Epidemiology and Health

Volume 25 (2); December 2003

Original Articles

The Association between Bone Density at Os calcis and Body Composition according to Years since Menopause in Postmenopausal Women Aged 45-84 Years Living in a Rural Area.: Eun Kyung Shin, Ki Suk Kim, Hee Young Kim, Kyung Eui Hong, Hyo Jee Joung, Sung Il Cho; Korean J Epidemiol. 2003;25(2):108-118.

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Abstract PDF: Abstract
OBJECTIVES
This cross-sectional study aimed to compare early postmenopausal women with late menopausal women in respect to body composition as a major determinant of calcaneal bone density.
METHODS
Areal bone density was measured at os calcis with peripheral dual energy X-ray absorptiometry. Soft lean mass and fat mass were measured using bioelectric impedance in 109 postmenopausal women aged 45 to 84 years.
RESULTS
When age and height were adjusted, the variance of calcaneal bone density was better explained by fat mass (15%) than by soft lean mass (7%) in early postmenopausal women. In contrast, soft lean mass (17%) explained the variance of calcaneal bone density better than fat mass (11%) in late postmenopausal women. However, interaction terms between years since menopause (YSM) and soft lean mass or fat mass were not statistically significant in multiple linear regression model for total postmenopausal subject.
CONCLUSION
The findings of this study suggest that fat mass is the major determinant of calcaneal bone density in early postmenopausal women, whereas fat free mass is more important determinant of calcaneal bone density in late postmenopausal women.; Summary

The Prevalence Rate of Fatty Liver and Its Risk Factors of Adult Women in a Rural Area.: June Young Suh, Byung Yeol Chun, Hee Jung Yoon, Kyung Eun Lee, Sam Soon Lee; Korean J Epidemiol. 2003;25(2):100-107.

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PURPOSE
To investigate the prevalence rate of fatty liver disease and its related factors of women in rural area.
METHODS
Seven hundreds and fifty four adult females (above age 30) at eleven Community Health Centers in Koryung County were recruited from 3 March 2001 to 30 May 2001. Abdominal ultrasonography, height, weight, and blood pressure were measured. A questionnaire interviewing method was used to collect life style data.
RESULTS
The prevalence of fatty liver disease was 13.4%. By simple analysis, age(p<0.05), diabetes mellitus(p<0.01), salt intake(p<0.05), and obesity (p<0.01) were significantly associated with fatty liver disease. In multiple logistic regression analysis, the risk for fatty liver in above 50 age group was 2.7 (95% CI: 1.25-5.99) times higher than that in 30-49 age group, overweight was 10.3 (95% CI: 5.26-19.99) times higher than normal group, 3.9 times (95% CI: 1.84-8.38) higher in person with diabetes mellitus than those without and the risk of current drinkers was 2.0 times (95% CI: 1.03-3.85) higher than non-drinkers.
CONCLUSION
Above findings suggested that risk factors significantly related with fatty liver were age, BMI, diabetes mellitus, and drinking in adult women.; Summary

The Characteristics of Relapsed Patients with Pulmonary Tuberculosis Registered at Two Public Health Centers in Seoul.: Songyi Han, Soonduck Kim, Jongsoon Park, Seonmi Ji, Jesuk Lee; Korean J Epidemiol. 2003;25(2):92-99.

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PURPOSE
The purpose of this study is to survey general and clinical characteristics of a group of relapsed patients with pulmonary tuberculosis, who are registered at a public health center in order to provide basic data for treatment of a patient's relapse, follow-up examination after the first treatment and health education. SUBJECT: Among 68 relapsed patients with pulmonary tuberculosis registered at two public health centers in Seoul from Jan, 1, 2002 to Dec. 31, 2002, 50 patients were selected as research subjects because they were contactable by telephone and they agreed to be a research subject.
METHOD
The research carried out the structured questionnaire survey by telephone and surveyed research subjects' general and clinical characteristics, diseases except tuberculosis, drinking and smoking habit and knowledge about pulmonary tuberculosis treatment. Furthermore, the results of x-ray, whether a cavity existed or not, bacteriologic test, culture examination and drug resistance examination were examined and interval to relapse and history of dose attitude were surveyed.
RESULTS
Among relapsed tuberculosis patients, male patients were 60% and they were more than women(40%). Patients over 60 were 42% most. In their occupation, 30% of them were unemployed and 50% of patients surveyed had monthly income below one million won. According to the findings in radiographic extent, most 50% of them were minimal, 44% were moderately advanced and 2% were far advanced. Patients who had cavity were 30%. According to the result in bacteriologic test, 54% showed positive smear pulmonary tuberculosis and 50.0% positive culture. According to the result in drug resistance, 24% showed drug resistance against one drug and 76% showed sensitive response. 46% had experienced medication side effects. According to interval to a relapse, 32% were relapsed less than 2 years, 14% less than 3-5 years and 54% more than 5 years. Average interval before a relapse were 11.6 years(11.6+/-11.15). There was a difference between their past regimen and their present regimen(P=0.001). The attitude towards taking a medication was assessed and they showed higher compliance with medication at present than in the past(P=0.001). In a case of smoking rate during treatment, the rate of non-smokers, who had been smokers, were higher(P=0.047).
CONCLUSION
As a result, in order to prevent the disease from being relapsed and to increase the rate of treatment effectiveness, we need to make patients recognize the importance of regular follow-up examination and we should control thoroughly the patients. Furthermore, we need to provide them with more health education not to stop taking a medication earlier.; Summary

Secular Trends of Suicide Mortality in Korea.: Jongsoon Park, Soonduck Kim, Seonmi Ji, Jesuk Lee; Korean J Epidemiol. 2003;25(2):84-91.

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PURPOSE
This study was conducted to analysis the trends and states of suicide mortality in Korea from 1983 to 2001.
METHODS
This study was based on data published in 1983-2001 from the annual report of the cause of death statistics of National Statistical Office.
RESULTS
First, both of annual suicide rate and adjusted suicide rate rapidly went up in 1996 and hit the highest in 1998. Second, since 1983 only when the suicide rate was the highest in the ages 20-24 rather than other age groups, the suicides have been continuously shown to be the highest in the old age group. Third, the seasonal percentages of suicides were generally high in spring and summer, the seasons when the percentage of sunshine is relatively high, in both results for men and women. Fourth, men have most frequently committed suicide through hanging while their suicide through falling from a high site have least frequently occurred but currently tends to gradually increase. Meanwhile, women have most frequently done suicide generally by using insecticide.
CONCLUSION
In Korea, the suicide rate and suicide percentage of the old people have been yearly increasing, and their suicide rate is also shown to the highest rather than those of other age groups. Therefore, it is necessary to prevent the suicide of the old people through a systematic analysis. Moreover, it is necessary to verify the risk factors and defensive factors for the suicide impulse and suicide attempt. On the basis of this, the construction of a nationwide social safety network for the national mental health is very important to find and treat the problems of the mental health to lead the people to suicide.; Summary

The Relationship between Tobacco Price Rises and Willingness to Quit Smoking among University Students.: Wook jin Lee, Seung jun Lee, Jae rang Lee, Jung myung Lee, Joo hyoung Lee, Eun choel Park, hoo yeon Lee; Korean J Epidemiol. 2003;25(2):76-83.

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BACKGROUND
The smoking rate of adult male is 68.2% in Korea and that of adolescent and women has risen recently. Ministry of Health and Welfare plans to raise the price of cigarettes by 1,000 Won per pack this year in hopes of securing funds to aid the underprivileged and discourage excessive smoking. In this study, we tried to find the relationship between tobacco price increase and willingness to quit smoking among university students, and the factors associated with willingness to quit smoking.
METHOD
The data were collected by questionnaire survey from 225 university students living in Seoul. The questionnaire contained items on age, sex, smoking history, economical status and the intention to quit smoking when the tobacco price be raised.
RESULT
The proportion of smokers who has the intention to quit smoking if the price of tobacco be raised by 3,000 Won was 46.2%. The factors associated with willingness to quit smoking were age of initiating smoking, opinion for price of cigarette, self efficacy scores, current plans to quit smoking, and viewpoint of changes in the rate of smokers.
CONCLUSION
The results showed that tobacco price rises will increase willingness to quit smoking among university students.; Summary

Survival Rate and Factors Affecting Survival among Patients of Lung Cancer Lived in Daejeon City.: Kil Hoi Lee, Yunhyung Kwon, Tae Yong Lee; Korean J Epidemiol. 2003;25(2):62-75.

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Abstract PDF: Abstract
PURPOSE
This study was carried out to investigate survival rate and the factors affecting survival among lung cancer patients who have been registered in Daejeon Cancer Registry from 1998 to 2000.
METHODS
Kaplan-Meier method and Cox proportional hazard model were used to evaluate the factors affecting survival of lung cancer patients.
RESULTS
Lung cancer was more common in men than women, with an overall sex ratio in Daejeon, Korea of roughly 3:1. The incidence of lung cancer was 17.1 per 100,000 population in 1998, 21.4 in 1999, and 22.4 in 2000. Average age of incidence was 64.8 years old and 11.7% of study subjects having family history of lung cancer. Forty eight % of lung cancer was diagnosed as Stage III and 40.6% as Stage IV. Histologically, squamous cell carcinoma was 39.7% of all and most frequent, and then adenocarcinoma 25.5%, and small cell carcinoma 19.3%. 3-year survival rate of female was higher than that of males, and that of smoker was the lowest among groups according to the smoking level. Survival rate by age fell dramatically in group over 70 years. Lung cancer patients diagnosed as Stage III and Stage IV had a much lower survival rate than those diagnosed as Stage I or II. Stage, LDH and age were proved to be important variables that affect the mortality of lung cancer patients.
CONCLUSION
We found that the stage at diagnosis was a critical factor that affected the survival of lung cancer patients from this study. So It is essential to develop early diagnosis of lung cancer and then it needs to evaluate the effectiveness of that.; Summary

Review

Status on Occurrence and Preventive Measures of Disasters in Korea.: Hyun Sul Lim; Korean J Epidemiol. 2003;25(2):47-61.

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Abstract PDF: Abstract
Disasters are emergencies of a severity and magnitude resulting in deaths, injuries, illness and/or property damage that cannot be effectively managed by the application of routine procedures or resources. These events are caused by nature, the result of technological or manmade error. Natural disasters include typhoon, flood, heavy snowfall, drought, famine, and earthquake. Natural disasters are unpreventable and, for the most part, uncontrollable. Technological or manmade disasters include fire, nuclear accidents, bombings, and bioterrorism. The severity of damage caused by natural or technological disasters is affected by population density in disaster-prone areas, local building codes, community preparedness, and the use of public safety announcements and education on how to respond correctly at the first signs of danger. Recovery following a disaster varies according to the public's access to pertinent information, pre-existing conditions that increase or reduce vulnerability, prior experience with stressful situations, and availability of sufficient savings and insurance. Epidemiology can be used to investigate the public health and medical consequences of disasters. The aim of disaster epidemiology is to ascertain strategies for the prevention of both acute and chronic health events. Disaster epidemiology includes rapid needs assessment, disease control strategies, assessment of the availability and use of health services, surveillance systems for both descriptive and analytic investigations of disease and injury, and research on risk factors contributing to disease, injury, or death. With both disasters and the number of people affected by such events on the increase, the importance of disasters as a public health program is now widely recognized in Korea. The epidemiologists must do their best effort for prevention of disasters.; Summary

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