2

2
1. (Occupational Diseases)



( )
(Organic solvent toxicity) (Cause-effect
dose-response relationship)
2. (Work-related diseases)




( ) (
)


3
1. (workers)

seroderma pigmentosum
DNA





2. (work conditions)





(working environments)
1. (physical environments)
(noise)

2. (biological environments)

3. (chemical environments)


4. (psychological environments) (occupational stress) (burnout)
(psychosomatic disorders)

5. (ergonomics)

*
*






-
70,000
(material safety data sheet-MSDS)

- (dose response rela-tionship)

-

-



(physical rehabilitation)
(vocational rehabilitation)
(fitness for work)

: 395 / : 2555



- ...

: 386 / : 2554

- -

Plantar fasciitis ...

: 388 / : 2554


...

: 377 / : 2553

. .

...


: 376 / : 2553
( )
...

: 375 / : 2553



...

: 373 / : 2553



...
2
1:
2:

32
32

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.

32.

1.
1.1.
1.2.
1.3.
1.4.
1.5.
1.6.
1.7.
2.
2.1.
2.1.1.
2.1.2.
2.1.3.
2.1.4.
2.1.5.
2.1.6.
2.2.
2.2.1.
2.2.2.
2.2.3.
2.2.4.
2.3.
2.3.1.
2.3.2.
2.3.3.
3.
3.1.
3.2.
3.3.
3.4.

3.5.
3.6.
3.7.
3.8.
3.9.
3.10.
4.
4.1.
4.1.1.
4.1.2.
4.1.3.
4.1.4.
4.2.
4.2.1.
4.2.2.
4.2.3.
4.2.4.
4.2.5.
4.3.
4.3.1.
4.3.2.
4.4.
4.4.1.
4.4.2.
4.4.3.
4.4.4.
5.
5.1.
5.2.
5.3.

6.
6.1.
6.2.
6.3.
6.4.
6.5.
6.6.
7.
7.1.
7.1.1.
7.1.2.
7.1.3.
7.2.
7.2.1.
7.2.2.
7.2.3.
8.
8.1.
8.1.1.
8.1.2.
8.1.3.
8.2.
8.2.1.
8.2.2.
8.3.
8.3.1.
8.3.2.
8.3.3.
8.4.
8.4.1.
8.4.2.

8.4.3.
9.
9.1.
9.2.
9.3.
10.
10.1.
10.2.
10.3.
10.4.
11.
11.1.
11.2.
11.3.
12.
13.
13.1.
13.2.











1.
2.
3.
4.
5.
6.
7.



2
.

.

"
"
"
"

. (Unsafe Acts)

. (Unsafe Conditions)

 (Unsafe Acts)
1.

2.

3.
4.
5.


(Unsafe
conditions)
1.
2.
3.

4.
5.

6.
7.







1.
2.
3.
4.
5.

1.
2.
3.
4.

5.






1.
2.
3.
4.
5.

(Safety)
:

** (Loss Prevention)

1. (Hazard Identification)
2. (Technical Evaluation)
3. (Engineering Design)

3. (Accidents)
:
:
: /

(Occupational Accident)
:
/ /

H.W. Heinrich 3
1. (Human causes) 88%
2. (Mechanical failure) 10%
3. (Act of god) 2%

2
1. (Unsafe act) 85%
2. (Unsafe condition) 15%

(Unsafe Act)

*
*
*
*

*
*
*

*
(Unsafe Condition)


*
* (
)
*
*
-
-
-
-
-

1.
2.

 13


(O Donnell)
(Edelman and Mandle. 1994 : 16;
citing O Donnell. 1987. Definition of Health Promotion)
(Kreuter and Devore)

(Edelman and Mandle. 1994 : 16; citing Kreuter and Devore.
1980. Reinforcing of the Health Promotion.)
(2541 : 10)






(.)
6 8 2541
"

10
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

10
( , 2541 : 7)

1. 2


.. 2503

2.
3.

4.
5.

3

1.

1.1
(
2531 : 70)

1.2

1.3


1.4

2.

2.1 (self concept)

(Snugg, and Combs, 1959,
2531 : 77-106)
(physical self)

(self-esteem)

 ( 2531 : 77-106)

( 2532 : 18-19)

2.2 (perception)


(Koos 1954
quoted in Bradshaw 1988 : 12)










2.3

(health belief)




12


2.4





2.5




2.6 (stress)

3. (life style)

50
(Walker et al 1988 :89)
3.1








3.2






2
7 (Breslow Engstrom : 1980 quoted in
Kulbok, Earls, and Montgomery 1986. 21-35)




3.3

3.4
48
25 (S.D. 25)

4

(Hayter 1980 quote in Murray and Zentner, 1985:412)



3.5




3.6
2
3.6.1


1.



(Bee-Pollen)

(peroxidation)
(hydrocortisone epidermal growth factor = EGF)

(Cyclic AMP) (keratinocytes)

(ultraviolet) (photo aging)

( 2533:29)

2.

2
( , 2523 :
47-49)



3.


( 2531 :
152)
3.6.2

1.


2.

3.
(amphetamine)




4.
2

1. 6


(norm)

1.1







1.2







1.3






1.4

 10
( 2533:249)
1.4.1

1.4.2







--
1.5






1.6

2.


2.1








2.2







2.3

?:

: (Therapeutic Nutrition Diet Therapy)

1.
2.
3. 4.
[]

:



5

[]

: (Nutrition for old Age) 40

40-60 60
[]

: (Nutrition for Adult) 20-40

20


[]

: (Nutrition for Adolescence)

16-20 10-21

10-12 1315 []

" " (HEALTH PROMOTION)

CEA Winslow (1920)


Kreater M Devore (1980)


Cartills Saigado (1984)

(1986)

(Pender 1987 : 4,57)

M O"Donnell (1991)
/

Green Kreuter (1991)
(Educational supports) (Environmental supports)
/ (action) (conditions)
/ /
/

/
(health- directed behevior)

(healthrelated behevior) /
(condition of
living)
(Lifestyle)



Green Kreuter
(Environmental supports)
/ (action) (conditions)
/
/ (Green and Kreuter,
1991:4)


" " Green Kreuter

/ (organization)

Dr.Ilono Kichbush, Regional Officer for Health Promotion WHO, European
Office Canadian Public Health Association ..1986
"...
2 :

:

( )
..." (to make healthier
choices the easier choices)











(Voluntary actions)




(Green &
Kreuter, 1991:14)

19

19
(lifestyles) (Green
& Kreuter, 1991:5) poor laws



1 (The Era of Resource Development)
2

(medicine facilities)

2 (The Era of Redistribution)
..1960
(neighberhood health centers)
(Medicare) (Medicaid)

 ..1960
"" ""
/


3 (The Era of Cost - Containment)
..1970


(Medical Care)
(President"s Committee on Health Education)
( /
)
" "

/
/



/
PRECEDE - PROCEED MODEL Lawrence W.Green Marshall W.
Kreuter (Green and Kreuter ,1991)
(Model) 2
1 (Diagnostic Phase) PRECEDE (
Predisposing, Reinforcing, Enabling, Constructs in Educational, EnvironmentalDiagnosis and Evaluation )

 2 1
PROCEED ( PolicyRegalatory
and Organization Constructions in Educational and Environment Development )
PRECEDE - PROCEED MODEL
(out puts) Model
/
1 (Social Diagnosis)

2 (Epidemiological Diagnosis)



(Dimensions)
3 (Behavioral and Environment Diagnosis)

(Environment health - related Behavioral factors)
2
4 (Education and Organization Diagnosis)

3 3
(Predisposing factors) (Reinforcing factors) (Enabling factors)

3
4
(intervention)

5 (Administrative and Policy Diagnosis)

 5

Model 6,7,8 9
7,8,9
Model
PRECEDE - PROCEED MODEL 2
1)
2)

/



OTTAWA CHARTER FOR
HEALTH PROMOTION
17-21 ..1986
" The first International Conference on Health promotion"
(charter) ..2543
Ottawa Charter for Health promotion

( 4
)

1. Advocate

2. Enable

3. Medicate /


(Health promotion Action)

1. (Build Healthy Public Policy)

-



2. (Create Supportive Environment)
2



(Healthy society), (Healthy city),
(Healthy workplace) (Healthy school)

3. (Strengthen Community Action)

-


4. (Develop Personal Skills)

(life skills)

5. (Reorient Health Services)

4 (4 Dimention of Health Promotion)
5

1. (Health enhancemance) 2
1.1

1.2 -

2. (Population groups)

3. (Key settings)
(Sponsorship)
4. (Strategies)
, (Society marketing),
(Advocate),
(Coalition Building & Networking), (Community development),
(Prevention Health Service), (Public
Policy Development), - (Legislation & Regulation),
(Fiscal Policy)

2 Adelaide,
outh Aistralia 5-9 ..1988 OTTAWA

5 1

4
1) 2) 3)

 4)
,
/
,
,

3 Sunsvall
9-15 ..1991
(Supportive Environments)
/
- (empowerment)
, ,
(spiritual),

4
1.



2.


3. " "

4.




4
1.

2.
- (empowerment)
3. (Alliances for health)

4. (Mediating) ( )

-

..1974 " " (Health
Promotion) /

" 2000" ..
1977

 ..1975 (Public-Law 94-371)

The Health information and Health
(Office of Health information and
Health Promotion) Center for Disease Control ..1975

" " (Health Promotion) ..1979
" " (Health Promotion)
(Era of Health Promotion)

" "
1 3
" "
health directed behavior
health related behavior
condition of living
lifestyle
Green Kreuter


2 PROCEDE - PROCEED MODEL ( 1
3)
WHO UNICEF
Alma-Ata 1977



"A
New Perspective on the Health of Canadians" ..1974

 Lalonde Report
(Pederson ;
O"Neil; and Rootman,1994) Lalonde Report

/ (health care)
Lalonde
(concept) " -"
" " "- "
Health For All Ottawa Charter
Lalonde Report
4
6
-
(Pederson, O"Neil Rootman, 1994: 62)

" " Achieving Health For All : A Framework for
Health Promotion ( Jake Epp.. Minister of National Health and Welfare, 1984) Towards and
Expanded Health Field Concept and Research Issues in a New Era of Health Promotion. (Raeburn &
Rootman, 1989) 7 Labonte " "
(Labonte, 1993) Pederson, O"Neil Rootman, 1994: 64 8
Labonte " "

Labonte " " (Domain)
(illness) (disease)
/ (Health/wellness) F
D
E
G
C



Pathways to Better Health
(National Health Strrategy) ......
" -
"
(WHO) "




"

/
/




100
5
1.
2.
3. (Self - help Organizations)
4.
5.


3
(medical approach) (Behavior approach)
- (social-economic- environment approach)
(Labonte,1992) 1 2 -
3

20

(structural and environmental change)
Ottawa Charter for Health Promotion (WHO,1986)

1.
1.
1. (health-reated services)
1.
1.




Australian Nutrition Foundation, National Heart Foundation






(Australian Dietary Guidelines)
(National Food and Nutrition Policy)
, (Housing Department)
(Community Services)
/ Better Cities Program


/


()
30
30


..1993 26
Healthy Cities Projects (Whelan,1990; Mowbray,1990; Prior,1990)



Healthy Cities
(Health Promotion in Schools)
(Health Promotion in Schools) -
..1980



*
*
*
*
*
*
*
*
* (empowering children)

General Medical Practice
20 (General Medical Practice)
Community Medicine General Practice
Family Medicine Program (FMP)



:


"Healthy Lifestyle"

(Health Promotion in the workplace)

:
1.
2.
3.
4. (health screening)

VICTORIAIN HEALTH PROMOTION FOUNDATION "Vichealth"

..1987
(7%)
Health Food and Exercise, Safe Drinking, Pap
smears, Mental Health, Safe sex


Strategic plan
Net Working -
Healthy School, Health cities, Healthy workplace,
Healthy community, Sports, Arts & Culture
,
(illness prevention programs)


.



2 13
1.
2. 3. 4. 5.
2
1. 2.
3.
13
2 13

2
1.

2.

2-4

3.

5-11

4.

12-16

5.

16-18

13
1.

19-21

2.

21-42

3.

42-53