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1 J. Fd Hyg. Safety Vol. 23, No. 3, pp. 276~283 (2008) Journal of Food Hygiene and Safety Available online at 어린이건강관련유해물질연구방향 이효민 정기화 1 식품의약품안전청국립독성과학원위해관리기술연구과 1 덕성여자대학교약학대학 Chemical Risk Factors for Children s Health and Research Strategy Hyo Min Lee and Ki Hwa Jung 1 Director, Risk Management Research Division, National institute of Toxicological Research, Korea Food and Drug Administration, Seoul , Korea 1 College of Pharmacy, Duksung Women's University, Seoul , Korea (Received August 18, 2008/Revised September 18, 2008/Accepted September 23, 2008) ABSTRACT To provide the research strategy for protection of children s health from hazardous chemical, we reviewed the hazardous chemicals can be exposed through maternity, children's life style and living environment. Recently, diseases related with children s living condition were focused as asthma, atopy, childhood developmental disability, congenital malformations and obesity. Children can be exposed to hazardous chemicals through an ambient air, water, soil, food, toys and other factors such as floor dust. Also children s health was deeply related with a wrong life style and neglectful caring by a lack of knowledge and information of harmful ones at parents and child care center s nursers. According to the previous study, the chemical risk factor of children s health were identified as inorganic arsenic, bisphenol A, 2,4-D, dichlorvos, methylmercury, PCBs, pesticide, phthalates, PFOA/PFOS, vinyl chloride, et al. Domestic studies for identification of causality between children exposure to chemicals and resulted hazardous effects were not implemented. The confirmation of chemical risk factors through simultaneously performing toxicological analysis, human effect study, environmental/human monitoring, and risk assessment is needed for good risk management. And also, inter-agency collaboration and sharing information can support confirming scientific evidence and good decision making. Key words: children health, environmental risk factor, chemical risk factor 서론 최근세계각국에서는정부주관하에어린이건강을보호하기위한다양한정책들을추진하고있다. 정책의내용을살펴보면식품 환경으로부터의유해물질노출의최소화, 영양불균형식생활문화의개선뿐아니라, 비만을유발할수있는매스컴광고규제, 판매규제와같은교육환경개선등으로구체화되고있다. 우리나라의경우, 유해물질노출로부터의안전관리는여러부처와연관된것이어서정책의실효성을거두기위해서는연구차원에서의세심한전략적연계성을유지하고과학적사실에근거한정 *Correspondence to: Hyo Min Lee, Risk Management Research Division, National Institute of Toxicological Research. Korea Food and Drug Administration, Seoul , Korea Tel: ~4, Fax: hmlee@kfda.go.kr 보를공유하는것이매우중요하다. 우리나라에서는환경부와식품의약품안전청을주축으로어린이건강관련정책이추진되고있다. 어린이환경권을보호하고안전하게자랄수있는환경을조성하기위한환경부 ( 환경보건법 ) 의정책과식품의위해성분 ( 당, 나트 륨, 트랜스지방및첨가물등영양위해성분 ), 식중독및비만등으로부터어린이의건강을보호하기위한식품의약품안전청의정책 ( 어린이식생활안전관리특별법 ) 을근거 로긴밀한상호연계성이필요한유해물질안전관리를중심으로향후추진되어야할연구방향에대해기술하고자한다. 어린이건강에영향을미치는환경위해요소 세계보건기구 (World Health Organization; WHO, 2003) 에의하면매년 5백만명이상의어린이 (14세이하, 특히개도국 ) 들이환경요인으로인해사망한다고보고되고있 276

Chemical Risk Factors for Children's Health and Research Strategy 277 으며, 기후변화, 질병인자확산, 실내공기질, 수돗물및유해화학물질등이주요인이고무의식적인중독사고사망도 5만명에이를것으로추정되고있다.

2 Chemical Risk Factors for Children's Health and Research Strategy 277 으며, 기후변화, 질병인자확산, 실내공기질, 수돗물및유해화학물질등이주요인이고무의식적인중독사고사망도 5만명에이를것으로추정되고있다. 특히아토피와천식등의환경성질환이어린이를중심으로지속적으로증가하고있어의료비증가와삶의질저하에따른사회적부담이매우큰것으로추산되고있다. 대기, 수질, 토양, 식품및생활환경으로부터어린이에게미치는위해요소의다양한영향과질환발생과의관계는매우복잡하게연계되어있어그원인-상관관계 (causality) 를확인하기어렵다 (Figure 1). 어린이들은대기, 수질, 토양및식품을통해유해물질에노출되며, 장난감등유해제품및중독사고이외에도부모와보육기관의지식 정보부족에의한관리소홀과잘못된생활문화에의해민감하게영향을받을수있다. 최근보고에의하면어린이생활환경과연계된질환은천식, 아토피, 소아발달장해, 선천성기형및비만등으로서미환경보호국 (U.S. Environmental Protection Agency; U.S.EPA) 에서수행하고있는어린이건강사업을토대로어린이건강에영향을미치는유해화학물질에대한연구결과를물질별로고찰하고자한다. 어린이건강에영향을미치는유해화학물질과건강영향 U.S.EPA의어린이건강보호국 (the Office of Children s Health Protection; OCHP) 에서는어린이건강에영향을미치는환경위해요소의잠재적영향을확인하고유해영향을최소화하기위한방법을모색하기위하여대기, 수질, 토양및식품중유해물질에대한모니터링과모체, 어린이체내에서의유해물질모니터링을실시하며, 역학연구를기 초로환경적유해물질노출과연계된어린이질환을규명하여관리대상물질을제시한바있다. 얻어진연구결과는정부기관의안전관리전략을수립하고관리우선순위를결정하는등정책결정에활용되며, 장기적으로는무수히많은화학물질의사용으로부터인체노출을최소화하고관리대상화학물질의목록을최신화하는데사업목표를두고있다. U.S.EPA가최근확인한어린이건강에영향을미치는환경유래유해물질은무기비소 (inorganic aresenic; Ar), 2,4- D(2,4-dichlorophenoxyacetic acid; 2,4-D), 디클로르보스 (dichlorvos; DDVP), 메틸수은 (methyl mercury; MeHg), 프탈레이트 (phthalates) 와비닐클로라이드 (vinyl chloride; VC) 등 18종이있으며 (Table 1), 비스페놀 A (bisphenol A; BPA), 탄화플루오르옥탄술폰산 / 퍼플루오로옥탄산 (perfluorooctane sulfonate/perfluorooctanoate; PFOS/PFOA), 잔류성유기오염물 Table 1. Chemicals Effecting Children s Health by U.S. EPA, TEACH* 1) Chemicals Arsenic Manganese Atrazine Methyl mercury Bisphenol A Nitrates and nitrites Benzene Perfluorinated compounds** Benzo(a)pyrene Permethrin and resmethrin Diethyltoluamide(DEET) Phthalates 2,4-Dichlorophenoxyacetic acid POPs*** (Polychlorinated biphenyls,pcbs) Dichlorvos Trichloroethylene Formaldehyde Vinyl chloride *U.S.TEACH = U.S.Toxicity and Exposure Assessment for Children s Health **PFOS/PFOA = Perfluorooctane sulfonate/perfluorooctanoate ***POPs = Persistent Organic Pollutant Fig. 1. Risk Factor Effects to Children Environmental Living Condition and Health.

3 278 Hyo Min Lee and Ki Hwa Jung 질 (persistent organic pollutants; POPs) 도어린이건강에영향을미친다고알려졌다 (Table 1). 어린이는생리적, 행동습성및노출형태가성인과다르다. 어린이는성인에비해체중당음료나식품을더많이섭취하며, 호흡량과체용적 (body volume) 이더크다. 게다가특유의행동양식 ( 바닥기어다니기, 부적절한물건입에넣기등 ) 과생활패턴 ( 실외에서보내는시간이어른에비해많은점, 바닥과접하는횟수, 면적이어른에비해크다 ) 을갖기때문에일부물질은어린이에게더큰영향을미친다. 또한유해물질의흡수, 배설, 대사과정이환경오염물질에더유해한영향을받기쉽고, 또한세포가 2) 아직미성숙하며성장중이기때문에유해물질에대한위해성이더높아질수있는데, 특히신경발달기능에민감한영향을크게받을수있다. 무기비소는자연상태의지각 ( 일부암석과광물 ) 에존재하며, 토양, 지하수, 지표수및대기로유입되고일부동 식물에전이된것을식품으로섭취하여노출된다 3). 노출경로에따라건강에미치는영향이다르며, 식품을통해경구노출되는경우메스꺼움, 설사, 복통및구토를야기하고피부암, 방광암, 신장암과간암을유발한다. 피부로 4) 접촉할경우피부변색과외상, 과다색소침착이일어나며, 호흡을통한노출시점막염증을유발하고폐암발생을증가시킨다. 어린이는특유의 hand-to-mouth activity로인해성인에비해노출량이상대적으로크며, 오염된토양을통한노출과음용수, 식품의섭취를통해주로노출된다. 모체를통한무기비소의태중노출시폐암위험성이증가하였고, 어린이의모발연구결과에의하면고용량의무기비소노출은낮은지능 (IQ) 과장기기억력감소및피부손상을유발시키는것으로보고되고있다. 최근인도에서조사된연구에따르면무기비소노출은어린이와어른에서림프구의염색체와 DNA의손상을증가시켰고무기비소를호흡하거나음용수섭취를통해노출되었을시조산, 사산, 자연유산및유아사망률이증가되는것으로보고되고있다 5). 피부암과폐암발생을증거로 WHO, 국제암연구기관 (International Agency for Research on Cancer; IARC) 에서는무기비소를발암물질 (human carcinogen) 로분류하고있다. 6) 식료품의캔, 병마개, 식품포장재및치과용수지등에주로사용되는비스페놀 A(bisphenol A; BPA) 는에폭시레진과폴리카보네이트 (Polycarbonates; PC) 생산에이용되는단량체 (monomer) 로 7), 산화방지제, 염화비닐안정제로서사용된다. 일반인들은식품용기나포장재에사용된 BPA가식품으로전달되고그식품을섭취하여노출되는경우가대부분이다. 대다수의연구들은 BPA노출량 (exposure level) 이나그출처를확인하는데초점을맞추고있어 BPA노출과건강영향에관한연구는부족하나, 식혜, 탄산음료, 과일주 스, 커피및차등의음료수를포함한통조림식품의식품별노출기여도는총노출의 80% 를차지하고있고나머지는그밖의다른통조림류에의해노출되는것으로보고되고있다. 탄산음료의경우평균농도는낮지만하루섭취량이상대적으로많기때문에노출기여도가높고, 이에비해참치통조림에의한평균섭취량은적지만높은 BPA 농도로인해높은노출기여도를나타낸다 8). 2세의취학전어린이 9명을대상으로 BPA의노출수준을평가한결과에의하면주당최소 26시간을탁아소에서지내는어린이의경우식품섭취이외에도활동시간을많이갖게되는실내 외의공기, 바닥먼지, 놀이터의흙을통해노출될수있으며이들매체를통해노출되는총BPA는 42.98ng/kg/ day수준인것으로확인되었다. 9) 임신중모체를통해 BPA에노출시태아에게영향을줄수있다. 남아의생식기관발달에유해한영향 ( 잠복고환및요도하열 ) 을미칠수있으며정자형성을억제하거나정자기형을유발한다고조사되었다 10,11). BPA노출이행동실험의결과와연관성을보이는것으로보아주의력결핍과잉행동장애 (Attention Deficit Hyperactivity Disorder; ADHD) 와 BPA노출의연관성을추정할수있다. 12) 우리나라에서제초제로사용되는 2,4-dichlorophenoxyacetic acid (2,4-D) 는저독성 (IV급) 으로분류하고주로벼에사용된다. 고용량의동물시험에서최기형성 (birth defects), 태 13) 아사망및요도기형이나타났으며, 임신및수유중인모체가 2,4-D에노출되었을시후세대영향및신경병리학적영향 (neurological effects) 을나타내는것으로보고되었고혈액, 간장및신장독성을초래하며, 만성경구투여시에는눈, 갑상선, 신장, 부신, 난소및정소에유해영향이알려지고있다 14). 주로집먼지를섭취 호흡하거나, 식품이나음용수를섭취하였을경우노출되며 2,4-D를처리한호수에서수영할때노출될수도있다. 실 내외, 토양의 2,4-D를측정한결과실내공기샘플 10개중 6개, 실외공기샘플 10개중 7개, 토양샘플 10개중 3개가검출한계 (the limit of detection; LOD, Air LOD = 0.1 ng/m, Dust/soil 3 LOD = ppm, Food LOD = 0.2~0.5 ppb) 이상으로검출되었으며, 주로식이섭취와호흡에의해노출되는것으로나타났다. 15) Dichlorvos (2,2-dichlorovinyl dimethyl phosphate) 는유기인계농약이며 DDVP로알려져있는살충제이다. 독성은고독성 (II급), 보통독성 (III급) 으로품목에따라다르며, 우리나라에는들깨, 복숭아, 뽕나무및사과등의작물에사용된다. 모체를통해 dichlorvos에노출된어린이에서신경기능장해와면역독성이관찰되었고, 혈액암 ( 재생불량성빈혈이나급성림프모구백혈병 ) 과연관성을보였다. 성인이 dichlorvos에노출되었을시신경독성, 호흡기부작용유발및피부영향을나타내었으며급성노출의경우, 메스꺼움, 불안, restlessness 및안구열상및 heavy sweating

4 Chemical Risk Factors for Children's Health and Research Strategy 279 을유발시킨다. 심해질경우혼수상태, 호흡곤란과사망에까지이를수있다. 어린이는주로, 집기 (household) 나 pest strips 및 flea collars을사용하여배출된 dichlorvos를호흡하여노출된다. 16) 메틸수은 (methyl mercury, MeHg) 은인위적으로생산한것이아니라무기수은이환경중에서전환된것이다. 주 17) 요수은배출원으로석탄연소발전소, 소각시설, 수은전지, 수은온도계및수은함유형광등과치과용아말감등이알려지고있는데, 메틸수은은고노출시정신지체, 뇌성 ( 소 18) 아 ) 마비와발작을유발할수있는잠재적신경독성물질이며, 뇌발달에특히나민감한영향을야기한다. 사람은주로어류의섭취를통해이루어진다. 어린이는태중노출 (in utero), 모유와어패류의섭취를통해노출되며어류의종류에따라섭취량이다르다. 메틸수은은지방용해도가높아서소화관에서의흡수가빠르고혈액수액관문과태반관문을쉽게통과하여태아에치명적인독성을일으킬수있다 19). PFOS/PFOA (Perfluorooctane sulfonate/perfluorooctanoate; Pyrethroids; Perfluorinated compounds, PFCs) 는전자레인지용팝콘봉지, 피자박스, 패스트푸드 사탕류포장재 20), 계면활성제및표면보호제로사용되고있으며, 세정제, 샴 21) 푸, 치실과 denture cleaner와같은개인관리용품에도 PFOA 가사용되고있으나, 점차 Perfluorooctanesulfonyl fluoride 22) (POSF) 의사용을줄이는추세이다. 체중당어린이의노출량이청소년이나어른보다높다는연구보고가있다. 23) PFOA/PFOS가제대혈액혈청에서각각 99% 와 100% 가검출되었으며 ( 각각 4.9 ng/ml, 1.6 ng/ml; 기하평균농도 ) 24), 임신중모체의 PFCs 노출은태아에전달될수있고, 고농도의 PFOS에노출되었을시태아의체중이감소하였으며, 구개열, 전신부종 ( 부종 ), 골화지연 ( 복장뼈분절및지골 ) 및심장기형이관찰되었다. 25) Phthalates는 phthalic angydride에 ethyl, butyl, benzyl, allyl, octyl 및 heptyl ether 또는 alcohol 등으로부터고온에서촉매에의한 ester 반응을통해합성되며, 석유화학합성플라스틱류중특히, poly-vinylchloride (PVC) 등에약 5~80% 혼합하여사용되는플라스틱가소제로서, 의료용구 ( 정맥주사, 혈관주사, 체외막산소공급장치 (Extra Corporeal Membrane Oxygen; ECMO) 나투석에사용되는플라스틱관 ), 고무호스, 비닐포장, 장난감, 건축자재, 자동차내장재등의플라스틱제품뿐만아니라각종화학제품및화장품용매 ( 매니큐어, 향수, 헤어스프레이등 ), 잉크, 도료, 의료, 카펫등생활용품에이르기까지광범위하게사용되고있다. phthalate 노출은정자수및운동성감 26) 소, 정관손상, 고환및부고환의무게감소를야기하며, 집먼지를통한 phthalate 노출이천식, 알레르기증상과연관있다는연구결과가있다 27,28). 점진적프탈레이트사용금지의대안으로가장독성이낮은프탈레이트류의사 용을위한비교독성연구가수행된결과, 정자운동성감소에대한영향은 di-2-dehylhexyl phthalate (DEHP) > dibutyl phthalate (DBP) > di-n-octyl phthalate (DnOP) > di-undecyl phthalate (DUP) > diisodecyl phthalate (DIDP) > butylbenzyl phthalate (BBP) 순으로나타났다 26). 특히 DEHP는우리주변에서가장많이사용된다. 국내에서조사된 DEHP에대한인체노출자료는거의없는실정으로이에대한조사연구가필요하다. 외국에서의조사결과에따르면 DEHP 의독성영향은간장장해등의일반독성, 생식 발생독성및내분비계장해작용등이많이알려져있으며, 특히, 태자이상, 정자이상, 및생식기관이상등을포함하는생식 발생독성은설치류및포유류를이용한실험에서다수보고되고있다. 동물실험에서는발암성이확인이되었으나발암기전이인체에서는규명되지않아비발암물질로분류되었다. 그러나최근연구결과에따르면인체에서도유사한발암기전을나타낸다는보고가있어이에대한논란의여지가있다. 어린이는모유, 우유와이유식의섭취를통해노출되었으나, 미국은 1986년에젖병에 phthalate 사용을금지하였고, 캐나다는 2007년, 어린이장난감에 29) phthalate사용을제한하였다. 어린이는다양한경로를통해농약에노출된다. 농약은광범위하게사용되기때문에일반적으로거주지주변에도축적되어있어호흡, 피부및비식이섭취 ( 장난감을빨거나토양을먹을경우 ) 를통해노출될수있으며, 모유나이유식섭취를통해주로노출된다 30). 농약노출이소아백혈병 (leukemia), 뇌종양 (brain cancer), 신경아세포종 (neuroblastoma), 비호지킨림프종 (non-hodgkin s lymphoma), 윌름즈종양 (Wilms s tumor) 및유잉종양 (Ewing s sarcoma) 의발병위험성을증가시킴을보이는역학조사연구가다수보고되었다. Wahm과 Ward가발간한논문을토대로 1998년이후의연구를검토하였다. 15건의사례-대조연구, 4건의코호트연구및 2건의생태학적연구가 1998년이후로발표되었으며 21건의연구중 15건의연구는어린이의농약노출과부모의직업적노출모두소아암발생을통계학적으로증가시킨다고보고하였다. 농약노출과소아암발생과의상관성은어느정도연관성이규명되고있다. 31) 농약 (Pesticides) 노출은신경계에영향을미쳐기억력장애, 집중력장해, 우울증및불안 / 민감증상을유발한다. 32) 설치류연구모델 (rodent model study) 을토대로한독성학적증거와역학조사연구결과에따르면유기인계농약에노출되었을시신경발달장해가유발되었다. 2세때 33) 유기인계농약에노출되어중독증상을보인 9~10세의어린이 ( 조사당시 ) 를조사한결과, 행동인지장해를보였다. 34) 또한유기인계살충제의태중노출 (in utero) 은태아무게감소, 머리둘레감소와조산의위험성을증가시키며 ( 이연구들은농촌과도시에서수행되었으며, 농촌 / 도시모두에서위험한수준의농약에노출될가능성이있다 ), 유기인

5 280 Hyo Min Lee and Ki Hwa Jung Table 2. Concentrations of Targeted Groups of PCBs in Multiple Media at Several Child Care Centers Compounds Medium Median all centers* Low-income range** Low-income mean* Middle-income range** Middle-income mean* PCBs*** Indoor air, ng/m ~ ~ Outdoor air, ng/m ~ ~ Dust, ppm (HVS3)**** ~ ~ Dust, ppm (vacuum bag)**** ~ ~ Soil, ppm ~ ~ Solid food, ppb <0.04 <0.04(4/4) <0.04 <0.04(6/6) <0.04 Liquid food, ppb < (4/4) <0.04 <0.04(6/6) <0.04 *Mean and median values are calculated using one half the detection limit for those samples for which the targeted compounds were at concentrations below the LOD of the method. data are shown for four low-income and six middle-income centers. **The number of samples below the detection limit is shown in parentheses, for example, (3/4) indicates three of the four samples were at concentrations below the LOD of the method. ***PCB = sum of all targeted polychlorinated biphenyls ****HVS3 = High Volume Small Surface Sampler; dust sample collected during the 48-h sampling period with the HVS3 surface sampler.;vacuum bag = vacuum bag sample from cleaning over the previous month using the center s regular vacuum cleaner.for the HVS3, n = 4 for low-income and n = 7 for middle-income centers. for the vacuum bags, n = 3 for the low-income and n=4 for the middle-income centers. 계농약노출은천식이나천명 (wheeze) 과같은호흡기질환과도관련성이있다는연구보고가있다 35-37). Polychlorinated biphenyls (PCBs) 는 chlorinated hydrocarbons 의혼합물로 1930년이래변압기, 축전기의절연유, 윤활유, 가소제, 도료및복사지등으로다양한산업분야에서사용되었으나 1970년에사용이금지되었다. PCBs는토 38) 양, 퇴적물과생물학적조직 (biological tissues) 의유기물질과결합하며, 토양중 PCBs가식물이나동물체내로전달되고, 이를식품으로섭취하여주로노출된다. PCBs의경우호흡 > 비식품섭취 >> 식품섭취순으로노출된다. 저소득층가정의어린이와중산층가정의어린이의노출량차이는적으며노출매체에따라다르다 (Table 2) 15). 사람에게서신경학적 면역계손상이보고되었으며, 그증상으로과잉행동, 집중력장해, 기억력감퇴, 행동이상, abnormally weak reflexes, 운동신경미숙 (greater motor immaturity), 출생시과잉놀람반응, 자극에대한무반응 (less responsive to stimulation), 시각인지부전, 인지장해, 단기기억력및계획능력저하 (poor planning ability) 가나타났다 39,40). 임신중고용량의 PCBs에노출되었던모체에서태어난어린이를조사한결과낮은지능과연관성을보였고, 11세의어린이를조사한연구에서는유아기의낮은인지기억력, 취학전 IQ test에서낮은점수획득, 그리고 poor verbal IQ와 reading comprehension이나타났다. 41,42) 또한, 노출되지않은집단에비해출생시적은몸무게를갖고있었으며, 조산 (shorter gestation period), 출생시머리둘레감소, 성장장애및지연등의증상을보였다. PCBs의과다한노출이뇌신경의변화를초래하며 ADHD 에서보여지는행동과잉장애및학습장애들의특징적인 Table 3. Hazardous Chemicals and Health Effects on Children s health Effect Substance Effect Next Generation High Exposure Sensibility 2,4-D(R),Arsenic (T),Atrazine (R), Benzen (G), Benzo (a) pyrene (G), Dichlorvos (R,D), Formaldehyde(T), Manganese**, Methylmercury, Perflourinatedcompounds (PFOS,PFOA), Pesticides,Phthalate (T), Trichloroethylene, Vinylchloride (E), PCBs (E,T) Benzo(a)pyrene, Manganese, Vinylchloride BisphenolA,Manganese,Nitrate,Phthalate *R = Reproductive toxicity; T = Teratogenic toxicity; D = Developmental toxicity; E = Embryotoxic **Manganese is essential nutrition but high exposure causes. adverse effects. 요소가관찰된점으로보아이들내분비장애물질의노출 과 ADHD와의관련가능성이추정된다는연구가우리나라에서보고되었다. 12) 선천성기형모니터링체계구축을위한다기관공동연구의일환으로총 18개산부인과전문병원으로부터 2007년도에 932건 ( 전체 5,517건 ) 의선천성기형사례를확인하고이에대한자료의의무기록을토대로하여분석한결과, 선천성기형과환경적인자와의연관성은확인되지않았다. 43) Vinyl chloride는 DNA의화학적변화를야기하는유전독성발암물질이다. (WHO, IARC) 44) Vinyl chloride는 PVC 플라스틱과비닐제품생산에사용되며다양한건축자재, 의료용구및자동차용품제조에도사용된다. 일반인은대기, 실내공기를호흡하거나지하수섭취에의해노출되며,

Chemical Risk Factors for Children's Health and Research Strategy 281 Fig. 2. Association with Study of Hazardous Substance related Children s health. Table 4.

6 Chemical Risk Factors for Children's Health and Research Strategy 281 Fig. 2. Association with Study of Hazardous Substance related Children s health. Table 4. Future Studies of Chemical Risk Effecting Children Health Examine the reason and factors that caused congenital health disorder and impairment through conducting toxicological study of hazardous chemicals effecting children s health Confirming Congenital Effect on Prenatal + Animal Experimental Study + (Genetic, Reproductive, Embryotoxic) Retrospective Study of Obstetrics/Gynecology Study of acquired developmental disability (disorder) disease Identifying adverse effects during developing postnatal + Animal Study + Epidemiological Cohort Study Establish methodology necessary to identify hazardous chemicals effecting children s health (Causality)and promote large scale projects Long-term Epidemiological Studies + Cooperative Promotion through Collaboration of Regulatory Body + Experts in Several Parts Participation Identifying of hazardous chemical substances level (degree) in air, water, soil, food, determining contaminant level in mother and children's body, and finding children s disease by environmental factor in the same project. U.S.EPA에의하면직업적으로노출되는사람들에게서간육종혈관발생이보고되었다. 어린이는인형과같은 PVC 45) 로제조되는플라스틱장난감을빨거나씹는행동을통해노출될수있다. 어른에서심혈관, 위, 혈액, 근골격계, 간장, 내분비, 피부, 안구, 면역, 신경학적, 생식독성뿐아니라발암성등이보고되었다. 또한, 부모의 vinyl chloride 노출은최기형성유발과연관성이있다는연구결과도알려지고있다 46). 암발생에있어서영 유아와어린이는어른에비해더민감한것으로나타났다. ( 기타민감군 : 간장질환자, 심박이상, 말초순환부전, 전신경화증환자, 유기염소계살충제에노출된사람및알코올중독치료제중 antabuse 투여자 ) 47) 어린이건강과유해화학물질에대한연구방향 현재유해물질안전관리에대한업무가여러부처에분산되어있어서다음과같은문제점이나타나고있다. 동 일목적으로수행된연구임에도불구하고위해요소에대한결과해석이매우상이하거나, 자료의증거부족으로정책이추정에의해결정되는사례가확인되고있다. 어린이건강에영향을미치는유해화학물질의영향은크게두가지로구분할수있는데출생전모체노출로인한선천성기형과발달장애와출생후성장과정을통한노출에의한건강영향으로구분할수있다. 출생전모체노출로인한어린이건강영향연구를위해서는모체에의한선천적영향여부확인, 동물실험연구및후향적산부인과임상연구 (Retrospective study) 를통해확인하는연구체계를갖추는것이필요하다 (Table 4). 또한출생후노출로인한건강영향은성장과정중유해물질의건강영향확인, 동물실험연구및역학적코호트연구등이필요하다. 이를위해서부처별연계된소관업무를중심으로대규모협력사업을추진하여유익한결과를확보하는것이중요하다.

7 282 Hyo Min Lee and Ki Hwa Jung 결론 감사의글 어린이건강관리를위한유해물질의연구방향은생활환경중식품, 실내공기, 토양, 장난감등의다양한매체를통해노출될수있는유해물질에대해어린이건강에미치는영향을확인하기위해독성평가, 인체영향연구및환경모니터링과위해평가등을고려해야한다. 그리고어린이건강에영향을미치는유해물질의원인-상관관계를확인하고, 부처간협력에의해어린이건강관련유해물질관리정책에반영하여야한다. 동물실험과역학연구에의한기초조사를통해어린이민감성에대한증거를확보하여아토피와소아발달장해등의어린이민감성에대한증거확보와함께식품, 환경등의유해물질모니터링및 Life activity 패턴분석을통해노출평가, 인체모니터링및역학연구가수행되어져야하며생활환경을통한어린이고노출확인연구가이루어져이를통해어린이건강을위하여우선적으로연구되어야할유해물질에대해실생활에서건강영향을확인하고정책방향을결정하고, 관리우선순위를정하는의사결정이행해져야한다. U.S.EPA 등국내 외선행연구결과에의한어린이출생전 후건강에영향을미칠수있는주요유해물질은 inorganic arsenic, BPA, 2,4-D, dichlorvos, methylmercury, PCBs, pesticide, phthalate, PFOA/PFOS, vinyl chloride 등으로서국내에서도이들을포함한확인연구가수행되어져야할것이다. 또한어린이들의행동발달과연관된생활환경에서의다양한인체노출이확인됨에따라탁아소, 유치원과같은경우어린이활동공간을대상으로환경모니터링및위해관리활동도병행되어야할것이다. 요약 국내 외선행연구결과에의한어린이출생전 후건강에영향을미칠수있는주요유해물질은 inorganic arsenic, BPA, 2,4-D, dichlorvos, methylmercury, PCBs, pesticide, phthalate, PFOA/PFOS, vinyl chloride 등으로서국내에서도이들을포함한확인연구가수행되어져야할것이다. 또한어린이들의행동발달과연관된생활환경에서의다양한인체노출이확인됨에따라탁아소, 유치원과같은경우어린이활동공간을대상으로환경모니터링및위해관리활동도병행되어야할것이다. 또한어린이건강에영향을미치는유해물질을중심으로독성평가, 인체영향연구, 환경및인체모니터링과위해평가를수행하므로유해물질의원인-상관관계를확인하고사실자료에근거한관리정책을반영하는것이바람직하다. 본연구와 J. Fd Hyg. Safety 23권 1호 pp. 80~84 (2008) 의연구는덕성여자대학교 2007년도교내연구비지원에의해수행되었음 참고문헌 1. U.S. Toxicity and Exposure Assessment for Children s Health 2. U.S. Environmental Protection Agency (U.S.EPA): Office of Research and Development strategy for research on risks to children. Office of Research and Development, Science Council Review Draft. (1997) 3. U.S. Agency for Toxic Substances and Diseases (ATSDR): Toxicological Profile for Aresenic. ATSDR (2005) 4. U.S.EPA: Technology Transfer Network Air Toxics Web Site: Arsenic Compounds. (2000) 5. U.S.EPA, Toxicity and Exposure Assessment for Children's Health (TEACH): Inorganic Arsenic TEACH Chemical summary. U.S. EPA, TEACH (2007) 6. WHO, International Agency for Research on Cancer (IARC): IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. IARC 84 (2004) 7. Bisphenol A Information & Resources (2007) 8. 박종세등 : 내분비계장애물질의위해성분석을통한관리경제성연구. 식품의약품안전청 (2005) 9. Wilson, N.K., Chuang, J.C., Lyu, C., Menton, R. and Morgan, M.K.: Aggregate exposures of nine preschool children to persistent organic pollutants at day care and at home. J expo Anal Environ Epidemiol 13 pp (2003) 10. Roy, D., Palangat, M., Chen, C-W., Thomas, R.D., Colerangel, J., Atkinson, a. and Yan, Z-J.: Biochemical and molecular changes at the cellular level in response to exposure to environmental estrogen-like chemicals. J Toxicology and Environmental Health 50(1) pp.1-30 (1997) 11. 고광락등 : Bipsphenol A (BPA) 에의해야기되는생식세포이상영향연구. 식품의약품안전청 (2005) 12. 장춘곤등 : 내분비계장애물질과관련이의심되는인간질병또는현상에관한연구 (B)- 내분비계장애물질과주의력결핍과잉행동장애및학습장애와의연관성. 식품의약품안전청 (2006) 13. 품목별농약등록현황조치 hp_pumok_item_list.asp 14. U.S.EPA, TEACH. 2,4-Dichlorophenoxyacetic Acid(2,4-D) TEACH Chemical summary. U.S.EPA, TEACH (2007) 15. Nancy, K.W., Jane, C.C. and Christopher, L.: Levels of persist organic pollutants in several child day care centers. J of Exposure Analysis and Environmental Epidemiology 11 pp (2001) 16. U.S.EPA, TEACH: Dichlorvos TEACH Chemical sum-

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PowerPoint 프레젠테이션 2005 National Institute of Environmental Research 천연물질 ( g/kg ) 보툴린독소 파상풍균 10-9 10-8 페일리톡신 시겔라 테트로도톡신 10-7 10-6 10-5 10-4 니코틴 카페인 10-3 10-2 10-1 1 / 동물명 반수치사량 동물명 반수치사량 국제암연구센터 (IARC) 미국환경청 (U.S.EPA)