• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.17 no.2
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• pp.131-139
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• 2022

Objectives This study aimed to analyze the medical utilization of low back pain (LBP) patients after back surgery and estimate the medical costs of Korean and Western medicine collaborative treatment, odds ratio, and hazard ratio between the two groups using the 2019 Health Insurance Review and Assessment Service-National Patient Sample (HIRA-NPS-2019). Methods Data management and descriptive analysis, logistic regression, and survival analysis were conducted for defining and estimating the LBP patients after back surgery in the NPS 2019 dataset. Results A total of 216,424 patients out of 991,189 were identified as having LBP. Among the patients with LBP, 1,734 were treated with surgery while 214,690 were not. Among those who had surgery, 937 were treated with conventional treatments only and 797 underwent Korean medicine treatments. The odds ratio of the logistic regression analysis was 0.7129, suggesting that Korean medical treatment experience group had a 28.7% lower risk of reoperation than the Western medical treatments only group. The hazard ratio of the survival analysis was 0.9145; thus, the risk probability of reoperation was estimated to be approximately 8.55% lower. The 50% risk of reoperation was 69 days (0.5044) for the conventional group, and 97 days (0.5008) for the Korean medical group in the survival analysis using the Kaplan-Meier graph. Conclusions These results could be utilized in future studies in conducting economic evaluation for estimating cost-effectiveness of Western medicine and Korean medicine treatment compared to Western medicine alone in LBP patients after back surgery in a South Korean perspective. mended and should be applied while taking the necessary precautions.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• v.25 no.2
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• pp.143-149
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• 2023

Objective: The purpose of this nationwide age- and sex- matched longitudinal study was to determine the pyogenic spondylitis (PS) increases the incidence of ischemic stroke (IS) in Korea. Methods: From the National Health Insurance Service (NHIS), we collected the patient data for the period from January 1, 2004 to December 31, 2015. PS was classified according to the International Classification of Disease codes M46.2-M46.8, M49.2, and M49.3. By using a 1:5 age- and sex- stratified matching, a total of 628 patients and 3140 control subjects were included in the study. The IS incidence rates in PS and control group was calculated by using the Kaplan-Meier method. The outcome of hazard ratio of IS was estimated by Cox proportional hazards regression analyses. This study did not exclude PS as a result of postoperative complications. Results: According to the study, 51 patients (8.12%) in the PS group and 201 patients (6.4%) in the control group experienced IS. The adjusted hazard ratio of IS in the PS group was 3.419 (95% CI: 2.473-4.729) after adjusting individual medical condition and demographics. Following the results of subgroup analysis, the risk ratio of IS was greater in most of the subgroup categories (male, female, age <65, age >65, non-diabetic, hypertensive, non-hypertensive, dyslipidemic and non-dyslipidemic subgroup). However, the risk of IS did not differ significantly in diabetic subgroup (95% CI: 0.953-4.360). Conclusions: The risk rate of IS increased in patient with pyogenic spondylitis.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.33 no.4
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• pp.517-527
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• 2023

Objectives: We examine cases of chemical poisoning that occurred in the cleaning of metal parts and the regulations on halogenated solvents in other countries and propose regulations necessary to prevent chemical poisoning from halogenated solvents. Methods: We collected cases of chemical poisoning through the website of the Korea Occupational Safety and Health Agency. A review of the literature was conducted focusing on regulations related to halogenated solvents in the United States and the European Union, particularly for cleaning metal parts. Among the Material Safety Data Sheets submitted to the government, MSDS containing eleven substances were extracted to confirm the composition and product use. We investigated cleaning methods for metal parts used in South Korea. For the hazard classification, the European Chemicals Agency or Japan's NITE's website was used. Results: In the case of poisoning, the cleaning methods involving trichloromethane were dipping and dry, which was not found in the literature. It was confirmed that many halogenated solvents and dimethyl carbonate were used for metal cleaning in South Korea. In vapor degreasing using TCE in the USA, even if the facility is strictly managed, such as by installing cooling coils in open cleaning facilities, the risk of exposure to TCE is considered to be not only carcinogenic but also a concern for acute and chronic effects. In comparison, exposure through Korean work methods such as dipping and drying operations is inevitably much higher. Conclusions: The transition to water-based cleaning with low-hazard chemicals should be a priority in the cleaning process. In the case of metal parts that require precise cleaning, if the use of a halogenated solvent is inevitable, a closed degreasing facility should be used to minimize exposure. The current regulations in the Occupational Safety and Health Act, the Chemical Substances Control Act, and the Air Environment Conservation Act do not require cleaning facilities to minimize emissions. To protect the health of workers using halogenated solvents to clean metal parts, regulations that require a fundamental reduction in exposure will be necessary.

• Health Policy and Management
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• v.14 no.2
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• pp.99-116
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• 2004

This study estimates the determinants of national health expenditures of OECD countries using panel regression method. The data used are OECD Health Data(2003) covering 33 countries and from 1970 to 2001. This study shows several important different results compared to the previous studies. Further this study estimates the determinants of Korean case using data from 1m to 2000, and compare with the results of OECD panel. The main findings are as follows. The income elasticity of health expenditures is estimated below 1.0, but is shown above 1.0 when the different health systems of each country are controlled. The women's labor participation influences strongly positive effect on the health expenditures. The diffusion of new technologies is positively related with the increasing expense. The increasing government expenditures have a tendency not to contain health expenses, but to increase expenses. The expansion of public health insurance holders is containing the expenses, and the increasing number of doctors is pushing expenditures. This implies the health expenditures are influenced more by the induced demand of providers rather than the moral hazard of patients. However, the above result is opposite in Korean case. The existence of primary care doctors affects slightly up warding rather than containing expenditures. Finally the determinants are seriously depending upon which factors are included in the model and which statistical model is chosen. Therefore it must be cautious to interpret the results of statistical model.

• Journal of the Korean Society of Food Science and Nutrition
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• v.40 no.1
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• pp.116-122
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• 2011

This study was conducted to investigate the microbiological hazard of spoons and their cases carried by nursery school children and to evaluate the reduction effects of washing methods and ultraviolet (UV) treatments against Escherichia coli on the spoon and spoon case. A total of 78 spoons and their cases were sampled to test about total aerobic bacteria, coliform bacteria, Staphylococcus aureus, Bacillus cereus and Salmonella spp. Total aerobic bacteria were detected over 2.7 log CFU/100 $cm^2$ in 20 out of 36 spoons (55.6%), 9 out of 20 zipper-type spoon cases (45.0%) and 13 out of 22 plastic-type spoon cases (59.1%). Coliform bacteria were also detected in 19 out of 36 spoons (52.8%), 14 out of 20 zipper-type spoon cases (70.0%) and 14 out of 22 plastic-type spoon cases (63.6%). The pathogens tested in this study were not found in all samples except for the zipper-type spoon cases which were contaminated with Staph. aureus (2 samples) and B. cereus (3 samples). The results indicated that the sanitary conditions of spoons and their cases should be improved promptly. To evaluate the reduction effects of washing methods and UV treatments against E. coli, the spoons and their cases were treated at different cleaning times with and without soap, and different UV exposure times, respectively. E. coli with initial cell number of 4 log CFU on the spoons and their cases was not detected when they were cleaned at running water for 30 sec after dish sponging with soap for 30 sec. In UV treatments, E. coli with the same level of washing method was not detected after UV exposure for 15 minute in the spoons and their cases. From the results, the washing and UV treatment should be used to control the microbial contamination of spoons and their cases for more than 1 and 15 minutes, respectively.

• Journal of Food Hygiene and Safety
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• v.27 no.1
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• pp.30-36
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• 2012

This study was conducted to evaluate the microbiological hazard on nursery school children's hands and to investigate the reduction effect of hand washing education. A total of 59 nursery school children's hands were tested. The average number of total aerobic bacteria was $3.72{\pm}0.38log\;CFU/hand$. Five children's hands(2 male and 3 female) were positive(14.3%) for the coliform bacteria. These results showed that hand washing education are required repetitively. Among the pathogenic bacteria tested in this study, $Staphylococcus$ aureus and $Bacillus$ $cereus$ were detected in 9(25.7%) and 16(45.7%) out of 35 their hands, respectively. Twelve out of sixteen $B.$ $cereus$ isolates(70.0%) produced enterotoxin. The results indicate that the hand hygiene of nursery school children needs to be improved. Comparing before and after hand washing in educated and non-educated group, the reduction effect of total aerobic bacteria on their hands was 0.42 and 0.60 log CFU/hand, respectively. The educated group showed 0.18 log CFU/hand higher reduction effect than non-educated group but microorganism did not eliminate perfectly. From the results, using a hand sanitizer after washing with soap and the continuous hand washing education are required to control the contaminated bacteria on nursery school children's hands.

• KDI Journal of Economic Policy
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• v.30 no.2
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• pp.99-128
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• 2008

Nearly all Koreans are insured through National Health Insurance(NHI). While NHI coverage is nearly universal, it is not complete. Coverage is largely limited to minimal level of hospital and physician expenses, and copayments are required in each case. As a result, Korea's public insurance system covers roughly 50% of overall individual health expenditures, and the remaining 50% consists of copayments for basic services, spending on services that are either not covered or poorly covered by the public system. In response to these gaps in the public system, 64% of the Korean population has supplemental private health insurance. Expansion of private health insurance raises negative externality issue. Like public financing schemes in other countries, the Korean system imposes cost-sharing on patients as a strategy for controlling utilization. Because most insurance policies reimburse patients for their out-of-pocket payments, supplemental insurance is likely to negate the impact of the policy, raising both total and public sector health spending. So far, most empirical analysis of supplemental health insurance to date has focused on the US Medigap programme. It is found that those with supplements apparently consume more health care. Two reasons for higher health care consumption by those with supplements suggest themselves. One is the moral hazard effect: by eliminating copayments and deductibles, supplements reduce the marginal price of care and induce additional consumption. The other explanation is that supplements are purchased by those who anticipate high health expenditures - adverse effect. The main issue addressed has been the separation of the moral hazard effect from the adverse selection one. The general conclusion is that the evidence on adverse selection based on observable variables is mixed. This article investigates the extent to which private supplementary insurance affect use of health care services by public health insurance enrollees, using Korean administrative data and private supplements related data collected through all relevant private insurance companies. I applied a multivariate two-part model to analyze the effects of various types of supplements on the likelihood and level of public health insurance spending and estimated marginal effects of supplements. Separate models were estimated for inpatients and outpatients in public insurance spending. The first part of the model estimated the likelihood of positive spending using probit regression, and the second part estimated the log of spending for those with positive spending. Use of a detailed information of individuals' public health insurance from administration data and of private insurance status from insurance companies made it possible to control for health status, the types of supplemental insurance owned by theses individuals, and other factors that explain spending variations across supplemental insurance categories in isolating the effects of supplemental insurance. Data from 2004 to 2006 were used, and this study found that private insurance increased the probability of a physician visit by less than 1 percent and a hospital admission by about 1 percent. However, supplemental insurance was not found to be associated with a bigger health care service utilization. Two-part models of health care utilization and expenditures showed that those without supplemental insurance had higher inpatient and outpatient expenditures than those with supplements, even after controlling for observable differences.

• Journal of the Korean Society of Safety
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• v.14 no.2
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• pp.103-108
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• 1999

This study focused on risk assessment for inhalation of airborne volatile organic compounds (VOCs) in Ulsan industrial complex area. For non-carcinogenic risk, even the highest hazard index of toluene was estimated to be $4.8\times10^{-2}$, which was much lower than 1. The total hazard index of VOCs was estimated to be $5.8\times10^{-2}$. However, lifetime average cancer risk from the inhalation of airborne VOCs was estimated to be about $1.1\times10^{-3}/$, which was much higher than a risk standard of $10^{-5}$. The risk of $4.4\times10^{-5}$. came from benzene, the only human carcinogen among VOCs, while that of $1.05\times10^{-3}$ from probable human carcinogens including 1,3-butadiene and 1,2-dichloroethane. About 70% and 20% of total VOC cancer risk was due to the inhalation of 1,3-butadiene and 1,2-dichloroethane, respectively. Therefore, proper risk management of these 3 VOCs was required for the protection of health from cancer burden in Ulsan industrial complex area.

• Journal of the Korean Society of Hazard Mitigation
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• v.8 no.4
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• pp.9-16
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• 2008

Ubiquitous technology is proposed which is used wireless sensor network for deflection management at casting and after casting of FCM bridge. Proposed method are analyzed which are sensor experiment and existing FCM bridge using ubiquitous sensor network. Wireless sensor network enables low-cost sensing of environment. As a results, the field application shows that USN is useful method for structural health monitoring system which long distance away.

• Proceedings of the Korean Society for Quality Management Conference
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• 2010.04a
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• pp.254-261
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• 2010

The increase in hazard level is attributed to the industrial hazard environment; complete national environmental hazards to human health include climate change. The damage level in Korea from 1993 to 2009 has exceeded the Increase In adverse environmental conditions. Priority areas of concern will include those risks that are most likely to occur and are expensive when they do take place such as accident or injury at a community pool. Therefore, in this paper, we suggest the System Engineering method for application to the railway RAMS. Recently, the requirement of high-integrity level of infrastructure has been deemed important. The systems level approach is defined through the assessment of the RAMS interactions between elements of complex system applications.