Epidemiology and Health

Volume 15 (2); December 1993

Original Articles

Chromosome aberration and glutathio -S- transferase activitiy in peripheral lymphocytes of workers exposed to ethylene oxide.: Jin Sook Kim, Sung Eun Lee, Hai Won Chung; Korean J Epidemiol. ;15(2):212-221.

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This study was undertaken to compare the frequency of chromosome aberrations and Glutathion -S- Transferase activity in peripheral lymphocytes between workers exposed to ethylene oxide and control group. Chromosome aberrations were analyzed in 200cells per sample after culture for 48-51hrs. The results obtained were as follows: 1. The overall frequencies of cells with chromosome aberration were 1.8% in the exposed group and 0.9% in the control group. And the overall level of GST activity was 8.39 I.U in the exposed group and 7.99 I.U in the control group. 2. In the control group, It was found that significant increase in chromosome aberrations was associated with increasing age, but GST activity was not correlated with age. 3. For the exposed group, significant increase in chromosome aberration was observed among the workers working under poor ventilation compared to those under good ventilation. The frequencies of cells with chromosome aberration were 1.3% among the workers under good ventilation, 2.0% under poor ventilation and 2.7% under no ventilation. GST activity was not, however, correlated with the types of ventilation of the working environment. From above results, it is suggested that the exposure to ethylene oxide increased the frequency of chromosome aberration and the level of GST activity, but there was no significant correlation between the frequency of chromosome aberration and level of GST activity.; Summary

A study on prevalence rate and related risk factors for house wive's low back pain.: Tea Yeal Kim, Chul Hyun Nam; Korean J Epidemiol. ;15(2):196-211.

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The purpose of the study is to find out the prevalence rate and main contributing factors for house wive's low back pain and to develope educational programs, to improve working environment and to provide the necessary basic materials for prevention and rehabilitation program of the low back pain. The subjects of study were reside in small-medium sized cities of Pohang, Kyung Ju, Young Chun in Kyung Pook Province. The subjects of 1,500 house wives whose children are registered to respective schools of kindergarten, elementary schools, middle schools and high schools. The study was conducted during April/26/1993 to May/10/1993. The analysis of survey based on relatively good quality response by 950. The results of the study summerized are as follows : 1. Among 950 subjects, the largest age group were 30-34, 48.8%, the weight were 50~54Kg, 32.8% and the height were 160-164cm, 49.5%. Among 950 subjects, educationally, graduate from high school were 51.2% ； the largest group. Also in economic state, the middle class were 70.3%, age of marriage were younger than 24 years old, 50.8% and number of family of 3-4 were 78.0%. 2. Among 950 subjects, the prevalence rate of low back pain showed 46.5%, premarital low back pain experience consist of 15.6%, postmarital low back pain was 70.6%. 3. In relation of general characteristics and low back pain prevalence, the age, age of marriage and number of family showed no significance but education, economics and lenght of marriage were highly significant (p<0.01). 5. In relation of house working environment and low back pain prevalence, much time cousuming house work, most difficult task house work, method of house cleaning and laundry were not significant but method of child carryring, degree of house work sharing were statistically significant (p<0.05). There were highly significant with repetitive trunk rotation and forward bending, lifting and handling during house work (p<0.01). 6. In relation of obstetric and gynecology factors and low back pain prevalence, number of child birth and method of child birth were not significant but statistically significant to amount of house work during pregnancy and highly significant The cause of low back pain consist of 28.0% unknown, 18.1% claim of long period of working with squatting position, 15.6% claim long period of work with stoop position. The type of low back pain symptom among present low back pain group consistent of 83.7% are low back pain only, 44.3% and 38.5% have distal and proximal radiating pain respectively and 21.0% felt weakness to lower extremities. Among the present low back pain group, 76.9% have experience of treatment, in that 47.5% low back pain medical information gained through friends high risk factors by biological, house and house-work environment. Therefore, regard to the house wive’s low back pain, proper prevention and management, house and house-work environment should be considered in ergonomic view point of architecture for work position. House wive’s low back pain are mostly due to female physiologic characteristics such as menstruction, pregnancy, child birth and related factors and psychologic factors as well. The continuous research is needed for many interesting issues of house wive’s low back pain in new future.; Summary

An epidemiologic survey on cancer epidemic at pukcheju-gun.: Yoon Ok Ahn, Byung Joo Park, Jong Myon Bae, Duk Hyung Lee, Dong Jin Kim, Jun Hwan Kim, Jong Won Kang, Yong Jin Jung, Dong Mo Rhie; Korean J Epidemiol. ;15(2):185-195.

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According to a newspaper account for the epidemic occurrence of cancer patients at an area of Pukcheju-gun, epidemic survey was conducted to identify the epidemicity and possible cause of the cancer epidemic from Sep. 23, 1993 to Sep. 28, 1993. Housefold survey for identifying prevalent There was no female cancer cases, no temporal dusting pattern of cancer occurrence and no clustering of specific types of cancer. In the evaluation of ground water and sea water, carcinogenic substances were not detected. According to the above evidences, it was difficult to confirm that there was an epidemic occurrence of cancer at the area. And the possibility of the association of environmental carcinogenic factors with the cancer occurrence seemed to be very low.; Summary

A study on the positive rate of rubella antibody and the sero-conversion rate after rubella vaccination.: Young Jeon Choi, Hung Bae Park, Young Jeon Shin, Bae Joong Yoon, Joong Surk Hahn; Korean J Epidemiol. ;15(2):173-184.

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Rubella is a viral disease in childhood. Its clinical manifestations are nonspecific and not serious. Rubella was not interested until Gregg noted that rubella infection in early pregnancy could lead to a congenital cataract, in 1941. Gregg's report gave the impetus of many investigations. They proved that rubella lead to various congenital defects, such as, heart defect, deafness, mental retardation, etc.. It was called ‘Congenital rubella syndrome’. Live-attenuated rubella vaccines were developed and licensed in United State and United Kingdom in 1969. However, nationwide vaccination pregram in Korea did not begin until the early 1980s. This study was carried out 1) to obtain positive rate of rubella antibody among female students who were target population of British type vaccination program, 2) to estimate sero-conversion rate after rubella vaccination. Study population was 1st grade students(1,190persons) of 9 girls' high schools in Gyenggi-Do, and they were not target population of MMR (mealses, mumps, rubella) vaccination program, The rubella antibody, Im-munoglobulin G, was measured by ELISA (Enzyme-Linked Immunosorbent Assay； Robzyme®, Abott) The results were summarized as follows 1. Positive rate among 1,008 female, students who didn't have past history of rubella vaccination was 83.1% (838/1,008) and there were no significant differences according to age, residential area (rural area/city area/mixed area) and socioeconomic status (p>0.05). 2. Vaccinations were applied to 171 sero-negative students in initial antibody test. In second test, sero-conversion rate was 94.7% (162/171). Second vaccination and 3rd sero-logic test were given to 9 students, who were negative in the second test after 1st vaccination. Among them, only 4 students (44.4%) got immunity, and their Rubazyme indicies as a indicator of antibody titer were lower than that of students antibodies were converted to positive after 1st vaccination. 3. Among 172 vaccinees, 17 persons (9.9%) were suffered from mild and transient side effects. These results suggested that the British type vaccination program be required in girls aged 10-14 years who didn't take MMR. Effectiveness of vaccine used in this study was confirmed because of it’s high sero-conversion rate and minimal side effects.; Summary

Avoidable' causes of death in Korea 1982-1991.: Yun Mi Song, Chang Yup Kim; Korean J Epidemiol. ;15(2):160-172.

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For the basic study of the impact of qulaity of health care services on the health status of population, mortality from potentially avoidable causes of death in Korea for the period of 1982-1991 was analyzed, based on a list which was revised from the original version by Rutstein et al(1976). The conditions listed were suggested to serve as negative indicatiors of the quality care services provided to target populations. Data for analysis were from the Annual Report on the Causes of Death Statistics 1982-1991 by the Korea National Statistical Office. In 1991, 24.9% of death were classified as avoidable. There was large decline for avoidable causes of death by 37.4% of 1982. Mortality from all other causes, however, showed a smaller decline of 24.6%. Mortality from avoidable causes decreased more remarkably for male than female. As for age groups, decrease in avoidable deaths was more prominent than unavoidable deaths in the population of age more than 65 years, while in younger age groups deaths due to unavoidable causes were more sharply decreased. The most rapidly declined cause of mortality was acute respiratory disease, and nutritional deficiency, pneumonia and influenza, meningitis, and hypertension showed similar decreasing tendencies. Among causes, mortality from epilepsy and rheumatic diseases was not so markedly lessened. In Korea, compared to other developed countries, the rate of decrease in deaths from avoidable causes was rather lower. Additional analyses, however, should be performed for more valid information on the features of mortality patterns, offer validation of existing mortaling data. In the consecutive studies, the change of health services factors would be correlated with mortality changes.; Summary

Spouse concordance of plasma cholesterol, blood pressure and body mass index.: Yun Mi Song, Jung Soon Kim; Korean J Epidemiol. ;15(2):149-159.

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To know the role of environmental factors upon the blood concordance for those factors. 20-29 years. And it was highest and significant for the spouse pairs married over 30 years 2. Concordance for hypertension was significantly positive for spouse pairs. Degree of concordance increased with the increase of the duration of marriage except for the spouse pairs married over 30 years. And it was highest and significant for the spouse pairs married for 10-29 years. 3. Concordance for body mass index was significantly positive (P<0.05) for spouse pairs. Degree of concordance increased with the increase of the duration of marriage except for the spouse pairs married over 30 years. And it was highest and significant for the spouse pairs married for 20-29 years. The data presented here suggested some environmental effect on serum cholesterol, blood pressure and obesity, although it was very little and appeared after long period.; Summary

Relation of long-term weight change to risk factors for coronary artery disease.: Sung Kook Lee, Byung Yeol Chun, Kyung Min Park, Yun Kyeong Rho, Jin Wouk Jeong, Min Hae Yeh; Korean J Epidemiol. ;15(2):132-148.

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This study was conducted to examine the relation of long-term weight change to the risk factors for coronary artery idsease. The study subjects included 592 healthy male workers in a steel company in Kyungpook province who were employed between 1971 and 1978 and whose age was between 23 and 29 years old at the time of employment. In this study, healthy worker was defined as a man with normal body weight (90%≤ideal body weight<110%), [ideal body weight=(individual height in cm-100)x0.9], no sugar no protein in urine, (m and) systolic blood pressure (SBP)<140mmHg and diastolic blood pressure (DBF)<90mmHg. Between July 2 and September 30, 1992, all of the study subjects were tested for serum lipid [cholesterol (TC), triglyceride (TG)，and HDL-cholesterol (HDL-C)] and uric acid with 10ml fasting blood, and height, weight and blood pressure were measured. A questionnaie was administered for life style, behavioral pattern and demographic characteristics. The study subjects were classified by their long-term weight change into four group；weight lost group(W.L.G., N=40), weight stable group (W.S.G., N=257), mild weight gain group (M.W.G.G., N=127)f severe weight gain group (S.W.G.G., N=168). The average age (SD) of the study subjects was 45.66(3.93) years. Proportions of the workers with shortness of breath and palpitation were significantly increased with weight increment. Weight increment was positively associated with SBP (p<0.001), DBP (p<0.001), TG (p<0. 001), atherosclerosis index (AI) (p<0.01) and uric acid(p<0.001), whereas negatively associated with HDL-C (p<0.001). Odds ratios (OR) of the S.W.G.G to the W.S.G. for shortness of breath (OR=2.41), palpitation (OR=2.68), SBP(OR=2.31), DBP(OR=2.18), TG(OR=4.11), HDL-C(OR=1.86), AI(OR=2.19) and uric acid(OR=3.39) were significantly greater than 1. On the other hand, ORs of the W.L.G. to the W.S.G. for HDL-C (OR=0.26), AI(OR=0.47) were significantly smaller than 1. Weight change showed significant effect on short ness of breath, palpitation, SBP. DBP, TG, HDL-C, AI and uric acid when the effects of other variables [weight change (raw data), age, drinking and smoking habits, exercise and behavior pattern] were controlled by the stepwise logistic regression analysis. For those significant fisk factors and symptoms, ORs of each weight change group in reference to the W.S.G (dummy variable) were calculated by logistic regression method. ORs of the W.L.G. for HDL-C (OR=0.26) and AI(OR=0.37) were significantly smaller than 1. ORs of the M.W.G.G. for all the risk factors and symptoms were not significant, and ORs of the S.W.G.G. for shortness of breath (OR=1.75)，palitation(OR=2.05), SBP(OR=2.53), DBP(OR=2.41), TG(OR=2.81), HDL-C (OR=2.28), AI(OR=2.16) and uric acid (OR=2.20) were significantly greater than 1.; Summary

Correlation study on foods/nutrients intake and the mortality and the morbidity of carcers of stomach and colorectum in Korea.: Myong Kyun Cynn, Dong Hyun Kim, Keun Young Yoo; Korean J Epidemiol. ;15(2):119-131.

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Chronological correlation analysis studies with 10 to 12 years lag period between various foods/nutrients intakes and mortalities of gastro-intestinal cancers such as stomach cancer, colorectal cancer in Korea were performed to investigate the effect of dietary factors on carcinogenesis. Information on the foods/nutrients intake from 1969 to 1988 were obtained from National Nutritional Survey Report published annually by Ministry of Health and Social Affairs. Data on the death due to stomach and colorectal cancers between 1981 and 1990 were gathered from Annual report on the cause of death statistics, National Stati Stical Office and Data on the morbidity from Medical insurance statistical yearbook, Korea Medical Insurance Corporation. Since 1969, the intakes of total energy and cereals which is a major supplier of carbohydrate have gradually decreased, whereas, those of total protein, protein from animal sources, lipid have remarkably increased in recent years. While the mortality from stomach cancer has increased upto 1984, and then decreased steadily for male and female, that of coloncancer has increased continuously during this period. The mortality of male stomach cancer has correlated only with niacin among various nutrients. There appears to be no good, correlating food group or nutrient found whth mortalities; Summary

Alcohol and coronary heart disease.: Kwang Ho Meng; Korean J Epidemiol. ;15(2):113-118.

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In recent years, a number of epidemiological studies have revealed that habitual moderate alcohol drinking is associated with reduced risk of coronary heart disease. The apparent pretective effect is not large, but the consistency of the association and the existence of plausible mechanisms increase the likelihood that the negative assoceation is causal. Possible mechanisms include the effect of regular drinking on increasing high density lipopretein cholesterol and the acute effect of alcohol on depressing platelet aggregation and reducing fibrinogen levels. However, other studies which have shown that alcohol acutely impairs ventricular function and increases the risk of arrhythmias, suggest the opposite. Much of this controversy concern the varying definitions of 'heavy' and 'moderate' drinking and some methodological problems. With considering of these issues, this paper reviews two major questions: does heavy alcohol intake increase the risk of coronary heart disease? And, is moderate intake protective? This paper, then, concludes that evisdence is far from complete: but it does point towards a pretective effect of moderate alcohol consumption. However, if alcohol intake were to increase in the population the social and medical consequences would be large. An increased alcohol intake is therefore not recommended as a community measure for coronary heart disease prevention.; Summary

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