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Volume 24 (1); June 2002
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Original Articles
The Study on Active and Environmental Tobacco Smoke in Biological Samples among High School Students in Korea .
Sun Ha Jee, Su jung Kim, So young Won, Ho Sang Shin, Chang Su Kim, Hee Ja Kim
Korean J Epidemiol. 2002;24(1):83-92.
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Abstract
PURPOSE
The objective of this study was to determine the active and environmental tobacco smoke (ETS) in biological samples (plasma, saliva and urine) among high school students in Korea.
METHODS
Study samples were from 99 nonsmoker or smoking volunteers from high school in Kyungki-do in 2000. ETS was defined as the having smokers of their family members or their friends. Urinary samples were extracted with ethyl ether at pH 10.5, and the extract was injected in GC-NPD. Plasma or saliva was extracted with methylene chloride at pH 10.5 and the quantification was performed with GC-MS (SIM). Peak shapes and quantitation of nicotine and cotinine were excellent, with linear calibration curves over a wide range of 1 to 3000 ng/mL.
RESULTS
The results are as followings1. The prevalence of smoking among study subjects were 18.2% among males and 6.1% among females. A 69.7% of total subjects among both males and females were exposed at ETS. 2. The primary metabolite cotinine of nicotine was good indicator of ETS exposure in nonsmokers. Salivary cotinine was found to be highly correlated to the concentration of cotinine in plasma (r=0.9480). 3. Urine cotinine was increased among those with smokers in their family members, while salivary or blood cotinine was increased among with smoking friends. 4. Blood cotinine was highly correlated with salivary cotinine, but it was relatively poorly correlated with urine cotinine.
CONCLUSIONS
In conclusion, the results show how the students in high school in Korea suffer from secondhand smoke. It appeared that salivary cotinine was easy to collect and best way to predict the ETS among adolescents
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The Association of Reproductive and Menstrual Factors and Colon and Rectal Cancer Risk in Korean Women.
Bong Wha Lee, Dong Hyun Kim, Hunjae Lee, Dae Yong Whang, Yoon Ok Ahn
Korean J Epidemiol. 2002;24(1):76-82.
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Abstract
Recently, there were several epidemiological studies demonstrating that reproductive and menstrual factors are associated with the risk of colorectal cancer in women. A hospital-based case-control study has been conducted to investigate whether the histories of childbearing, menstruation, and breast-feeding are associated with colorectal cancer risk. The cases were consecutively diagnosed, histologically confirmed, incident patients with cancers of the colon and rectum aged 30-79 who were admitted to three tertiary hospitals in Seoul, Korea between March 1995 and August 1997. Controls were selected in the same hospitals as the cases during the same periods. Finally, a total of 151 cases and 110 controls were selected and interviewed on their reproductive and menstrual characteristics using a structured questionnaire. Earlier age at first birth appears to be related with increased risk of colorectal cancer (multivariate relative risk[RR] of colorectal cancer for <21 vs 25 > or = 2.33; 95% confidence interval[CI] 1.1-5.1, p for trend 0.03). Compared with women who experienced menarche at age 16 or older, women whose menarche occurred at age 14 or less appeared at significantly higher risk of rectal cancer(multivariate RR of colorectal cancer for < or = 14 vs > or =16 = 2.26; 95% CI 1.0-3.4, p for trend 0.03). We found no associations for parity, incomplete pregnancies, menopause, use of oral contraceptives, and hormone replacement therapy. These findings suggest that events of reproductive life may have a bearing on female subsequent risk of colon and rectal cancer
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The Epidemiologic Characteristics of Measles for Two Years in a Metropolitan City: Based on the reported measles cases since 2000.
Hyun Kyun Ki, Young Hwa Jung, Jae Keun Chung, So Yeon Ryu, Ki Soon Kim
Korean J Epidemiol. 2002;24(1):63-75.
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Abstract
PURPOSE
There has been an epidemic of measles in Korea since 2000. Therefore, we analyze the epidemiologic haracteristics of measles in Gwangju Metropolitan City.
METHODS
We reviewed the epidemiologic investigation records and laboratory data of the measles patients reported in Gwangju Metropolitan City from January 1st 2000.
RESULTS
1) Demographic characteristics: Totally, 3,392 cases were surveyed and 3,300 cases were enrolled (3,300/3,392, 97.3%). Fifty-four percents of the patients were male (1,771/3,300) and forty-six percents of the patients were female (1,529/3,300). Average age of the patients was 8.20 years (8.20 5.56 years). Forty-seven percents of the patients were reported in the interval from November 2000 to December 2000 (1,582/3,298, 47.9%). 2) Clinical manifestations of the patients: Common symptoms of measles patients were fever (3,300/3,300, 100.0%), skin rash (3,068/3,300, 93.0%), cough (2,889/3,300, 87.5%), rhinorrhea (1,883/3,300, 57.1%), headache (1,445/3,300, 43.8%), conjunctival injection (1,182/3,300, 35.8%), and oral thrush (832/3,300, 25.2%). Among the patients, 250 patients had complications (250/3,300, 7.6%) and most of them were respiratory complications (220/250, 88.0%). 3) Vaccination: Eighty-six percent of the enrolled patients answered the question about vaccination (2,854/3,300, 86.4%); 808 patients were not taken a shot (808/2854, 28.3%), 1,762 patients received one dose (1,762/2,854, 61.7%), and 284 patients received additional dose (284/2,854, 9.9%). 4) Laboratory data: Laboratory confirmed cases were 780 patients (780/3,300, 23.6%); 603 cases were confirmed serologically, 185 cases were positive in PCR, and virus was isolated in 6 cases. Genetic sequencing of the isolated viruses was clade H1 and closely related to that of China.
CONCLUSION
Therefore, adequate surveillance and maintenance of high coverage rate of the vaccination would be the crucial factors to eradicate measles
Summary
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Outbreak of Salmonellosis Misdiagnosed with Amebiasis in Gumi City and Chilgok County, Korea.
Hyun Sul Lim, Geun Ryang Bae, Tai Soon Yong
Korean J Epidemiol. 2002;24(1):54-62.
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Abstract
PURPOSE
S: In May 29, 1999, the health department in Gumi city received a report from a local pediatrician that three children who attended a kindergarten were diagnosed with amebic dysentery. By May 31, fifteen more children from the same kindergarten were diagnosed with amebic dysentery. We conducted an investigation in order to verify the diagnosis, and to implement appropriate control measures.
METHODS
We conducted a questionnaire survey on 264 children in 3 kindergarten in Gumi city. Furthermore, 726 children in 4 kindergarten and 13 academies in Chilgok county whose lunch is supplied by the same unlicensed catering company were monitored for diarrheal symptoms.
RESULTS
Of 264 children in Gumi city, 74 children fitted the case definition (attack rate, 28%). Of 726 children in Chilgok county, 50 children were reported to have diarrheal symptoms. The clinical picture was dominated by the following symptoms; abdominal pain (85.1%), fever (83.8%), headache (50.0%), chilling (45.9%), vomiting (28.4%). The median duration of diarrhea was 2 days, and the median frequency of diarrhea was 3 times/day. Salmonella Typhimurium of the same antibiogram pattern were isolated from fifteen cases. However, no evidence of amebiasis was found from laboratory results or epidemiologic pattern.
CONCLUSIONS
: This epidemic was caused by Salmonella Typhimurium, which were present in lunch supplied by the unlicensed catering company. Improvement of the diagnostic ability in local health centers as well as public health centers and reinforcement of strict protocols regarding appropriate management of catering services should be emphasized
Summary
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Knowledges and Attitudes of College Student to Aquired Immune Deficiency Syndrome.
Jin Ho Chun, Seong Hoon Lee, Hae Sook Sohn, Jong Tae Lee
Korean J Epidemiol. 2002;24(1):37-53.
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Abstract
OBJECTIVES
Though AIDS is one of the most serious and world-wide health problem, there have been developed no effective control measure but individually oriented prevention. This study was performed to help preparing the efficient control program for college student who are sexually active, considered as a risk group for HIV infection.
METHODS
Subjects were 852 college students of one university in Gyungsangnam-do. From September to October 2001, questionnaire survey on the students' knowledge and attitude, and status of health education about AIDS (HEAIDS) was done. Collected data was analyzed using SAS (ver 6.21) program.
RESULTS
The subjects were freshman (52.1%) and enrollment (47.9%), with department of medicine (19.1%), nursing (25.8%), health administration (9.1%), business (11.4%), chemical (16.2%), food (8.8%), gymnastics (9.5%). Though about 90% of them agreed with the necessity of HEAIDS, half of them (54.7%) had no experience of HEAIDS and most (88.1%) of them considered it had been insufficient. The informations about AIDS was acquired mainly from TV newspaper (73.0%), but partly from specified health education (16.1%). They have no experience of unsafe sexual contact (96.1%), however, they considered that they can have accidental sexual contact (22.7%) in the future. Response for intention to use of preventative condom use was certainly (66.7%) and questionable (33.3%). About the knowledges on HIV infection and transmission, most of them knew relatively well about no curative medicine (94.8%), infected by sexual contact (85.7%), common use of needle (96.4%), transfusion (95.2%), transplantation (89.8%), longitudinal infection (88.7%). However, the correct answer rate was relatively low in clinical spectrum; can maintain normal life with medical care (31.0%), and some transmission route; kiss (46.9%), cough sneezing (45.8%), common use of bowl towl (49.1%) and bath (43.4%), insect like mosquitos (49.1%), razor (35.4%). The mean level of the knowledges on HIV infection and transmission was 67.5 and 71.6 out of a possible 100, respectively. The knowledge level (p=0.003) and certainty to use of preventable condom use (p=0.001) was higher in HEAIDS experienced group. Experiences to HEAIDS was more in enrollment (50.5%) than freshman (40.5%) (p=0.004), medicine (51.4%) than health (32.1%) and general (41.9%) by department group (p=0.001). With regard to the attitudes on HIV infection, they didn't agreed with 'had intention to check themselves for HIV infection (94.2%)', 'case or suspected case can attend to same school with my children (71.8%)', 'had intention to join in clinical trial of new regimen for AIDS (74.4%)'.
CONCLUSIONS
This result showed that present status of HEAIDS for college students is still insufficient. Because the knowledges and attitudes about AIDS are influenced by HEAIDS, professional and efficient education program would be emphasized on the practical level for health protection, eg, preventative condom use. This study has also another meanings to reveal the positive effect and to recall the motive for individual-based prevention
Summary
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Key Message
Green Tobacco Sickness on Tobacco Harvesters in a Korean Village.
Hyun Sul Lim, Kwan Lee
Korean J Epidemiol. 2002;24(1):29-36.
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Abstract
PURPOSE
This study was conducted to understand the proportion and the risk factors of green tobacco sickness (GTS).
METHODS
The authors conducted a questionnaire among tobacco harvesters; 94 people from 59 households at a village in Youngduk-gun from Feb 1 to Feb 3, 2002.
RESULTS
The study group contained 49 females and 45 males. The mean durations of employment and the length of the working day were 23.3 14.2 years and 11.8 2.7 hours, respectively. The symptoms related to tobacco harvest were dizziness in 64 cases (68.1%), headache in 46 cases (48.9%), nausea in 45 cases (47.9%), sore eyes in 37 cases (39.4%), and vomiting in 36 cases (38.3%). The experience of GTS up until 2001 was 70.2%. The proportion of GTS in 2001 was 67.0% and was significantly higher in females (84.9%, p<0.01). The proportion of GTS by work days in 2001 was 16.4 spells/100 person days. The proportion of non-smokers was significantly higher than smokers (p<0.01). Therefore, smoking was negatively associated with GTS. The use of gloves and wristlets significantly increased the proportion of GTS (p<0.05). Through multiple logistic regression, significantly associated factors with GTS were found to be smoking (OR=0.18, 95% CI: 0.06-0.54), wearing of gloves (OR=9.20, 95% CI: 1.27-66.52), and sweating (OR= 3.52, 95% CI: 1.08-11.47). Of those who reported GTS in 2001, 65.6% underwent treatment from the local medical facilities. The distribution of the medical facilities utilized was pharmacies 39.3%, and medical health centers 26.2%.
CONCLUSIONS
: In Korea, there are many tobacco harvesters, and most may be stricken with green tobacco sickness. In the future it is hoped that more extensive epidemiological studies will be conducted
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The Effect of Anthropometric Change on Blood Lipids in Adolescents in Rural Area of Korea.
Kyeong Soo Cheon, Myoung Hee Kim, Kirang Kim, Mi Kyung Kim, Young Jeon Shin, Bo Youl Choi
Korean J Epidemiol. 2002;24(1):17-28.
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Abstract
Primary prevention of atherosclerosis is important for reducing morbidity and mortality from cardiovascular disease. As modifiable risk factors for atherosclerosis which appears and progresses in early life, obesity and hyperlipidemia are related with each other. Especially hyperlipidemia during adolescent period is closely related to cardiovascular morbidity and mortality in later life, but the association between anthropometric changes in growth period and lipids level in adolescence is not known yet. Therefore we investigated the effect of anthropometric changes in growth period on adolescent lipids level among 615 high school students in rural area of Korea. The study results were as the followings; In childhood, the weight and the height of boys didn't differ from those of girls, however, began to exceed them at 14 and 15 years old respectively. The body mass index(BMI) of both genders was appeared to increase with age. The BMI increase of girls was greater than that of boys from twelve years of age. The BMI slope (annual average increment of BMI; coefficient of regression line) of girls was greater than that of boys(t-test, p<0.01). The proportion of high obesity tracking group was 13.1%(82 persons). In multivariate analysis, total cholesterol and LDL-cholesterol were positively correlated with obesity tracking in boys; BMI slope and BMI at 7 years old in girls. The HDL-cholesterol didn't show any significant association with those factors. The triglyceride was related to BMI slope and obesity tracking in boy, but nothing in girls. In this study, the obesity at 7 years old, the BMI slope, and the obesity tracking are associated with adolescent serum lipid level. For primary prevention of cardiovascular disease, it is needed to develop more active prevention or health promotion program for children and adolesecents in Korea.
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A study on Statistical Method for Controlling the Effect of Intermediate Events: Application to the Control of the Healthy Worker Effect.
Chung Mo Nam, Jinheum Kim, Dae Ryong Kang, Yeon Soon Ahn, Hoo Yeon Lee, Dae Hee Lee
Korean J Epidemiol. 2002;24(1):7-16.
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Abstract
PURPOSE
The healthy worker effect is an important issue in occupational epidemiology. This study was conducted to propose a new method to test the relation between exposure and mortality in the presence of the healthy worker effect.
METHODS
In this study, the healthy worker hire effect was assumed to operate as a confounding variable of health status at the beginning of employment and healthy worker survival effect as a confounding and intermediate variable of employment status. In addition, the proposed method reflects the length bias sampling caused by changing of an employment status. Simulation studies were also carried out to compare the proposed method with Cox's time dependent covariates models .
RESULTS
The theoretical development of the healthy worker survival effect is based on the result that an observation with change of an employment status requires that the survival time without intermediate event exceeds the waiting time for the intermediate event. According to our simulation studies, both the proposed method and Cox's time dependent covariates model which includes the change of employment status as time dependent covariates seem to be satisfactory at 5% significance level. However, Cox's time dependent covariates models without or with the change of employment status as time fixed covariate are unsatisfactory. The proposed test is superior in power to tests based on Cox's model.
CONCLUSIONS
The healthy worker effect may not be controlled by classical Cox's proportional hazards models. The proposed method performed well in the presence of healthy worker effect in terms of level and power
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Review
Methods for Estimation of Nationwide Cancer Incidence from Population-based Cancer Registries .
Jong Myon Bae, Choong Won Lee, Duk Hee Lee, Yoon Ok Ahn
Korean J Epidemiol. 2002;24(1):1-6.
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Abstract
While there has not been a nationwide cancer incidence data yet, it is necessary to consider a preferable method for estimation of nationwide cancer incidence under the cancer registry system in Korea. Some papers and texts related to estimate a nationwide cancer incidence were searched and reviewed. It could be summarized into 5 major methods: (1) for having only mortality data for all cancers, (2) of using major demographic factors, (3) of using nationwide mortality data, (4) of using nationwide mortality and survival data, and (5) of considering cancer risk factors. Among the methods, second method of using major demographic factors would be preferable in Korean situation
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Epidemiol Health : Epidemiology and Health