Epidemiology and Health

Original Articles

Prediction of the 10-year risk of atherosclerotic cardiovascular disease in the Korean population: Sangwoo Park, Yong-Giun Kim, Soe Hee Ann, Young-Rak Cho, Shin-Jae Kim, Seungbong Han, Gyung-Min Park; Epidemiol Health. 2023;45:e2023052. Published online May 12, 2023; DOI: https://doi.org/10.4178/epih.e2023052

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
Proper risk assessment is important for the primary prevention of atherosclerotic cardiovascular disease (ASCVD). However, no validated risk prediction tools are currently in use in Korea. This study sought to develop a 10-year risk prediction model for incident ASCVD.
METHODS
Using the National Sample Cohort of Korea, 325,934 subjects aged 20-80 years without previous ASCVD were enrolled. ASCVD was defined as a composite of cardiovascular death, myocardial infarction, and stroke. The Korean atherosclerotic cardiovas cular disease risk prediction (K-CVD) model was developed separately for men and women using the development dataset and validated in the validation dataset. Furthermore, the model performance was compared with the Framingham risk score (FRS) and pooled cohort equation (PCE).
RESULTS
Over 10 years of follow-up, 4,367 ASCVD events occurred in the overall population. The predictors of ASCVD included in the model were age, smoking status, diabetes, systolic blood pressure, lipid profiles, urine protein, and lipid-lowering and blood pressure-lowering treatment. The K-CVD model had good discrimination and strong calibration in the validation dataset (time-dependent area under the curve=0.846; 95% confidence interval, 0.828 to 0.864; calibration χ<sup>2</sup>=4.73, goodness-of-fit p=0.32). Compared with our model, both FRS and PCE showed worse calibration, overestimating ASCVD risk in the Korean population.
CONCLUSIONS
Through a nationwide cohort, we developed a model for 10-year ASCVD risk prediction in a contemporary Korean population. The K-CVD model showed excellent discrimination and calibration in Koreans. This population-based risk prediction tool would help to appropriately identify high-risk individuals and provide preventive interventions in the Korean population.; Summary

Korean summary
국민건강보험공단 표본 코호트를 이용하여, 한국인 인구에서 10년 죽상경화성 심혈관질환 위험 예측 (K-CVD) 모델을 개발하였다. 한국인 인구집단을 기반으로 개발된 K-CVD 모델은 한국 인구집단에서 판별력과 교정력 측면에서 우수한 성능을 보여주었다. K-CVD 모델은 한국인 집단에서 심혈관질환의 고위험군을 적절하게 식별하고, 예방적 중재를 시행하는데 있어 도움이 될 것으로 생각된다.

Key Message
Using a nationwide cohort, the Korean ASCVD risk prediction (K-CVD) model was developed for 10-year ASCVD risk prediction. The K-CVD model showed excellent discrimination and calibration in a contemporary Korean population. This population-based risk prediction tool would help to appropriately identify high-risk individuals and provide preventive interventions in the Korean population.

Changes in metabolic syndrome and the risk of breast and endometrial cancer according to menopause in Korean women: Thi Xuan Mai Tran, Soyeoun Kim, Boyoung Park; Epidemiol Health. 2023;45:e2023049. Published online May 1, 2023; DOI: https://doi.org/10.4178/epih.e2023049

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study investigated how changes in metabolic syndrome (MetS) are associated with the subsequent risk of breast and endometrial cancer according to menopausal status.

METHODS

This cohort study, using data from the National Health Insurance Service database, included women aged ≥40 years who underwent 2 biennial cancer screenings (2009-2010 and 2011-2012) and were followed up until 2020. Participants were grouped into MetS-free, MetS-recovery, MetS-development, and MetS-persistent groups. Menopausal status (premenopausal, perimenopausal, and postmenopausal) was assessed at 2 screenings. Cox proportional hazard regression was used to assess the association between MetS changes and cancer risk.

RESULTS

In 3,031,980 women, breast and endometrial cancers were detected in 39,184 and 4,298, respectively. Compared with the MetS-free group, those who recovered, developed, or had persistent MetS showed an increased risk of breast cancer, with adjusted hazard ratios (aHRs) of 1.05, 1.05, and 1.11, respectively (p<0.005). MetS persistence was associated with an increased risk of breast cancer in postmenopausal women (aHR, 1.12, 95% confidence interval [CI], 1.08 to 1.16) but not in premenopausal or perimenopausal women. MetS persistence was associated with an increased risk of endometrial cancer in premenopausal, perimenopausal, and postmenopausal women, with aHRs of 1.41 (95% CI, 1.17 to 1.70), 1.59 (95% CI, 1.19 to 2.12), and 1.47 (95% CI, 1.32 to 1.63), respectively.

CONCLUSIONS

Increased breast cancer risk was associated with recovered, developed, and persistent MetS in postmenopausal women. Meanwhile, increased endometrial cancer risk was found in obese women who recovered from MetS or persistently had MetS, regardless of menopausal status, when compared to MetS-free women.

Summary

Korean summary
- 폐경후 여성에서 대사증후군이 회복되었거나, 지속적으로 대사증후군을 앓고 있거나, 대사증후군이 발병한 여성은 유방암 위험과 관련이 있었습니다. - 한편, 폐경 상태와 관계없이 대사증후군에서 회복되었거나 지속적으로 대사증후군를 앓고 있는 비만 여성은 대사증후군이 없는 여성에 비해 자궁내막암 위험이 증가하는 것으로 나타났습니다.

Key Message
- Increased breast cancer risk was associated with recovered, developed, and persistent MetS in postmenopausal women. - Increased endometrial cancer risk was found in obese women who recovered from MetS or persistently had MetS, regardless of menopausal status, when compared to MetS-free women.

Citations

Citations to this article as recorded by

Melatonin, BAG-1 and cortisol circadian interactions in tumor pathogenesis and patterned immune responses
George Anderson
Exploration of Targeted Anti-tumor Therapy.2023; : 962. CrossRef
Changed Endocrinology in Postmenopausal Women: A Comprehensive View
Vidhi Motlani, Gunjan Motlani, Soumya Pamnani, Akshat Sahu, Neema Acharya
Cureus.2023;[Epub] CrossRef

The association between tobacco or nicotine product use behaviors and non-compliance with mask-wearing during the COVID-19 pandemic: a cross-sectional study in Korea: Da-eun Lee, Heewon Kang, Sung-il Cho; Epidemiol Health. 2022;44:e2022087. Published online October 7, 2022; DOI: https://doi.org/10.4178/epih.e2022087

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
It is necessary to investigate tobacco or nicotine product (TNP) use which acts as a risk factor for coronavirus disease 2019 (COVID-19) infection. Especially, wearing a mask is difficult to practice while using TNP. Therefore, this study aimed to examine the association between TNP use behaviors and non-compliance with mask-wearing during the COVID-19 pandemic.
METHODS
The samples of 208,618 Korean adults from 2020 Community Health Survey in Korea were used. As an independent variable, TNP use behaviors such as TNP use status, changes in TNP use after the COVID-19 outbreak, TNP types, and attempt to quit were analyzed. Logistic regression was performed on gender-stratified participants.
RESULTS
Among men, the odds ratio (OR) of current and former TNP users were 2.00 (95% confidence interval [CI], 1.66 to 2.40) and 1.32 (95% CI, 1.09 to 1.60), respectively, compared to never users. In women, OR was 1.50 (95% CI, 1.00 to 2.26) for former users. Cigarette use was more associated with not wearing a mask than non-cigarette tobacco or nicotine product (NCTNP) use (OR, 1.53; 95% CI, 1.12 to 2.08). Men whose TNP use decreased had lower non-compliance (OR, 0.52; 95% CI, 0.36 to 0.74); while women whose TNP use increased had lower non-compliance (OR, 0.13; 95% CI, 0.07 to 0.26).
CONCLUSIONS
Current and former users were less likely to wear masks. Cigarette use was more associated with not wearing a mask than NCTNP use. Changes in TNP use showed association for men and women; however, in the opposite direction. Therefore, more attention should be paid to TNP use prevention and cessation support during the epidemic of respiratory infectious diseases. Moreover, it is necessary to identify risk factors of cigarette users in compliance with mask-wearing.; Summary

Korean summary
담배 또는 니코틴 제품 (Tobacco or Nicotine Products, TNPs) 현재사용자와 과거사용자는 비사용자 대비 마스크 미착용 연관성이 높고, 비궐련 담배 또는 니코틴 제품 (Non-Cigarette Tobacco or Nicotine Products, NCTNPs) 사용자보다는 일반담배 사용자의 마스크 미착용 연관성이 높다. 남성에서는 코로나19 유행 이전 대비 TNPs 사용이 감소했을 때, 여성에서는 증가했을 때 마스크 미착용 연관성이 낮았다. 따라서 호흡기 감염병 유행 시기에는 더욱 TNPs 사용 예방과 금연 지원에 관심을 가질 것을 제안한다.

Key Message
During the epidemic of respiratory infectious diseases, more attention should be paid to tobacco or nicotine products (TNPs) use prevention and cessation support.

Awareness of and practice toward cancer prevention recommendations: results of the Korean National Cancer Prevention Awareness and Practice Survey in 2021: Jin-Kyoung Oh, Eunjung Park, Byungmi Kim, Yoon-Jung Choi, E Hwa Yun, Min Kyung Lim, Jeong-Soo Im, Eun Young Park; Epidemiol Health. 2022;44:e2022068. Published online August 26, 2022; DOI: https://doi.org/10.4178/epih.e2022068

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Abstract

OBJECTIVES
This study reports data regarding the awareness and practice of cancer prevention among Koreans in 2021 and behavioral changes during the coronavirus disease 2019 (COVID-19) pandemic.

METHODS

We collected Cancer Prevention Awareness and Practice Survey data through face-to-face interview surveys using a structured questionnaire completed by 4,000 randomly selected men and women aged between 20 years and 74 years in 17 provinces. We examined the awareness and practice of 10 cancer prevention recommendations and evaluated their associations with potential risk factors through multiple logistic regression analysis adjusted for age, gender, residence, marital status, education, and income.

RESULTS

Eighty percent of participants knew that cancer is preventable, while 45% practiced cancer prevention. Cancer prevention practice tended to be more common among older participants (adjusted odds ratio [aOR], 1.39 per 10-year increment; 95% confidence interval [CI], 1.29 to 1.49) and less common among rural inhabitants (aOR, 0.66; 95% CI, 0.51 to 0.86) than among urban residents and among single people (aOR, 0.55; 95% CI, 0.45 to 0.66) than among married people. Practices were the highest for avoiding burned or charred foods (87.6%) and lowest for vaccination against human papillomavirus (14.5%). Refusal to follow recommendations was most common for avoiding alcohol consumption (7.9%). The most difficult recommendations to follow were (1) regular exercise (57.7%); (2) maintaining a healthy body weight (46.1%); and (3) avoiding alcohol (40.1%). The most significant COVID-19-related changes were less exercise (32.5%) and increased body weight (25.6%).

CONCLUSIONS

The awareness of cancer prevention was high, but the practice was low. Recommendations targeting awareness and practice need to be further promoted.

Summary

Korean summary
2021년 국민 암예방 인식 및 실천행태 조사에 따르면, 국민의 80%는 암이 예방 가능하다는 사실을 알고 있으나, 45%만이 암예방을 위한 건강생활을 실천하고 있음. 암예방수칙 중 가장 지키기 어려운 항목으로는 ‘운동하기’(57.7%)를 꼽았고, 그 다음으로 ‘건강체중 유지하기’(46.1%)와 ‘소량음주도 피하기’(40.1%)순으로 나타났음. 코로나19 유행으로 인한 가장 흔한 변화는 운동 감소(32.5%)와 체중 증가(25.6%)로 나타났음.

Key Message
According to the data collected from the Cancer Prevention Awareness and Practice Survey in 2021, 80% of participants knew that cancer is preventable, while 45% practiced cancer prevention. The most difficult recommendations to follow were (1) regular exercise (57.7%); (2) maintaining a healthy body weight (46.1%); and (3) avoiding alcohol (40.1%). The most significant COVID-19-related changes were less exercise (32.5%) and increased body weight (25.6%).

Citations

Citations to this article as recorded by

Risk Factors of Gastric Cancer and Lifestyle Modification for Prevention
Kwang-Pil Ko
Journal of Gastric Cancer.2024; 24(1): 99. CrossRef
Factors Affecting Adherence to National Colorectal Cancer Screening: A 12-Year Longitudinal Study Using Multi-Institutional Pooled Data in Korea
Dae Sung Kim, Jeeyoung Hong, Kihyun Ryu, Sang Hyuk Lee, Hwanhyi Cho, Jehyeong Yu, Jieun Lee, Jong-Yeup Kim
Journal of Korean Medical Science.2024;[Epub] CrossRef
Imposing stragies for health promotion fund for alcohol
Kwang Wook Koh, Hye Sook Kim, Seong Hyun Koh
Korean Journal of Health Education and Promotion.2023; 40(4): 45. CrossRef
Cancer risk based on alcohol consumption levels: a comprehensive systematic review and meta-analysis
Seunghee Jun, Hyunjin Park, Ui-Jeong Kim, Eun Jeong Choi, Hye Ah Lee, Bomi Park, Soon Young Lee, Sun Ha Jee, Hyesook Park
Epidemiology and Health.2023; 45: e2023092. CrossRef

Bacillus of Calmette and Guérin (BCG) and the risk of leprosy in Ciudad del Este, Paraguay, 2016-2017: Nancy Carolina Cuevas, Victor M. Cardenas; Epidemiol Health. 2021;43:e2021060. Published online September 8, 2021; DOI: https://doi.org/10.4178/epih.e2021060

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Abstract Summary PDF

Abstract

OBJECTIVES
Paraguay has experienced a 35% reduction in the detected incidence of leprosy during the last ten years, as the vaccination coverage against tuberculosis (Bacillus of Calmette and Guérin [BCG] vaccine) reached ≥95% among infants. The objective of this case-control study was to evaluate the protective effect of BCG on the risk of leprosy.

METHODS

We used a population-based case-control study of 20 leprosy confirmed cases reported among residents of Ciudad del Este, Paraguay, diagnosed in 2016-2017. Three controls were selected from a random sample of households from the city. We assessed vaccine effectiveness using 1- odds ratio [OR], and confounding for age, gender, education, occupation, and marital status using stratified and exact logistic regression, and explored if there was effect modification calculating the synergy factor (SF) and relative excess risk due to interaction (RERI).

RESULTS

After controlling for age, gender, education, occupation and marital status, the OR of BCG scar on the risk of leprosy was 0.10 (95% confidence interval [CI], 0.02 to 0.45), for an estimate of vaccine effectiveness of 89.5% reduced risk of leprosy (95% CI, 55.2 to 98.1). There was evidence of heterogeneity by which the effectiveness of BCG seemed stronger among younger persons (Breslow-Day and Z-test of the SF had a p<0.05), and both the RERI and SF indicated a less then multiplicative and additive interaction of BCG and younger age.

CONCLUSIONS

BCG vaccination was associated with a decreased risk of leprosy in the study population, particularly in persons born after 1980.

Summary

Key Message
Paraguay had the second highest reported incidence in the Americas, but no previous study had investigated the topic of BCG for leprosy in Paraguay. We confirmed that BCG protected from leprosy, hence it may have contributed to the observed decline of leprosy.

Citations

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BCG and SARS-CoV-2—What Have We Learned?
Jakub Kulesza, Ewelina Kulesza, Piotr Koziński, Wojciech Karpik, Marlena Broncel, Marek Fol
Vaccines.2022; 10(10): 1641. CrossRef

Factors associated with indoor smoking at home by adults across Korea: a focus on socioeconomic status: Bomgyeol Kim, Yejin Lee, Young Dae Kwon, Tae Hyun Kim, Jin Won Noh; Epidemiol Health. 2020;42:e2020067. Published online October 28, 2020; DOI: https://doi.org/10.4178/epih.e2020067

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Secondhand smoke is an issue that cannot be ignored due to its various negative effects. Especially, secondhand smoke inside the household is an area where health policy must pay attention as it can affect all age groups. This study aims to identify the factors associated with smoking inside the household focusing on socioeconomic status in Korea.

METHODS

We used data from the Community Health Survey of 2017 and a total of 33,462 participated in the study. Data were analyzed through IBM SPSS version 25.0 to conduct binary logistic regression analysis.

RESULTS

Results indicated that indoor smoking had a significant association with socioeconomic status. This association was more marked in those participants who had low household income or those with elementary school education level or less. Furthermore, the study indicates that when the smoker is a woman, older, has higher stress, and is a heavier smoker, the probability of her smoking inside the house is higher.

CONCLUSIONS

Based on the results, it is meaningful that this study has found the factors of smoking inside household. The result identify the factors associated with indoor smoking at home, and it can be used as baseline data for developing new smoking cessation policies.

Summary

Korean summary
이 연구는 가정 실내 흡연과 관련된 다양한 요인들을 파악하였으며, 소득, 교육수준과 같은 사회경제적 요인과 가정 실내 흡연의 연관성을 확인하였다. 이를 통해 가정 실내 흡연 감소를 위한 금연 정책의 근거자료로 활용될 수 있을 것으로 기대된다.

Citations

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Tobacco usage in the home: a cross-sectional analysis of heated tobacco product (HTP) use and combustible tobacco smoking in Japan, 2023
Satomi Odani, Takahiro Tabuchi
Environmental Health and Preventive Medicine.2024; 29: 11. CrossRef
Impacts of smoking ban policies on billiard halls sales in South Korea using objective sales information of a credit card company: A quasi-experimental study (Preprint)
Jin-Won Noh, Jooyoung Cheon, Hohyun Seong,, Young Dae Kwon, Ki-Bong Yoo
JMIR Public Health and Surveillance.2023;[Epub] CrossRef

Effects of a cancer prevention education program on elementary school students’ knowledge, attitude, self-efficacy, and intentions in South Korea: Su Yeon Kye, Soon-Yong Hwang, Kyung Hee Oh, Jae Kwan Jun; Epidemiol Health. 2019;41:e2019027. Published online June 16, 2019; DOI: https://doi.org/10.4178/epih.e2019027

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Abstract

OBJECTIVES
Most children and adolescents have low levels of cancer knowledge and awareness, and infrequently engage in preventive behaviors. This study examined the effects of a short classroom-based intervention for cancer prevention on knowledge, attitude toward cancer preventability, self-efficacy, and behavioral intentions of fifth-grade elementary school students.

METHODS

The study was based on a pre-post-follow-up, 2-group, quasi-experimental design. Participants in the intervention group attended two 40-minute sessions on cancer prevention education and watched a music video about cancer prevention, while participants in the control group were only exposed to the music video. Self-reported knowledge, attitude toward cancer preventability, self-efficacy, and behavioral intentions were assessed 1 week pre-intervention and post-intervention, as well as 3 months post-intervention.

RESULTS

The 3-month post-intervention results revealed partial effects, indicating that the education intervention improved knowledge and attitudes toward cancer preventability; however, no effects were observed on self-efficacy and behavioral intentions 3 months after the intervention.

CONCLUSIONS

Long-term regular booster sessions are required to improve not only social-cognitive factors, but also behavioral intentions, which could result in behavior changes promoting cancer prevention.

Summary

Korean summary
대부분의 아동과 청소년들은 암예방행동 실천을 잘 하지 못하고 있을뿐만 아니라 낮은 암지식 수준을 보인다. 본 연구는 초등학교 5학년 학생들을 대상으로 단기간의 교실 중심의 암예방중재가 지식, 암예방가능성에 대한 태도, 자기효능감, 행동의도에 미치는 영향을 살펴보았다. 사전-사후-3개월이후 추후조사의 형태로 두 집단 유사실험설계로 구성되었다. 중재집단의 참여자들은 2회의 40분으로 구성된 암예방교육에 참여하였고 암예방뮤직비디오를 시청하였다. 대조집단의 참여자들은 암예방뮤직비디오만 시청하였다. 지식, 암예방가능성에 대한 태도, 자기효능감, 행동의도가 중재전, 중재직후, 중재3개월후에 자가보고형식으로 측정되었다. 3개월 이후 추후조사에서 지식과 암예방가능성에 대한 태도가 향상되었으나, 자기효능감과 행동의도에서는 통계적으로 유의한 차이가 나타나지 않았다. 인지적 요소뿐만 아니라 행동적 요소를 변화하기 위해서는 장기간의 추가교육이 필요할 것으로 판단된다.

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Effectiveness of an Educational Program on Awareness of Breast Cancer Risk Factors, Symptoms, and Barriers to Seeking Medical Help among Adolescent Omani School Students—An Interventional Study
Khadija Al-Hosni, Moon Fai Chan, Mohammed Al-Azri
Current Oncology.2023; 30(4): 4126. CrossRef
Assessing the effectiveness of a school educational video on cancer and radiotherapy
Masanari Minamitani, Atsuto Katano, Keiichi Nakagawa
Health Education Journal.2023; 82(7): 820. CrossRef
Cognition of the warning symptoms and risk factors for cancer among Chinese college students: a cross-sectional study based on a summer social practice activity
Lin-sen Feng, Qing-li Li, Qing Yang, Yu-lu Zhu, Fu-lin Yin, Qi-yao Wang, Wen-jue Zhong, Xiao-qian Wu, Ruo-yu Yan, Zheng-jiao Dong
Annals of Medicine.2023;[Epub] CrossRef
What Children and Adolescents Know and Need to Learn about Cancer
Carol Sigelman, Imani Jami, Eleanor D’Andria
The Journal of Genetic Psychology.2022; 183(4): 294. CrossRef
The impact of a breast cancer educational intervention in Ghanaian high schools
Josephine Nsaful, Florence Dedey, Edmund Nartey, Juliana Labi, Nii Armah Adu-Aryee, Joe Nat Clegg-Lamptey
BMC Cancer.2022;[Epub] CrossRef
Human genetics education as part of the Japanese Cancer Education Comprehensive Support Project
Fumi Yamada-Kurebayashi, Motoko Sasaki, Asami Kuga, Risa Kojima, Hidehiko Miyake
Journal of Community Genetics.2022; 14(2): 163. CrossRef
The Effectiveness of Interventional Cancer Education Programs for School Students Aged 8–19 Years: a Systematic Review
Khadija Al-Hosni, Moon Fai Chan, Mohammed Al-Azri
Journal of Cancer Education.2021; 36(2): 229. CrossRef
Adolescents’ Perceptions About Cancer and Preferences for Cancer Education
Olufunmilola Abraham, Claire A. Rosenberger, Sarah M. LeMay, Sarah J. Bittner
Cancer Control.2021; 28: 107327482110360. CrossRef

Seasonality of tuberculosis in the Republic of Korea, 2006-2016: Eun Hee Kim, Jong-Myon Bae; Epidemiol Health. 2018;40:e2018051. Published online October 20, 2018; DOI: https://doi.org/10.4178/epih.e2018051

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Abstract

OBJECTIVES
While the seasonality of notified tuberculosis has been identified in several populations, there is not a descriptive epidemiological study on the seasonality of tuberculosis in Korea. This study aimed to evaluate the seasonality of tuberculosis in Korea from 2006 to 2016.

METHODS

Data regarding notified cases of tuberculosis by year and month was obtained from the Infectious Diseases Surveillance Yearbook, 2017 published by the Korea Centers for Disease Control and Prevention. Seasonal decomposition was conducted using the method of structural model of time series analysis with simple moving averages.

RESULTS

While the trough season was winter from 2006 to 2016, the peak season was summer between 2006 and 2012, but shifted to spring between 2013 and 2016.

CONCLUSIONS

Notified tuberculosis in Korea also showed seasonality. It is necessary to evaluate factors related to the seasonality of tuberculosis for controlling tuberculosis.

Summary

Korean summary
2006-2016년 신고된 신환자의 연보를 근거로 결핵발생의 계절성 여부를 분석한 결과, 2006-2012년까지는 여름, 2013년이후는 봄에 발생 신고율이 높은 계절성을 확인하였다. 계절성을 야기하는 이유들을 찾아서 향후 결핵 예방에 활용할 필요가 있다.

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Epidemiology-based wastewater monitoring for ecological risks of anti-tuberculosis drugs mixture effects
Wei-Yu Chen, Yi-Fang Chen, Jer-Min Tsai, Hsin-Mei Huang, Yong-Chao Su
Science of The Total Environment.2023; 892: 164560. CrossRef
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Predicting needlestick and sharps injuries and determining preventive strategies using a Bayesian network approach in Tehran, Iran: Hamed Akbari, Fakhradin Ghasemi, Hesam Akbari, Amir Adibzadeh; Epidemiol Health. 2018;40:e2018042. Published online August 20, 2018; DOI: https://doi.org/10.4178/epih.e2018042

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Abstract PDF Supplementary Material

Abstract

OBJECTIVES
Recent studies have shown that the rate of needlestick and sharps injuries (NSIs) is unacceptably high in Iranian hospitals. The aim of the present study was to use a systematic approach to predict and reduce these injuries.

METHODS

This cross-sectional study was conducted in 5 hospitals in Tehran, Iran. Eleven variables thought to affect NSIs were categorized based on the Human Factors Analysis and Classification System (HFACS) framework and modeled using a Bayesian network. A self-administered validated questionnaire was used to collect the required data. In total, 343 cases were used to train the model and 50 cases were used to test the model. Model performance was assessed using various indices. Finally, using predictive reasoning, several intervention strategies for reducing NSIs were recommended.

RESULTS

The Bayesian network HFACS model was able to predict 86% of new cases correctly. The analyses showed that safety motivation and fatigue were the most important contributors to NSIs. Supervisors’ attitude toward safety and working hours per week were the most important factors in the unsafe supervision category. Management commitment and staffing were the most important organizational-level factors affecting NSIs. Finally, promising intervention strategies for reducing NSIs were identified and discussed.

CONCLUSIONS

To reduce NSIs, both management commitment and sufficient staffing are necessary. Supervisors should encourage nurses to engage in safe behavior. Excessive working hours result in fatigue and increase the risk of NSIs.

Summary

Citations

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Perspective

Vitamin D supplementation as a control program against latent tuberculosis infection in Korean high school students: Eun Hee Kim, Jong-Myon Bae; Epidemiol Health. 2018;40:e2018035. Published online July 27, 2018; DOI: https://doi.org/10.4178/epih.e2018035

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Abstract Summary PDF Supplementary Material

Abstract

The prevalence of latnet Mycobacterium tuberculosis infection (LTBI) in the first-grade high school students in South Korea was 2.1%, which was the lowest level at congregated settings in 2017. For LTBI cases refusing anti-tuberculosis (TB) medication or having poor compliance, additional support should be considered. Eight systematic reviews concluded that vitamin D (VD) deficiency is a risk factor for TB. While three of four South Korean adolescents were VD deficiency, VD supplementation could be a practical remedy to protect LTBI students of refusing anti-TB medication or having poor compliance.

Summary

Korean summary
잠복결핵검진 검사 양성자이면서 항결핵제 복용을 거부하는 고1학생에 대한 사후 조치가 필요하다. 그동안의 연구결과들에 근거할 때, 잠복결핵이 활동성결핵으로의 전환을 억제하기 위해서 비타민 D 보충제의 투여를 검토해 볼 수 있다.

Citations

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Vitamin D and the risk of latent tuberculosis infection: a systematic review and meta-analysis
Yan Cao, Xinjing Wang, Ping Liu, Yue Su, Haotian Yu, Jingli Du
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Association of vitamin D levels and risk of latent tuberculosis in the hemodialysis population
Shang-Yi Lin, Yi-Wen Chiu, Hui-Ru Yang, Tun-Chieh Chen, Min-Han Hsieh, Wen-Hung Wang, Yen-Hsu Chen
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Tuberculosis risk is associated with genetic polymorphisms in the LRP2, CUBN, and VDR genes
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Original Article

Infectious disease-related laws: prevention and control measures: Mijeong Park; Epidemiol Health. 2017;39:e2017033. Published online July 25, 2017; DOI: https://doi.org/10.4178/epih.e2017033

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study examines recently revised Korean government legislation addressing global infectious disease control for public health emergency situations, with the aim of proposing more rational, effective and realistic interpretations and applications for improvement of law.

METHODS

The Korea reported its first laboratory-confirmed case of Middle East Respiratory Syndrome (MERS) coronavirus on May 20, 2015. Since the first indexed case, Korean public health authorities enforced many public health measures that were not authorized in the law; the scope of the current law was too limited to cover MERS. Korea has three levels of government: the central government, special self-governing provinces, and si/gun/gu. Unfortunately, the Infectious Disease Control and Prevention Act does not designate the specific roles of each level of government, and does not state how these governmental branches should be vertically integrated in a state of emergency.

RESULTS

When thinking about these policy questions, we should be especially concerned about introducing a new act that deals with all matters relevant to emerging infectious diseases. The aim would be to develop a structure that specifies the roles of each level of government, and facilitates the close collaboration among them, then enacting this in law for the prevention and response of infectious disease.

CONCLUSIONS

To address this problem, after analyzing the national healthcare infrastructure along with the characteristics of emerging infectious diseases, we propose the revision of the relevant law(s) in terms of governance aspects, emergency medical countermeasure aspects, and the human rights aspect.

Summary

Korean summary
본 연구의 목적은 2015년 메르스 발생 후, 감염병의 예방 및 관리에 관한 법률의 입법경과를 검토하여 감염병으로 인한 공중보건위기 대응과 관련된 법률의 보다 구체적인 개선방안을 제시하는 것이다. 중앙정부와 지자체의 협력을 위한 거버넌스, 응급상황에서의 긴급의약품 제공을 위한 절차, 격리 대상자의 인권보장과 관련된 부분의 충분한 법적 상당성을 갖추기 위해 국가 보건의료체계 하부구조 측면에서 문제점을 분석한 후 법률 개정방안을 제언하였다.

Citations

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Ning Wang, Long Zhang, Zhidong Teng
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Soyeoun Kim, Jinhyun Kim, Bo Youl Choi, Boyoung Park
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Spatial autocorrelation may bias the risk estimation: An application of eigenvector spatial filtering on the risk of air pollutant on asthma
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Interorganizational Coordination and Collaboration During the 2015 MERS-CoV Response in South Korea
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An Epidemiologic Study on the Leptospiral Infection in the Period of an Anticipated Epidemic: Bo Youl Choi, Dae Eun Chung, Soo Jin Lee, Hung-Bae Park, Jeoung Bae Park, Kyung Hee Lee, Jeong Soon Kim; Korean J Epidemiol. 1992;14(1):91-101. Published online June 30, 1992

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Abstract PDF: Abstract
A large epidemic of leptospirosis was anticipated in September 1990 because flood has resulted the heavy rain for 4 consecutive days from the 8th of September, 1990, in the Yang-pyeung Gun (Country), a farm area of Central Korea. Actually, patients were already appearing sporadically soon after the flood. Soldiers of ROK Army units stationed in this area were under the higher risk since many of them participated in field works (such as tieing rice plant fallen by the flood) as a part of Civil Aid Plan. The objectives of this study were 1) to detect infected ones at early stage 2) to estimate the attack rates of infection and apparent infection through serologic examinations, 3) to estimate pathogenecity and case-fatality rate and 4) to compare the rates of infection by the type of work and the use of protective devices. All of those with febrile episode were interviewed and the leptospiral antibody was examined during the one month period after the field work. Serologic examinations (including the interview) were done twice with 1 week interval (first on 8th to 10th of October, about 4 weeks following the days of field work) for 446 soldiers belong to three companies stationed in the country area. The serologic test (Microscopic agglutination test) were performed with 4 strains. Icterohemorrhagiae lai and Canicola canicola Hond Utrecht IV as standard strains, and 6P-049-1 and YP-35-1 as strains isolated in Korea in 1986, in accordance with WHO guideline. The results are as follows. 1. Among 57 febrile, suspected cases, 37 had serological tests twice and, 20 of them (54.1%) were serologically confirmed to be infected whereas among other 20 subjects who had single serological test, only 2 persons (10.0%) were serologically positive. 2. The dates of onset of fever in confirmed cases were clustered in 10 to 20 days from late September to early October, which coincided well with the duration of exposure (Sep. 13-18). 3. The attack rate of infection and apparent infection were estimated to be 11.2% (95% C. I. ; 8.3-14.1%), 1.8% (95% C. I. ; 0.7-3.1%). Pathogenecity and case-fatality rate were estimated to be 16.0% (95% C. I. ; 6.0-26.0%) and 0%, respectively. 4. The attack rate of infection of persons who worked in rice paddy for 3-6 days, for 1-2 days and participated in other field work were 3.5, 2.7 and 2.1 time high respectively as high as that of persons who did not join in field work (p<0.05). 5. The effectiveness of protective devices shown in this study was rater poor; perhaps the preparation of the protective devices was not sufficient because the mobilization of army is usually a sudden order. For more satisfactory prevention in the future, a complete clothing (including glove and boots) and chemoprophyaxis (with doxycycline) are recommended.; Summary

Original Articles

International Cooperation in the Control and Prevention of Emerging and Reemerging Infectious Diseases.: Hae Kwan Cheong; Korean J Epidemiol. 2006;28(1):85-91.

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Abstract PDF: Abstract
This paper discusses the recent increase in the incidence of emerging and reemerging infectious diseases and the role of international cooperation in coping with such public health threats. The historical background and its evolution are reviewed and the need, advantages, and possible areas of international cooperation are presented. A current example and model of international cooperation at various levels is described. Finally, two of the main issues in the process of international cooperation are discussed: the ethical aspect of scientific communication and national interest, and intellectual property issues.; Summary

Epidemiologic Transition of Communicable Diseases in Korea: Academia's Contributions to the National Communicable Disease Prevention and Control Programs.: Joung Soon Kim, Hae Kwan Cheong; Korean J Epidemiol. 2006;28(1):4-21.

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Abstract PDF: Abstract
This paper describes the transition of communicable diseases in Korea since 1970s. Some of Korean's general living background and health indicators are introduced, followed by trends in the changes during the last several decades in socioeconomic, demographic, and living environmental status, which are closely associated with the transition of communicable diseases. The current incidence of classified, notifiable disease, the incidence by year, and the transition of communicable diseases are presented. Governmental responses to prevent and control communicable diseases, including both emerging and re-emerging infectious diseases, which have become recognized as having public health importance are described. Finally, the role played by academia during the last several decades in the successful control of communicable diseases is analyzed.; Summary

Accidents Status of Freshmen for 2 Months before Entrance University.: Young Sun Min, Hyun Sul Lim; Korean J Epidemiol. 2005;27(1):173-181.

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Abstract PDF: Abstract
OBJECTIVES
In recent years, Korea has experienced a loss of manpower and economy due to accidents. The consequences have been comprehensive. Nevertheless, there have been few recent Korean studies on adult accidents. Therefore, this study was carried out to examine the incidence pattern of accidents for 2 months before entering university among university freshmen.
METHODS
The subjects were 1,920 university freshmen who visited the university health center for health examination from March 8 to 12, 2004, and self-reported questionnaire was given to the subjects. The authors developed a questionnaire including age, gender, place and type of high school, experience of accidents, occurrence time and type of accidents and so on.
RESULTS
The monthly incidence of accident was 9.9 per 1,000 population. The accident cases were 28 in male and 10 in female, and the incidence of males was significantly higher than females. The frequent accident states were 15 cases in 'Ordinary life' (39.8%), 10 in 'Sports activities' (26.3%), 9 in 'Walking' (23.7%) and so on. The accident types were 13 cases of 'Tumbling over' (34.2%), 12 of 'Crash' (31.6%), 8 of 'Traffic accident' (21.0%) and so on. The frequent injury types were 19 cases of 'Sprain' (50.0%), 15 of 'Contusion' (38.4%) and 2 of 'Laceration' (5.3%). One's own carelessness was the most frequent cause of accident (65.8%). After the accident, 28 cases(73.7%) visited the hospital, 7 (18.4%) were hospitalized, and 3 (7.9%) underwent surgery.
CONCLUSIONS
Because the most frequent cause of accidents was one's own carelessness, self-consciousness and attention are needed. The authors expect that this study will go far toward increasing concern of researchers and administrators for the accidents among adults.; Summary

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