λ³Έλ¬Έ λ°”λ‘œκ°€κΈ°

μΉ΄ν…Œκ³ λ¦¬ μ—†μŒ

Investigation to Reduce Delivery Delay Rate of Proficiency Test Materials and Maintaining Materials in Proper Temperature Ranges during Delivery

Background: The Korean Association of External Quality Assessment Service provides proficiency test (PT) materials through a logistics company. We investigated the delivery times of PT materials in 2020 and the methods to reduce delivery delay. We also attempted to prolong the proper storage temperature with the addition of ice pack. 
Methods: The lead times of deliveries from 2020 were calculated. We also checked the duration for which 600 gΓ—6 packs of dry ice or 24Γ—16 cm ice gel packs could maintain the proper temperature. To reduce delivery delay, the delivery day for HbA1c testing material was changed from Monday to Tuesday. To prolong the duration of proper temperature maintenance for cold shipping, an extra 12Γ—17 cm ice gel pack was added. 
Results: The average delivery time was 23 hours, 5 minutes, and 12 seconds (min–max: 17:9:8–84:31:39). The average delivery delay rate was 2.81% (min–max: 0.23%–11.25%). The delay rate for shipping on Monday was 11.25%; changing the delivery day to Tuesday reduced the delay rate to 1.76%. The addition of a 12Γ—17 cm-sized ice gel pack along with the 24Γ—16 cm gel pack prolonged the duration of proper storage temperature maintenance for cold shipping by 6 hours. 
Conclusions: Shipping on Tuesday instead of Monday can be an effective option to reduce the delivery delay rate, and the addition of a 12Γ—17 cm ice gel pack can prolong the proper cold shipping temperature.

Keywords: Proficiency test materials, Sample stability, Delivery delay rate, Storage temperature range

μ„œλ‘ 

 

ν˜„μž¬ λŒ€ν•œμž„μƒκ²€μ‚¬μ •λ„κ΄€λ¦¬ν˜‘νšŒλŠ” 외뢀정도관리λ₯Ό λͺ©μ μœΌλ‘œ 신빙도쑰사사업을 μ‹œν–‰ν•˜κ³  있으며, λ§€ν•΄ μ‹ λΉ™λ„μ‘°μ‚¬λ¬Όμ§ˆμ„ 참가기관에 λ°°μ†‘ν•˜κ³  μ‹œν–‰λœ 검사결과λ₯Ό λΆ„μ„ν•¨μœΌλ‘œμ¨ κ²€μ‚¬μ˜ 정밀도와 정확도λ₯Ό 높이기 μœ„ν•΄ λ…Έλ ₯ν•˜κ³  μžˆλ‹€. μ‹ λΉ™λ„μ‘°μ‚¬λ¬Όμ§ˆμ€ νƒλ°°νšŒμ‚¬λ₯Ό 톡해 λ°°μ†‘λ˜λ©°, 2019λ…„μ—λŠ” μ•½ 1,820μ—¬ 개의 참가기관에 총 8차에 걸쳐 물질이 λ°°μ†‘λ˜μ—ˆλ‹€. μ‹ λΉ™λ„μ‘°μ‚¬λ¬Όμ§ˆμ„ λΉ λ₯Έ μ‹œκ°„ 내에 λ°°μ†‘ν•˜λŠ” 것은 μ‹ λΉ™λ„μ‘°μ‚¬μ‚¬μ—…μ˜ κ°€μž₯ μ€‘μš”ν•œ λΆ€λ¬Έ 쀑 ν•˜λ‚˜μΌ 것이닀. 배솑이 μ§€μ—°λ˜λ©΄ μ‹ λΉ™λ„μ‘°μ‚¬λ¬Όμ§ˆμ„ 적정 λ³΄κ΄€μ˜¨λ„μ— λ°°μ†‘ν•˜κΈ° μœ„ν•˜μ—¬ ν•¨κ»˜ λ™λ΄‰ν•œ λ³΄λƒ‰λ¬Όμ§ˆμ΄ λ…Ήμ•„μ„œ 물질이 적정 λ³΄κ΄€μ˜¨λ„λ₯Ό λ²—μ–΄λ‚  수 있고, 물질이 λ³€μ§ˆλ˜μ–΄ 검사결과에 영ν–₯을 끼칠 수 있기 λ•Œλ¬Έμ΄λ‹€.

λŒ€ν•œμž„μƒκ²€μ‚¬μ •λ„κ΄€λ¦¬ν˜‘νšŒλŠ” ν™ˆνŽ˜μ΄μ§€ κ²Œμ‹œνŒμ„ 톡해 각쒅 인증사업과 신빙도쑰사사업에 λŒ€ν•œ 문의λ₯Ό μ ‘μˆ˜ν•˜κ³  μžˆλ‹€. λ˜ν•œ 배솑과정 쀑 λ°œμƒν•  수 μžˆλŠ” 물질 μ΄μƒμ΄λ‚˜ 배솑 지연에 κ΄€λ ¨ν•œ κ²Œμ‹œκΈ€μ„ μ ‘μˆ˜ν•˜μ—¬ λŒ€μ‘ν•¨μœΌλ‘œμ¨ μ‹ λΉ™λ„μ‘°μ‚¬μ‚¬μ—…μ˜ κ°œμ„ μ„ 도λͺ¨ν•˜κ³  μžˆλ‹€.

λ³Έ μ—°κ΅¬μ—μ„œλŠ” λŒ€ν•œμž„μƒμ •λ„κ΄€λ¦¬ν˜‘νšŒκ°€ 신빙도쑰사사업 참가기관에 λ¬Όμ§ˆμ„ μ•ˆμ •μ μœΌλ‘œ 배솑할 수 μžˆλ„λ‘, 배솑 μ†Œμš”μ‹œκ°„μ„ μ‘°μ‚¬ν•˜κ³  배솑 지연을 κ°μ†Œμ‹œν‚€κΈ° μœ„ν•œ λ°©μ•ˆμ„ λͺ¨μƒ‰ν•˜κ³ μž ν•˜μ˜€λ‹€. λ˜ν•œ 배솑 지연이 λΆˆκ°€ν”Όν•  경우, μš΄μ†‘ μ‹œ 적정 μ˜¨λ„λ₯Ό μœ μ§€ν•˜κΈ° μœ„ν•œ λ°©μ•ˆμ„ λ§ˆλ ¨ν•˜κ³ μž ν•˜μ˜€λ‹€.

재료 및 방법

 

1. μ‹ λΉ™λ„μ‘°μ‚¬λ¬Όμ§ˆ λ°°μ†‘μ‹œκ°„ 관리

1) μ‹ λΉ™λ„μ‘°μ‚¬λ¬Όμ§ˆ λ°°μ†‘μ‹œκ°„ νŒŒμ•…

2020년에 총 8차의 배솑이 μ˜ˆμ •λ˜μ—ˆμœΌλ©°, 신빙도쑰사사업 참가기관에 물질이 λ„μ°©λœ 상세내역을 νƒλ°°νšŒμ‚¬λ‘œλΆ€ν„° 전달받아 배솑 μ†Œμš”μ‹œκ°„μ„ νŒŒμ•…ν•˜μ˜€λ‹€. λ˜ν•œ 배솑 쀑 보관에 영ν–₯을 끼칠 수 μžˆλ‹€κ³  μ˜ˆμΈ‘λ˜λŠ” μ€‘μš” μ‹œμ μ— 따라 λ°°μ†‘μ‹œκ°„μ„ 4개 μ‹œκ°„ ꡬ획으둜 λ‚˜λˆ„μ—ˆλ‹€(Table 1).

Table 1 . Breakdown of lead time at which proficiency test materials were delivered.

SectionLead time (hr)
Section 1 27 hours after shipping (after 1 day, before 6 PM)
Section 2 27.01–41.00 (after 2 days, before 8 AM)
Section 3 41.01–51.00 (after 2 days, before 6 PM)
Section 4 >51.01 (after 2 days, after 6 PM)


2) 배솑 μ§€μ—°λΉ„μœ¨ κ°μ†Œ μœ„ν•œ λ°©μ•ˆ λͺ¨μƒ‰

μ‹€ν—˜μ„ ν†΅ν•˜μ—¬ 냉동과 냉μž₯ λ°°μ†‘μ˜ 각 κ²½μš°μ— λ³΄λƒ‰λ¬Όμ§ˆμ΄ λͺ¨λ‘ μ†Œλͺ¨λ˜μ–΄ λ°°μ†‘μƒμž λ‚΄ μ˜¨λ„κ°€ 물질의 적정 λ³΄κ΄€μ˜¨λ„μΈ –70℃– –20℃ λ˜λŠ” 2℃–8℃ μ΄μƒμœΌλ‘œ μƒμŠΉν•˜λŠ” μ‹œκ°„μ„ μΈ‘μ •ν•˜μ—¬, 이λ₯Ό 배솑 μ§€μ—°μ˜ κΈ°μ€€μ‹œκ°„μœΌλ‘œ μ±…μ •ν•˜μ˜€λ‹€. μ‹€ν—˜μ€ μ˜¨λ„ 23℃–27℃가 μœ μ§€λ˜λŠ” μ‹€λ‚΄μ—μ„œ μ‹œν–‰ν•˜μ˜€μœΌλ©°, μ‹€μ œ 배솑 μ‹œμ™€ 같이 냉동 λ°°μ†‘μ‘°κ±΄μœΌλ‘œ λ“œλΌμ΄μ•„μ΄μŠ€ 600 gΓ—6개 그리고 냉μž₯ λ°°μ†‘μ‘°κ±΄μœΌλ‘œ μ€‘ν˜• μ•„μ΄μŠ€κ²”(24 cmΓ—16 cm) 1개λ₯Ό 넣은 λ°°μ†‘μƒμž 각각 1κ°œμ— μ˜¨λ„ 둜거(Tempod 100Γ— Data logger; TempSen Electronics, Shanghai, China)λ₯Ό λ™λ΄‰ν•˜μ˜€λ‹€. μ˜¨λ„ 둜거 동봉 μ™Έ λ“œλΌμ΄μ•„μ΄μŠ€λ‚˜ μ•„μ΄μŠ€κ²”μ˜ μ’…λ₯˜λ‚˜ 개수 λ“± 연ꡬ에 κΈ°μΈν•œ 변경사항은 μ—†μ—ˆλ‹€.

μ‹ λΉ™λ„μ‘°μ‚¬λ¬Όμ§ˆμ€ 톡상 μΌμš”μΌμ— νƒλ°°νšŒμ‚¬μ—μ„œ μˆ˜κ±°ν•˜μ—¬ 배솑이 μ‹œμž‘λœλ‹€. κ·ΈλŸ¬λ‚˜ HbA1c 물질이 ν¬ν•¨λ˜μ–΄ μžˆλŠ” 2차와 8μ°¨ 배솑 μ‹œ, κ³΅μ—¬μžκ°€ 평일에 물질 μ œμ‘°κΈ°κ΄€μ— λ‚΄μ›ν•˜μ—¬ μ±„ν˜ˆ ν›„ 물질이 μ œμž‘λ˜κΈ° λ•Œλ¬Έμ— μ›”μš”μΌμ— 배솑이 μ‹œμž‘λœλ‹€. νƒλ°°νšŒμ‚¬μ™€ λ…Όμ˜κ²°κ³Ό, μ›”μš”μΌμ€ μΌλ°˜νƒλ°° λ¬ΌλŸ‰μ΄ λ§Žμ•„ μ‹ λΉ™λ„μ‘°μ‚¬λ¬Όμ§ˆμ˜ 배솑 λ˜ν•œ 지연될 ν™•λ₯ μ΄ λ†’λ‹€λŠ” 것이 μΆ”μ •λ˜μ–΄, HbA1c 물질이 ν¬ν•¨λœ 2020λ…„ 8μ°¨ 배솑 μ‹œμ—λŠ” ν™”μš”μΌμ— λ°°μ†‘ν•˜λŠ” λ°©μ•ˆμ„ μ‹œλ„ν•˜μ˜€λ‹€. λ˜ν•œ λ°°μ†‘μ‹œκ°„μ„ λ‹¨μΆ•μ‹œν‚¬ 수 μžˆλŠ” λ‹€λ₯Έ μš΄μ†‘λ°©λ²•μ„ μ‘°μ‚¬ν•˜μ˜€λ‹€.

2. 물질 배솑과정 쀑 μ˜¨λ„ 관리

1) 배솑과정 쀑 μ˜¨λ„ νŒŒμ•…

(1) 냉동 λ°°μ†‘κ³Όμ •μ˜ μ˜¨λ„

2019λ…„ 배솑 상세내역을 μ‚΄νŽ΄λ³Ό λ•Œ, 일반적으둜 μ œμ£Όλ„ λ“± λ„μ„œμ‚°κ°„μ§€μ—­ μ°Έκ°€κΈ°κ΄€μ˜ 배솑 지연이 λ§Žμ•˜λ˜ 것이 ν™•μΈλ˜μ—ˆλ‹€. λ”°λΌμ„œ μ œμ£Όλ„ μ†Œμž¬ μ°Έκ°€κΈ°κ΄€ 4곳을 λ¬΄μž‘μœ„λ‘œ μ„ μ •ν•˜μ—¬ μ‹ λΉ™λ„μ‘°μ‚¬λ¬Όμ§ˆκ³Ό ν•¨κ»˜ μ˜¨λ„ 둜거λ₯Ό λ™λ΄‰ν•˜μ—¬ 배솑 μ‹œ μ˜¨λ„λ₯Ό ν™•μΈν•˜μ˜€λ‹€. 2020λ…„ 7μ°¨ 배솑은 냉동 배솑 회차둜 λ“œλΌμ΄μ•„μ΄μŠ€ 600 gΓ—6κ°œμ™€ ν•¨κ»˜ μ˜¨λ„ 둜거λ₯Ό λ™λ΄‰ν•˜μ˜€λ‹€.

(2) 냉μž₯ λ°°μ†‘κ³Όμ •μ˜ μ˜¨λ„

8μ°¨ 배솑은 냉μž₯ 배솑 회차둜 냉동 λ°°μ†‘κ³Όμ •μ˜ μ˜¨λ„ 확인 λ•Œμ™€ 같이 μ œμ£Όλ„ μ†Œμž¬ 4개 참가기관에 μ€‘ν˜• μ•„μ΄μŠ€κ²”κ³Ό ν•¨κ»˜ μ˜¨λ„ 둜거λ₯Ό λ™λ΄‰ν•˜μ—¬ 배솑 쀑 μ˜¨λ„ λ³€ν™”λ₯Ό ν™•μΈν•˜μ˜€λ‹€.

2) 적정 μ˜¨λ„ μœ μ§€ μœ„ν•œ λ°©μ•ˆ λͺ¨μƒ‰

배솑이 μ§€μ—°λ˜μ–΄λ„ μ΅œλŒ€ν•œ 적정 λ³΄κ΄€μ˜¨λ„λ₯Ό μœ μ§€ν•˜κΈ° μœ„ν•˜μ—¬ λ³΄λƒ‰λ¬Όμ§ˆμ˜ 개수λ₯Ό μΆ”κ°€ν•˜λŠ” λ°©μ•ˆμ„ μ‹œλ„ν•˜μ˜€λ‹€. κΈ°μ‘΄ μ‹ λΉ™λ„μ‘°μ‚¬λ¬Όμ§ˆ 배솑 μ‹œ λ™λ΄‰λ˜λŠ” μ€‘ν˜• μ•„μ΄μŠ€κ²”μ„ λ°°μ†‘μƒμž 1κ°œμ— λ„£κ³  μ†Œν˜• μ•„μ΄μŠ€κ²”(12 cmΓ—17 cm)을 1개 μΆ”κ°€ν•˜μ—¬ μ‹€ν—˜μ„ μ‹œν–‰ν•˜μ˜€λ‹€.

κ²°κ³Ό

 

1. μ‹ λΉ™λ„μ‘°μ‚¬λ¬Όμ§ˆ λ°°μ†‘μ‹œκ°„ 관리

1) μ‹ λΉ™λ„μ‘°μ‚¬λ¬Όμ§ˆ λ°°μ†‘μ‹œκ°„ νŒŒμ•…

μ‹ λΉ™λ„μ‘°μ‚¬λ¬Όμ§ˆμ˜ 평균 λ°°μ†‘μ‹œκ°„μ€ 23μ‹œκ°„ 5λΆ„ 12초(μ΅œλ‹¨β€“μ΅œμž₯: 17μ‹œκ°„ 9λΆ„ 8μ΄ˆβ€“84μ‹œκ°„ 31λΆ„ 39초)μ˜€λ‹€(Fig. 1). 배솑 ν›„ 27μ‹œκ°„(ꡬ획 1) 내에 평균 94.08%의 기관에 배솑이 μ™„λ£Œλ˜μ—ˆκ³ , 27.01–41.00μ‹œκ°„(ꡬ획 2)κ³Ό 41.01–51.00μ‹œκ°„(ꡬ획 3), 그리고 50.01μ‹œκ°„ 이후(ꡬ획 4)에 배솑이 μ™„λ£Œλ˜λŠ” κΈ°κ΄€μ˜ 평균 λΉ„μœ¨μ€ 각각 2.79%, 2.55%, 그리고 0.58%μ΄μ—ˆλ‹€(Fig. 2). 51.01μ‹œκ°„μ„ 초과(ꡬ획 4)ν•˜μ—¬ 물질이 λ°°μ†‘λ˜λŠ” κΈ°κ΄€ μ€‘μ—λŠ” λ„μ„œμ§€μ—­μ˜ 기관이 λŒ€λΆ€λΆ„μ΄μ§€λ§Œ, νƒλ°°νšŒμ‚¬μ˜ 였λ₯˜λ‘œ μΈν•΄μ„œ 배솑이 μ§€μ—°λ˜λŠ” κ²½μš°κ°€ λ§€ νšŒμ°¨λ‹Ή μ΅œμ†Œ 2κΈ°κ΄€ 이상 ν¬ν•¨λ˜μ–΄ μžˆμ—ˆλ‹€.

Figure 1. The lead time for each delivery of proficiency test (PT) in 2020. 

Figure 2. The distribution of lead time for each delivery of proficiency test in 2020. 

2) 배솑 μ§€μ—°λΉ„μœ¨ κ°μ†Œ μœ„ν•œ λ°©μ•ˆ λͺ¨μƒ‰

냉동과 냉μž₯ 배솑 μ‹œ λ°°μ†‘μƒμž λ‚΄λΆ€ μ˜¨λ„κ°€ 적정 λ³΄κ΄€μ˜¨λ„ μ΄μƒμœΌλ‘œ μƒμŠΉν•˜λŠ” μ‹œκ°„μ€ 각각 46μ‹œκ°„κ³Ό 36μ‹œκ°„μ΄μ—ˆλ‹€(Fig. 3). μ΄λŸ¬ν•œ 배솑 μ§€μ—° 기쀀점을 λ°”νƒ•μœΌλ‘œ κ³„μ‚°ν•œ 전체 회차의 배솑 μ§€μ—°λΉ„μœ¨μ€ 평균 2.81%(μ΅œμ €β€“μ΅œκ³ : 0.23%–11.25%)μ˜€λ‹€(Table 2). 냉동과 냉μž₯ λ°°μ†‘μ˜ 평균 배솑 μ§€μ—°λΉ„μœ¨μ€ 각각 2.58%(μ΅œμ €β€“μ΅œκ³ : 0.23%–4.92%)와 2.88%(μ΅œμ €β€“μ΅œκ³ : 0.69%–11.25%)μ˜€λ‹€. μΌμš”μΌμ— λ°°μ†‘λœ 회차의 평균 배솑 μ§€μ—°λΉ„μœ¨μ€ 1.57%(μ΅œμ €β€“μ΅œκ³ : 0.23%–4.92%)μ˜€κ³ , μ›”μš”μΌμ— λ°°μ†‘λœ 2μ°¨ 배솑 μ‹œ 배솑 μ§€μ—°λΉ„μœ¨μ€ 11.25%둜 κ°€μž₯ λ†’μ•˜λ‹€. 배솑 지연을 κ°μ†Œμ‹œν‚€κΈ° μœ„ν•˜μ—¬ ν™”μš”μΌμ— λ°°μ†‘λœ 8μ°¨ λ°°μ†‘μ—μ„œλŠ” 배솑 μ§€μ—°λΉ„μœ¨μ΄ 1.76%둜 κ°μ†Œν•˜μ˜€λ‹€.

Table 2 . Delivery delay rate for each challenge (%).

1st2nd3rd (frozen)4th5th6th7th (frozen)8thAverage
Delay rate 0.69 11.25 0.23 1.22 1.39 0.99 4.92 1.76 2.81


Figure 3. Experiment to check temperature changes in delivery boxes. (A) For frozen shipping, 6 pieces of 600 g dry-ice maintained the temperature inside of delivery box between –70℃ and –20℃ for 46 hours; 46 hours is defined as time point to delivery delay. (B) 12cmΓ—17cm ice-gel maintained the temperature inside of delivery box between 2℃ and 8℃ for 36 hours; 36 hours is defined as time point to delivery delay. 

배솑 μ§€μ—°λΉ„μœ¨μ„ κ°μ†Œν•˜κΈ° μœ„ν•΄ 항곡택배λ₯Ό μ‚¬μš©ν•˜λŠ” λ°©μ•ˆμ„ μ‚΄νŽ΄λ³΄μ•˜μ„ λ•Œ, μ œμ£Όλ„ ν•­κ³΅νƒλ°°μ˜ 경우 1개의 μ°Έκ°€κΈ°κ΄€λ‹Ή 10만 μ›μ˜ λ°°μ†‘λ£Œκ°€ μ†Œμš”λ˜μ–΄ λΉ„μš© μƒμŠΉμ˜ λ¬Έμ œκ°€ λ°œμƒν•˜λ©°, 배솑 지연이 μ’…μ’… λ°œμƒν•˜λŠ” μ—°ν‰λ„λ‚˜ λͺ©ν¬ λ“±μ˜ κΈ°κ΄€μ—λŠ” μ μš©ν•  수 μ—†λ‹€λŠ” μ œν•œμ μ΄ μžˆμ—ˆλ‹€. 우체ꡭ 읡일 νŠΉκΈ‰μ˜ 경우, 크기 30 cmΓ—23 cmΓ—26 cm의 λ°°μ†‘μƒμž 전체λ₯Ό μš°μ²΄κ΅­μ— 직접 μš΄μ†‘ν•˜μ—¬ μ ‘μˆ˜μ‹œμΌœμ•Ό ν•˜λŠ” 쑰건이 μžˆμ–΄ μ μš©ν•˜κΈ°μ— μ œν•œμ μ΄ μžˆμ—ˆλ‹€.

2. 물질 배솑과정 쀑 μ˜¨λ„ 관리

1) 배솑과정 쀑 μ˜¨λ„ νŒŒμ•…

(1) 냉동 λ°°μ†‘κ³Όμ •μ˜ μ˜¨λ„

2020λ…„ 7μ°¨ 배솑은 2020λ…„ 10μ›” 11일에 μ‹œν–‰λ˜μ—ˆμœΌλ©°, 기상청 보고에 μ˜ν•˜λ©΄ 2020λ…„ 10μ›” 11일뢀터 15μΌκΉŒμ§€ μ „κ΅­μ˜ μ˜¨λ„λŠ” 12.3℃–26.1℃에 λΆ„ν¬ν•˜μ˜€λ‹€[1]. μ œμ£Όλ„ μ†Œμž¬ 4개 μ°Έκ°€κΈ°κ΄€μ˜ λ‹΄λ‹Ήμžλ‘œλΆ€ν„° 물질 수령 후에도 λ“œλΌμ΄μ•„μ΄μŠ€κ°€ 남아 μžˆμŒμ„ ν™•μΈν•˜μ˜€μœΌλ‘œ, 배솑과정 쀑 μ˜¨λ„λŠ” –68.1β„ƒμ—μ„œ –20.6β„ƒλ‘œ μœ μ§€λ˜μ—ˆλ‹€(Fig. 4). 평균 λ°°μ†‘μ‹œκ°„μ€ 38μ‹œκ°„ 23λΆ„ 47초(μ΅œλ‹¨β€“μ΅œμž₯: 27:32:36–42:29:09)μ˜€λ‹€.

Figure 4. Temperature changes during the frozen proficiency test materials delivery. (A) The delivery box was arrived about 27 hours later, and the temperature inside of delivery box was maintained under –20℃. (B–D) The delivery boxes were arrived between 38 to 42 hours later, and the temperatures were maintained between –68.1℃ and –20.6℃ (β†’: arrival time). 

(2) 냉μž₯ λ°°μ†‘κ³Όμ •μ˜ μ˜¨λ„

2020λ…„ 8μ°¨ 배솑은 2020λ…„ 10μ›” 27일에 μ‹œν–‰λ˜μ—ˆμœΌλ©°, 2020λ…„ 10μ›” 27일뢀터 31μΌκΉŒμ§€ μ „κ΅­μ˜ μ˜¨λ„λŠ” 17.4℃–22.9℃에 λΆ„ν¬ν•˜μ˜€λ‹€[1]. μ œμ£Όλ„ μ†Œμž¬ 4개 μ°Έκ°€κΈ°κ΄€μ˜ λ‹΄λ‹Ήμž λͺ¨λ‘λ‘œλΆ€ν„° 물질 수령 μ‹œ μ•„μ΄μŠ€κ²”μ€ λͺ¨λ‘ λ…Ήμ•„ μžˆμ—ˆμŒμ„ ν™•μΈν•˜μ˜€λ‹€. 배솑과정 쀑 μ˜¨λ„λŠ” 2.0℃–15.3℃에 이λ₯΄λ©°, 평균 λ°°μ†‘μ‹œκ°„μ€ 39μ‹œκ°„ 15λΆ„ 42초(μ΅œλ‹¨β€“μ΅œμž₯: 27:01:35–44:56:32)μ˜€λ‹€. 4개 κΈ°κ΄€ 쀑 1개 κΈ°κ΄€μ—μ„œλŠ” 27μ‹œκ°„ λ§Œμ— λ¬Όμ§ˆμ„ μˆ˜λ Ήν•˜μ˜€μœΌλ©°, 배솑 μ™„λ£Œ μ‹œκΉŒμ§€ μƒμž λ‚΄ μ˜¨λ„λŠ” 8℃ 미만으둜 μœ μ§€λ˜μ—ˆμ§€λ§Œ, 배솑에 40–44μ‹œκ°„μ΄ μ†Œμš”λœ 3개 κΈ°κ΄€μ—μ„œλŠ” 평균 36μ‹œκ°„μ΄ μ§€λ‚˜λ©΄ 8℃ μ΄μƒμœΌλ‘œ μƒμŠΉν•˜κΈ° μ‹œμž‘ν•˜μ—¬ 졜고 15.3℃에 이λ₯΄λ €λ‹€(Fig. 5).

Figure 5. Temperature changes during the delivery of cold proficiency test materials. (A) The delivery box was arrived about 27 hours later, and the temperature inside of delivery box was maintained between 2℃ and 8℃. (B-D) The delivery boxes were arrived about 44 hours later, and the temperature was increased above 8℃ from 36 hours after delivery started (β†’: arrival time). 

2) 적정 μ˜¨λ„ μœ μ§€ μœ„ν•œ λ°©μ•ˆ λͺ¨μƒ‰

μ œμ£Όλ„ μ†Œμž¬ 4개 기관에 냉동 배솑 μ‹œ 42μ‹œκ°„μ΄ λ„˜μ–΄λ„ λ°°μ†‘λ°•μŠ€ λ‚΄λΆ€ μ˜¨λ„κ°€ –20℃ μ΄ν•˜λ‘œ μœ μ§€λ˜μ—ˆκΈ°μ— 좔가적 λ°©μ•ˆμ€ μ‹œλ„ν•˜μ§€ μ•Šμ•˜λ‹€. 냉μž₯ 배솑 μ‹œ, λ°°μ†‘μƒμž λ‚΄ μ˜¨λ„ μœ μ§€μ‹œκ°„μ„ μ—°μž₯ν•˜κΈ° μœ„ν•˜μ—¬ κΈ°μ‘΄ μ€‘ν˜• μ•„μ΄μŠ€κ²”κ³Ό ν•¨κ»˜ μ†Œν˜• μ•„μ΄μŠ€κ²” 1개λ₯Ό μΆ”κ°€ν•œ κ²°κ³Ό 포μž₯μƒμž λ‚΄λΆ€ μ˜¨λ„λŠ” 42μ‹œκ°„κ°€λŸ‰ 8℃ λ‚΄λ‘œ μœ μ§€λ˜μ–΄ 6μ‹œκ°„κ°€λŸ‰ 더 μ˜€λž«λ™μ•ˆ μ˜¨λ„ μœ μ§€κ°€ κ°€λŠ₯ν•˜μ˜€λ‹€(Fig. 6). μ†Œν˜• μ•„μ΄μŠ€κ²”μ„ 2개 μΆ”κ°€ν•˜μ˜€μ„ λ•Œμ—λŠ” μƒμž λ‚΄λΆ€ μ˜¨λ„κ°€ 3μ‹œκ°„ 이상 μ˜ν•˜λ‘œ λ‚΄λ €κ°„ μƒνƒœλ‘œ μœ μ§€λ˜μ—ˆκΈ° λ•Œλ¬Έμ— 물질의 용혈이 λ°œμƒν•  κ°€λŠ₯성이 μžˆμ–΄ 더 이상 μ‹€ν—˜μ„ μ§„ν–‰ν•˜μ§€ μ•Šμ•˜λ‹€.

Figure 6. The temperature change when 12 cmΓ—17 cm-sized iced-gel was added into the delivery box. 

κ³ μ°°

 

일반적으둜 μƒν’ˆν™”λœ μ‹ λΉ™λ„μ‘°μ‚¬λ¬Όμ§ˆμ˜ 냉동 보관쑰건은 –70β„ƒμ—μ„œ –20℃이며, 냉μž₯ 보관쑰건은 2℃–8℃이닀[2,3]. λŒ€ν•œμž„μƒκ²€μ‚¬μ •λ„κ΄€λ¦¬ν˜‘νšŒμ˜ μ‹ λΉ™λ„μ‘°μ‚¬λ¬Όμ§ˆμ„ 적정 λ³΄κ΄€μ˜¨λ„λ₯Ό μœ μ§€ν•œ μƒνƒœλ‘œ μ•ˆμ •μ μœΌλ‘œ λ°°μ†‘ν•˜κΈ° μœ„ν•˜μ—¬ 배솑 μ†Œμš”μ‹œκ°„μ„ κ΄€λ¦¬ν•˜κ³  배솑이 μ§€μ—°λ˜λŠ” κΈ°κ΄€μ˜ λΉ„μœ¨μ„ κ°μ†Œμ‹œν‚€κ³ μž ν•˜μ˜€λ‹€.

냉동과 냉μž₯ 배솑에 λŒ€ν•œ 각각의 λ°°μ†‘μ‹œκ°„μ„ ν™•μΈν•œ λ’€, λ³΄λƒ‰λ¬Όμ§ˆμ΄ λͺ¨λ‘ λ…Ήμ•„μ„œ λ°°μ†‘μƒμž λ‚΄λΆ€ μ˜¨λ„κ°€ 적정 λ³΄κ΄€μ˜¨λ„ μ΄μƒμœΌλ‘œ μƒμŠΉν•˜λŠ” 배솑 μ§€μ—° 기쀀점을 λ°”νƒ•μœΌλ‘œ κ³„μ‚°ν–ˆμ„ λ•Œ 평균 2.33%(μ΅œμ €β€“μ΅œκ³ : 0.11%–11.26%)μ—μ„œ 배솑이 μ§€μ—°λ˜μ—ˆλ‹€(Table 2). μ •ν™•λ„κΈ°λ°˜ HbA1c ν”„λ‘œκ·Έλž¨μ΄ μ†ν•œ 물질 배솑 μ‹œ, 일반 택배 λ¬ΌλŸ‰μ΄ λ§Žμ€ μ›”μš”μΌμ„ ν”Όν•΄μ„œ ν™”μš”μΌμ— λ°°μ†‘ν–ˆμ„ λ•Œ, 배솑 μ§€μ—°λΉ„μœ¨μ΄ 11.26%μ—μ„œ 1.71%둜 κ°μ†Œν•¨μ„ ν™•μΈν•˜μ˜€λ‹€. λ”°λΌμ„œ μΆ”ν›„ 정확도 기반 HbA1c 물질 배솑 μ‹œ, ν™”μš”μΌμ— 배솑을 μ‹œν–‰ν•œλ‹€λ©΄ 배솑 μ§€μ—°λΉ„μœ¨μ„ 쀄일 수 μžˆμ„ 것이며, 이λ₯Ό 톡해 적정 λ³΄κ΄€μ˜¨λ„λ₯Ό μœ μ§€ν•œ μƒνƒœλ‘œ 배솑 될 수 μžˆλŠ” ν™•λ₯ μ„ 높일 수 μžˆμ„ κ²ƒμœΌλ‘œ νŒλ‹¨λœλ‹€.

νƒλ°°μ‚¬μ˜ 였λ₯˜λ‘œ μΈν•œ κ²½μš°μ™€ λ„μ„œμ‚°κ°„μ§€μ—­μ˜ μ°Έκ°€κΈ°κ΄€μ˜ 경우 λΆˆκ°€ν”Όν•˜κ²Œ 배솑이 지연될 κ²½μš°κ°€ λ°œμƒν•˜κΈ°μ—, 배솑 쀑 λ°°μ†‘μƒμž λ‚΄ μ˜¨λ„ λ³€ν™”λ₯Ό ν™•μΈν•˜κ³ , 졜μž₯ μ‹œκ°„ λ™μ•ˆ 물질의 적정 λ³΄κ΄€μ˜¨λ„λ₯Ό μœ μ§€ν•˜κΈ° μœ„ν•œ λ°©μ•ˆμ„ λ§ˆλ ¨ν•˜κ³ μž ν•˜μ˜€λ‹€. 냉동 λ°°μ†‘μ˜ 경우 평균 46μ‹œκ°„κΉŒμ§€ –20℃ μ΄ν•˜λ‘œ μœ μ§€λ˜μ–΄ 평균 0.64%에 ν•΄λ‹Ήν•˜λŠ” μ†Œμˆ˜μ˜ κΈ°κ΄€μ—λ§Œ 배솑 지연이 λ°œμƒν•  κ²ƒμœΌλ‘œ μ˜ˆμƒλ˜λ©°, λ°°μ†‘μƒμžμ˜ 곡간이 μ œν•œλ˜μ–΄ μžˆμ–΄ 좔가적인 λ“œλΌμ΄μ•„μ΄μŠ€μ˜ μ μž¬κ°€ λΆˆκ°€λŠ₯ν•˜μ—¬ 좔가적인 방법은 κ³ λ €ν•˜μ§€ μ•Šμ•˜λ‹€. 냉μž₯ 배솑 μ‹œλŠ” 기쑴의 μ€‘ν˜• μ•„μ΄μŠ€κ²”λ§Œ μ‚¬μš© μ‹œ 36μ‹œκ°„ κ°€λŸ‰ 2℃–8β„ƒλ‘œ μœ μ§€λ˜μ–΄ 평균 2.89%의 기관에 배솑이 μ§€μ—°λ˜μ—ˆλ‹€. 반면, μ†Œν˜• μ•„μ΄μŠ€κ²”μ„ μΆ”κ°€ν•˜λ©΄ 42μ‹œκ°„κΉŒμ§€ 8℃ λ‚΄λ‘œ μ˜¨λ„κ°€ μœ μ§€λ˜μ–΄, 평균 0.55%(μ΅œμ €β€“μ΅œκ³ : 0.10%–1.82%)둜 배솑 μ§€μ—°λΉ„μœ¨μ„ κ°μ†Œμ‹œν‚¬ 수 μžˆμ„ κ²ƒμœΌλ‘œ νŒλ‹¨λ˜μ—ˆλ‹€.

λŒ€ν•œμž„μƒκ²€μ‚¬μ •λ„κ΄€λ¦¬ν˜‘νšŒμ˜ μ‹ λΉ™λ„μ‘°μ‚¬λ¬Όμ§ˆμ˜ λ°°μ†‘μ‹œκ°„μ„ κ΄€λ¦¬ν•˜κ³  이에 λ”°λ₯Έ μ˜¨λ„ λ³€ν™”λ₯Ό κ΄€λ¦¬ν•˜λŠ” 것은 μ‹ λΉ™λ„μ‘°μ‚¬μ‚¬μ—…μ˜ κ°€μž₯ μ€‘μš”ν•œ λΆ€λΆ„ 쀑 ν•˜λ‚˜μΌ 것이닀. 냉동 배솑 μ‹œμ—λŠ” ν˜„μž¬μ˜ 방법을 μœ μ§€ν•  λ•Œ, 99.36%에 ν•΄λ‹Ήν•˜λŠ” 기관에 μ•ˆμ •μ μœΌλ‘œ μ‹ λΉ™λ„μ‘°μ‚¬λ¬Όμ§ˆμ„ 배솑할 수 μžˆμ„ κ²ƒμœΌλ‘œ 예츑되며, 냉μž₯ 배솑 μ‹œμ—λŠ” μ†Œν˜• μ•„μ΄μŠ€κ²”μ„ μΆ”κ°€ν•˜λŠ” 방법을 μ μš©ν•œλ‹€λ©΄ 기쑴의 97.11%μ—μ„œ μ΅œλŒ€ 99.45%의 기관에 μ•ˆμ •μ μœΌλ‘œ μ‹ λΉ™λ„μ‘°μ‚¬λ¬Όμ§ˆμ„ 배솑할 수 μžˆμ„ κ²ƒμœΌλ‘œ νŒλ‹¨λœλ‹€.