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1 한국산업보건학회지, 제27권제2호 (2017) ISSN X(Print) ISSN (Online) Original Article 헤어드레서의근골격계통증수준과관련요인 정년구 1 ㆍ정종현 2 ㆍ피영규 2* 1 선린대학교뷰티디자인학과, 2 대구한의대학교보건학부 Musculoskeletal Pain Levels among Hairdressers and Affecting Factors Nyun Koo Joung 1 ㆍJong-Hyeon Jung 2 ㆍYoung Gyu Phee 2* 1 Dept. of Beauty Design, Sunlin University 2 Faculty of Health, Daegu Hanny University ABSTRACT Objectives: This study was designed to define the musculoskeletal pain levels among selected hairdressers and the risk factors for these musculoskeletal pain levels. Methods: A survey was conducted from July 1 to August 10, 2011 among 199 hair dressers working in Seoul and Gyeonggi-do Province using a self-administered Nordic Musculoskeletal Questionnaire. The affecting factors for musculoskeletal pain levels were analyzed using multiple logistic regression. Results: The musculoskeletal pain levels by body region were low back(6.19), ankle/foot(6.14), shoulder(5.27), knee(5.27), back(5.23) and wrist/hand(5.18). In stepwise regression, significant actors affecting the level of pain by body region were height on wrist/hand, low back, and knee and age on elbow. Conclusions: Based on these results, in order to prevent musculoskeletal diseases among hair dressers, standing time should be decreased and stretching should be performed regularly to protect the low back and knee. Key words: Hairdresser, musculoskeletal pain levels I. 서론현대는급격한경제성장과산업발전으로소득수준이높아지고생활수준이향상됨에따라인간다운삶과아름다움에대한욕구가증대되면서미용산업은중요한가치의시장으로써확대되고있다. 더구나현대미용업종사자의역할은기존의단순한고객접객과기술의제공에서벗어나고객관리의전문적인서비스및마케팅, 아름다움을표현하는기술의전문성과고객의건강관리까지그영역이확대되어업무의범위와역할에있어서영역별세분화및전문성이요구되고있는실정이다 (Lee et al., 2013). 2005년중소기업통계청자료에의하면미용업종사자는 13만 2,852명에불과했으나, 3년후인 2008년에는 20만명이넘는것으로파악되고있다 (Lee & Yang, 2010). 미용실수또한 2008년도 82,551개소, 2009년도 89,017개소, 2010년도 95,194개소로꾸준히증가하고있다 (MoHW, 2011). 이렇듯미용업종사자와미용실수의증가추세에반하여산업이발달해도기계화할수없는미용업고유의인적서비스특성은미용각분야마다차이는있겠지만장시간근무와시술시의자세, 기구의사용, 화학물질에대한노출, 미세먼지와분진흡입, *Corresponding author: Young Gyu Phee, Tel: , Fax: , yphee@dhu.ac.kr Faculty of Health Science, Daegu Haany University. 1 Hannydae-ro, Gyeongsan-si, Gyeongbuk Received: June 2, 2017, Revised: June 18, 2017, Accepted: June 23, 2017 This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. 130

2 헤어드레서의근골격계통증수준과관련요인 131 불규칙한식습관, 작업관련스트레스등으로종사자들은심리적육체적으로많은문제를안고있으며작업으로인한질병노출과건강관리에대한접근은아직까지이루어지지못하고있는실정이다 (Stock & Cone, 1998; Kwon et al., 2005). 우리나라는 1995년에산업재해보상보험법시행규칙제39조에경견완증후군이신체에과도한부담을주는작업으로인한질병으로인정된이후근골격계질환자수가 2013년 5,318건, 2014년 5,057건, 2015 년 5,072건으로다소감소하는경향이지만, 2015년의경우근골격계질환이전체업무상질병요양자의수의 64.0% 를점유하여사업장에서가장많이발생하는업무상질병이되었다 (MoEL, 2016). 2010년의경우산업재해보험을가입한미용업근로자는약 12,933명이며전체산업의 0.2% 수준으로미국에비해다소낮은점유율을보이고있지만산업재해는점차증가하는추세로보고되고있다 (MoEL, 2011). 헤어분야의헤어드레서는공중위생법제2조2항에따라파마, 머리카락자르기, 머리카락모양내기, 머리피부손질, 머리카락손질, 머리카락, 머리감기, 손톱과발톱의손질및화장, 의료기기나의약품을사용하지아니하는눈썹손질, 얼굴의손질및화장을행하는영업으로정의된다 (MoHW, 2011). 이들미용인들중헤어드레서는머리자르기, 염색, 파마, 코팅, 기타머리손질등의업무등이있고이러한업무를위하여대부분손가락및손목, 어깨등을반복적으로사용하게된다 (Song & Han, 2005). 그리고장시간서서작업을하게되고간헐적으로쪼그려앉기, 좌우로몸통을돌리거나뒤틀기등이근골격계질환의위험요인으로작용한다 (Park et al., 2000). 이와같은미용사들의작업이상지의근육, 인대, 신경에장애를유발한다는외국의연구도보고된바있다 (Morgensterm et al., 1991; Feuerstein & Fitzgerald, 1992; Hadler, 1992; Harber et al., 1992). 또한, Park et al.(2000) 의연구결과에의하면미용업종사자들의 94.9% 가요통을느끼는것으로나타났으며, 이러한결과는일반인구집단의요통발생률이 50 80% 인것을비교해볼때매우높은수준이다. 그동안근골격계질환에대한연구는자동차회사 (Yang & Roh, 2003), 농업인 (Lee et al., 2008), 물리치료사 (Kim et al., 2005), 병원종사자 (Kee & Song, 2006), 소방관 (Kim et al., 2007), 식당종사자 (Lee et al., 2007), 조선소 (Kim et al., 2003), 항공정비사 (Chae & Kim, 2005) 등다양한업종및직군을중심으로자각증상및인간공학적평가중심으로진행되었다. 한편, 피부미용업종사자에대한연구도일부수행된바있으나그내용이건강장애 (Kim, 2002), 작업환경실태 (Lee, 2009), 직무스트레스 (Kim, 2005) 에초점이맞춰져있거나대부분이근골격계질환자각증상에주안점을두었다 (Kang et al., 1999; Park et al., 2000; Song & Han, 2005). 또한, 연구대상이피부미용업을포괄하는종사자를대상으로하였으며헤어드레서들만의근골격계통증수준을파악한연구는상당히부족한실정이다. 본연구의목적은미용업종사자중헤어드레서를대상으로노르딕근골격계질환조사도구 (Nordic Musculoskeletal Questionnaire, NMQ) 를활용하여근골격계통증수준을파악하고이에영향을미치는요인을규명하고자하였다. Ⅱ. 연구방법 1. 연구대상 2011년 7월부터 8월일까지서울과경기일부지역의미용실에근무하고있는헤어드레서 225명을대상으로하였으며, 직접방문하여설문취지와기입방법을설명하고자기기입식으로설문조사를수행하였다. 총 225부의설문지중응답이불성실하거나오류가있는설문지 26부를제외한 199부를최종대상으로하였다. 2. 연구방법 1) 설문조사조사대상자의기본적인특성파악과비직업성근골격계질환자선별을위하여한국산업안전보건공단 (2003) 에서제시한근골격계부담작업유해요인조사지침 (KOSHA CODE H ) 의일부를활용하였고조사대상자의일반적특성으로연령, 성별, 학력, 결혼여부, 직위, 경력, 신장, 체중, 음주및운동여부등을조사하였다. 2) 근골격계통증수준의파악근골격계통증수준파악을위하여 Kuorinka et al.(1987) 이근골격계와관련된통증불편함등의자각

3 132 정년구ㆍ정종현ㆍ피영규 증상여부를측정할수있도록고안한 NMQ를 Choi et al.(2008) 이한글로번역한후증상의강도를측정할수있는항목을추가하여개발한 노르딕스타일 설문지를재구성하여사용하였다. NMQ 의경우신체부위가 9개로세분화되어구분되어있고, 통증의강도는시각적상사척도 (Visual analogue scale, VAS) 를이용하여 1점부터 10점까지표시하도록되어있어통증수준을구체적으로파악할수있는장점이있으며, 이도구의타당성은이미검증된바있다 (Descatha et al, 2007). 3. 자료분석수집된자료의분석은 SPSS(Ver. 12.0K) 프로그램을이용하였으며일반적특성에따른근골격계통증수준의차이는교차분석을수행하였다. 또한신체부위별근골격계통증수준에영향을미치는요인은단 계적회귀분석을실시하였다. Ⅲ. 연구결과 1. 연구대상자의일반적특성헤어드레서의연령은 30세이하가 72.9%(145명 ) 로대부분이었고, 여성이 70.9%(141명 ) 로남성보다많았으며, 학력은대졸이상자가 59.8%(119명 ) 를차지하였다 (Table 1). 응답자의 84.9%(169명 ) 가미혼이었으며, 직위는디자이너가 47.7%(95명 ) 이었고, 경력은 5년미만이 52.8%(105명 ) 로가장많았다. 신체적특성으로신장의경우 cm가가장많은 49.8%(99 명 ) 이었고, 체중은 kg이 43.7%(87명 ) 로가장많았다. 1주일에 1회음주하는경우가 40.2%(80명 ) 로가장많았으며, 운동을하지않는경우가 56.3%(112명 ) 로나타났다. Table 1. General characteristics of subjects (N=199) Variables Classification No. of subjects Percentage(%) Age(yrs) < Gender male female Education level under high school above college Marital status married unmarried Position staff designer above chief designer Job career(years) < Height( cm ) < Weight( kg ) < Drinking per week one two and more none Exercise none regular

4 헤어드레서의근골격계통증수준과관련요인 신체부위별근골격계통증수준 1) 신체부위별근골격계통증수준신체부위별근골격계통증수준은허리 (6.19점) > 발목 / 발 (6.14점) > 어깨 (5.47점) > 무릎 (5.27점) > 등 (5.23점) > 손목 / 손 (5.15점) > 등의순으로파악되었다 (Table 2). Table 2. The musculoskeletal pain levels by body region Body region No. of subjects Mean±S.D. Min Max Neck ± Shoulder ± Elbow ± Wrist/hand ± Back ± Low back ± Hip/thigh ± Knee ± Ankle/foot ± Table 3. The musculoskeletal pain levels of upper body by general characteristics Variables Classification Neck Shoulder Elbow Wrist/hand Back Age(years) ± ± ± ± ± < 5.00± ± ± ± ±2.41 Gender male 5.34± ± ± ± ±2.14 female 4.74± ± ± ± ±2.40 Education level under high school 5.02± ± ± ± ±2.51 above college 4.81± ± ± ± ±2.19 Marital status married 4.86± ± ± ± ±2.05 unmarried 4.91± ± ± ± ±2.39 Position staff 5.10± ± ± ± ±2.12 designer 4.79± ± ± ± ±2.39 above chief designer 4.75± ± ± ± ±2.88 Job career (yrs) <5 4.87± ± ± ± ± ± ± ± ± ± ± ± ± ± ±2.43 Height( cm ) < ± ± ± ± ± ± ± ± ± ± ± ± ± ± ±2.36 Weight( kg ) < ± ± ± ± ± ± ± ± ± ± ± ± ± ± ±2.14 Drinking per week one 5.19± ± ± ± ±2.60 two and more 4.74± ± ± ± ±1.00 none 4.64± ± ± ± ±2.38 Exercise none 4.92± ± ± ± ±2.38 regular 4.87± ± ± ± ±2.29

5 134 정년구ㆍ정종현ㆍ피영규 2) 일반적특성에따른신체상부근골격계통증수준일반적특성에따른신체상부의근골격계통증수준을비교한결과를 Table 3에제시하였다. 연령은 30세이하가어깨, 손목 / 손, 등부위의통증수준이 30 세이상에비하여높은것으로조사되었으나통계적유의성은없었다. 성별의경우남성이, 직위는스탭이, 경력은 5년미만의대상자들의신체상부의통증수준이전반적으로높게나타났으나통계적으로유의한차이는없었다. 신장은 160 cm미만인대상자의경우손목 / 손과등부위, 170 cm이상인경우목, 어깨, 팔꿈치부위에서통증수준이다소높았으나통계적으로유의하지는않았다. 체중의경우 60 kg이상인대상자에게서어깨, 팔꿈치부위의통증수준이높 게나타났으나역시통계적유의성은없었다. 3) 일반적특성에따른신체하부근골격계통증수준일반적특성에따른신체하부의근골격계통증수준을비교한결과 30세이하의대상자, 직위의경우스텝, 경력의경우 5년미만의대상자들에게서다소높게나타났으나통계적으로유의하지않았다 (Table 4). 그러나허리부위의경우신장이 160 cm미만의대상자들이그이상인대상자들에비하여통증수준이통계적으로유의하게높게나타났다 (p<0.05). 3. 신체부위별통증수준에영향을미치는요인신체부위별통증수준의영향요인을파악하기위하 Table 4. The musculoskeletal pain levels of lower body by general characteristics Variables Classification Low back Hip/thigh Knee Ankle/foot Age(years) ± ± ± ± < 5.80± ± ± ±2.04 Gender male 6.42± ± ± ±1.45 female 6.12± ± ± ±2.24 Education level under high school 6.05± ± ± ±1.79 above college 6.27± ± ± ±2.34 Marital status married 5.38± ±(-) 5.00± ±1.88 unmarried 6.33± ± ± ±2.17 Position staff 6.35± ± ± ±1.95 designer 6.36± ± ± ±2.27 above chief designer 4.60± ± ± ±2.27 Job career(yrs) <5 6.46± ± ± ± ± ± ± ± ± ± ± ±2.24 Height( cm ) < ±1.75* 3.71± ± ± ± ± ± ± ± ± ± ±2.23 Weight( kg ) < ± ± ± ± ± ± ± ± ± ± ± ±1.83 Drinking per week one 7.05±1.84 * 3.78± ± ±2.26 two and more 5.13± ± ± ±1.66 none 5.74± ± ± ±2.26 Exercise none 6.23± ± ± ±2.20 regular 6.13± ± ± ±2.01 * p<0.05 by t-test or One-way ANOVA

6 헤어드레서의근골격계통증수준과관련요인 135 Table 5. Risk factors of musculoskeletal pain levels Independent variables Age Neck Shoulder Elbow Wrist/hand Back Low back Hip/thigh Knee Ankle/foot B t B t B t B t B t B t B t B t B t 30< vs ** Sex female vs male ** Marital status unmarried vs married ** Height( cm ) 170 vs < * * - - Weight( kg ) <50 vs 50 60> * Exercise no vs yes * F(p) (0.007) (<0.001) (0.024) (0.030) (0.010) (0.018) (0.039) (0.032) Adj R * : p<0.05, : p<0.01 by stepwise regression 여단계적회귀분석을수행한결과는 Table 5와같다. 신체상부에해당되는목과어깨의경우영향요인이없는것으로나타났으나팔꿈치부위의경우연령이적고남성이며, 운동을안하는경우가영향을미치는것으로확인되었다. 신체하부의허리와무릎부위는신장이영향요인으로파악되었다 (p<0.05). Ⅳ. 고찰미용업계종사자들은전문직업인으로서정신적부담이가중되고과중한작업증가와함께긴근무시간으로정신적, 육체적피로가누적되고, 반복적으로기구를사용하는작업, 팔을어깨높이의상태에서장시간기립한상태로고정된시선을유지하는불균형적인자세, 복잡한장비와도구의사용등으로인하여근골격계질환자각증상의호소율과유병율이높게나타나고있다 (Kang et al., 1999; Park et al., 2000). 우리나라의경우근골격계질환이 1980년대에문제로대두되며 1994년에처음으로업무상질병으로인정받은후 (Park et al., 1989), 산업구조의변화와사회적인식및관심의증가로인해작업관련성근골격계질환이증가하고있으며산업보건분야에서중요한과제로대두되어왔다 (Kim, 2005). 이에고용노 동부는근골격계질환에대한예방조치의필요성을판단하여 2002년산업안전보건법에사업주에게근골격계부담작업에대한적절한조치를취하도록의무화했으나그대상이사업주와근로자의관계가성립되는업종으로한정되었다. 이로인하여고용관계가비교적명확한제조업등의업종을중심으로근골격계질환자각증상에대한연구가많이수행되어왔으나통증수준을파악한연구는드문실정이다. 다양한미용산업의한분야에해당하는헤어드레서는직업의특성상고객의만족과감동을위하여커트, 퍼머, 염색, 드라이, 아이롱, 샴푸및두피마사지등의시술을수행하게된다. 이러한과정에서고객중심의다양한편의및각종서비스제공을위하여부자연스러운자세로신체상부및하부부위에무리를주고팔을앞으로내밀거나위로든채다양한기계나기구를손가락이나손목을이용하여반복적인동작의작업을긴입식근무시간동안수행하는등의근골격계질환위험에크게노출되어있다. 특히, 헤어드레서들이근무하는미용실의경우잦은이직과임시직의채용으로불안정한고용특성과대부분소규모로운영되고있어근골격계질환의개선을포함한예방차원의관리도거의이루어지고있지못하며, 정기적인건강진단도실시하고있지못하는실정이다.

7 136 정년구ㆍ정종현ㆍ피영규 신체부위별근골격계통증수준은허리 (6.19점), 발목 / 발 (6.14점), 어깨 (5.47점), 무릎 (5.27점), 등 (5.23점), 손목 / 손 (5.15점), 목 (4.90), 엉덩이 / 허벅지 (4.36점), 팔꿈치 (3.83) 순으로파악되었다. 헤어드레서를대상으로한선행논문결과신체부위별로나타난통증의우선순위를살펴보면 Song & Han(2005) 의연구는어깨, 다리 / 팔, 허리, 손 / 손목 / 손가락, 목, 팔 / 팔꿈치순으로통증을느끼는것으로나타났고, Yang(2005) 의연구는어깨, 손목, 팔, 허리, 손가락, 목, 무릎, 종아리, 발목, 발가락, 팔꿈치순으로본연구결과와는다소차이를보였는데이는연구대상이헤어드레서가아닌미용종사자로포괄적이었고, 조사도구의차이때문인것으로판단된다. 한편, 간호사를대상으로조사한결과의경우그통증수군이허리, 어깨, 목, 발, 종아리, 등, 무릎, 손목, 아래팔, 위팔, 엉덩이, 허벅지순으로본연구결과와다소유사한경향을보이기도하였다 (Choi, 2005). 일반적특성에따른신체부위별근골격계통증수준을비교한결과어깨, 손목 / 손, 등부위는연령이 30세이하의대상자들이통계적으로유의하게높은통증수준을보였다. 헤어드레서는직업의특성상연령이낮은경우직급이높지않아많은시술에따른근무시간과장시간서있는근무로인하여상지부위의통증을호소하고있는것으로보인다. 따라서처음헤어드레서로배치되는경우근골격계부담작업의부하를줄이는작업자세및작업방법등의근골격계질환예방을위한교육은필요한것으로보인다. 허리부위의경우신장이 160 cm이하대상자들의통증수준이통계적으로유의하게높은경향을보였는데이는신장이작은사람의작업수행위치가상대적으로높게위치해있기때문으로, 작업시허리모양을비틀거나뒤로젖히는나쁜자세에서허리부위에높은유병률을보인다고한 Kim(1998) 의연구결과를감안할때허리통증을감소시키기위한교육과작업전 후스트레칭등은반드시필요한것으로보인다. 신체부위별통증수준에영향을미치는요인을살펴본결과팔꿈치부위의경우연령과성별, 손 / 손목, 허리와무릎부위는신장이적을수록통증수준에영향이있는것으로나타났고, 등은체중이영향요인으로파악되었다. 허리와무릎등신체하부의통증수준 을감소시키기위해서는피로예방을위하여발받침대와피로예방매트설치와굽이높은신발을가급적착용하지않는것이권장된다. 본연구는조사대상자가서울과경기지역에근무하는헤어드레서들로제한되어전체헤어드레서로확대해석하여일반화하기에는다소무리가있으며, 근골격계통증수준은주관적판단에의한것이므로절대적기준으로해석하기는다소무리가있다는제한점이있다. V. 결론 본연구는 2011년 7월부터 8월까지서울과경기일부지역의미용실에근무하고있는헤어드레서 199 명을대상으로 NMQ를활용하여근골격계통증수준을신체부위별로파악하고영향요인을규명하고자하였다. 신체부위별통증수준은허리 (6.19점) > 발목 / 발 (6.14점) > 어깨 (5.27점) > 무릎 (5.27점) > 등 (5.23 점 ) > 손목 / 손 (5.15점) > 등의순으로나타났다. 신체부위별근골격계통증수준의영향요인은팔꿈치부위의경우연령이적고남성이며, 운동을안하는경우가영향을미치는것으로확인되었으며, 허리와무릎부위는신장이영향요인으로파악되었다이는헤어드레서들의작업특성상입식작업이대부분으로적절한휴식시간부여, 작업전 후스트레칭등은반드시필요한것으로보이고, 굽이낮고편안한신발착용과입식의자의지급과이를활용할수있는방안이요구된다. References Chae DH, Kim JH. Risk Factors for Musculoskeletal Symptoms in Aviation Maintenance Technicians. Korean J Occup Environ Med 2005;17(3): Choi WK. Characteristics of Musculoskeletal Pain in Nurses. Graduate school of Health Yonsei University. Seoul; Yonsei University Press p Choi WJ, Sung NJ, Kang YJ, Han SH. Validity of NIOSH-and Nordic-style Questionnaires in the Screening and Surveillance of Neck and Upper Extremity Workrelated Musculoskeletal Disorders. Korean J Occup Environ Med 2008;20(3): Descatha A, Roquelaure Y, Chastang JF, Evanoff B, Melchior

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Lumbar spine

Lumbar spine CT 32 111 DOI : 10.3831/KPI.2010.13.2.111 Lumbar Spine CT 32 Received : 10. 05. 23 Revised : 10. 06. 04 Accepted : 10. 06. 11 Key Words: Disc herniation, CT scan, Clinical analysis The Clinical