Epidemiology and Health

Volume 17 (1); June 1995

Original Articles

Epidemiological Study on the Mumps Epidemic: In one Primary School in Hwasung-Kun, Kyonggi-Do.: Joung Soon Kim, Bo Youl Choi, Hung Bae Park, Young Jon Shin, Jeong Il Son, Mo Ran Ki, Yong Wha Oh, Keum Nie Bang, In Suk Choi; Korean J Epidemiol. 1995;17(1):105-115.

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In the last years, according to the increasing incidence of measles and other viral diseases, it have been needed to study on not only the fundamental epidemiological characteristics of mumps and measles but also judgement on the effectiveness of vaccine that meet our domestic situation. The author carried out questionnaire to obtain epidemiological characteristics and vaccine efficacy of mumps on epidemics of mumps in one primary school in Hwasung-kun, Kyonggi Do from Feb. to July, 1994. The results are summarized as follows: 1. Total students was 556, but 446(78.4%) responded to the questionnaire. Among that 446,130(29. 1%) have suffered from mumps. From 9 to 10 year old students had the high attack rates, especially 10 year olds has the highest(39. 7%). 2. From Feb. 2, 1994, first case was on, to July 6, 1994, the epidemic was continues, and attack rate was higest in May(50. 5%). 3. Among the 130 mumps patients, 5 have suffered from complication(3.8%) : encephalitis 3(2 in male, 1 in female). 4. Vaccination rate was 91%, and as ages were lowered, the rates were higher. 5. Attack rate was higher in group who had time interval after vaccination less than 5 years than total attack rate, and was higher in group who had been vaccined after 5 year old. 6. Attack rate in vaccinated group was 27.3%. 7. Vaccine efficacies, be judged by three methods of analysis according to case definition and vaccination status, were 37.4 39. 2%. 8. Factors that have significantly affected the mumps epidemic were vaccination status and vaccination age.; Summary

An Epidemiologic Investigation of Typhoid Fever Outbreak in 0hchun Middle and High Schools Located in Young-il Gun Kyungpook Province.: Jung Han Park, Ju Young Lee, Do Young Lee; Korean J Epidemiol. 1995;17(1):94-104.

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An epidemiologic investigation was conducted to identify the source of infection and the mode of transmission of typhoid fever outbreak occurred in Ohchun middle and high schools located in Young il Gun, Kyungpook Province from May 21 to Jun 4, 1994. Four out of 13 hospitalized students in three general hospitals in Pohang City were culture positive typhoid fever (Salmonella typhi Group D). Review of the in and outpatient logbooks of the three general hospitals in Pohang City, county health center and local clinics in the vicinity of the Ohchun middle and high schools suggested that the outbreak was confined to the schools. Drinking water source of the schools was two underground water pumps that had no treatment facilities; one in northern end and the other in southern end of the main school building. However, the southern water pump was closed on April 28, 1994 because a recent test for the water revealed E-coli suggesting a possible fecal contamination. Two hundred twenty students stated that they had experienced symptoms related to typhoid fever since April l, 1994 in a self administered questionaire survey of all of the 2, 226 students. Personal interviews with these 220 students were performed to confirm the clinical history together with a rectal swab culture for typhoid fever and Widal test. A total of 39 patients were detected; 15 confirmed cases (culture-positive) and 24 suspected cases (symptom positive with equal to or greater than 1:160 titer of Salmonella O-antibody or 1:320 titer of H-antibody titer in Widal test). The epidemic curve showed a unimodal curve with a peak on the second week(17 May, 1994) and tailed down to the 5th week (22 28 May, 1994). The overall incidence rate of typhoid fever was 1.8 per 100 students; 1.5 (1.6 for male, 1.5 for female) in the middle school and 2. 4 (6. 2 for male, 0. 4 for female) in the high school. When contrasted with the students who did not drink water at all in the school, the relative risks of incidence rate of typhoid fever for the students who drank the underground water of the school, both underground water and water brought from home, or water brought from home only were 55.5, 19.0, and 3.0 respectively. Three classes which had especially high incidence rates of typhoid fever were located in the southern part of the main school building, where the contaminated underground water pump is located. These findings suggested that the source of infection was the contaminated underground water of the school. Both of the two underground water pumps were closed permanently and the public running water was supplied to the schools.; Summary

An Epidemiologic Study on the Health Hazards of Inhabitants chronically exposed to Glass Fiber.: Hyun Sul Lim, Yun Chul Hong, Jung Ran Kim, Hae Kwan Cheong, Ji Yong Kim, Nam Won Paik, Hoe Kyeong Cheong, Chong Han Lem; Korean J Epidemiol. 1995;17(1):76-93.

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Fiberglass, as a substitute of asbestos, is used for more than 60 years as a insulator material. Health hazards including irritation of skin, mucosa and respiratory system associated with use of fiberglass is reported. Many studies on the fibrogenicity and carcinogenicity of fiberglass was conducted but evidence is not sufficient to confirm the carcinogenicity or fibrogenicity. Authors studied the health hazards among 152 inhabitants(71 men and 81 women) from 32 households living around the fiberglass factory which produced the fiberglass insulators and glasswool panels for 20 years. Questionnaire survey on household and persons, examination of underground water, pathologic examination of subcutaneous tumors and examination of fiberglass in tumor tissues were done. The results are as follows; 1. Fiberglass concentration of underground water sampled from 33 households in the study area was 13. 7-95. 9 fiber/cc with the diameter to length ratio more than 1:20. 2. Prevalence of dermatosis among study subjects was 23.0 % (35 cases). Prevalence was not associated with the distance from the factory nor duration of exposure. 3. There were 15 cases of subcutaneous tumor with prevalence of 9. 9 %. Age of subcutaneous tumor cases was all above 30 year-old except one cases, who was 5 year old child, who lived in the surveyed area since he was born. Prevalence of subcutaneous tumor was significantly high in area A(42.9 %) than area B(4.6 %, p<0.01). Prevalence of subcutaneous tumor was higher in long-term exposed inhabitants, but was not statistically significant. 4. Pathologic examination exhibits partly encapsulated fat tissue masses and cut surfaces were pale yellow with gritty sensation. The masses consist of mature fat cells showing variation in size and shape. On polarizing microscope, the peripheries of tumors include small irregular threads of doubly refractile material probably represent glass fibers in fibrocollagenous tissue. Concentration of fiberglass in tissue was 5.1-10.2 fiber/rag wet tissue in case 1, 25.8-184.9 fiber/mg wet tissue in case 2 and 40.8-126.5 fiber/mg wet tissue in case 3. Length of fiberglass was shorter than that in underground water. 5. Cases of malignant tumor among inhabitants since last 10 years were 4, 3 of whom was developed in a same household just near the factory. Diagnoses of malignancy cases were stomach cancer, stomach and esophageal cancer, oral cavity cancer, and stomach cancer with liver metastasis. On review examination of tissues of endoscopic biopsy specimen from a case of stomach cancer, there was adenocarcinoma with no evidence of fiberglass materials. Authors concluded there is evidences that fiberglass was strongly associated with the development of the health hazards including dermatosis and benign subcutaneous tumor. However, the association of fiberglass exposure with the development of malignant tumor was not clear, although strongly suggested. For the prevention of development of further health hazards, it is recommended that under ground water source should be closed and further experimental study to confirm the mechanism of the tumorigenesis and follow up survey on the inhabitants should be conducted.; Summary

Asthma and Air Pollution in Korea.: Kee Un Choi, Do Myung Paek; Korean J Epidemiol. 1995;17(1):64-75.

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With rapid industrialization and urbanization, environmental pollution has become an urgent health problem. Asthma attack is a common and severe disease, and can be a sentinel event of worsening air pollution. There are, however, few studies about the epidemiolgy of asthma and the association between asthma and low level air pollution in Korea. This study was conducted to describe the trend and pattern of asthma attack and to examine the effect of air pollutants on admission in Korea. Combined data of this study are medical insurance claims for asthma, data from telemetry system of the Ministry of Environment for air pollutants, and air temperatures from monthly weather reports of the Meteorological Administration. To describe the temporal trends of asthma in Korea, insurance claims since 1985 were analized. Age specific asthma visit/admissions per 1000 eligible persons, as well as ratio of asthma visit/admissions over all visit/admissions showed a steady increase in asthma attack in Korea. Asthma prevalence was relatively high among under 5 years and over 50 years of age, and in these age groups asthma was more prevalent among males. The effects of relatively low level air pollution and weather condition on the number of patients who had asthma attacks admitted to hospitals in Seoul area were studied from April 2 to April 24, 1993. Asthma admissions were examined throughout the study period (392 cases), except sunday and holiday(354 cases) and except sunday, holiday and saturday (293 cases), while grouped into three age categories (3 12, over 40, and all age). Following results were obtained through correlation and multiple regression analysis. The number of adimission were significantly correlated with ambient air concentrations of total suspended particles (TSP), sulfur dioxide (SO2) and carbon monoxide(CO). 1) The number of admissions on the same day were significantly correlated with ambient air maximal concentrations of total suspended particcles among persons who were above 40 year old. 2) The effects of maximal daily concentrations of sulfer dioxide(SO2) among persons who were of 3- 12 age were significant when one day lagged asthma admission was compared with the air pollution on the previous day. 3) The number of admissions on 1-day lag were significantly correlated with ambient air maximal daily concentrations of carbon monoxide(CO) among persons who were above 40 year old. The associations between temperatures and number of admissions were not significant in this study. Levels of pollutants were fairly low, the monthly mean being 0.022 ppm for SO2, 0.032 ppm for NO2, 3.2 ppm for CO, 0.015 ppm for 03, and 240 micro gram/m3 for TSP. The mean temperature was 10.6degrees C. These results suggest that concentration of air pollutants lower than those given as guidelines may increase the incidence of asthma attacks.; Summary

Relationship of health status and health practices.: Il Suh, Soon Young Lee; Korean J Epidemiol. 1995;17(1):48-63.

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PURPOSE
The purpose of this study was to examine the health behaviors (such as smoking, alcohol consumption, exercise, duration of sleep, body weight, eating habit of breakfast and snack) affecting self-perceived health status, and to determine the relationships. RESEARCH METHODS: This study utilized the data from Korean National Health Survey (KNHS) in 1992. The data consisted of random sample of 2,799 individuals (1,304 male and 1,495 females) whose ages were between 20 and 59. The analytic methods for the study were chi square analysis, logistic regression.
RESULTS
The results of the study were as follows : (1) There was a negative relationship between duration of smoking and health status in linear pattern; (2) The frequency of alcohol drinking had a significant relationship with health status in quadratic pattern. That is, the health status of moderate drinkers was better than that of non-drinkers and heavy drinkers; (3) There was no significant relationship between the frequency of exercise and the health status. But in further analysis, the relationship between them was positive in linear pattern. That is, the health status of daily exercisers was better than that of the others; (4) Duration of sleep significantly influenced the health status in quadratic pattern. That is, the persons who sleep for 7-8 hours per day were better than that of the others; (5) The health status of persons with normal body weight was higher than that of persons with underweight or overweight; (6) Eating breakfast or not did not influence the health status, and taking snack or not influenced the health status; (7) In mutivariate analysis, The younger the persons were and the longer the level of education was, the higher the health status was in both male and female. In female, the higher the economic status was, the higher the health status was. And the smoking and the weight status significantly and independently influenced the health status in both male and female. And in male, the moderate drinking positively influenced the health status.
CONCLUSION
History of no smoking, moderate alcohol consumption, regular exercise, 7-8 hours sleeping and maintaining the normal body weight were health-promotive behaviors. And especially no smoking, moderate drinking and maintaing the normal body weight singnificantly influenced the self perceived health status.; Summary

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