, it will be necessary to use the appropriate method of releasing the hospital performance data to the public to minimize any unwanted impact such as risk-based hospital selection.

Human Health Risk Assessment of n-Butyl Glycidyl Ether from Occupational Workplaces (작업장에서의 n-부틸 글리시딜 에테르에 대한 건강 위험성 평가)

  • Moon, Hyung-Il;Choi, Hyeon-Il;Sin, Saemi;Byeon, Sang-Hoon
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.23 no.1
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    • pp.20-26
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    • 2013
  • Objectives: This study was conducted to evaluate the health risk of workers exposed to butyl glycidyl ether to prevent them from developing occupational diseases. Methods: The workplaces that coat floor with epoxy were selected and the samples were collected and analyzed with NIOSH 1616 Method. We calculate workplace reference concentration using with NOAEL estimated by the study of Anderson et al. in 1978. Risk was calculated by the ratio of exposure to workplace reference concentration. Monte-Carlo simulation was performed to derivate the median, cumulative 90%, and cumulative 95% value by using Crystal Ball. Results: Butyl glycidyl ether is a skin, eye irritator and can result in central nervous system depression, allergic reaction. NOAEL was 38 ppm and workplace reference concentration was calculated as 0.73 ppm corrected with uncertainty factors. Geometric mean was 1.152 ppm and geometric standard deviation was 1.522 by the workplace environment measurement. The median, cumulative 90%, and cumulative 95% value of risk were calculated as 1.617, 1.934, and 2.092, respectively. Conclusions: Not only cumulative 90% and cumulative 95% value but also the median of risk is higher than 1.0 by the risk characterization, so it can do a lot of harm to workers. Therefore, the process of derivating workplace reference concentration and the appropriacy of the uncertainty factors should be re-examined.

Adverse Outcome Pathways for Prediction of Chemical Toxicity at Work: Their Applications and Prospects (작업장 화학물질 독성예측을 위한 독성발현경로의 응용과 전망)

  • Rim, Kyung-Taek;Choi, Heung-Koo;Lee, In-Seop
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.29 no.2
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    • pp.141-158
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    • 2019
  • Objectives: An adverse outcome pathway is a biological pathway that disturbs homeostasis and causes toxicity. It is a conceptual framework for organizing existing biological knowledge and consists of the molecular initiating event, key event, and adverse output. The AOP concept provides intuitive risk identification that can be helpful in evaluating the carcinogenicity of chemicals and in the prevention of cancer through the assessment of chemical carcinogenicity predictions. Methods: We reviewed various papers and books related to the application of AOPs for the prevention of occupational cancer. We mainly used the internet to search for the necessary research data and information, such as via Google scholar(http://scholar.google.com), ScienceDirect(www.sciencedirect.com), Scopus(www.scopus. com), NDSL(http: //www.ndsl.kr/index.do) and PubMed(http://www.ncbi.nlm.nih.gov/pubmed). The key terms searched were "adverse outcome pathway," "toxicology," "risk assessment," "human exposure," "worker," "nanoparticle," "applications," and "occupational safety and health," among others. Results: Since it focused on the current state of AOP for the prediction of toxicity from chemical exposure at work and prospects for industrial health in the context of the AOP concept, respiratory and nanomaterial hazard assessments. AOP provides an intuitive understanding of the toxicity of chemicals as a conceptual means, and it works toward accurately predicting chemical toxicity. The AOP technique has emerged as a future-oriented alternative to the existing paradigm of chemical hazard and risk assessment. AOP can be applied to the assessment of chemical carcinogenicity along with efforts to understand the effects of chronic toxic chemicals in workplaces. Based on these predictive tools, it could be possible to bring about a breakthrough in the prevention of occupational and environmental cancer. Conclusions: The AOP tool has emerged as a future-oriented alternative to the existing paradigm of chemical hazard and risk assessment and has been widely used in the field of chemical risk assessment and the evaluation of carcinogenicity at work. It will be a useful tool for prediction, and it is possible that it can help bring about a breakthrough in the prevention of occupational and environmental cancer.