• 제목/요약/키워드: Sanitary survey

검색결과 233건 처리시간 0.018초

2004년 경상북도 성주군에서 발생한 장병원성대장균의 유행에 관한 역학조사 (An Epidemiologic Investigation of Enteropathogenic Escherichia Coli (EPEC) Outbreak in Seongju-gun, Gyeongbuk, 2004)

  • 백달현;염석현;이관;임현술
    • 농촌의학ㆍ지역보건
    • /
    • 제30권1호
    • /
    • pp.39-50
    • /
    • 2005
  • 목적: 2004년 7월 13일 경상북도 성주군 소재 ${\bigcirc}{\bigcirc}$중 정보고등학교에서 집단 설사증 환자가 발생하여 발생 원인을 추정하고, 예방 대책을 수립하기 위하여 본 역학조사를 수행하였다. 방법: 2004년 7월 14일 전체 학생 및 교직원 및 조리원 345명 중 275명(79.7%)에 대하여 보건요원 5명이 직접 면담을 통해 설문조사를 시행하였다. 역학조사와 동시에 145명에 대해 직장도말검사를 시행하였고, 보존식, 조리기구, 식수 등의 71건의 가검물을 경상북도보건환경연구원에 검사를 의뢰하였다. 또한 식수 공급경로와 급식소 내 환경에 대하여 오염 여부를 조사하였다. 본 연구의 장병원성대장균 설사증 환례의 정의는 설사를 1회 이상 경험하고, 열, 구토, 뒤무직 중 1개 이상의 증상이 있는 설사증 의심 사례와 배양검사에서 확진된 설사증 확진자로 하였다. 통계는 SPSS 10.0을 이용하여, chi-square검사 및 chi-square 경향검사를 시행하였고, 섭취 음식별 설사증 발병의 위험도는 Taylor series를 이용하여 산출하였다. 결과: 275명 중에서 확진자는 8명이었고, 이중 3명은 불현성 감염자이었다. 확진자 8명과 설사증 의심 사례 93명을 포함하여 장병원성대장균 설사증 환례는 101명으로 발병률은 36.7%이었고, 남녀 설사증 발병률의 차이는 없었다. 고등학생이 39.1%로 중학생20.4%보다 설사증 발병률이 높았으며(p<0.05), 중학생과 고등학생 각각 학년이 증가할수록 설사증 발병률이 높았다(p<0.05). 기타 가검물에서는 균이 배양되지 않았다. 학교에 공급되는 모든 식수에서는 염소가 검출되었고, 학생들은 정수기를 이용하거나 급식소 내에 끓여놓은 보리차를 음용하였다. 설사증 환자의 발생일별 분포는 7월 9일 첫 설사증 환자가 발생 후 7월12일에 최대로 발생하였고, 설사의 평균 횟수는 $5.1{\pm}4.5$(중앙값: 4, 최소: 1, 최대: 30)회이었고, 평균 설사 기간은 $2.1{\pm}1.1$(중앙값: 2, 최소: 1, 최대: 5)일이었다. 식수 섭취별 설사증 발병률은 유의하지 않았으나, 7월 7일 제공된 급식의 경우 비섭취자에 대한 섭취자의 비교위험도가 4.12(95% 신뢰구간 1.39-12.2)로 다른 일자의 급식에 비해 매우 높았으며, 최종적으로 급식될 때 익히지 않은 상태에서 제공되는 음식들 중 유의한 음식은 샐러드로 비교위험도가 1.66(95% 신뢰구간 1.07-2.57)이었다. 7일 점심때 제공된 급식이 오염되었다고 가정하여 추정한 평균 잠복기는 $5.0{\pm}1.1$일(중앙값: 5.1, 최소: 22일, 최대 : 7.3)일이었다. 결론: 이번 장병원성대장균 유행은 물의 오염에 의한 가능성은 거의 없으며, 불현성 감염자인 조리보조원이 최종적으로 익히지 않은 상태에서 제공되는 샐러드와 다른 음식들을 조리하면서 구멍 난 조리장갑을 사용하여 여러 종류의 음식이 오염되었을 가능성이 높다.

  • PDF

국내 주요 5성급 호텔의 위생실태 조사와 ATP 결과의 상관분석 평가 연구 (Correlation Analysis of Inspection Results and ATP Bioluminescence Assay for Verification of Hygiene Status at 5 Star Hotels in Korea)

  • 김보람;이정아;하상도
    • 한국식품위생안전성학회지
    • /
    • 제36권1호
    • /
    • pp.42-50
    • /
    • 2021
  • 외식산업의 급속한 성장과 함께 호텔을 비롯한 외식업체에서는 식품안전 요구 및 위생에 대한 중요성 이 증가하고 있다. 이에 현장에서 위생상태를 판단할 수 있는 신속하고 실용적인 모니터링기법이 요구된다. 본 연구는 국내5성급 호텔 5군데를 대상으로 개인위생(작업자의 손), 조리기구(칼, 도마, 식품보관용기, 슬라이스 머신 칼날, 제빙기 스쿱), 시설·설비(냉장고 손잡이, 작업대, 싱크대), 고객 접점항목(뷔페용 집게)에 대한 위생관리 실태를 조사하였고 그에 대한 검증법인 ATP 값의 상관관계를 도출하고자 하였다. 5개 호텔의 위생관리 실태조사 결과, 다른 검사 항목보다 상대적으로 조리기구 및 개인위생 결과가 비교적 위생적으로 관리되고 있었으며(조리기구 92.2%, 개인위생 91.4%, 시설·설비 76.19%, 고객 접점항목 88.6%)으로 시설·설비는 비교적 미흡한 것으로 나타났다. ATP검사 결과, 조리 기구(51±45 RLU/25 ㎠)는 시설·설비(167±123 RLU/25 ㎠)보다 비교적 위생적으로 잘 관리되었다. 위생실태 조사 결과 점수와 ATP 값의 상관성 분석을 실시한 결과, 각 호텔 별 작업자 손, 조리기구, 시설·설비의 대부분 음의 상관관계를 가지며 높은 상관성(-0.64 - -0.89)을 보였다. 또한 이번 연구에서 각 검사 항목의 평소 상태의 ATP 값(1020±1254 RLU/25 ㎠)에 비해 세척 후 ATP 값(92±67 RLU/25 ㎠)이 현저히 감소되어 세척의 유효성을 확인하는 도구로 적합성을 확인할 수 있었다. 호텔을 비롯한 외식업체에서 수행하는 주관적인 위생실태조사와 ATP 검사법을 병행한다면, 실시간으로 보이지 않는 오염물질의 객관적인 수치화를 통해 식품사고 발생을 예방하기 위한 효과적인 모니터링 방법이 될 것으로 사료된다.

한국농촌보건(韓國農村保健)의 문제점(問題點)과 개선방안(改善方案) (Innovative approaches to the health problems of rural Korea)

  • 노인규
    • 농촌의학ㆍ지역보건
    • /
    • 제1권1호
    • /
    • pp.5-9
    • /
    • 1976
  • The categories of national health problems may be mainly divided into health promotion, problems of diseases, and population-economic problems which are indirectly related to health. Of them, the problems of diseases will be exclusively dealt with this speech. Rurality and Disease Problems There are many differences between rural and urban areas. In general, indicators of rurality are small size of towns, dispersion of the population, remoteness from urban centers, inadequacy of public transportation, poor communication, inadequate sanitation, poor housing, poverty, little education lack of health personnels and facilities, and in-accessibility to health services. The influence of such conditions creates, directly or indirectly, many problems of diseases in the rural areas. Those art the occurrence of preventable diseases, deterioration and prolongation of illness due to loss of chance to get early treatment, decreased or prolonged labour force loss, unnecessary death, doubling of medical cost, and economic loss. Some Considerations of Innovative Approach The followings art some considerations of innovative approaches to the problems of diseases in the rural Korea. 1. It would be essential goal of the innovative approaches that the damage and economic loss due to diseases will be maintained to minimum level by minimizing the absolute amount of the diseases, and by moderating the fee for medical cares. The goal of the minimization of the disease amount may be achieved by preventive services and early treatment, and the goal of moderating the medical fee may be achieved by lowering the prime cost and by adjusting the medical fees to reasonable level. 2. Community health service or community medicine will be adopted as a innovative means to disease problems. In this case, a community is defined as an unit area where supply and utilization of primary service activities can be accomplished within a day. The essential nature o the community health service should be such activities as health promotion, preventive measures, medical care, and rehabilitation performing efficiently through the organized efforts of the residents in a community. Each service activity should cover all members of the residents in a community in its plan and performance. The cooperation of the community peoples in one of the essential elements for success of the service program, The motivations of their cooperative mood may be activated through several ways: when the participation of the residents in service program of especially the direct participation of organized cooperation of the area leaders art achieved through a means of health education: when the residents get actual experience of having received the benefit of good quality services; and when the health personnels being armed with an idealism that they art working in the areas to help health problems of the residents, maintain good human relationships with them. For the success of a community health service program, a personnel who is in charge of leadership and has an able, a sincere and a steady characters seems to be required in a community. The government should lead and support the community health service programs of the nation under the basis of results appeared in the demonstrative programs so as to be carried out the programs efficiently. Moss of the health problems may be treated properly in the community levels through suitable community health service programs but there might be some problems which art beyond their abilities to be dealt with. To solve such problems each community health service program should be under the referral systems which are connected with health centers, hospitals, and so forth. 3. An approach should be intensively groped to have a physician in each community. The shortage of physicians in rural areas is world-wide problem and so is the Korean situation. In the past the government has initiated a system of area-limited physician, coercion, and a small scale of scholarship program with unsatisfactory results. But there might be ways of achieving the goal by intervice, broadened, and continuous approaches. There will be several ways of approach to motivate the physicians to be settled in a rural community. They are, for examples, to expos the students to the community health service programs during training, to be run community health service programs by every health or medical schools and other main medical facilities, communication activities and advertisement, desire of community peoples to invite a physician, scholarship program, payment of satisfactory level, fulfilment of military obligation in case of a future draft, economic growth and development of rural communities, sufficiency of health and medical facilities, provision of proper medical care system, coercion, and so forth. And, hopefully, more useful reference data on the motivations may be available when a survey be conducted to the physicians who are presently engaging in the rural community levels. 4. In communities where the availability of a physician is difficult, a trial to use physician extenders, under certain conditions, may be considered. The reason is that it would be beneficial for the health of the residents to give them the remedies of primary medical care through the extenders rather than to leave their medical problems out of management. The followings are the conditions to be considered when the physician extenders are used: their positions will be prescribed as a temporary one instead of permanent one so as to allow easy replacement of the position with a physician applicant; the extender will be under periodic direction and supervision of a physician, and also referral channel will be provided: legal constraints will be placed upon the extenders primary care practice, and the physician extenders will used only under the public medical care system. 5. For the balanced health care delivery, a greater investment to the rural areas is needed to compensate weak points of a rurality. The characteristics of a rurality has been already mentioned. The objective of balanced service for rural communities to level up that of urban areas will be hard to achieve without greater efforts and supports. For example, rural communities need mobile powers more than urban areas, communication network is extremely necessary at health delivery facilities in rural areas as well as the need of urban areas, health and medical facilities in rural areas should be provided more substantially than those of urban areas to minimize, in a sense, the amount of patient consultation and request of laboratory specimens through referral system of which procedures are more troublesome in rural areas, and more intensive control measures against communicable diseases are needed in rural areas where greater numbers of cases are occurred under the poor sanitary conditions.

  • PDF