Epidemiology and Health

Volume 13 (2); December 1991

Original Articles

Quality of life and cardiovascular diseases in F.R. Germany: a social epidemiological study on life satisfaction behavior.: De Hi Kim, Kyung Kyoon Chung; Korean J Epidemiol. 1991;13(2):204-214.

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Seven variables of Life Satisfaction Index are as follows: work situation, living situation, financial situation, free time, health, familiar (family) situation, and relation to friends. Each variable takes the face scale of 1 through 7 points. The linear equation of the life satisfaction factor is as follows : FSz = (0.22095) * XS1Z + (0.21162) * XS2Z + (021152) * XS3Z + (0.19820) * XS4Z (0.16394) * XS5z + (0.23220) * XS6Z - (0.23366) *XS7Z FSz : Factor score in case z ; XSiZ : Standardized score of variable i in case z. The Standardized "London School of Hygiene Cardiovascular Questionnaire" (symptom questionnaire) was used in order to discriminate the angina pectoris group from the no angina pectoris group, to distinguish the angina grade 1 group from the angina grade 2 group, and to tell the possible infarction group from the no infarction group. The results of the study are as follows : 1) There is a significant difference between the possible infarction group and the no infarction group in every life satisfaction variable. (p<0.001) 2) There is a significant difference between the angina pectoris group and the no angina pectoris group in every life satisfaction variable. (p<0.001 ; p<0.05) 3) There is a significant difference between the angina pectoris grade 1 group and the angina pectoris grade 2 group in every life satisfaction variable. (p<0.001 : p<0.05) 4) There is a significant difference between the possible infarction group and the no infarction group in life satisfaction factor. (p<0.001) 5) There is a significant difference between the angina pectoris group and the no angina pectoris group in life satisfaction factor. (p<0.05) 6) There is a significant difference between the angina pectoris grade 1 group and the angina pectoris grade 2 group in life satisfaction factor. (p<0.001); Summary

A rural health study through screening approaches.: Gil Soo Son, Yong Tae Yum, Soung Hoon Chang; Korean J Epidemiol. 1991;13(2):197-203.

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Screening deseases for community health is the search for previously unrecognized diseases or physiologic conditions whether they are caused or influenced by work-associated factors or not. In Korea it has been of a large-scale prevention effort by employers of which industries hired more than 5 workers each. Screening results may be useful in a surveillance system to be analyzed epidemiologically for the protection of the community people both living in rural and urban areas. However, the safety and health law for industry of Korea excluded rural people from target of screening. Unique way to cope with is approaching for research purpose of selected study areas in terms of pilot primary health care programs. In this study, a total of 4,500 rural people who were living in Yeoju Kun, Kyonggi Province are selected as research target people asking to participate in screening test. Of them, the total of 2,753 persons participated in the screening tests and interview. The results were as follows. 1. Examinee consisted of 45.8% of male and 54.2% of female where as standard population showed 49.6 v/s 50.4. 2. Highest participation rate of 18.7% was shown in the 50~54 age group. However, participation rate ratio of 2.93 was shown in the age group of 55~59. 3. The highest participation rate ratio by educational level was shown in primary school group and in order of no education, middle school and high school group. 4. Most of participation (80.7%) were aggriculture group whereas rate ratio was highest (2.70) in employee including simple labourers. 5. Motivation of participation was to confirm their health in 40.1% and rest of them was to check their bad or ill health. 6. Most of participation (94.9%) expressed the regular check-up (screening) would be necessary. 7. According to the screening tests 20.9% of hypertensives, 7.8% of hearing defect, 1.4% of positive urine sugar, 11.4% of abnormally high sugar level in blood, 0.1% of positive urine protein, about 2% of abnormal liver function tests, 5.0% of positive HBsAg, 13.6% of Anti-HBs and 2.5% of active lung tuberculosis were detected.; Summary

A survey on the factors associated with low back pain in rural women.: Jung Rak Kim, Myeong Ryeol Yoon, Dae Yong Hong, Han Woo Lee, Sung Hak Park, Jong Young Lee, Moo Sik Lee; Korean J Epidemiol. 1991;13(2):185-196.

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To examine the associated factors with low back in rural women, public health doctors interviewed with each woman who had been seen in 12 branches of the health center in the vicinity of Chinju in Gyeongnam Province from August 1 to September 15, 1991. The results were as follows: 1. 66% of 391 study subjects reported an episode of low back pain during recent 6 months. In simple analysis low back pain was significantly associated with age, educational level, number of children, low back pain experience after delivery, abortion, farming, work posture and heavy materials lifting. 2. In multiple logistic regression to control confounding effects by interrelated independent variables, low back pain was significantly associated with low back pain experience after delivery (odds ratio=2.18), work posture (odds ratio=2.42) and heavy materials lifting (odds ratio=2.37) 3. Acute low back pain (defined as low back pain which occurred for the first time in the past 6 months) was significantly associated with only one variable i.e. heavy materials lifting (odds ratio=3.09). 4. Recurrent low back pain (defined as low back pain which recurred in recent 6 months) was significantly associated with low back pain experience after delivery (odds ratio=5.44), work posture (odds ratio=3.00) and heavy materials lifting (odds ratio=8.71). 5. Chronic low back pain (defined as low back pain which had persisted for more than 6 months) was significantly associated with number of children (odds ratio=1.42), back pain experience after delivery (odds ratio=2.26), abortion (odds ratio=2.05) and work posture (odds ratio=5.59).; Summary

A study on leptospiral infection status and biological characteristics of the strains isolated from wild rats in some areas of Korea.: Seon Il Park, Joung Soon Kim; Korean J Epidemiol. 1991;13(2):169-184.

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In order to study Leptospiral infection status and biological characteristics of the strains isolated from wild rats, a total of 34 wild rats were captured alive from three locations including Hwasung-gun, Yangju-gun and Seoul city during the period of four months from the December 1990 to the March 1991. Rodents were anesthetisized with ether, blood was taken from heart puncture and then autopsied. Blood and kidney specimens were inoculated into tubes of EMJH semisolid medium and incubated at 30°C for six weeks. These cultures were examined 6 times by dark field microscopy at weekly intervals. Serogroup and serovar of isolates were identified by micro-agglutination test and cross-agglutination absorption test Lung, liver and kidney were sectioned with a sharp scalpel and touch printed on slide glasses and then silver-stained. Blood specimens were allowed to clot and sera were collected for serologic test. These procedures were necessary to see the distribution of Leptospira by tissues and antibody titer as the length of infection gets longer. Pathogenicity test and horizontal infection test were also carried out on Guinea pigs and mice with the strains isolated. The summarized results are as followings : 1. Kidney tissue and blood sample from 34 rats were cultured for Leptospira and four(11.8%) strains were isolated. All strains belonged to Leptospira interrogans Icterohemorrhagiae serogroutp 1 out of 1 Apodemus agrarius, 2 out of 10 Rattus rattus, 1 out of 16 Rattus norvegicus, none out of 7 Mus musculus. Of 4 isolates, cultured H-9 was identified as Serogroup Icterohemorrhagiae serovar lai. 2. Leptospiras were seen in 8 of 34 (23.5%) silver-stained kidney sections, 5 in lung sections (14.7%), and 4 in liver sections (11.8%) 3. All strains isolated were Gram negative, resistant to 5-FU, sensitive to 8-Azaguanine, spherical conversion in 1 M NaCl ; typical Leptospiras with hook in E.M. were observed These strains did not grow in 13℃ culture temperature. Thus all strains demonstrated Leptospim interrogans characteristics. 4. The overall Leptospira seropositive rate was 20.6% (7 samples/ in 34 blood of wild rats. Of 7 seropositive rat sera, 3 (8.8%) were positive for L. Icterohemorrhagiae, 2 (5.9%) for 87M-67 (local lai), one showed cross reaction between L. Sejroe and L. Bataviae. 5. As Guinea pigs and mice were inoculated intraperitoneally with 1 ml of 7 day old culture containing approximately 2 x 108org/ml of Y-2 isolated strain, massive hemorrhage and inflammatory cell infiltration (lymphocyte, plasma cell,) were major pathological findings in heimatoxylin-eosin stained sections. LD50 by probit analysis was 1.87 x 1011 org/ml [y(probit)=-13.530+1.644 Log x] and horizontal infection between mice was confirmed. 6. Leptospires were seen in blood of experimental animals at 24 hours after experimental inoculation and they disappeared around 288 hours. Leptospires were observed in liver first and then in all organs by 4 days after experimental infection. 7. Antibody was detectable in 2 days after the experimental infection and then increased gradually. Although the titer dropped incidentally to 1 : 20 at 6 days after infection, relatively high titer was maintained from 12 days of infection. Key words : Leptospira, wild rat isolation, serology, histopathology.; Summary

Out-patient visits for respiratory diseases and yellow sand phenomena.: Seok Lee, Young Wook Lim, Yong Chung; Korean J Epidemiol. 1991;13(2):159-168.

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This study was performed to assessed the association between out-patients visits for respiratory diseases(ICD 460-493) and Yellow sand phenomena by the proportion of out-patient visits for respiratory disease to all diseases in three clinical departments - internal medicine, paediatrics, ENT. The proportin was acquired by analysing one data sets ; comparison among pre-Yellow sand phenomena period, Yellow sand phenomena period and post-Yellow sand phenomena period in 1988. The number of subjects of the comparison among periods were 6,793 out-patients in 1988 from one hospital in Seoul during 5 weeks, the first week being the period of pre-Yellow sand phenomena (4.11-4.16), the second week, Yellow sand phenomena (4.8-4.23), the third week, post-Yellow sand phenomena stage 1(4.25-4.30), the forth week, post-Yellow sand phenomena stage 2(5.2-5.7), and the fifth week, post-Yollow sand phenomena stage 3(5.9-514). The results of this study were as follows ; 1. The proportions of out-patient visits for respiratory disease to total visits were 11.6% during pre-Yellow sand phenomena period, 19.8% in Yellow sand phenomena period, 16.6% in post-Yellow sand phenomena period 1, 21.4% in post-Yellow sand phenomena period 2, and 11.8% in post-Yellow sand phenomena period 3. In the periodical comparison, the most frequent disease was acute upper respiratory infections of multiple or unspecified site (ICD 465) during all periods, and the change in the proportions of that disease by period was the same as the change in the ratios of total respiratory diseases. 2. The ratio of out-patient visits by men to those by women during all periods was 1.3, but the ratio was reversed in period of Yellow sand phenomena and post-Yellow sand phenomena period 1 and 2. 3. Susceptable age groups, who showed an increase in out-patient visits for respiratory disease during Yellow sand phenomena were ages of 0-9 and ages of 50 or over. In these age groups, the proportions of out-patient visits for respiratory disease to total visits in the periods of Yellow sand phenomena and post-Yellow sand phenomena period 1 and 2 were 1.5-1.7 times the proportions in the period of pre-Yellow sand phenomena. This study has some limitations. Instead of the number of incidences of respiratory disease, out-patient visits were used for the analysis. The interpretations of results might be limited in consideration of the differences between medical care utilization and incidences of respiratory disease. The proportion of out-patient visits for respiatory disease to total visits was increased by the Yellow sand phenonmena. However this study could not definitely conclude that Yellow sand phenomena had a direct relationship with increasing incidence of respiratory diseases.; Summary

A survey on prevalence of smoking and knowledge and attitude towardsmoking in female industrial workers.: Soon Ok Choi, Jung Han Park; Korean J Epidemiol. 1991;13(2):146-158.

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To define the prevalence of smokers among the female industrial workers and their knowledge and attitude toward smoking, a self-administered questionnaire survey was conducted on 1,478 female workers of six electric and textile manufacturing industries in Gumi Industrial Complex in May-June, 1990. Of the 1,388 workers who completed the questionnaire. 7.3% was current smokers and 4.5% was exsmokers. The prevalence of smoker increased with age. The prevalence of smoker was higher in the married workers than in the single women, in the workers living with their family than in those at the domitory, and in the primary school or college graduates than in the middle or high school graduates. Such differential prevalence rates, however, was attributed to the increased prevalence of smokers with age. Regarding the health effect of smoking, 91.7% of the non-smokers answered that it is harmful while 54.4% of the current smokers answered so. About three quarters of the respondents regarded the nicotine harmful but most of them answered that tar, carbonmonoxide, and other chemical materials are not harmful. Eighty percent of the respondents acknowledged the harmful effects of smoking on the respiratory disease but only about 30% acknowledged the harmful effects on the gastric and duodenal ulcer, heart disease and liver disease. The percentage of the respondents who believed that the smoking lowers the brain function was 85.5% among the non-smokers and 63.4% among the smokers. The percentage of the respondents who approved the harmful effect of passive smoking was 96.2% among the non-smokers and 85.1% among the smokers. Also 94.3% of the non-smokers approved the fact that smoking during the pregnancy is very harmful to fetus and 70.3% of the smokers approved the fact. One quarter of the current smokers have had education for anti-smoking and 60% of the women who had anti-smoking education strongly supported the necessity of such education. Among all the study subjects, 62.5% wanted to make the smokers stop smoking through anti-smoking education, 17.1% wanted to arrange smoking rooms, and 13.6% wanted to prohibit smoking at the workplaces. Such findings as many of the respondents had no accurate knowledge about the health effects of smoking and many of them demanded the anti-smoking education suggest that the anti-smoking education program is needed for the working women.; Summary

Cholera in Korea, 1991: models of transmission.: Han Joong Kim, Il Suh, Hee Choul Oh, Kyoo Sang Kim, Sun Ha Jee, Soon Young Lee, Sun Hee Lee; Korean J Epidemiol. 1991;13(2):123-139.

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In August-September 1991，Korea had a cholera epidemic caused by Vibrio El Tor Ogawa with 92 bacteriologically confirmed cases and 8 deaths. Seochun-gun Choongnam, Kunsan-si and Okgu-gun Chunbuk area, which are located near the mid-west coast of the country, were mainly affected. Vibrio cholerae were isolated from sewage water, sea water, squid and shell-fish tested during the epidemic, and an epidemiologic study found that consumption of raw shellfish or fish was the most probable source of cholera infection. Vibrio cholerae were thought to have spread from foreign countries and there were some evidence that an environmental reservoir of cholera might play a role in the transmission of cholera in this epidemic.; Summary

Epidemiological characteristics of cholera epidemic in Korea, 1991.: Hee Choul Oh, Jong Ku Park, Mook Shik Kim, Kyoo Sang Kim, Sun Ha Jee, Soon Young Lee, Sun Hee Lee; Korean J Epidemiol. 1991;13(2):112-122.

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From July 30th through September 9th, 1991, 188 cases of cholera were reported throughout most provinces in Korea. Of the cases 92 were bacteriologically confirmed and 96 were diagnosed by clinical symptoms. Through screening of the cholera epidemic area residents 58 inapparent infections were discovered and 8 deaths occurred. A population interview survey was conducted to the people inhabiting the five villages at the two epidemic foci, Sochon and Okgu. Other various information sources such as reported cases to health centers or quarantine stations, medical records of some hospitals, and laboratory findings of National Institute of Health were used to describe the cholera epidemic. Data from these sources were rearranged and analysed on an individual bases. Epidemiological characteristics of the 1991 cholera epidemic of Korea are as follows: 1. Vibrio cholerae biotype El Tor, sero type Ogawa was the causitive agent. 2. The epidemic duration was 25 days from August 13th to September 7th. 3. Epidemiological investigation of the two epidemic foci-Sochon, and Okgu counties-in the west coastal regions of the Korean penisula-revealed that 155 cases occurred in explosive outbreaks amounting to 82.5% of the total 188 noted cholera cases. 4. The epidemic curve of the 1991 cholera epidemic showed that of a typical point-source outbreak suggesting that there were few secondary infected cases. 5. Lower incidence rates among younger age groups and higher incidence rates among older age groups were noted. These findings support that this cholera outbreak was epidemic not endemic. These findings suggest that epidemiological characteristecs of the 1991 cholera epidemic differ from those of 1980 or before, in number of patients, duration of epidemic and the epidemic curve pattern. The authors suspect that improved national and personal hygiene might explain the difference.; Summary

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