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1 대한응급의학회지제 27 권제 6 호 Volume 27, Number 6, December, 2016 원 저 Trauma 국내자전거사고에서자전거도로와그외장소에서의비교 : 임채석 박원빈 조진성 양혁준 이 근 가천대학교의과대학길병원응급의학교실 Comparison of Bicycle Injury Characteristics between Bicycle Lane and other Accident Site in Korea: Chea Suk Lim, M.D., Won Bin Park, M.D.*, Jin Seong Cho, M.D., Hyuk Jun Yang, M.D., Geun Lee, M.D. Department of Emergency Medicine, Gachon University Gil Medical Center, Incheon, Korea Purpose: This study aimed to evaluate the epidemiology of bicycle injuries in Korea. It analyzed the injury severity of bicycle accidents by making a comparison between accidents that originated from bicycle lanes and accidents that originated in other sites since the inception of the Korea Promoting Bicycle Usage Act in Methods: We performed a retrospective study on 23,038 cases from January 2011 to December 2014, utilizing the data from the emergent department-based, in-depth injury surveillance system. The main analysis of death was conducted by a multivariate logistic regression, using SPSS statistics ver We also classified bicycle accidents in accordance with the sites of accident bicycle lane and other sites, accident year, age, gender, injury location, activity, helmet use, and alcohol consumption. Results: The entire study population of 23,038 patients were divided into two groups depending on accident site: 4045 from bicycle lane and 18,993 from other accident sites. According to the analysis, the percentage of accidents involving female was significantly higher in bicycle lane than in other accident sites (75.8% vs. 79.3% p<0.001). The highest bicycle accident occurred alone (77.3%) in bicycle lane and 57% in other accident sites. However, motor vehicle crash was significantly higher in other accident sites than in bicycle lane (32.9% vs. 10.2%). The result from a multivariate logistic regression demonstrates that bicycle lanes significantly decreases the severity of mortality on average (odd ratio, 0.46; 95% confidence interval ). Conclusion: We found that bicycle lanes have a significant impact on decreasing not only general accidents caused by bicycles, but also mortality. Key Words: Bicycling, Injuries, Mortality 서론자전거는무동력운송수단으로자원절약과환경오염방지, 교통혼잡의개선뿐아니라사용자의육체및정신 건강에도움을주는등의장점을가지고있어네덜란드, 덴마크등많은나라에서정책적으로그사용을장려하고있다 1,2). 국내에서도지난실용정부시절관련업체의지원, 교통법규의개정, 홍보사업등을통하여자전거이용활성화에노력을기울였고, 2010년부터국가자전거도로를확 책임저자 : 박원빈인천광역시남동구남동대로 774번길 21 가천대학교길병원응급의학교실 Tel: , Fax: , o1bin2@naver.com 접수일 : 2016년 7월 24일, 1차교정일 : 2016년 7월 25일, 게재승인일 : 2016년 8월 22일 이논문은질병관리본부에서지원한응급실손상환자표본심증조사를이용한연구임. 522

2 Characteristics of Bicycle Injury in Korea / 523 Article Summary What is already known in the previous study Previous related studies have not proved that bicycle injury on the bicycle lane was less likely to be risky than the accident at the other sites. What is new in the current study This study has been conducted for the first time in Korea in order to compare the severity of bicycle injury on the diverse sites since the Korean National Bicycle Policy implemented. This study mainly proved the negative correlation between the severity (mortality) caused from bicycle injury and bicycle lane. 장신설하는사업을시행하여 2014년까지총 9,374개노선에 19,717 km의자전거도로망을구축하였다 3). 그러나자전거장려정책에따른자전거이용자수의증가와더불어자전거와관련한손상환자의수또한증가하였다. 도로교통공단발표자료에따르면국내자전거사고는 2010년 11,259건, 2011년 12,121건, 2012년 12,908 건, 2013년 13,316건, 그리고 2014년 16,664건으로매년증가하고있고, 전체교통사고사망자중자전거사고사망자가차지하는비율역시 4.9% 에서 5.5% 로증가하는추세이다 4). 이렇듯정부의자전거장려정책결과자전거이용자수뿐아니라자전거와관련한손상역시증가하고있으나이에대한국내의의학적연구는부족한실정이다. 과거전국단위의자전거사고에대한역학조사및자전거도로와일반도로를비교한환자의특성에관한연구가있었으나, 정부의적극적사업이전의연구혹은일개병원수준의연구가대부분이기때문에현재의역학적특성및보건학적지표를반영한다고보기에는한계가있다 5.6). 이에본저자들은정부의자전거장려정책이후증가된자전거관련손상환자들의역학적특성, 안전과관련한행동, 응급실진료결과, 사망률등을자전거도로내손상과그외장소에서의손상으로나누어비교분석을시행하였다. 대상과방법 보건복지부산하질병관리본부가주관하는사업으로응급실에손상으로내원한환자의손상기전, 원인등에대한자료를수집조사하여, 손상통계의산출과이를바탕으로한예방관리정책수립에유용한정보를제공하고자함에있다. 연구기간중조사참여병원에자전거손상으로내원한환자들을대상으로연구를시행하였고, 자전거손상환자는응급실손상환자표본심층조사의기본조사항목에서손상기전이자전거사고로분류된환자들중환자의역할이운전자및동승자인자인경우로정의하였고, 보행자혹은자전거외부에있으면서자전거에의해발생한손상환자는대상에서제외하였다. 2. 방법선별된환자들은사고발생장소를기준으로자전거도로내에서사고가발생한환자군과그외의장소에서사고가발생한환자군으로분류하여각각의일반적인특성 ( 연령, 성별 ) 및병원전정보 ( 손상시활동, 손상기전, 손상유발물질, 헬멧착용여부 ), 응급실진료결과, 중증도, 사망률등을비교분석하였다. 또한, 대상환자들의중증도비교분석을위하여응급실진료후집중치료실입원률을조사하였고, 초과사망비보정중증도계수 (The Excess Mortality Ratio-adjusted Injury Severity Score, EMR-ISS) 를이용하여 9점미만을경증, 9점이상 25점미만을중등, 25점이상을중증으로분류하였다 7). 마지막으로응급실및입원후사망한환자들을대상으로다변량분석을시행하여환자의사망과상관관계가있는인자를파악하였다. 3. 통계저자들은대상환자들을자전거도로내손상환자군과그외장소의손상환자군으로나누어비교분석을시행하였다. 명목변수에대해서카이제곱검정을사용하였으며, 사망에영향을주는인자에대한다변량분석은로지스틱회귀분석을이용하였다. 통계프로그램은 SPSS Statistics ver (SPSS Inc., Chicago, IL, USA) 을이용하여정리하였고, p-value는 0.05 미만을통계적유의함으로정의하였다. 1. 대상 결 과 본연구는 2011년 1월 1일부터 2014년 12월 31일까지 4년간총 20개병원의응급실손상환자표본심층조사자료를기초로진행하였다. 응급실손상환자표본심층조사는 연구기간동안운수사고로연구참여병원응급의료센터를방문한 168,256명중자전거와관련한손상으로내원한환자는총 26,892명이었다. 이들중 8세미만의환자

3 524 / 임채석외 3,133명및자전거관련손상의당사자가운전자혹은동승자가아닌보행자및간접적손상인자로자전거가관여한자 128명을제외하였다. 또한, 사고의장소가정확하게명시되어있지않거나실내인경우의 593명을제외하여총 23,038명의자전거손상환자를최종연구대상으로선정하였다. 그중 4,045명 (17.6%) 이자전거도로에서사고가발생하였고, 18,993명 (82.4%) 이자전거도로외의장소에서사고가발생하였다 (Fig. 1). 1. 연도별환자발생빈도의변화연도별전체자전거손상의발생빈도는 2011년 5,018 명에서 2012년은 4,919명으로 0.4% 감소하였으나, 2013년에 5,703명으로 3.4% 증가하였고 2014년 7,398 명으로 7.3% 증가하여 2011년과비교하여 10.3% 의증가를보였다. 자전거도로내에서의손상발생역시의미있는증가를보였다. 2011년에는전체자전거손상중 13.9% 를차지하였으나, 이후매년증가하여 2014년에는 19.8% 에이르는것을확인할수있었다 (Fig. 2). 2. 일반적특성및병원전정보자전거도로내손상환자들은그외장소에서손상환자들과비교하여남성이차지하는비율이통계적으로의미있는차이를보였으며 (75.8% vs. 79.3%, p<0.001), 연령별분포에서자전거도로에서의사고는 15-64세그룹이 77.4%, 8-14세 22.9%, 65세이상의그룹은 10.1% 순이었으나, 그외장소에서는각각 64.9%, 24.4%, 10.7% 의분포를보였다 (p<0.001). 또한자전거도로에서손상환자는그외장소에비해응급실내원시 119 이용이적은것으로확인되었다 (37.4% vs. 39.2%, p=0.029). 손상시활동에따른분류를보면자전거도로에서의손상환자의경우레저및운동중에발생한손상은 71.3%, 출퇴근및등하교를포함한일상생활을위한용도로써의이용에는 28.4%, 여행을목적으로한자전거이용에있어서는 0.3% 의분포를보였고, 그외장소에서는각각 62.9%, 36.5%, 0.6% 의분포를보였다 (p<0.001). 사고기전에따른분류에서자전거도로내손상환자들은단독으로넘어지는사고 (77.3%), 자전거대자전거 (10.2%), 자전거대사람및사물과부딪히는경우 (7.7%), Fig. 1. Study flow diagram detailing the stratification and selection of patients who enrolled this study. Total 23,038 patients enrolled this study.

4 Characteristics of Bicycle Injury in Korea / 525 Fig. 2. Comparison of accident site according to the year. The number of patients has increased every year in bicycle accidents, and also increased the number of accidents on the bicycle lane. Table 1. Demographic characteristics between bicycle lane and other accident site Bicycle lane (N=4,045) Accident site Other accident site (N=18,993) p-value Gender Male 3,065 (75.8) 15,063 (79.3)0 <0.001 Age (15.7) 4,638 (24.4) < ,131 (77.4) 12,317 (64.9) (6.9) 2,038 (10.7) Route to ED Using EMS 1,512 (37.4) 7,451 (39.2) <0.029 Self-transport 2,533 (62.6) 11,542 (60.8)0 Activity Routine 1,149 (28.4) 6,929 (36.5) <0.001 Leisure and exercise 2,884 (71.3) 11,948 (62.9)0 Trip 0.12 (0.3).116 (0.6) Helmet use <0.001 Yes (24.2) 1,102 (7.4)0 Alcohol <0.001 Yes.137 (3.4).980 (5.2) Injury mechanism, n=17,687 <0.001 Alone 1,754 (77.3) 8,780 (57.0) Collisions Bicycle (10.2).493 (3.2) Motor vehicle.110 (4.8) 5,068 (32.9) Person and object.174 (7.7) 1,076 (7.0)0 Values are presented as n (%). ED: emergency department, EMS: emergency medical service

5 526 / 임채석외 마지막으로자동차와의충돌 (4.8%) 의순서로발생하였으나, 그외장소에서는단독으로넘어지는사고 (57.0%), 자동차와의충돌 (32.9%), 사람및사물에부딪히는경우 (7.0%), 자전거대자전거 (3.2%) 의분포로자동차와의충돌이자전거도로에서손상보다많은부분을차지하였다 (p<0.001). 헬멧의착용은자전거도로내손상환자들이그외장소의손상환자들과비교하여통계적으로의미있게더많이착용하며 (24.2% vs. 7.4%, p <0.001), 음주후자전거주행은자전거도로내손상환자군에서더적음을알수있었다 (3.4% vs. 5.2%, p<0.001) (Table 1). 으나 (89.3% vs %), 입원 (9.3% vs. 13.3%), 집중치료실입원 (1.4% vs. 2.9%) 및사망환자 (0.1% vs. 0.5%) 의비율은더낮았다. 각각의결과는통계적으로유의미하였다 (p<0.001). 또한 EMR-ISS의결과가작성된 17,296명의환자들중자전거도로내손상환자들에서경증환자가차지하는비율은 46.2% 로그외장소의손상환자들 (41.0%) 보다통계적으로의미있게더많았으며, 중등도환자는 48.2%, 중증환자는 5.2% 로그외장소의도로손상환자들의분포와비교하여더적어자전거도로내손상환자들의중증도가더낮음을알수있었다 (p<0.001) (Table 2). 3. 응급실진료결과와중증도분석 4. 사망환자의특성 응급실진료결과, 자전거도로에서의손상환자들은그외장소에서손상환자들에비해퇴원환자들의비율은더높았 다변량로지스틱회귀분석을통해사망과유의하게연관된인자를조사한결과자전거도로의승산비 (odd ratio, Table 2. ED disposition and EMR ISS between bicycle lane and other accident site Bicycle lane (N=4,045) Accident site Other accident site (N=18,993) p value Disposition of ED Discharge and transfer 3,611 (89.3) 15,829 (83.3)0 <0.001 Admission to general ward.375 (9.3) 2,501 (13.2) Admission to ICU 0.55 (1.4).559 (2.9) Death 00.4 (0.1).104 (0.5) EMR ISS group, n=17,296 Mild 1,458 (46.2) 5,803 (41.0) <0.001 Moderate 1,532 (48.6) 7,131 (50.4) Severe.163 (5.2) 1,209 (8.5)0 Values are presented as n (%). ED: emergency department, EMR-ISS: Excessive Mortality Ratio - Injury Severity Score, ICU: intensive care units Table 3. Multivariate logistic regression analysis for expire in bicycle accident patients Variable Odds ratio 95% CI Gender Female Age Accident site Bicycle lane Route to ED Self-transport Activity Leisure and exercise Trip Injury mechanism, collisions Bicycle Motor vehicle Person and object Unknown Alcohol Yes Unknown CI: confidence interval, ED: emergency department

6 Characteristics of Bicycle Injury in Korea / 527 OR) 가 0.46 (95% confidence interval [CI], ) 로자전거도로와낮은사망률간에통계적유의성을보였다. 여성또한낮은사망률과통계적으로유의한관계를보였으며 (OR, 0.52; 95% CI, ), 자동차와의충돌 (OR, 4.51; 95% CI, ) 과 65세이상의환자군 (OR, 24.27; 95% CI, ) 이높은사망률과의통계적유의성을보였다. 또한그외에도사고당시활동이여행인경우 (OR, 6.29; 95% CI, ), 레저및운동중손상인경우 (OR, 1.41; 95% CI, ) 가높은사망률과의통계적유의성을확인할수있었다 (Table 3). 고찰이번연구를통하여본저자들은자전거관련손상에서자전거도로의존재가중증도및사망률을낮추는데기여함을알수있었으며, 2010년실용정부의자전거장려정책이후실제자전거손상환자가점점증가함을밝혀냈다. 이결과는비슷한정책을시행했던네덜란드, 덴마크등에서도확인할수있었던현상이며, 자전거인프라확장을통한자전거손상에관한연구를통해서본외국의사례와도같았다 2). 또한자전거도로내에서손상환자들이증가하고있음을밝혀냈는데이는정부의자전거장려정책의일환인자전거도로확장사업의효과로풀이된다. 본연구에서자전거손상의남녀비율은 3.7:1로이전국내연구와큰차이는없었다 5,6). 하지만자전거도로에서손상은여성이 24.2% 그외장소에서는 20.7% 로여성의경우자전거도로에서의사고가더많다는사실을확인할수있었다 (p<0.001). 이러한결과는여성의경우남성에비해자전거이용중안전을중시하는경향이높다는 Phillip 등 8) 의연구와비슷한결과였다. 연령에따른자전거도로이용비율은 8세이상 15세미만의경우 15.7%, 15세이상 65세미만은 77.5%, 65세이상의환자는 6.9% 의분포를보여, 15세미만의환자가전체의약 30% 를차지했던다수의연구와는차이를보였다 9,10). 이러한결과는본연구에서나이를 8세이상으로의제한이영향을미친것으로생각한다. 또한 8세-15세미만연령의경우자전거손상장소가자전거도로에서 12.1% 로, 15세이상 65세미만의환자군에서보인 20.3% 보다낮음을확인할수있었는데, 행정자치부연구조사에따르면소아연령의경우대부분의사고는등하교시간과방과후시간에집중되어있다는점을참고해보았을때학교에서의자전거도로이용교육및통학로자전거도로의정비및신설등을통한개선이필요하다고본다 11). 또한, 자전거도로에서의손상환자군의경우헬멧착용자의비가더많고, 음주후이용자비가더적어, 안전에대 한더높은인식도및관련행동을보임을확인할수있었다. 물론헬멧착용및음주여부가중증도와사망률에미치는영향에대해서는논란이있으나 12-15), 자전거도로의확충과이에관련한안전교육및홍보등이더욱진행된다면이러한결과들이자전거관련손상환자들의중증도와사망률을낮추는데긍정적영향을미칠수있을것으로기대한다. 본연구에서자전거관련손상으로인한총사망자수는 200명으로 0.9% 의사망률을보였다. 유사대상으로시행한 Kim 등 5) 의연구에서발표한 0.6% 의사망률보다높았으나, 당시의연구는자전거활성화정책이전의연구였고, 총환자수가 5,000여명수준으로이번연구와는다소차이가있을수있다고생각하며, 본연구에서도입원후결과가사망인환자를제외하고응급실진료결과에서사망한환자만을조사하였을때 0.5% 로유사한사망률을보여자전거손상으로인한사망자수를파악하는데있어본연구가조금더정확하다고볼수있다. 하지만, 도로교통관리공단에서발표한국내자전거사고치사율은 2014년 16,664명중 283명 (5.9%) 으로집게되어, 본연구에서보여준 2014년자전거손상으로응급실에원한 7,398명중사망자 45명 (0.6%) 과는차이가있으나, Cryer 등 16) 이연구에서주장한것처럼경증의자전거사고의경우관공서공식데이터에는누락되는경우가많고, 현장에서사망한경우응급실데이터에는포함되지않으며, 또한사망률은병원에내원한자전거손상환자의수중자전거손상사망자수를말하나, 관리공단의치사율은자전거사고발생건수중사망자수를말해둘간의차이를비교하는것은무리가있다고생각한다. 하지만, 국내자전거장려정책이전의연구중하나인 Wee 등 6) 의연구에서자전거도로내손상환자군과그외장소에서의손상환자군사이의사망률의통계학적차이는없었다고보고하였으나, 본연구에서는각각 4,114명중 4명 (0.1%), 18,816명중 104명 (0.5%) 으로통계적유의미한차이를보였다 (p<0.001). 이결과는자전거장려정책이후시행된자전거도로의확충이자전거손상환자의생존에영향을미치고있는것으로생각한다. 이번연구에서자전거손상기전의빈도는단독손상, 자동차와의충돌, 사람및사물과의충돌, 자전거간의충돌순이었지만, 사망과의연관성에대한다변량분석에서자동차와의충돌은단독손상에비해승산비가 4.5 (95% CI, ) 로높아그위험성에통계적의미를부여할수있었다. 이결과는다수의연구와유사한결과였다 17,18). 또한 Daniels 등 19) 의연구결과와같이자전거도로에서의손상은사망률과의연관성에서그외장소에비해승산비가 0.45 (95% CI, ) 로낮아자전거도로의이용은자동차와의충돌을줄임으로써안전을보장할뿐아니라그자체만으로도그외장소에서자전거이용에비해안전함을확인할수있었다. 추가로일반도로에서사고다발지역을

7 528 / 임채석외 표시하는것과같이자전거도로에서사고다발위치에표지판설치및자전거도로상태재정비, 점검등을강화한다면, 도로간중증도차이는더욱커질것으로생각한다. 본연구는정부의자전거장려정책이후시행된최초의자전거관련손상에관한연구이며, 유일한다기관연구이다. 여러손상과관련된연구가응급실을기반으로시행되고있으며, 여기에는환자들을가장먼저접촉하고평가하여손상이나질병의변화추이를가장먼저파악할수있다는장점이있다. 그동안양적팽창위주의정책에만머물렀던자전거장려정책에서한단계발전한질적개선, 즉안전교육, 표지판등의개선, 홍보사업등에정책방향을제시할수있는자료로본연구결과가이용될수있다고생각한다. 더욱중요한것은현재잠정중단된자전거도로확장사업의재개에대한필요성이본연구를근거로하여제기될수있다는점이장점이라고하겠다. 또한본저자들은본연구를계기로외상에취약한 15세이하그리고 65세이상의연령을대상으로한연구, 보호장구착용의효율성에대한연구, 계절, 요일, 시간에따른자전거손상에영향을미치는인자에대한연구등추가적연구의필요성을인지할수있는기회가되었다. 이러한여러장점들에도불구하고본연구는몇가지한계점을가지고있다. 첫째, 연구기간이 4년으로비교적짧다는점이다. 그러나현재우리나라는이전실용정부의자전거장려정책이정권변화이후한꺼풀꺾인시점에있고, 국가자전거도로구축사업을조기종료할계획에있어지금연구를시행하는것이향후올바른정책방향에도움이될수있다고생각한다. 또한, 정부의양적팽창에치우친정책의한계점이자전거손상에미치는영향을확인할수있었다. 둘째, 손상부위에대한정보가부족하다는점이다. 이는본연구의한계가아니라응급실손상환자표본심층조사사업이풀어야할과제로생각한다. 하지만현재까지위사업자료들을토대로한여러연구들이발표되었고, 여러보건지표및정부정책에영향을주고있으므로본연구에상기정보를이용한것은합당하다고생각한다. 다만, 향후다른손상조사체계와의연계를통한더자세한연구를시행볼필요성은느끼고있다. 결론정부의자전거장려정책이후자전거관련사고는증가일로에있으며, 이에대한대책중의하나로자전거전용도로의확충이중증도와사망률을낮추는데기여함을저자들은본연구를통해밝혀냈다. 여기에대한지속적인정부의관심과지원, 그리고학계의추가적인연구가필요할것이다. References 01. Hamer M, Chida Y. Active commuting and cardiovascular risk: a meta-analytic review. Prev Med. 2008;46: Pucher J, Buehler R. Making cycling irresistible: lessons from the Netherlands, Denmark and Germany. Transport Rev. 2008;28: Available at: EachDtlPageDetail.do?idx_cd=2854. Accessed June 29, Available at: selectbcycltfcacd.do?menuid=web_kmp_ovt_tas_ BTT. Accessed June 29, Kim BI, Jung JH, Jung KY. The epidemiology of bicycle injury in Korea: patients who visited 55 emergency rooms. J Korean Soc Traumatol. 2009;22: Wee JH, Park JH, Park KN, Choi SP. A comparative study of bike lane injuries. J Trauma Acute Care Surg. 2012;72: Kim J, Shin SD, Im TH, Kug Jong Lee, Ko SB, Park JO, et al. Development and validation of the Excess Mortality Ratio-adjusted Injury Severity Score using the International Classification of Diseases 10th edition. Acad Emerg Med. 2009;16: Graitcer PL, Kellermann AL, Christoffel T. A review of educational and legislative strategies to promote bicycle helmets. Inj Prev. 1995;1: Chen WS, Dunn RY, Chen AJ, Linakis JG. Epidemiology of nonfatal bicycle injuries presenting to United States emergency departments, Acad Emerg Med. 2013;20: Linn S, Smith D, Sheps S. Epidemiology of bicycle injury, head injury, and helmet use among children in British Columbia: a five year descriptive study. Canadian Hospitals Injury, Reporting and Prevention Program (CHIRPP). Inj Prev. 1998;4: Available at: researchcommon/retrieveresearchdetailpopup.do?researc h_id= Accessed August 17, Attewell RG, Glase K, McFadden M. Bicycle helmet efficacy: a meta-analysis. Accid Anal Prev. 2001;33: Liller KD, Nearns J, Cabrera M, Joly B, Noland V, McDermott R. Children s bicycle helmet use and injuries in Hillsborough County, Florida before and after helmet legislation. Inj Prev. 2003;9: Joseph B, Pandit V, Zangbar B, Amman M, Khalil M, O Keeffe T, et al. Rethinking bicycle helmets as a preventive tool: a 4-year review of bicycle injuries. Eur J Trauma Emerg Surg. 2014;40: Bambach MR, Mitchell RJ, Grzebieta RH, Olivier J. The

8 Characteristics of Bicycle Injury in Korea / 529 effectiveness of helmets in bicycle collisions with motor vehicles: a case-control study. Accid Anal Prev. 2013;53: Cryer PC, Westrup S, Cook AC, Ashwell V, Bridger P, Clarke C. Investigation of bias after data linkage of hospital admissions data to police road traffic crash reports. Inj Prev. 2001;7: Frank E, Frankel P, Mullins RJ, Taylor N. Injuries resulting from bicycle collisions. Acad Emerg Med. 1995;2: Rivara FP, Thompson DC, Thompson RS. Epidemiology of bicycle injuries and risk factors for serious injury. Inj Prev. 1997;3: Daniels S, Brijs T, Nuyts E, Wets G. Injury crashes with bicyclists at roundabouts: influence of some location characteristics and the design of cycle facilities. J Safety Res. 2009;40:141-8.

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012임수진 Received : 2012. 11. 27 Reviewed : 2012. 12. 10 Accepted : 2012. 12. 12 A Clinical Study on Effect of Electro-acupuncture Treatment for Low Back Pain and Radicular Pain in Patients Diagnosed with Lumbar