의과대학 학생의 해부학 실습 시 포름알데히드의 노출이호흡기·안구점막 및 피부계통의 주관적 자각 증상에 미치는 영향
The Effects of Formaldehyde Exposure on Self-reported Symptoms of Respiratory-eye Mucosa and Integumentary System during Anatomy Practices among Korean Medical Students
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초록
이 연구는 해부학 실습 시 시신 고정을 위해 이용되는 포름알데히드 등의 화학약품에의 노출이 의과대학생이 주관적으로 느끼는 불편함과 호흡기 점막 및 안구 점막 관련 증상, 피부 계통의 주관적 자각 증상에 미치는 영향을 분석하였다. 연구대상은 해부학 실습을 수강한 의학과, 의학전문대학원 1·2학년 학생으로 이들을 대상으로 웹설문조사를 실시하였다. 총 14개교 학생 대표들을 통해 설문조사를 홍보하였으며, 이 중 설문 응답에 동의한 총 463 명의 자료를 최종 분석하였다. 분석결과, 해부학 실습 시 중등도 이상의 불편함을 느꼈다고 응답한 대상자는 261명(56.4%)이었다. 실습 이후 알레르기성 비염, 안구 건조증 등의 기존 질환 악화가 있었다고 응답한 대상자는 104명(43.2%)이었으며, 기존 질환의 과거력이 없었던 학생 중 증상이 새롭게 발현한 대상자는 209명(95.0%)이었다. 기존 질환의 악화에 영향을 미치는 요인을 다중로지스틱 회귀분석을 실시한 결과, 호흡기·점막의 경우 남자에 비해여자 (OR: 2.000, 95% CI: 1.169~3.421)일 때, 주관적 불편감을 느낄수록 (OR: 3.190, 95% CI: 1.807~5.632) 위험도가 높았다. 피부계통의 경우, 연령이 높을수록 (OR: 2.612, 95% CI: 1.187~5.750), 보호 장비 착용 금지 (OR: 2.217, 1.006~4.885)일 때 유의하게 높았다. 새로운 증상 유발에 영향을 미치는 요인의 경우, 호흡기·점막은 주관적 불편감을 느낄수록 (OR: 5.097, 95% CI: 1.075~24.160), 피부계통의 경우 여자 (OR: 1.711, 1.090~2.686)일 때, 주관적 불편감을 느낄수록 (OR: 1.921, 95% CI: 1.218~3.031), 보호 장비 미착용 (OR: 1.953, 1.189~3.210)일 때 유의하게 높았다. 이 연구를 통해 우리나라 의과대학생들은 해부학 실습 시 포름알데히드 등의 화학약품의 노출 위험을 최소화 할수 있는 장비를 제대로 착용하고 있지 못하며, 실습 시 각종 화학약품에의 노출로 인해 주관적 불편감 및 관련 질환을 경험하고 있음을 확인하였다. 해부학 실습에 대한 안전 가이드라인을 강화하고 학생 건강권을 보호할 수 있는 제도적 장치가 마련되어야 한다.
Abstract
This study aims to determine the effects of formaldehyde exposure on self-reported symptoms of respiratory-eye mucosa and integumentary system during anatomy practices among Korean medical students. Data were collected using the web-based survey. Study subjects in 1st and 2nd grade medical student, and having anatomy dissection in medical college and medical graduate school. A total of 463 students from the 14 medical college and medical graduate school participated in this study. The results show that 261 (56.4%) of the participants responded feeling discomfort above moderate at anatomy dissection. After anatomy dissection, 104 (43.2%) students responded aggravating the symptom allergic rhinitis, xerophthalmia and so on. 209 (95.0%) of them responded the new symptom’s appearance. In the result of multiple logistic regression, women (OR: 2.000, 95% CI: 1.169~3.421) and the students with feeling discomfort (OR: 3.190, 95% CI: 1.807~5.632) were more likely to increase the risk of pre-existing respiratory · eye mucosal system symptom’s aggravation than the counter parts. For pre-existing integumentary system symptom’s aggravation, risk is significantly higher in elder age group (OR: 2.612, 95% CI: 1.187~5.750) and with disapproval protective equipments (OR: 2.217, 1.006~4.885). In case of new symptom’s appearance, people with feeling discomfort above moderate (OR: 5.097, 95% CI: 1.075~24.160) in respiratory · eye mucosal system were more likely to increase the risk of new symptom’s appearance. And for integumentary system, risk was higher in people with feeling discomfort (OR: 1.921, 95% CI: 1.218~3.031), in woman (OR: 1.711, 1.090~2.686) and without enough protective equipments preparation (OR: 1.953, 1.189~3.210). This study confirms the protective equipments for minimizing exposure from chemicals for cytological fixation (e,g formaldehyde) is not worn enough and students in anatomy dissection experience discomfort and disease after anatomy dissection. Therefore, this study indicates that the safe guideline in anatomy dissection should be enhanced and institutional strategy to protect student’s right of health should be provided.
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