초록

- 어린이 환경보건 출생코호트 연구 지원센터 구축운영
- 상세코호트 산모모집 및 환경노출에 따른 건강영향조시
- 대규모 코호트 국가 빅데이터 연계 방안 모색
- 출생코호트 교육 및 홍보전략 수립 시행

(출처 : 프리즘)

Abstract ▼

IV. Study Results
1. Development of Organizational Structure
• For an efficient and systematic operation of the Ko-CHENS, the organizational structure was developed. It consists of the headquarters, the regional centers and the support center.
• The Ministry of Environment is the headquar

IV. Study Results
1. Development of Organizational Structure
• For an efficient and systematic operation of the Ko-CHENS, the organizational structure was developed. It consists of the headquarters, the regional centers and the support center.
• The Ministry of Environment is the headquarters to oversee the overall operation of the project.
• The National Institute of Environmental Research is the headquarters operations which provides an extensive support for the Ministry, including the gathering and storage of biological samples, the IRB process, and the collection of data.
• The regional centers created a regional network, have recruited subjects (pregnant women) for the cohort study, conducted follow-up, collected of biological samples, and input data.
• The support center, which supervises the regional centers, developed a study protocol, have provided a support to recruit subjects for the regional centers, have recruited subjects, collected biological sample, devised the data linkage strategy between the data from the National Health Insurance Service and that from the Ko-CHENS, developed a promotion strategy, promoted the project, and trained newly recruited researchers.
• 12 environmental health centers and the support center have convened to create a nationwide network of recruiting offices. A total of 17 recruiting offices, including 8 public health centers and 9 university hospitals and obstetrics and gynecology clinics, agreed to engage in the main cohort study. A total of 27 recruiting offices, including 1 public health center and 26 university hospitals and obstetrics and gynecology clinics, agreed to participate in the core cohort study.

2. Research Protocol Development and Applications
• A study protocol for the Ko-CHENS has been completed through a two-year strategic project, in which a considerable improvement of the protocol has been made on the basis of analyzing similar protocols of developed countries’. A protocol on the recruiting strategies has also been developed, and a protocol on the assessment of environmental exposures to pregnant women study subjects, which encompasses a variety of steps of exposure assessment, from building a survey questionnaire to analyzing biological samples collected, has been developed. The protocol has been validated by conducting research and exposure assessment with an application of it.

3. Core Cohort and the Main Cohorts Management
A. Status Report
• The total number of recruitment in 2015 was 6,230, with the core cohort being 1,230 and the main cohort being 5,000, respectively. As a result, the target has been exceeded by 10%, with 1,348 subjects recruited for the Core Cohort and 5,489 subjects recruited for the Main Cohort.

B. Participants Questionnaires Result (Pregnant woman)
• Demographic characteristics: age group between 30-35 was 50.16%, had the highest proportion; for monthly family income, income group between 2-4million won had the highest percentage, 54.75% and income group less than 2million won had the least, 10.70%; for educational level, the group who had higher level of education than college(two-year college) accounted for 67.82% with the highest proportion and the percentage of group who had no higher than high school was 23.62%.
• Outdoor environment characteristics: most of the participants resided in the city, 91.87%, and rural and mountain area accounted for 5.98%; the ratio of participants who lived near factory or plant within 2km was 15.90%, near bus or taxi terminus was 34.17%, and near gas station within 500m is 52.81%; furthermore, the ratio of participants who responded that there is a lot of noise near their houses were 22.65%.
• Indoor environment characteristics: the people who resides in apartments was 66.09% and had the highest proportion; for chemical agents exposure, the participants who have used mosquito repellents within a year was 59.53% and for kitchen&bathroom disinfectant within a year was 75.84%.
• Junk food intake: the ratio of participants who intake instant cup noodles more than one time per week was 10.92%, hamburger&pizza more than one time per week was 9.71%, frozen food was 22.05%, beverage from can was 29.40%, and beverage from plastics was 20.65%.
• Secondhand smoke: participants who were exposed to secondhand smoke once or two times per week accounted for 10.56%, three or four times per week accounted for 3.80% and the ratio of participants who were exposed secondhand smoke everyday accounted for 5.14%; the proportion of pregnant smokers in the whole participants was 2.57%; the ratio of participants who drank alcohol during pregnancy was 2.15%; and the ratio of participants who responded that they do regular exercise accounted for 19.47%.
• Hygiene/cosmetic items: the ratio of participants who used perfume was 27.11%; cosmetics 86.18%; and antibacterial items 30.33%.
• Radiation exposure: 99.88% of all participants used the cell phone; and the participants who have a job that requires them to wear radiation monitoring badges or job that requires to be examined the exposure of radiation regularly accounted for 3.83%.

4. Data Linkage Strategy
• Ko-CHENS adopts both the European and the American cohort study designs to seek an effective and scientific way to establish a cohort study. In regard with data collection strategy, a direct method and a linkage to the national health database system have been considered. A roundtable on negotiating the common measure of the data linkage with the National Health Insurance Service has been organized, and a pilot project for linking the cohort data with the big data from the National Health Insurance Service has been performed. Through the pilot project, a complementary strategy for the data linkage developed: collecting more data from the main cohort or writing a memorandum of understanding with the National Health Insurance Service.

5. Education and Promotion
• Education by a standardized protocol: as a wide range of stakeholders partake in the Ko-CHENS, including recruiting offices throughout the nation, practitioners in various fields, collaborators, and related companies, an educational program on the protocols, the research management, and the quality control was held in an attempt to obtain standardized data.
• Researcher manual, work log, and education by phase and continuous education: manuals and work logs about the standardization protocols were distributed. To control and ensure the research quality, two educational sessions for the entire researchers, six regional visits, a DB info session, a visit session to the support center for newly recruited researchers, and operation of a hotline for researchers were conducted to raise understanding of the Ko-CHENS, standardize the process, improve the research quality, and strengthen the management ability.
• Development of a PR strategy including creating mascots, opening an internet community and mobile-friendly website, and production of a PR video: to raise the awareness of the cohort study and encourage the participation of the research to pregnant women, mascots which symbolize the children were created and used in all publicity materials. An Internet community and a mobile-friendly website were subsequently opened for subjects to easily access the information. In addition, as a viral marketing, subjects participating in the research were asked to introduce the study through their social network service accounts. Add to this, a promotional video and a logo song were produced, and PR through recruiting offices was conducted. Lastly, transit advertising, media board advertising through the liaison with public institutions, radio and magazine advertisement were conducted to promote the project nationwide.

(출처 : Abstract 15p)

목차 Contents

• 표지 ... 1
• 제출문 ... 2
• 요약문 ... 4
• Abstract ... 13
• 목차 ... 21
• 표목차 ... 23
• 그림목차 ... 27
• I. 어린이 환경보건 출생코호트 연구계획 ... 29
• 1장. 연구배경 및 필요성 ... 30
• 1절. 연구의 필요성 ... 30
• 2절. 국내외 동향 ... 32
• 2장. 연구 개요 및 최종목표 ... 44
• 1절. 연구 개요 ... 44
• 2절. 연구 방법 ... 48
• 3장. 추진 체계 ... 52
• 4장. 연도별 추진일정 ... 53
• II. 1차년도 과업 내용 및 방법 ... 54
• 1장. 과업 범위 ... 55
• 2장. 과업내용 및 방법 ... 56
• Ⅲ. 1차년도 과업 결과 ... 64
• 1장. 어린이 환경보건 출생코호트 기반 구축 ... 65
• 1절. 중앙센터/지역센터/지원센터 구축 ... 65
• 2절. 지역별 코호트별 모집기관 구축 ... 66
• 2장. 어린이 환경보건 출생코호트 프로토콜 개발 및 적용 ... 69
• 1절. 코호트 참여자 모집 ... 69
• 2절. 코호트 설문지 개발 및 표준화 ... 72
• 3절. 생체시료 수집, 이송, 보관 및 분석 ... 79
• 4절. 실내 및 개인노출 환경측정 ... 80
• 5절. DB 입력 및 관리 시스템 ... 82
• 3장. 상세 및 대규모 코호트 운영 ... 86
• 1절. 코호트 모집 현황 ... 86
• 2절. 설문조사 결과에 따른 참여자(임신부) 특성 ... 90
• 3절. 참여자(임신부) 생체 중 환경유해물질 농도 분석결과 및 요인분석 ... 142
• 4절. 참여자(임신부) 가구 내 실내환경 및 개인노출 측정 결과 및 요인 분석 ... 209
• 4장. 빅데이터 연계사업 ... 227
• 1절. 대규모/상세 코호트 국가 빅데이터 연계 ... 227
• 2절. 빅데이터 연계 시범사업 운영 ... 233
• 5장. 어린이 환경보건 출생코호트 교육, 홍보 사업 ... 252
• 1절. 어린이 출생코호트 교육 사업 ... 252
• 2절. 어린이 출생코호트 홍보 사업 ... 254
• Ⅳ. 결 론 ... 261
• 1장. 결과 ... 262
• 2장. 제언 ... 268
• Ⅴ. 기대성과 ... 269
• Ⅵ. 참고문헌 ... 272
• 부록 ... 277
• 부록Ⅰ. 코호트 참여자 모집 지침서 ... 278
• 부록II. 코호트 설문지 및 지침서 ... 310
• 부록III. 생명윤리위원회(IRB) 및 동의서 ... 398
• 부록IV. 코호트 DB 입력 시스템 ... 426
• 끝페이지 ... 457