노령인구의 환경노출에 의한 건강영향조사 Ⅳ -...

최 종 보 고 서

노령인구의 환경노출에 의한

건강영향조사 [Ⅳ]

Evaluation of Health Effect by Environmental

Exposure in Elderly Population [Ⅳ]

2010년 12월

국립환경과학원 환경부 National Institute of Environmental Research

제 출 문

국립환경과학원장 귀하

본 보고서를 환경부 국립환경과학원의 연구용역 과제 ‘노령인구의 환경노출에 의한 건강

영향조사[Ⅳ]’의 최종보고서로 제출합니다.

2010. 12.

서울대학교 의과대학

책임연구원 홍 윤 철

공동연구원:

서울대학교 의학연구원 김진희

고려대학교 보건과학대학 손종렬, 정영림

연구보조원 :

박현승, 배상혁, 박혜인, 김기문, 조경희, 최유미, 송남경

오윤희, 박현희, 최원

협력기관 :

서울시 성북보건소 치매지원센터

길음종합사회복지관

네오딘의학연구소

- 1 -

요 약 문

노령인구의 환경노출에 의한 건강영향 조사[Ⅳ]

대기 및 실내 오염물질에 의한 노출과 순환기/호흡기질환 등 건강영향과의 관련성에

대한 많은 연구가 이루어지고 있으나, 환경오염물질들에 취약한 집단인 노령인구에 대한

연구나 평가는 부족한 실정이다. 특히 고령화 사회로 접어들면서 노령인구가 급속도로

증가하고 있기 때문에 노령인구에서의 환경오염에 의한 건강영향평가와 이를 바탕으로

한 환경보건정책의 수립이 시급하다고 보여진다.

금번 ‘노령인구의 환경노출에 의한 건강영향조사[Ⅳ]’는 다음과 같은 내용으로 구성

되어 있다.

1) 치매센타(서울 성북구 소재)와 길음종합사회복지관에 방문한 60세 이상 성북구 거주

노인들을 대상으로 혈액과 소변을 채취하여 환경노출에 대한 생체지표를 측정·조사하였다.

2) 상기 조사대상 노인들에 대해 3차 년도에 시행된 건강검진을 반복수행하여 환경노출

에 의한 건강영향 평가를 수행하였다.

3) 상기 조사대상 노인들에 대해 기후변화와 관련된 노출을 파악하고 기후변화와 건강

과의 관련성을 파악하였다.

4) 상기 조사대상 노인들 가운데 본 연구에 참여하여 건강검진을 받았으며 개인별 환경

오염노출 측정에 동의한 분들을 대상으로 개인별 환경오염노출 상태를 측정하고, 측정

된 환경오염 노출과 건강상태와의 관련성을 파악하였다.

- 2 -

본 조사의 결과를 다음과 같이 요약하였다.

1) 생체지표를 이용한 환경오염에의 노출평가

PAHs(다환성방향족 탄화수소)의 노출을 평가하기 위해 요중 PAHs 대사산물인

1-OHP와 2-Naphthol을 측정하였다. 1-OHP의 경우 검진 차수에 따라 그 수준에서 유의

한 차이가 있었으나 성별, 연령별 차이는 관찰되지 않았다. 2-Naphthol의 경우 검진 차수,

성별, 연령별 그룹에 따라 그 수준에 유의한 차이가 있었다. 검진 차수에 의한 차이는

주변 환경에서의 PAHs 노출이 계절적인 요인 등에 의하여 검진 시기마다 달라 그 대사

산물의 농도가 달라지는 것으로 사료된다.

VOCs(휘발성유기화합물) 노출을 평가하기 위해 VOCs의 요중 대사산물을 측정하였다.

4가지 물질 muconic acid(뮤콘산), hippuric acid(마뇨산), mandelic acid(만델릭산),

methyl hippuric acid(메틸마뇨산)에서 모두 검진 차수에 따라 농도상 유의한 차이가

관찰되었다. 이들 물질 가운데 Hippuric acid만이 성별에 따라 농도상의 유의한 차이를

보였다. VOCs 역시 수시로 노출 수준이 상이한 물질이므로, 검진 차수에 따른 차이는

이러한 노출 수준의 변화로 인한 것으로 추측된다. 노출의 수준이 때에 따라 달라지므로

노출을 평가할 때 단면적인 측정보다 연속적인 모니터링이 중요하다.

요중 BPA(Bisphenol A)는 검진 차수 및 성별에 따라 유의한 차이를 보였으나, 연령

에 따른 유의한 차이는 보이지 않았다. 요중 BPA는 여성에서 노출이 더 높은 것으로

나타나, 이는 성별에 따른 노출 수준의 차이를 보여 주는 것으로 사료된다. 검진 차수

에 따른 차이는 반감기가 짧은 BPA의 농도가 수시로 변하기 때문인 것으로 추정된다.

요중 Phthalates(프탈레이트)의 경우, 모든 물질이 측정 차수에 따라 유의한 차이를

나타내었다. MEHP(5-OH+5-OXO), 5-OH, 5-OXO, MnBP 모두 성별에 따른 유의한

차이를 보였으며 연령대가 높아질수록 농도가 높아지는 것으로 나타났다. Phthalates

역시 검진 차수에 따른 차이는 수시로 변하는 노출 수준을 반영한 것으로 생각된다.

성별에 따른 유의한 차이는 Phthalates가 함유된 물질을 사용하는 정도가 성별에 따라

다르기 때문일 것으로 추정된다.

요중 HCHO(폼알데하이드)를 측정한 결과 여성이 남성보다 더 높은 농도를 보였다.

이는 성별에 따라 다른 노출 수준을 반영하는 것으로 생각된다.

혈중 중금속의 농도를 측정하였는데, Hg(수은)의 경우 검진 차수, 성별, 연령에 따라

유의한 농도의 차이를 관찰하였다. Pb(납)의 경우도 검진 차수와 성별에 따라 유의한 농도

의 차이가 있었으며, Cd(카드뮴)의 경우는 검진 차수에 따라서만 농도의 유의한 차이

를 관찰할 수 있었다.

- 3 -

비타민 D는 햇볕을 쬐면 생성되는 것으로, 검진 차수에 의한 변화는 기온, 일조량 등

의 변화를 반영하는 것으로 생각된다. 남성이 여성보다 높은 것은 외부 활동이 많은

남성의 특성을 반영하는 것으로 추정된다.

2) 개인별 환경오염노출 측정에 의한 노출 평가

서울시 성북구에 거주하는 만 60세 이상의 노령인구 중 100명을 대상으로 실내오염

물질 중 폼알데하이드와 TVOCs(총휘발성유기화합물)에 대한 개인별 환경오염 노출

및 성북구 S센터의 건강검진실에서 PM2.5를 측정하였다.

총휘발성유기화합물과 폼알데하이드에 대한 개인별 노출의 평균농도는 각각 495.1,

32.1µg/m3로 나타났으며, 농도 범위는 총휘발성유기화합물에 대해서는 27.5～

2692.0µg/m3, 폼알데하이드에 대해서는 0.5～174.9µg/m3로 나타났다. 실내공기질 기준

초과율은 각각 30%, 4%로 개인별 환경오염노출은 폼알데하이드보다는 총휘발성유기화

합물에 대해 높게 나타났다.

VOCs 중 벤젠, 톨루엔, 에틸벤젠, 자일렌에 대한 개인별 노출 평균농도는 벤젠은

5.0(1.7～14.2)µg/m3, 톨루엔은 45.8(9.4～262.4)µg/m

3, 에틸벤젠 7.6(1.1～38.0)µg/m

3,

m/p-자일렌 5.1(0.7～25.3)µg/m3, o-자일렌 4.4(1.0～16.7)µg/m3로 나타났다.

성북구 S센터에서 측정한 PM2.5 결과, 봄철이 여름철보다 높은 농도를 나타냈다. 봄철

측정 시 PM2.5는 외기 PM10과 비슷한 농도로 나타났고, 여름철에는 외기보다는 낮은

농도로 나타났다. 성북구 S센터는 2009년 여름에 개관한 신축 건물로, 특히 진료실에는

창문이 없어 여름철에 비해 봄철은 환기 정도가 낮은 것으로 생각된다.

3) 개인별 기후인자 노출 평가

건강검진 당시의 온도와 습도, 일조량을 측정한 결과, 온도의 경우 성별, 연령 군별

로 검진당시의 온도가 유의하게 달랐던 것으로 나타났다. 그러나 습도와 일조량의 경

우 성별, 연령 군별로 유의한 차이는 보이지 않았다. 또한 검진 차수별로 온도와 습도,

일조량 모두 유의한 차이를 보여주었는데, 이는 검진 차수별로 계절이 달라 나타나는

현상으로 보여진다. 온도와 습도 그리고 일조량이 건강검진에서 측정되는 여러 가지

생체지표와 연관성이 있다는 연구결과들이 최근 발표되고 있으며, 따라서 이러한 기상

의 변화와 건강영향과의 관련성에 대한 심도 있는 연구가 추진될 필요가 있다고 본다.

- 4 -

4) 노령인구의 건강평가

대상자들의 기본적인 자료 성별, 나이, 키, 몸무게 등이 각 검진 차수별로 유의한 차이

는 보이지 않았다. 그러나 혈압의 경우 검진 차수별로 유의한 차이를 보였으며 나이가

많아짐에 따라 혈압이 높아지는 것으로 나타났다. 혈압이 높아지는 것은 뇌졸중이나 심근

경색 등의 심혈관계 질환의 위험요소로, 나이가 많아질수록 이러한 위험이 높아지는 것은

일반적으로 알려져 있는 사실이다.

폐기능 검사 역시 연령이 높아질수록 폐기능이 유의하게 떨어지는 것으로 나타났다.

한편 폐기능 검사에서 일반적으로 남성의 결과가 여성보다 좋게 나타나는 것은 검진

시 남성이 숨을 불어내는 힘이 여성보다 큰 것이 이유 중 하나이다.

전반적인 기능을 평가하는 Balance test나 치매, 우울증 검사의 경우 나이가 많아질

수록 악화되는 것으로 나타났다. 따라서 연령의 증가에 따른 기능의 감퇴로 인한 고위

험군에 대한 대책을 수립할 필요성이 있다고 본다.

또한 심혈관질환의 위험요인의 하나인 심박변이의 감소가 연령대가 높아짐에 따라

심해지는 것으로 나타났으며, 역시 연령의 증가에 따른 기능의 감퇴를 반영하는 것으

로 생각된다.

CBC 결과에서 성별에 따른 차이는 보통 여성의 생리에 의한 것으로 설명되나 본 연구

의 경우 여성 대상자의 대부분이 폐경 후 연령이므로 본 연구에서의 성별에 따른 차이

는 성별에 따른 조혈기능에 차이 또는 영양 상태의 차이에서 기인한 것으로 추정된다.

Glucose의 경우 검사 차수에 따라 유의하게 다른 결과를 나타내었다. 이것은 식사 후

경과시간, 식사의 종류 등에 따라 영향을 받는 검사의 특성 때문인 것으로 추정된다.

5) 환경노출이 건강에 미치는 영향 평가

1-OHP 및 2-naphthol 노출의 증가는 혈압의 증가와 산화손상을 일으키는 것으로

나타났으며 우울증을 증가시키는 것으로 나타났다. 이는 PAHs 노출에 대한 혈압 증가

와 산화손상 및 우울증 증세 야기를 시사한다고 볼 수 있다.

VOCs 대사산물들은 모두 매우 낮은 수준을 보여 알려진 독성은 나타나지 않은 것

으로 생각된다. 그러나 벤젠 대사산물인 Muconic acid, 스티렌의 대사산물인 Mandelic

acid, 자일렌의 대사산물인 Methyl hippuric acid 노출의 증가는 모두 산화손상지표를

상승시켰으며, 이는 VOCs 노출이 산화손상을 야기할 수 있음을 보여주고 있다. 특히

벤젠 대사산물인 Muconic acid는 신체능력을 떨어드렸으며, 톨루엔의 대사산물인

Hippuric acid를 포함한 모든 VOCs 대사산물들은 대사증후군 지표들인 포도당, 인슐린,

HOMA 지표의 증가와 관련성을 보여 향후 이들의 노출과 insulin resistance와의 관련성

을 파악할 필요성이 있다.

- 5 -

벤젠 노출 증가는 우울증 척도들을 증가시키는 경향이 있음을 확인하였으나, 노출측정

을 수행한 총 연구대상자 수가 너무 적어 생체지표들과의 관련성이 낮은 것으로 파악

되므로 향후 모든 대상자들에 있어 벤젠 노출 측정을 실시하여 상호관련성을 파악하고

우울증 발생과의 관련성을 추가 연구할 필요가 있다고 보여진다.

비스페놀A(BPA) 노출의 증가는 HRV의 LF1의 감소, 심장박동수의 증가와 관련성을

보여주어 자율신경계에 영향을 주는 것으로 나타났다. 또한 BPA 노출의 증가는 혈압

을 증가시키는 것으로 나타나 심혈관계 질환 발생에 영향을 미칠 가능성을 나타내었다.

또한 간기능 지표들인 AST, ALT, r-GTP를 모두 증가시키는 것으로 나타났으며,

산화손상의 증가와도 유의한 관련성을 보여주었다. BPA는 일반적인 생활환경에서 널리

사용되는 흔한 물질로서, 인체에 대한 직접적인 독성이 명확히 알려진 바는 없으나, 여성

호르몬인 에스트로젠과 비슷한 형태를 가져 신체 내에서 호르몬과 유사작용을 하여 건강

영향을 나타낼 것으로 의심되고 있다. 본 과제의 분석 결과는 BPA의 만성노출이 실제

로 자율신경계 이상, 심혈관계 이상, 간기능 저하, 산화손상 등의 질병발생에 악영향을

줄 수도 있음을 시사하는 것으로 향후 더욱 심도 깊은 연구가 필요할 것으로 생각된다.

또 다른 내분비계장애물질인 프탈레이트에 대한 건강 영향을 살펴보았을 때, MEHHP,

MEOHP 또한 폐기능을 저하시키고 휘발성유기화합물과 유사하게 대사증후군 지표들

인 포도당, 인슐린, HOMA 지표들의 증가를 야기하였으며 산화손상지표인 MDA를 증가

시키는 것으로 나타났다. MnBP 노출 또한 대사증후군 지표들인 인슐린, HOMA 지표

들의 증가를 야기하였으며, 산화손상지표인 MDA의 증가를 야기하는 것으로 보여져,

이들 물질의 노출에 따른 당뇨 및 산화손상이 공통된 건강영향으로 생각되며, 향후 이들

에 대한 추가 연구가 필요할 것으로 판단된다.

폼알데하이드 노출의 증가는 자율신경 균형검사인 심박변이의 LF1, HF1을 모두 감소

시키는 것으로 나타나, 자율신경계에 악영향을 줄 수 있을 것으로 추정된다. 또한 폼알

데하이드 노출의 증가는 대사증후군 관련, 포도당, 인슐린, HOMA 지표의 증가와,

산화손상지표인 MDA를 증가시키는 것으로 나타나 향후 insulin resistance와 산화손상

과의 관련성을 연구할 필요가 있다고 보여진다. 그러나 생체지표로의 폼알데하이드 노출

값과 적은 수의 연구대상자들에 있어서 측정된 환경노출측정치는 상호 관련성이 낮아

향후 연구대상자 모두에게 환경노출 측정을 실시하여 추가 관련성을 연구할 필요가 있

다고 보여진다.

수은 노출의 증가는 혈압을 증가시키고, 간기능을 떨어뜨리는 것으로 나타났다. 수은

노출이 주로 생선 섭취를 통하여 이루어지고 생선(회 등)의 섭취는 주로 음주와 함께

이루어지는 점을 고려하여 남녀에 따른 또는 음주여부를 고려한 건강영향 평가가 수행

되었다. 성별과 음주여부를 고려한 건강영향 평가에서 수은 노출은 성별과 음주와는

- 6 -

상관없이 독립적으로 간기능을 떨어뜨리는 것으로 확인되었다. 또한 수은 노출의 증가

는 초기치매척도인 K-FAQ의 증가와도 유의한 관련성을 보여주어 향후 수은 노출에

대한 치매 발생 관련성을 추가 연구할 필요가 있다고 사료된다.

납 노출의 증가는 혈압을 증가시키고 간기능을 떨어뜨리는 것으로 나타났다. 납 노출

로 인한 폐기능의 저하는 수은과 마찬가지로 경제력과의 관련성이 높은 것으로 사료되

며, 향후 경제력 지표와의 상관성을 분석할 필요가 있다고 보여진다. 카드뮴 노출의 증

가는 폐기능을 저하시키는 것으로 나타났는데, 이것은 카드뮴의 만성노출이 만성기관지염,

폐기종에 이르는 폐포 손상 등을 일으킬 수 있다고 알려진 것과 일치하는 결과로 보여진다.

대기측정망 자료를 이용한 PM10 노출 증가는 폐기능을 떨어뜨리고 대사증후군 지표

들을 상승시키는 효과를 보여주었다. SO2 노출 증가는 혈압을 상승시키고 대사증후군

지표들의 증가와 상호관련성을 보여주었고, O3의 노출 증가는 대사증후군 지표들 모두

를 상승시키는 효과를 나타내었다. 또한 NO2의 노출 증가는 폐기능을 떨어뜨렸으며 자율

신경계의 저하를 야기하였고 O3와 마찬가지로 대사증후군 지표들 모두를 상승시키는

효과를 보였다. CO의 노출 증가는 또한 폐기능 및 신체능력을 떨어뜨리고 심박동 및

포도당 농도의 증가를 야기하였다. 기상청으로부터 얻어진 대기측정망을 통한 각 대기

오염물질들은 주로 호흡기와 대사증후군을 일으키는 것으로 보이나, 1차에서 3차까지

의 자료만을 얻을 수 있었기 때문에 차후에 최근 자료(4차, 5차)를 얻어 추가 분석할

필요성이 있다고 보여진다.

기온이 떨어지면 폐기능이 떨어지고 혈압이 높아지는 등 다양한 건강영향이 있는 것

으로 알려져 있다. 이러한 기온의 변화로 인한 건강영향이 다양하게 반영된다는 점을

고려하여 노출과 건강영향의 모든 분야에서 기온을 보정한 분석이 추가로 시행되었다.

기온은 대부분의 환경노출과는 독립적으로 건강에 영향을 미치는 것으로 판단되나, 일부

건강영향 평가(폐기능, 혈압, 산화손상)에 있어서는 다른 환경노출평가에 영향을 주는

것으로 보여 향후 이들에 대한 추가 연구가 필요할 것으로 판단된다. 기온과 상관성이

있는 습도 또한 비슷한 경향을 나타냈는데, 습도의 변화로 인한 건강영향은 온도 변화

에 의한 건강영향이 반영된 것으로 추정된다. 일조량은 우울증 발생에 영향을 미치는

것으로 알려져 있어 일조량과 우울증 발생간의 상호 관련성을 분석하였으나 본 연구에

서는 기온 등 여러 영향 요인들을 보정한 후에도 유의한 관련성은 나타나지 않았다.

비타민 D 또한 계절에 많이 영향을 받는 지표로서, 비타민 D가 건강에 미치는 영향을

또한 살펴보았다. 비타민 D는 기온의 효과를 보정한 후에도 여전히 대사증후군 지표들

모두를 떨어뜨리고 염증을 낮추는 효과를 나타내어 향후 노인들에게 비타민 D 섭취를

지향할 필요가 있는 것으로 사료된다.

- 7 -

목 차

◎ 요약문 ························································································································································1

제1장 서 론 ··················································································································································25

제1절 연구의 배경 및 목적 ··················································································································27

1. 연구의 배경 ·····································································································································27

1) 우리나라 사회의 고령화 현상 ··································································································27

2) 대기 및 실내오염과 노인질환 ··································································································28

3) 내분비계 장애물질 노출에 의한 건강영향 ············································································29

2. 연구 목적 ·········································································································································31

제2장 연구범위 및 방법 ····························································································································33

제1절 연구의 범위 ··································································································································35

1. 조사지역 및 대상 ···························································································································35

2. 조사항목 ···········································································································································35

1) 생체지표 ········································································································································35

가. 혈액검사 ·································································································································35

나. 소변검사 ·································································································································35

2) 환경노출 ········································································································································35

가. 개인별 환경노출측정 ···········································································································35

나. 실내 환경노출측정 ···············································································································37

3) 건강평가 ········································································································································38

가. 건강검진 ·································································································································38

나. 치매척도 및 간이 노인우울평가 ·······················································································38

- 8 -

제2절 연구 방법 ······································································································································38

1. 조사방법 ···········································································································································38

1) 건강검진 ········································································································································38

가. 신체측정 ·································································································································39

나. 혈압 ·········································································································································39

다. 혈액검사 ·································································································································39

라. 폐기능 검사 ·························································································································39

마. 심전도 검사 ·························································································································41

바. 심박변이 검사 ·····················································································································41

사. 간이 신체능력 검사 ···········································································································42

아. 치매척도 및 노인우울 검사 ·······························································································42

2) 시료보관 ········································································································································44

3) 생체지표조사 ································································································································46

가. 1-OHP ····································································································································46

나. 2-Naphthol ····························································································································48

다. Muconic acid ······················································································································51

라. Hippuric acid ······················································································································55

마. Mandelic acid ·····················································································································57

바. Methyl hippuric acid ········································································································59

사. BPA ······································································································································62

아. Phthalates ····························································································································66

자. 폼알데하이드 ·························································································································72

차. 수은 ·········································································································································73

카. 납 ·············································································································································76

타. 카드뮴 ·····································································································································79

파. 망간 ·········································································································································81

하. MDA ·······································································································································83

4) 혈액임상검사 ······························································································································86

5) 환경노출측정 및 분석 ··············································································································106

가. 개인별 폼알데하이드 ·········································································································106

나. 개인별 총휘발성유기화합물 ·····························································································108

다. 실내 PM2.5 ·························································································································109

6) 기후인자 측정 ····························································································································110

- 9 -

2. 정도관리 ·········································································································································111

1) 생체지표의 정도관리 ················································································································111

2) 환경노출측정의 정도관리 ········································································································114

3. 통계분석 ·········································································································································118

1) 1차, 2차, 3차, 4차, 5차의 환경노출 평가 및 건강검진 결과 비교 ································118

2) 환경오염 노출과 노출생체지표와의 상관성 ········································································118

3) 환경노출과 건강영향 평가 ······································································································118

제3장 연구결과 ··········································································································································119

제1절 생체지표를 이용한 환경오염 및 Vitamin D에의 노출 평가 ············································121

1. PAHs 대사물질 노출 평가 ······································································································121

2. VOCs 대사물질 노출 평가 ········································································································124

3. 내분비계장애물질(환경호르몬) 노출 평가 ·············································································127

1) BPA ············································································································································127

2) Phthalates ·································································································································129

4. 폼알데하이드 노출 평가 ·············································································································132

5. 중금속 노출 평가 ·························································································································133

6. 비타민 D 노출 평가 ····················································································································136

7. 과제별 생체지표 검사결과 비교 ·······························································································137

제2절 개인별 환경오염노출 측정에 의한 노출 평가 ····································································139

1. 오염물질별 실태조사 결과 ·········································································································139

1) 폼알데하이드 ······························································································································139

2) 총휘발성유기화합물 ··················································································································140

3) PM2.5 ············································································································································144

2 개인별 환경오염 노출과 노출생체지표와의 상관성 ······························································145

- 10 -

제3절 대기측정망 자료를 이용한 환경오염 노출평가 ··································································149

제4절 개인별 기후인자 노출 평가 ····································································································151

1. 개인별 건강검진 당시의 기후인자 노출 평가 ·······································································151

제5절 노인인구의 건강평가(건강검진) ····························································································154

1. 검강검진 대상자의 기본 정보 ···································································································154

2. 혈압 검사 ·······································································································································154

3. 폐기능 검사 ···································································································································157

4. 심박변이 검사 ·······························································································································157

5. 심전도 검사 ···································································································································157

6. 치매척도 및 노인우울평가, balance test 검사 ·····································································164

7. 혈액 임상검사 ·······························································································································169

제6절 환경노출이 건강에 미치는 영향 평가(Ⅰ) ··········································································182

1. 건강검진결과에 미치는 노출생체지표의 영향 평가(4차 단면조사) ·································182

1) 1-OHP 노출이 건강에 미치는 영향 ·····················································································182

2) 2-Naphthol 노출이 건강에 미치는 영향 ·············································································182

3) Muconic acid 노출이 건강에 미치는 영향 ·········································································185

4) Hippuric acid 노출이 건강에 미치는 영향 ·········································································185

5) Mandelic acid 노출이 건강에 미치는 영향 ········································································185

6) Methyl hippuric acid 노출이 건강에 미치는 영향 ···························································185

7) BPA 노출이 건강에 미치는 영향 ··························································································190

8) MEHHP 노출이 건강에 미치는 영향 ···················································································190

9) MEOHP 노출이 건강에 미치는 영향 ···················································································190

10) MnBP 노출이 건강에 미치는 영향 ·····················································································190

11) 폼알데하이드 노출이 건강에 미치는 영향 ········································································195

12) 수은 노출이 건강에 미치는 영향 ························································································197

13) 납 노출이 건강에 미치는 영향 ····························································································197

14) 카드뮴 노출이 건강에 미치는 영향 ····················································································197

15) 망간 노출이 건강에 미치는 영향 ························································································197

16) 비타민 D 노출이 건강에 미치는 영향 ···············································································202

- 11 -

2. 건강검진결과에 미치는 개인별 기후인자의 영향 평가(4차 단면조사) ···························204

1) 온도가 건강에 미치는 영향 ····································································································204

2) 습도가 건강에 미치는 영향 ····································································································204

3) 일조량이 건강에 미치는 영향 ································································································204

3. GIS를 이용한 대기오염노출이 건강에 미치는 영향(4차 단면조사) ·································208


1) 1-OHP 노출이 건강에 미치는 영향 ·····················································································210






7) BPA 노출이 건강에 미치는 영향 ··························································································218






1) 온도가 건강에 미치는 영향 ····································································································225

2) 습도가 건강에 미치는 영향 ····································································································225

3) 일조량이 건강에 미치는 영향 ································································································225


7. 건강검진결과에 미치는 개인별 환경오염노출의 영향 평가 ···············································231

1) 폼알데하이드 노출이 건강에 미치는 영향 ··········································································231

2) 총휘발성유기화합물 노출이 건강에 미치는 영향 ······························································231

3) 벤젠 노출이 건강에 미치는 영향 ··························································································231

4) 톨루엔 노출이 건강에 미치는 영향 ······················································································231

5) 에틸벤젠 노출이 건강에 미치는 영향 ··················································································232

6) 자일렌 노출이 건강에 미치는 영향 ······················································································232

7) PM2.5 노출이 건강에 미치는 영향 ·························································································232

- 12 -

8. 건강검진결과에 미치는 노출생체지표의 영향 평가(패널반복조사) ·································240

1) 1-OHP 노출이 건강에 미치는 영향 ·····················································································240






7) BPA 노출이 건강에 미치는 영향 ··························································································249





12) 수은 노출이 건강에 미치는 영향 ························································································257

13) 납 노출이 건강에 미치는 영향 ····························································································263

14) 카드뮴 노출이 건강에 미치는 영향 ····················································································263


9. 건강검진결과에 미치는 개인별 기후인자의 영향 평가(패널반복조사) ···························268

1) 온도가 건강에 미치는 영향 ····································································································268

2) 습도가 건강에 미치는 영향 ····································································································270

3) 일조량이 건강에 미치는 영향 ································································································270

10. GIS를 이용한 대기오염노출이 건강에 미치는 영향(패널반복조사) ·······························273

11. 대기 중 오염물질 노출이 건강에 미치는 영향(패널반복조사) ·······································274

1) PM10 노출이 건강에 미치는 영향 ·························································································274

2) SO2 노출이 건강에 미치는 영향 ···························································································274

3) O3 노출이 건강에 미치는 영향 ······························································································275

4) NO2 노출이 건강에 미치는 영향 ···························································································275

5) CO 노출이 건강에 미치는 영향 ····························································································275

제7절 환경노출이 건강에 미치는 영향 평가(Ⅱ)(기온보정 후 결과) ·····································281


1) 1-OHP 노출이 건강에 미치는 영향 ·····················································································281

- 13 -






7) Bisphenol A(BPA) 노출이 건강에 미치는 영향 ································································289





12) 수은 노출이 건강에 미치는 영향 ························································································296

13) 납 노출이 건강에 미치는 영향 ····························································································296

14) 카드뮴 노출이 건강에 미치는 영향 ····················································································296

15) 망간 노출이 건강에 미치는 영향 ························································································296



1) 습도가 건강에 미치는 영향 ····································································································302

2) 일조량이 건강에 미치는 영향 ································································································302



1) 1-OHP 노출이 건강에 미치는 영향 ·····················································································307






7) BPA 노출이 건강에 미치는 영향 ··························································································315





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1) 습도가 건강에 미치는 영향 ····································································································321

2) 일조량이 건강에 미치는 영향 ································································································321


7. 건강검진결과에 미치는 개인별 환경오염노출의 영향 평가 ···············································325

1) 폼알데하이드 노출이 건강에 미치는 영향 ··········································································325

2) 총휘발성유기화합물 노출이 건강에 미치는 영향 ······························································325

3) 벤젠 노출이 건강에 미치는 영향 ··························································································325

4) 톨루엔 노출이 건강에 미치는 영향 ······················································································326

5) 에틸벤젠 노출이 건강에 미치는 영향 ··················································································326

6) 자일렌 노출이 건강에 미치는 영향 ······················································································326

7) PM2.5 노출이 건강에 미치는 영향 ·························································································326

8. 건강검진결과에 미치는 노출생체지표의 영향 평가(패널반복조사) ·································334

1) 1-OHP 노출이 건강에 미치는 영향 ·····················································································334






7) BPA 노출이 건강에 미치는 영향 ··························································································343





12) 수은 노출이 건강에 미치는 영향 ························································································351

13) 납 노출이 건강에 미치는 영향 ····························································································357

14) 카드뮴 노출이 건강에 미치는 영향 ····················································································357


9. 건강검진결과에 미치는 개인별 기후인자의 영향 평가(패널반복조사) ···························362

1) 습도가 건강에 미치는 영향 ····································································································362

2) 일조량이 건강에 미치는 영향 ································································································362

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10. GIS를 이용한 대기오염노출이 건강에 미치는 영향(패널반복조사) ·······························365

11. 대기 중 오염물질 노출이 건강에 미치는 영향(패널반복조사) ·······································367

1) PM10 노출이 건강에 미치는 영향 ·························································································367

2) SO2 노출이 건강에 미치는 영향 ···························································································367

3) O3 노출이 건강에 미치는 영향 ······························································································367

4) NO2 노출이 건강에 미치는 영향 ···························································································368

5) CO 노출이 건강에 미치는 영향 ····························································································368

제4장 고찰 및 결론 ··································································································································375

제1절. 생체지표를 이용한 환경오염에의 노출 평가 ······································································377

제2절. 개인별 환경오염노출 측정에 의한 노출 평가 ···································································378

제3절. 개인별 기후인자 노출 평가 ···································································································379

제4절. 노령인구의 건강평가 ···············································································································379

제5절. 환경노출이 건강에 미치는 영향 평가 ·················································································380

◎ 참고문헌 ················································································································································383

◎ 부 록 ······················································································································································391

- 16 -

표 목 차

표 1. 건강진단 주요 조사항목 ·················································································································38

표 2. 1-OHP 대사체 분석기기의 분석조건 ··························································································47

표 3. 2-Naphthol 대사체 분석기기의 분석조건 ···················································································50

표 4. Muconic acid 분석기기의 분석조건 ·····························································································53

표 5. Hippuric acid 분석기기의 분석조건 ·····························································································56

표 6. Mandelic acid 분석기기의 분석조건 ····························································································58

표 7. Methyl hippuric acid 분석기기의 분석조건 ···············································································60

표 8. BPA 분석기기의 분석조건 및 Eluent Condition ······································································64

표 9. BPA Eluent Condition ····················································································································64

표 10. BPA 질량분석기 조건 ···················································································································64

표 11. Phthalate 분석기기의 분석조건 ··································································································68

표 12. Phthalate Eluent Condition ··········································································································68

표 13. Phthalate 질량분석기 조건 ··········································································································69

표 14. 폼알데하이드 분석기기의 분석조건 ···························································································72

표 15. 납 분석기기의 분석조건 ···············································································································77

표 16. 납 표준물질첨가법 ·························································································································78

표 17. 카드뮴 분석기기의 분석조건 ·······································································································80

표 18. 카드뮴 표준물질첨가법 ·················································································································81

표 19. 망간 분석 기기조건 ·······················································································································82

표 20. Graphite furnace 온도 프로그램 ·································································································82

표 21. 시료전처리 조건 ·····························································································································82

표 22. MDA 분석기기의 분석조건 ·········································································································84

표 23. 폼알데하이드 분석조건 ···············································································································107

표 24. GC/MSD 분석조건 ·······················································································································108

표 25. 내부정도관리 현황 ·······················································································································112

표 26. 내부정도관리 절차 ·······················································································································112

표 27. 외부정도관리 현황 ·······················································································································113

표 28. Repeatability of GC/MSD ··········································································································116

표 29. VOCs & HCHO의 검량선 작성 결과 및 검출한계 ·····························································117

표 30. 연령과 성별에 따른 요중 PAHs 대사물질 검사 결과 ·························································122

- 17 -

표 31. 연령과 성별에 따른 요중 VOCs 대사물질 검사 결과 ·························································125

표 32. 연령과 성별에 따른 요중 BPA 검사 결과 ·············································································128

표 33. 연령과 성별에 따른 요중 Phthalates 검사 결과 ···································································130

표 34. 연령과 성별에 따른 요중 폼알데하이드 검사 결과 ·····························································132

표 35. 연령과 성별에 따른 혈중 수은, 납, 카드뮴, 망간 검사 결과 ·············································134

표 36. 연령과 성별에 따른 혈중 비타민 D 검사 결과 ····································································136

표 37. 과제별 생체지표 검사결과 ·········································································································138

표 38. 타 연구의 개인노출농도 기하평균(GM) ·················································································141

표 39. 개인별 환경노출시료의 TVOC, HCHO 농도 ········································································143

표 40. 환경노출시료의 PM2.5 농도 ········································································································144

표 41. 개인별 환경오염 노출과 노출생체지표와의 상관성 ·····························································146

표 42. 연령과 성별에 따른 건강검진 전 1주일간 대기오염 노출평가 ·········································150

표 43. 건강검진 당시의 기후인자에 대한 노출 ·················································································152

표 44. 건강검진 대상자들의 기본 특성 ·······························································································154

표 45. 연령과 성별에 따른 혈압 검사결과 ·························································································155

표 46. 연령과 성별에 따른 폐기능 검사 결과 ···················································································158

표 47. 연령과 성별에 따른 심박변이 검사 결과 ···············································································160

표 48. 연령과 성별에 따른 심전도 검사 결과 ···················································································162

표 49. 연령과 성별에 따른 치매척도 및 노인우울평가 결과 ·························································165

표 50. 연령과 성별에 따른 balance test 결과 ············································································�

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