Most-read articles are from the articles published in 2021 during the last three month.
Methods
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Korea National Health and Nutrition Examination Survey, 20th anniversary: accomplishments and future directions
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Kyungwon Oh
, Yoonjung Kim
, Sanghui Kweon
, Soyeon Kim
, Sungha Yun
, Suyeon Park
, Yeon-Kyeng Lee
, Youngtaek Kim
, Ok Park
, Eun Kyeong Jeong
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Epidemiol Health. 2021;43:e2021025. Published online April 19, 2021
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DOI: https://doi.org/10.4178/epih.e2021025
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17,099
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558
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60
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Abstract
Summary
PDF
Supplementary Material
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Abstract
The Korea National Health and Nutrition Examination Survey (KNHANES) was initiated in 1998 to provide evidence for the development and evaluation of health policies and programs. The Korea Disease Control and Prevention Agency is responsible for the KNHANES and has conducted it as a series of surveys. Over the past 20 years, efforts to produce accurate, timely, and nationwide health statistics have been refined by establishing a continuous annual survey system with full-time field staff, incrementally expanding survey components, collaborating with relevant academic societies for quality control, and revising the survey methods. Additionally, the utility of the collected data was increased by linking the KNHANES data with related data from other government agencies or institutions and making the overall data publicly available on the official website of KNHANES (https://knhanes.kdca.go.kr). Additional long-term plans are being developed, including plans to continue producing nationwide health indicators and invigorating the utilization of the KNHANES data.
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Summary
Korean summary
국민건강영양조사는 국민건강증진법제16조에 근거하여 1998년부터 우리 국민의 건강수준, 건강행태, 식품 및 영양소 섭취 실태에 대한 국가단위 통계를 산출하는 조사사업이다. 본 연구에서는 건강지표 생산 확대, 조사 자료 활용도 향상 등 20년간의 성과를 요약하고 사회환경과 조사여건 변화를 반영한 건강통계 생산의 발전 방안을 제시하였다.
Key Message
The Korea National Health and Nutrition Examination Survey (KNHANES) is an ongoing surveillance system that was initiated in 1998 based on Ar¬ticle 16 of the National Health Promotion Act to produce nationwide statistics regarding the health status, health behaviors, and food and nutrient consumption of the Korean population. In this study, the 20-year accomplishments of the KNHANES including vigorous production of health indicators and improvement of data utilization are summarized, and future plans are presented to improve the health statistics to reflect changes in the social and survey environments.
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Citations
Citations to this article as recorded by

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Journal of Health, Population and Nutrition.2023;[Epub] CrossRef - Normal-Weight Obesity and Metabolic Syndrome in Korean Adults: A Population-Based Cross-Sectional Study
Jeonghyeon Kim, Seamon Kang, Hyunsik Kang
Healthcare.2023; 11(16): 2303. CrossRef - Differences in Associated Factors of Sedentary Behavior by Diabetes Mellitus Status: A Nationwide Cross-Sectional Study
Dong Kee Jang, Hyung Seok Nam, Mina Park, Yeo Hyung Kim
Journal of Clinical Medicine.2023; 12(17): 5453. CrossRef - Bidirectional associations between periodontal disease and systemic diseases: a nationwide population-based study in Korea
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Scientific Reports.2023;[Epub] CrossRef - Association between work-related physical activity and depressive symptoms in Korean workers: data from the Korea national health and nutrition examination survey 2014, 2016, 2018, and 2020
Min Jeong Joo, Ye Seul Jang, Yun Seo Jang, Eun-Cheol Park
BMC Public Health.2023;[Epub] CrossRef - Association between weight loss agents and elevated liver enzymes: a population-based cross-sectional study
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Scientific Reports.2023;[Epub] CrossRef - Association between long working hours and cigarette smoking, leisure-time physical activity, and risky alcohol use: Findings from the Korea National Health and Nutrition Examination Survey (2014–2021)
Seong-Uk Baek, Jin-Ha Yoon
Preventive Medicine.2023; 175: 107691. CrossRef - Public Awareness of Dyslipidemia Among the Korean Population: A Survey Study
Jae Hyun Bae, Eun-Sun Jin, Sung Eun Kim, Shinae Kang, Jong-Young Lee, Minsu Kim, Heung Yong Jin, Min-Jeong Shin, In-Kyung Jeong
Journal of Lipid and Atherosclerosis.2023; 12(3): 307. CrossRef - Standardized protocol of blood pressure measurement and quality control program for the Korea National Health and Nutrition Examination Survey
Hack-Lyoung Kim, Sang Min Park, In Jeong Cho, Yu-Mi Kim, Dae-Hee Kim, Sung Hye Kim, Kwang-Il Kim, Ki-Chul Sung, Sang-Hyun Ihm, Jinho Shin, Yoonjung Kim, Kyungwon Oh, Eun Mi Lee
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Eunjeong Ji, Soyeon Ahn, Jung-Yeon Choi, Cheol-Ho Kim, Kwang-il Kim
Scientific Reports.2023;[Epub] CrossRef - Muscle mass and chronic dizziness: a cross-sectional study of a Korean population
Eun Ji Kim, Hye Seon Jeong, Eunjin Kwon, Seong-Hae Jeong, Ji-Soo Kim
Journal of Neurology.2023;[Epub] CrossRef - A Korean Nationwide Cross-Sectional Study Investigating Risk Factors, Prevalence, and Characteristics of Sarcopenia in Men in Early Old Age
Jongseok Hwang, Soonjee Park
Healthcare.2023; 11(21): 2860. CrossRef - 국민건강영양조사 건강설문조사 순환조사체계 설계
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Public Health Weekly Report.2023; 16(42): 1433. CrossRef - National Nutrition Surveys Applying Dietary Records or 24-h Dietary Recalls with Questionnaires: A Scoping Review
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British Journal of Nutrition.2023; : 1. CrossRef - COPD Risk Factor Profiles in General Population and Referred Patients: Potential Etiotypes
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Korean Circulation Journal.2022; 52(5): 382. CrossRef - Inverse Association of Serum Folate Level with Metabolic Syndrome and Its Components in Korean Premenopausal Women: Findings of the 2016–2018 Korean National Health Nutrition Examination Survey
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Environmental Research.2022; 212: 113080. CrossRef - Cardiovascular Implications of the 2021 KDIGO Blood Pressure Guideline for Adults With Chronic Kidney Disease
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Epidemiology and Health.2022; 44: e2022021. CrossRef - Obesity, hypertension, diabetes mellitus, and hypercholesterolemia in Korean adults before and during the COVID-19 pandemic: a special report of the 2020 Korea National Health and Nutrition Examination Survey
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Epidemiology and Health.2022; 44: e2022041. CrossRef - Mental health of Korean adults before and during the COVID-19 pandemic: a special report of the 2020 Korea National Health and Nutrition Examination Survey
Hyunsuk Jeong, Suyeon Park, Jihee Kim, Kyungwon Oh, Hyeon Woo Yim
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Jae Hyun Bae, Kyung-Do Han, Seung-Hyun Ko, Ye Seul Yang, Jong Han Choi, Kyung Mook Choi, Hyuk-Sang Kwon, Kyu Chang Won
Diabetes & Metabolism Journal.2022; 46(3): 417. CrossRef - Serum folate levels and hypertension
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Hyun Yoon
Korean Journal of Clinical Laboratory Science.2022; 54(2): 149. CrossRef - Relationship between Anemia and Falls among Postmenopausal Women in Korea
Yunmi Kim, Jiyun Kim
International Journal of Environmental Research and Public Health.2022; 19(14): 8242. CrossRef - Smoking in the workplace: A study of female call center employees in South Korea
Hyunjin Oh, Sunjoo Boo, Petri Böckerman
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Rihwa Choi, Sang Gon Lee, Eun Hee Lee
Journal of Clinical Medicine.2022; 11(18): 5339. CrossRef - Prevalence Trends of Metabolic Syndrome among Korean Children and Adolescents from a Population-Based Cross-Sectional Survey
Ji Hyun Kim, Jung Sub Lim
Life.2022; 12(9): 1404. CrossRef - The Association of Mercury and ALT with Obesity in Korean Adults: Using Data from the Korea National Health and Nutrition Examination Survey for 11 Years (KNHANES 2005, 2008~2017)
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International Journal of Environmental Research and Public Health.2022; 19(21): 14468. CrossRef - Prevalence and management of hypertension in Korean adults
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Korean Journal of Clinical Laboratory Science.2021; 53(4): 342. CrossRef - Non-cancer disease prevalence and association with occupational radiation exposure among Korean radiation workers
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Scientific Reports.2021;[Epub] CrossRef
COVID-19: Original Article
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The role of vitamin D deficiency on COVID-19: a systematic review and meta-analysis of observational studies
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Mehmet Onur Kaya
, Esra Pamukçu
, Burkay Yakar
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Epidemiol Health. 2021;43:e2021074. Published online September 23, 2021
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DOI: https://doi.org/10.4178/epih.e2021074
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14,435
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619
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35
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Abstract
Summary
PDF
Supplementary Material
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Abstract
OBJECTIVES
Although vaccination has started, coronavirus disease 2019 (COVID-19) poses a continuing threat to public health. Therefore, in addition to vaccination, the use of supplements to support the immune system may be important. The purpose of this study was to synthesize evidence on the possible effect of low serum vitamin D levels (25[OH]D<20 ng/mL or 50 nmol/L) on COVID-19 infection and outcomes.
METHODS
We searched Google Scholar, PubMed, Scopus, Web of Science, and ScienceDirect without any language restrictions for articles published between January 1 and December 15, 2020. We performed 3 meta-analyses (called vitamin D and COVID-19 infection meta-analysis [D-CIMA], vitamin D and COVID-19 severity meta-analysis [D-CSMA], and vitamin D and COV ID-19 mortality meta-analysis [D-CMMA] for COVID-19 infection, severity, and mortality, respectively) to combine odds ratio values according to laboratory measurement units for vitamin D and the measured serum 25(OH)D level.
RESULTS
Twenty-one eligible studies were found to be relevant to the relationship between vitamin D and COVID-19 infection/outcomes (n=205,869). The D-CIMA meta-analysis showed that individuals with low serum vitamin D levels were 1.64 times (95% confidence interval [CI], 1.32 to 2.04; p<0.001) more likely to contract COVID-19. The D-CSMA meta-analysis showed that people with serum 25(OH)D levels below 20 ng/mL or 50 nmol/L were 2.42 times (95% CI, 1.13 to 5.18; p=0.022) more likely to have severe COVID-19. The D-CMMA meta-analysis showed that low vitamin D levels had no effect on COVID-19 mortality (OR, 1.64; 95% CI, 0.53 to 5.06, p=0.390).
CONCLUSIONS
According to our results, vitamin D deficiency may increase the risk of COVID-19 infection and the likelihood of severe disease. Therefore, we recommend vitamin D supplementation to prevent COVID-19 and its negative outcomes.
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Summary
Key Message
Although vaccination has started, it seems that Covid-19 will continue to threaten public health for a long time. In addition to the vaccine, the use of supplements to support the immune system may also be important. The purpose of this study is to indicate the possible effect of low serum vitamin D (25(OH)D<20 ng/mL or 50nmol/L) on the Covid-19 infection and outcomes. According to our remarkable results, vitamin D deficiency increases the risk of Covid-19 infection and the potential for the severity of the disease. Therefore, vitamin D supplements should be added to prevention and treatment protocols for Covid-19 disease.
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Citations
Citations to this article as recorded by

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Adrian R. Martineau
Proceedings of the Nutrition Society.2023; 82(2): 200. CrossRef - 100 years of vitamin D. The impact of vitamin D level in the time of COVID-19 pandemic
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Russian Journal for Personalized Medicine.2023; 2(6): 33. CrossRef - Vitamin D3 and COVID-19 Outcomes: An Umbrella Review of Systematic Reviews and Meta-Analyses
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Nutrients.2022; 14(13): 2602. CrossRef - Vitamin D Endocrine System and COVID-19: Treatment with Calcifediol
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Nutrients.2022; 14(13): 2716. CrossRef - Impaired Vitamin D Metabolism in Hospitalized COVID-19 Patients
Alexandra Povaliaeva, Viktor Bogdanov, Ekaterina Pigarova, Larisa Dzeranova, Nino Katamadze, Natalya Malysheva, Vitaliy Ioutsi, Larisa Nikankina, Liudmila Rozhinskaya, Natalia Mokrysheva
Pharmaceuticals.2022; 15(8): 906. CrossRef - Vitamin D and COVID-19. Two years of research
Andrey P. Fisenko, Svetlana G. Makarova, Dmitry S. Yasakov, Irina Yu. Pronina, Oksana A. Ereshko, Irina G. Gordeeva, Albina A. Galimova, Tamara R. Chumbadze, Evgeny Е. Emelyashenkov, Ayina M. Lebedeva
Russian Pediatric Journal.2022; 25(3): 199. CrossRef - Vitamin D as the essential immunonutrient – the evidence base update: A review
Svetlana G. Makarova, Evgeny E. Emelyashenkov, Dmitry S. Yasakov, Irina Yu. Pronina, Oksana A. Ereshko, Irina G. Gordeeva, Albina A. Galimova, Tamara R. Chumbadze, Ayina M. Lebedeva
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Johannes Menger, Zheng-Yii Lee, Quirin Notz, Julia Wallqvist, M. Shahnaz Hasan, Gunnar Elke, Martin Dworschak, Patrick Meybohm, Daren K. Heyland, Christian Stoppe
Critical Care.2022;[Epub] CrossRef - Prevention of covid-19 and other acute respiratory infections with cod liver oil supplementation, a low dose vitamin D supplement: quadruple blinded, randomised placebo controlled trial
Sonja H Brunvoll, Anders B Nygaard, Merete Ellingjord-Dale, Petter Holland, Mette Stausland Istre, Karl Trygve Kalleberg, Camilla L Søraas, Kirsten B Holven, Stine M Ulven, Anette Hjartåker, Trond Haider, Fridtjof Lund-Johansen, John Arne Dahl, Haakon E M
BMJ.2022; : e071245. CrossRef - Adipokines, and not vitamin D, associate with antibody immune responses following dual BNT162b2 vaccination within individuals younger than 60 years
Mariana Pavel-Tanasa, Daniela Constantinescu, Corina Maria Cianga, Ecaterina Anisie, Ana Irina Mereuta, Cristina Gabriela Tuchilus, Petru Cianga
Frontiers in Immunology.2022;[Epub] CrossRef - Vitamin D intoxication induced severe hypercalcemia from self-medication for COVID-19 infection: a public health problem?
Stefano PINI, Giuseppe SCAPARROTTA, Valentina DI VICO, Antonio FRAGASSO, Lucia F. STEFANELLI, Federico NALESSO, Lorenzo A. CALÒ
Minerva Endocrinology.2022;[Epub] CrossRef - Novel CYP11A1-Derived Vitamin D and Lumisterol Biometabolites for the Management of COVID-19
Shariq Qayyum, Radomir M. Slominski, Chander Raman, Andrzej T. Slominski
Nutrients.2022; 14(22): 4779. CrossRef - COVID-19 Prevention: Vitamin D Is Still a Valid Remedy
Rachel Nicoll, Michael Y. Henein
Journal of Clinical Medicine.2022; 11(22): 6818. CrossRef - Integrated bioinformatics and in silico approaches reveal the biological targets and molecular mechanisms of 1,25-dihydroxyvitamin D against COVID-19 and diabetes mellitus
Fanqiang Zeng, Yongli Xu, Chaoling Tang, Zhigang Yan, Chaohe Wei
Frontiers in Nutrition.2022;[Epub] CrossRef - Can vitamin D status influence seroconversion to SARS-COV2 vaccines?
Endrit Shahini, Francesco Pesce, Antonella Argentiero, Antonio Giovanni Solimando
Frontiers in Immunology.2022;[Epub] CrossRef - Cholecalciferol as part of complex therapy for acute COVID-19
K.A. Golovatyuk, T.L. Karonova, A.A. Mikhailova, D.I. Lagutina, A.T. Chernikova, E.Yu. Vasilieva, E.V. Shlyakhto
Profilakticheskaya meditsina.2022; 25(12): 106. CrossRef - Vitamin D Metabolism Gene Polymorphisms and Their Associated Disorders: A
Literature Review
Mohamed Abouzid, Franciszek Główka, Leonid Kagan, Marta Karaźniewicz-Łada
Current Drug Metabolism.2022; 23(8): 630. CrossRef - Nutraceuticals in prevention and management of COVID-19
Ivana Đuričić, Milica Zrnić-Ćirić, Bojana Vidović, Vanja Todorović, Nevena Dabetić, Nevena Ivanović
Hrana i ishrana.2021; 62(2): 7. CrossRef
Original Article
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Association of blood pressure measurements in sitting, supine, and standing positions with the 10-year risk of mortality in Korean adults
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Inkyung Baik
, Nan Hee Kim
, Seong Hwan Kim
, Chol Shin
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Epidemiol Health. 2023;45:e2023055. Published online June 8, 2023
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DOI: https://doi.org/10.4178/epih.e2023055
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Abstract
Summary
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Supplementary Material
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Abstract
OBJECTIVES
This prospective cohort study investigated the association between blood pressure (BP) as measured in different body postures and all-cause and cardiovascular (CV) mortality risk.
METHODS
This population-based investigation included 8,901 Korean adults in 2001 and 2002. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured sequentially in the sitting, supine, and standing positions and classified into 4 categories: (1) normal, SBP <120 mmHg and DBP <80 mmHg; (2) high normal/prehypertension, SBP 120-129 mmHg and DBP <80 mmHg/SBP 130-139 mmHg or DBP 80-89 mmHg; (3) grade 1 hypertension (HTN), with SBP 140-159 mmHg or DBP 90-99 mmHg; and (4) grade 2 HTN, SBP ≥160 mmHg or DBP ≥100 mmHg. The date and cause of individual deaths were confirmed in the death record data compiled until 2013. Data were analyzed using Cox proportional hazard regression.
RESULTS
Significant associations were found between the BP categories and all-cause mortality, but only when BPs were measured in the supine position. The multivariate hazard ratios (95% confidence intervals, [CIs]) were 1.36 (95% CI, 1.06 to 1.75) and 1.59 (95% CI, 1.06 to 2.39) for grade 1 HTN and grade 2 HTN, respectively, compared with the normal category. The associations between the BP categories and CV mortality were significant regardless of body posture among participants ≥65 years, whereas they were significant for supine BP measurements only in those <65 years.
CONCLUSIONS
BP measured in the supine position predicted all-cause mortality and CV mortality better than BP measured in other postures.
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Summary
Korean summary
본 역학 연구는 한국 성인 8,901명을 연구대상자로 하여 기초조사에서 세가지 자세, 즉 앉은 자세, 누운 자세, 일어선 자세에서 혈압을 측정하고, 이후 10년 동안의 사망 여부를 추적조사하여, 측정 자세에 따른 혈압과 사망 위험과의 관련성을 분석하였다. 그 결과, 누운 자세에서 측정된 고혈압(기준: 수축기 혈압이 140 mmHg 이상 혹은 이완기 혈압이 90 mmHg 이상)인 사람은 정상 혈압(기준: 수축기 혈압이 120 mmHg 미만이고 이완기 혈압이 80 mmHg 미만)인 사람에 비해 36%(1단계 고혈압) 혹은 59%(2단계 고혈압) 가량 총 사망 위험이 유의적으로 증가하는 것으로 나타났다. 이에 비해, 앉은 자세 및 일어선 자세에서 측정, 정의된 고혈압은 총 사망 위험을 증가시켰지만 유의적인 결과를 나타내지 못했다. 추후 연구에서 재확인이 필요하지만, 본 연구 결과가 시사하는 바는 앉은 자세나 일어선 자세보다 누운 자세에서 측정하는 혈압이 총 사망 위험을 더 잘 예측하므로, 고혈압 진단 외의 추가적인 활용 가능성이 있는 것으로 평가된다.
Key Message
The current epidemiological study revealed that blood pressure measured in a supine position could predict all-cause mortality and cardiovascular mortality better than blood pressure measured in a sitting or standing position. As a result, blood pressure measurements in a supine position may be useful in assessing mortality risk.
Data Profile
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The Korea National Health and Nutrition Examination Survey data linked Cause of Death data
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Sungha Yun
, Kyungwon Oh
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Epidemiol Health. 2022;44:e2022021. Published online February 9, 2022
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DOI: https://doi.org/10.4178/epih.e2022021
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10,502
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587
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7
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Abstract
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Abstract
The Korea National Health and Nutrition Examination Survey (KNHANES) is a national health survey that is conducted annually to assess the health and and health-related behaviors of Korean population. To utilize KNHANES data to studies of mortality risk factors, the Korea Disease Control and Prevention Agency (KDCA) constructed a database linking KNHANES data to cause-of-death statistics in Statistics Korea, made available to researchers since 2020. The KNHANES data were linked to the Cause of Death Statistics based on resident registration numbers for subjects aged 19 years or older who agreed to link the data. The linkage rate between 2007-2015 National Health and Nutrition Examination Survey and 2007-2019 Cause of Death Statistics was 97.1%. In the linked dataset, the total death rate was 6.6%, of which neoplasms accounted for the highest death rate (32.1%), followed by circulatory system disease (22.7%) and respiratory system disease (11.5%). The linked dataset was made available through the Research Data Center of the KDCA after a review of the research proposal, and will be made available after periodical updates.
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Summary
Korean summary
1. 국민건강영양조사 자료가 사망 위험요인 규명 연구에 활용되도록 통계청의 사망원인통계와 연계자료 구축함
2. 2007~2015년 국민건강영양조사와 2007~2019년 사망원인통계의 연계율은 97.1%이었음
3. 국민건강영양조사-사망원인통계 연계자료는 2020년부터 연구자에게 질병관리청 내 학술연구자료처리실를 통해 제공되고 있음
Key Message
1. To utilize the Korea National Health and Nutrition Examination Survey (KNHANES) data to studies of mortality risk factors, the data were linked to the Cause of Death Statistics in the Statistics Korea.
2. The linkage rate between the 2007-2015 KNHANES and the 2007-2019 Cause of Death Statistics was 97.1%.
3. The Korea National Health and Nutrition Examination Survey data linked Cause of Death data have been provided to researchers through the Research Data Center in the Korea Disease Control and Prevention Agency (KDCA) since 2020.
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Citations
Citations to this article as recorded by

- Computational method of the cardiovascular diseases classification based on a generalized nonlinear canonical decomposition of random sequences
Igor Atamanyuk, Yuriy Kondratenko, Valerii Havrysh, Yuriy Volosyuk
Scientific Reports.2023;[Epub] CrossRef - The Association between Advanced Liver Fibrosis and Mortality Is Modified by Dietary Quality among Korean Adults: Results from the Korea National Health and Nutrition Examination Survey with Mortality Data
Juhee Lee, Garam Jo, Dahyun Park, Hee Ju Jun, Jae Hyun Bae, Min-Jeong Shin
Nutrients.2023; 15(6): 1501. CrossRef - Association of dietary sodium intake with impaired fasting glucose in adult cancer survivors: A population-based cross-sectional study
Kyuwoong Kim, Hamee Kim, Tae Joon Jun, Young-Hak Kim, Dong Keon Yon
PLOS ONE.2023; 18(5): e0286346. CrossRef - Fibrosis-4 Index Predicts Long-Term All-Cause, Cardiovascular and Liver-Related Mortality in the Adult Korean Population
Young-Gyun Seo, Stergios A. Polyzos, Kyung-Hee Park, Christos S. Mantzoros
Clinical Gastroenterology and Hepatology.2023; 21(13): 3322. CrossRef - The serotype-specific prevalence of pneumococci in hospitalized pneumonia patients with COPD: a prospective, multi-center, cohort study
Jae Yeol Kim, Jae-Woo Jung, Min-Jong Kang, Deog Kyeom Kim, Hayoung Choi, Young-Jae Cho, Seung Hun Jang, Chang-Hoon Lee, Yeon Mok Oh, Ji Sook Park
The Korean Journal of Internal Medicine.2023; 38(5): 714. CrossRef - The Korea Cohort Consortium: The Future of Pooling Cohort Studies
Sangjun Lee, Kwang-Pil Ko, Jung Eun Lee, Inah Kim, Sun Ha Jee, Aesun Shin, Sun-Seog Kweon, Min-Ho Shin, Sangmin Park, Seungho Ryu, Sun Young Yang, Seung Ho Choi, Jeongseon Kim, Sang-Wook Yi, Daehee Kang, Keun-Young Yoo, Sue K. Park
Journal of Preventive Medicine and Public Health.2022; 55(5): 464. CrossRef - Self-perceived Weight and Mortality in Korean Adults Based on the Korea National Health and Nutrition Examination Survey Data Linked to Cause of Death Statistics
Kayoung Lee
Journal of Obesity & Metabolic Syndrome.2022; 31(4): 313. CrossRef
Special Article
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The Korea National Disability Registration System
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Miso Kim
, Wonyoung Jung
, So Young Kim
, Jong Hyock Park
, Dong Wook Shin
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Epidemiol Health. 2023;45:e2023053. Published online May 11, 2023
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DOI: https://doi.org/10.4178/epih.e2023053
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2,899
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176
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2
Citations
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Abstract
Summary
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Supplementary Material
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Abstract
The Korea National Disability Registration System (KNDRS) was established in 1989 to provide social welfare benefits based on predefined criteria for disability registration and an objective medical assessment using a disability grading system. Disability registration requires (1) a medical examination by a qualified specialist physician and (2) a medical advisory meeting to review the degree of disability. Medical institutions and specialists for the diagnosis of disabilities are legally stipulated, and medical records for a specified period are required to support the diagnosis. The number of disability types has gradually expanded, and 15 disability types have been legally defined. As of 2021, 2.645 million people were registered as disabled, accounting for approximately 5.1% of the total population. Among the 15 disability types, disabilities of the extremities account for the largest proportion (45.1%). Previous studies have investigated the epidemiology of disabilities using data from the KNDRS, combined predominantly with data from the National Health Insurance Research Database (NHIRD). Korea has a mandatory public health insurance system that covers the entire Korean population, and the National Health Insurance Services manages all eligibility information, including disability types and severity ratings. In short, the KNDRS-NHIRD is a significant data resource for research on the epidemiology of disabilities.
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Summary
Korean summary
한국에서는 장애의 유형과 장애 유형별 장애정도를 장애인 복지법에서 규정하고 있다. 우리는 한국의 장애등록제도의 역사와 장애등록절차 그리고 장애유형별 통계 현황에 대해서 다루고자 한다.
Key Message
In Korea, the types and severity levels of disabilities are legally defined by the Korea National Disability Registration System (KNDRS). We address the history of the KNDRS, disability registration procedures, and current statistics.
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Citations
Citations to this article as recorded by

- Increased risk of Parkinson's disease amongst patients with age‐related macular degeneration and visual disability: A nationwide cohort study
Je Moon Yoon, Dong Hui Lim, Jinyoung Youn, Kyungdo Han, Bong Sung Kim, Wonyoung Jung, Yohwan Yeo, Dong Wook Shin, Don‐Il Ham
European Journal of Neurology.2023; 30(9): 2641. CrossRef - The link between disability and social participation revisited: Heterogeneity by type of social participation and by socioeconomic status
Jinho Kim, Gum-Ryeong Park, Eun Ha Namkung
Disability and Health Journal.2023; : 101543. CrossRef
Systematic Review
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The prevalence of Q fever in the Eastern Mediterranean region: a systematic review and meta-analysis
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Mozhgan Ahmadinezhad
, Leila Mounesan
, Amin Doosti-Irani
, Manijeh Yousefi Behzadi
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Epidemiol Health. 2022;44:e2022097. Published online October 28, 2022
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DOI: https://doi.org/10.4178/epih.e2022097
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4,221
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138
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3
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Abstract
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Supplementary Material
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Abstract
OBJECTIVES
Q fever, caused by the bacterium, is a major zoonotic disease around the world. This disease is common in the Eastern Mediterranean region; therefore, we conducted the first systematic review and meta-analysis on its prevalence in humans, animals, and ticks in the Eastern Mediterranean region.
METHODS
Major Iranian and international databases were searched from 2000 to 2021. We extracted the prevalence of Q fever in blood samples from animals and milk samples from animals, ticks, and humans as the main outcome. We reported the prevalence of seropositivity and molecular positivity as point estimates and 95% confidence intervals (CIs).
RESULTS
In this review, 112 papers were identified. The overall seroprevalence of Q fever was 22.4% (95% CI, 19.8 to 25.1). The pooled prevalence of Q fever in ticks was 17.5% (95% CI, -1.3 to 36.4). The prevalence was 25.5% (95% CI, 16.1 to 34.9) in humans. The prevalence of Q fever in animal blood samples from goats, sheep, camels, cattle, cats, dogs, horses, and buffalo were 28.1%, 25.1%, 25.0%, 20.1%, 9.8%, 8.4%, 6.5%, and 6.3%, respectively. Furthermore, the prevalence of Q fever in milk samples of animals was higher in cattle (20.3%) than in sheep (20.0%), goats (16.4%), and camels (3.3%).
CONCLUSIONS
Coxiella burnetii infections are common in humans and in a wide range of animal species, but they are still not recognized in many countries in the Eastern Mediterranean region, thus presenting a significant threat to human and animal health in the region.
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Summary
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Citations
Citations to this article as recorded by

- Two Cases of Acute Q Fever Diagnosed by mNGS and Literature Review
娇 罗
Advances in Clinical Medicine.2023; 13(07): 12005. CrossRef - Zoonotic diseases transmitted from the camels
Abdelmalik Ibrahim Khalafalla
Frontiers in Veterinary Science.2023;[Epub] CrossRef - Q fever and coxiellosis: implications for livestock and human health in the UK
Nick Wheelhouse, Richard Vazquez, Lorenzo Viora, Jo E. B. Halliday
Livestock.2023; 28(5): 221. CrossRef
Original Article
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Adherence to the World Cancer Research Fund/American Institute for Cancer Research and Korean Cancer Prevention Guidelines and cancer risk: a prospective cohort study from the Health Examinees-Gem study
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Jeeyoo Lee
, Aesun Shin
, Woo-Kyoung Shin
, Ji-Yeob Choi
, Daehee Kang
, Jong-Koo Lee
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Epidemiol Health. 2023;45:e2023070. Published online August 1, 2023
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DOI: https://doi.org/10.4178/epih.e2023070
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Abstract
Summary
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Supplementary Material
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Abstract
OBJECTIVES
The purpose of this study was to explore the association between adherence to 2 cancer prevention recommendations and cancer risk.
METHODS
In total, 104,386 individuals aged 40-69 years old who were recruited between 2004 and 2013 in the Health Examinees-Gem study were included. Adherence scores were constructed based on 8 items from the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) cancer prevention recommendations, including body weight, physical activity, diet, alcohol consumption and breastfeeding, and on 6 items from the Korean cancer prevention guidelines (smoking status, eating vegetables and fruits, salty foods, alcohol intake, physical activity, and body weight). A Cox proportional hazards model was used to estimate the associations between adherence scores and the risk of total and 5 major cancers.
RESULTS
The multivariable hazard ratio (HR) for total cancer with the high adherence score versus the lowest score (4.25-7.00 vs. 0.00-3.25) for the WCRF/AICR guidelines was 0.91 (95% confidence interval [CI], 0.82 to 1.00) in men. A reduced breast cancer risk was observed among women with the highest score. Men within the highest category of the Korean cancer prevention guideline score (3.25-6.00) had an HR of 0.80 (95% CI, 0.73 to 0.88) for developing total cancer compared to men within the lowest score (0.00-2.50). The higher adherence group among men showed lower risks of developing stomach, colorectal, and lung cancers.
CONCLUSIONS
Adhering to guidelines for cancer prevention can help to reduce the risk of developing cancer in Korean men. The association might differ by cancer type and gender.
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Summary
Korean summary
- 암예방 가이드라인 준수가 실제로 암 발생을 예방하는지에 대한 해외 연구들이 다수 있으나 한국을 포함한 아시아 국가에서 수행된 연구는 없다.
- 국제암연구재단 암예방수칙과 한국 암예방수칙을 준수하는 한국인 남성에서 암 발생 감소가 관찰되었다. 이러한 관련성은 암종에 따라 다르게 나타났다.
Key Message
- The adherence to the World Cancer Research Fund/American Institute of Cancer Research (WCRF/AICR) guidelines on cancer prevention has been addressed in several studies in Western countries.
-Among the Korean population, adherence to WCRF/AICR cancer prevention guidelines as well as the Korean cancer prevention guidelines helps prevent cancer in men. Association varies by gender and type of cancer.
Systematic Reviews
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The effect of peer support in diabetes self-management education on glycemic control in patients with type 2 diabetes: a systematic review and meta-analysis
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Akhmad Azmiardi
, Bhisma Murti
, Ratih Puspita Febrinasari
, Didik Gunawan Tamtomo
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Epidemiol Health. 2021;43:e2021090. Published online October 22, 2021
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DOI: https://doi.org/10.4178/epih.e2021090
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8,564
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244
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11
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Abstract
Summary
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Supplementary Material
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Abstract
OBJECTIVES
Diabetes self-management education (DSME) programs are a strategy to maintain healthy behaviors. Nevertheless, limited evidence has been reported from systematic evaluations of the effects of DSME integrated with peer support on glycemic control. This study aimed to review the effectiveness of DSME interventions integrated with peer support on glycemic control in patients with type 2 diabetes.
METHODS
A systematic search was carried out in electronic databases, including PubMed, Cochrane Library, ProQuest, SpringerLink, ScienceDirect, Scopus, and Google Scholar, for English-language articles published from 2005 until 2020. The effect size was estimated as the standard mean difference (SMD). The Cochrane Collaboration’s Risk of Bias tool was employed to assess the risk of bias.
RESULTS
Twelve studies were included in this study. DSME integrated with peer support effectively reduced glycated hemoglobin A1c (HbA1c) levels, with a statistically significant effect (SMD, -0.41; 95% confidence interval [CI], -0.69 to -0.13; p<0.001). Programs with a sample size <100 (SMD, -0.45; 95% CI, -0.79 to -0.11; p=0.009), duration of intervention ≤6 months (SMD, -0.52; 95% CI, -0.96 to -0.07; p=0.020), baseline HbA1c <8.5% (SMD, -0.42; 95% CI, -0.77 to -0.07; p=0.020), delivery by group (SMD, -0.28; 95% CI, -0.51 to -0.06; p=0.010), and high frequency of contact (SMD, -0.29; 95% CI, -0.48 to -0.10; p=0.003) had statistically significant effects on reducing HbA1c levels in patients with type 2 diabetes.
CONCLUSIONS
DSME integrated with peer support effectively enhances glycemic control in patients with type 2 diabetes. Programs with smaller participants groups, shorter interventions, weekly meetings, and closer group sessions improved glycemic control in patients with type 2 diabetes.
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Summary
Key Message
We reviewed and assessed the quality of the twelve articles included in this systematic review and meta-analysis. The findings of this review show that peer support integrated with diabetes self-management education programs can significantly enhance glycemic control in type 2 diabetes patients. Peer support is a critical component of a successful diabetes self-management programme in patients with type 2 diabetes. interventions programme with smaller groups, shorter durations, lower HbA1c baseline levels, group sessions, and high frequencies of sessions significantly enhanced glycemic control.
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Citations
Citations to this article as recorded by

- The current diabetes education experience: Findings of a cross-sectional survey of adults with type 2 diabetes
Kelley M. Baker, Carine M. Nassar, Neelam Baral, Michelle F. Magee
Patient Education and Counseling.2023; 108: 107615. CrossRef - 2023 update on Italian guidelines for the treatment of type 2 diabetes
Edoardo Mannucci, Riccardo Candido, Lina delle Monache, Marco Gallo, Andrea Giaccari, Maria Luisa Masini, Angela Mazzone, Gerardo Medea, Basilio Pintaudi, Giovanni Targher, Marina Trento, Giuseppe Turchetti, Valentina Lorenzoni, Matteo Monami
Acta Diabetologica.2023; 60(8): 1119. CrossRef - Mechanisms Activated in the Interaction between Peer Supporters and Peers: How do the Peer Supporters Perceive and Perform Their Role in an Intervention Targeted Socially Vulnerable People with Type 2 Diabetes: A Realist-Informed Evaluation
Stine Dandanell Garn, Charlotte Glümer, Sarah Fredsted Villadsen, Majken Lillholm Pico, Ulla Christensen, Gianpiero Greco
Health & Social Care in the Community.2023; 2023: 1. CrossRef - Fresh Start: A Comprehensive Pilot Produce Prescription Program to Improve Food Literacy and Glycemic Control in Rural, Uninsured Patients
Lauren R. Sastre, Brandon J. Stroud
American Journal of Lifestyle Medicine.2023;[Epub] CrossRef - Current evidence for designing self-management support for underserved populations: an integrative review using the example of diabetes
Ian Litchfield, Tim Barrett, Julian Hamilton-Shield, Theresa Moore, Parth Narendran, Sabi Redwood, Aidan Searle, Suma Uday, Jess Wheeler, Sheila Greenfield
International Journal for Equity in Health.2023;[Epub] CrossRef - Diabetes care components effectively implemented in the ASEAN health systems: an umbrella review of systematic reviews
Vannarath Te, Sokvy Ma, Ir Por, Wim Van Damme, Edwin Wouters, Josefien van Olmen
BMJ Open.2023; 13(10): e071427. CrossRef - The impact of veteran support and resources for diabetes (iNSPiRED) on diabetes distress: Results from a randomized, parallel-group trial
Mark E. Kunik, Tracy L. Evans, Israel C. Christie, Gala True, Andrea Bradford, Madhuri M. Vasudevan, Natalie E. Hundt
General Hospital Psychiatry.2023; 85: 55. CrossRef - A stepped wedge cluster randomized trial to evaluate the effectiveness of a community leader-driven kit-based diabetes self-management education approach in improving diabetes control and care: study protocol for the DElhi Diabetes INTervention Trial (DED
Jitender Nagpal, Swapnil Rawat, Lovely Gupta, Avantika Negi, Divya Shashi Oraon
Trials.2023;[Epub] CrossRef - Impact of Diabetes Self-Management Education on A1C Levels Among Black/African Americans: A Systematic Review
Hilda M. Okeyo, Martha Biddle, Lovoria B. Williams
The Science of Diabetes Self-Management and Care.2023;[Epub] CrossRef - Family doctors’ attitudes toward peer support programs for type 2 diabetes and/or coronary artery disease: an exploratory survey among German practitioners
K. Majjouti, L. Küppers, A. Thielmann, M. Redaélli, F. Vitinius, C. Funke, I. van der Arend, L. Pilic, M. Hessbrügge, S. Stock, B. Weltermann, D. Wild
BMC Primary Care.2022;[Epub] CrossRef - From clinic to community: A randomized controlled trial of a peer support model for adults with type 2 diabetes from specialty care settings in British Columbia
Tricia S. Tang, Rowshanak Afshar, Thomas Elliott, Jason Kong, Sabrina Gill
Diabetic Medicine.2022;[Epub] CrossRef
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Association between gallstones and the risk of biliary tract cancer: a systematic review and meta-analysis
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Dan Huang
, Hyundeok Joo
, Nan Song
, Sooyoung Cho
, Woosung Kim
, Aesun Shin
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Epidemiol Health. 2021;43:e2021011. Published online February 3, 2021
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DOI: https://doi.org/10.4178/epih.e2021011
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12,509
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385
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12
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Abstract
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Supplementary Material
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Abstract
OBJECTIVES
Biliary tract cancers (BTCs) are rare but highly fatal. Although the etiology of BTC is poorly understood, gallstones are proposed to be a major risk factor. We conducted a systematic review and meta-analysis to examine the associations between gallstone characteristics and BTC risk.
METHODS
We searched the MEDLINE, Embase, and Cochrane Central databases and systematically reviewed cohort and case-control studies published before April 9, 2018. All the included studies reported appropriate risk estimates and confidence intervals (CIs) for associations between the presence, size, number, or duration of gallstones and the risk of BTC, including gallbladder cancer (GBC), extrahepatic bile duct cancer (EBDC), and ampulla of Vater cancer (AOVC). Summary odds ratios (ORs) and their 95% CIs were calculated using a random-effects model in the meta-analysis. Subgroup analyses were conducted to inspect sources of potential heterogeneity, and the Egger test was performed to assess publication bias.
RESULTS
Seven cohort studies and 23 case-control studies in Asian, European, and American populations were included. The presence of gallstones was associated with an increased risk of BTC (OR, 4.38; 95% CI, 3.23 to 5.93; I<sup>2</sup>=91.2%), GBC (OR, 7.26; 95% CI, 4.33 to 12.18), EBDC (OR, 3.17; 95% CI, 2.24 to 4.50), and AOVC (OR, 3.28; 95% CI, 1.33 to 8.11). Gallstone size (>1 vs. <1 cm; OR, 1.88; 95% CI, 1.10 to 3.22) was significantly associated with the risk of GBC.
CONCLUSIONS
Gallstone characteristics, such as presence, size, and number, are associated with an increased risk of BTC. However, significantly high heterogeneity in the meta-analyses is a limitation of this study.
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Summary
Korean summary
The prevalence of APCT-detected sacroiliitis in CD patients was higher than that in controls, but the condition was asymptomatic. The clinical significance of asymptomatic sacroiliitis in Korean CD patients remains unclear.
Key Message
본 연구에서는 체계적 문헌고찰과 메타분석법을 활용하여 여러 선행연구에서 담도계암 전반과 담석의 다양한 특성사이에 연관성이 있는지 탐구하였다. 총 30개의 문헌을 분석한 결과 담석의 존재 여부가 담도계암과 각 하위 암의 위험을 모두 높이는 것으로 나타났고, 담석의 크기가 클수록 담낭암의 위험이 높은 것으로 드러났다. 본 연구는 담석과 담도계암 전반의 연관성에 대해 체계적으로 정리한 최초의 문헌으로서 담석과 담도계암의 관계에 대한 이해의 폭을 넓히고, 추후 해당 주제로 추가 연구를 수행하는 데에 있어 기준점이 될 수 있으리라 기대한다.
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Original Articles
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Trends in health behaviors over 20 years: findings from the 1998-2018 Korea National Health and Nutrition Examination Survey
-
Soyeon Kim
, Sunhye Choi
, Jihee Kim
, Suyeon Park
, Young-Taek Kim
, Ok Park
, Kyungwon Oh
-
Epidemiol Health. 2021;43:e2021026. Published online April 19, 2021
-
DOI: https://doi.org/10.4178/epih.e2021026
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9,988
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345
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15
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Abstract
Summary
PDF
Supplementary Material
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Abstract
OBJECTIVES
This study aimed to examine the trends in health behaviors in Korean population using data from the Korea National Health and Nutrition Examination Survey (KNHANES).
METHODS
The subjects were 96,408 adults aged 19 years or older who participated in the first (1998) through seventh (2016-2018) KNHANES health interview. The prevalence of health behaviors (cigarette smoking, alcohol drinking, and physical activity) and annual percent change (APC) were estimated using SAS and the Joinpoint program.
RESULTS
The prevalence of current cigarette smoking in men decreased by 2.8%p (APC= -2.8, p< 0.001) annually over the 20-year period, and the prevalence of exposure to secondhand smoke at home substantially decreased compared to 2005 (APC= -8.8, p< 0.001). Compared to 2005, the prevalence of current alcohol drinking in women, but not men, increased (APC= 2.0, p< 0.001), and the prevalence of binge drinking decreased in men (APC= -0.7, p< 0.001) and increased in women (APC= 2.4, p< 0.001). The prevalence of aerobic physical activity decreased from 2014 in both gendersd (p< 0.001). The prevalence of healthy behaviors practice (non-smoking, alcohol abstinence, and aerobic physical activity) was down-trending (APC= -5.3, p< 0.001), especially among women (APC= -6.4, p< 0.001).
CONCLUSIONS
Over the past 20 years, smoking behaviors improved. However, drinking behavior was unchanged and physical activity indicators markedly decreased. More active programs are necessary for improving health behaviors, which are major risk factors linked to chronic diseases.
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Summary
Korean summary
국민건강영양조사(1998-2018) 자료를 활용하여 지난 20년간 성인의 건강행태를 분석한 결과 흡연율과 간접흡연 노출률은 지속적으로 감소하였고, 신체활동 실천율 또한 감소하였다. 월간음주율과 폭음률의 경우 남자는 큰 변화가 없었던 반면 여자는 모두 증가하였다.
Key Message
This study aimed to examine the trends in health behaviors in Korean population using data from the 1998-2018 Korea National Health and Nutrition Examination Survey (KNHANES). Over the past 20 years, the prevalence of cigarette smoking and exposure to secondhand smoke in Korean adults consistently decreased, as well as the prevalence of physical activity. There was no considerable change in men, whereas in women, the prevalence of alcohol drinking and binge drinking both increased.
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- Adherence to Cancer Prevention Guidelines and Cancer Incidence and Mortality: A Population-Based Cohort Study
Jin-Kyoung Oh, Minji Han, Byungmi Kim, Eun Young Park
Cancer Research and Treatment.2023; 55(1): 15. CrossRef - Ocular motility disorders following coronavirus disease-19 vaccination
Kyung-Ah Park, Hyeshin Jeon, Dong Gyu Choi, Jae Ho Jung, Hyun-Jin Shin, Byung Joo Lee, Yeji Moon, Se-Youp Lee, Dong Cheol Lee, Soon Young Cho, Seong-Joon Kim, Sei Yeul Oh, Sunghyuk Moon, Shin Yeop Oh, Daye Diana Choi, Mi Young Choi, Won Jae Kim, Ungsoo Sa
Graefe's Archive for Clinical and Experimental Ophthalmology.2023; 261(4): 1127. CrossRef - Alcoholic liver disease in relation to cancer incidence and mortality: Findings from a large, matched cohort study in South Korea
Thi Phuong Thao Tran, Minji Han, Ngoc Minh Luu, Jin‐Kyoung Oh
Cancer Medicine.2023; 12(7): 8754. CrossRef - Associations of dual use of tobacco cigarettes and e‐cigarettes, sleep duration, physical activity and depressive symptoms among middle‐aged and older Korean adults
Mi‐Ae You, JiYeon Choi, Youn‐Jung Son
Nursing Open.2023; 10(6): 4071. CrossRef - Prevalence, Trend, and Risk Factors for Early Chronic Obstructive Pulmonary Disease: An Analysis of the Nationwide Population-Based Survey from 2010 to 2019 in South Korea
Taeyun Kim, Hyunji Choi, Ju-il Seo, Seung-Jin Kim, Ji-Eun Choi, Minsu Yun, Jihun Kang
COPD: Journal of Chronic Obstructive Pulmonary Disease.2023; 20(1): 153. CrossRef - Trends in the Quality of Primary Care and Acute Care in Korea From 2008 to 2020: A Cross-sectional Study
Yeong Geun Gwon, Seung Jin Han, Kyoung Hoon Kim
Journal of Preventive Medicine and Public Health.2023; 56(3): 248. CrossRef - Association of handgrip strength with new-onset CKD in Korean adults according to gender
Sung-Bum Lee, Miryung Kim, Hui-Jeong Lee, Jong-Koo Kim
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Biomedicines.2023; 11(8): 2212. CrossRef - Clinical and life style factors related to the nighttime blood pressure, nighttime dipping and their phenotypes in Korean hypertensive patients
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Clinical Hypertension.2023;[Epub] CrossRef - Combinations of lifestyle behaviors and cancer risk among Korean adults
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Journal of Clinical Medicine.2023; 12(22): 7086. CrossRef - Association of Muscle Strength with Non-Alcoholic Fatty Liver Disease in Korean Adults
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International Journal of Environmental Research and Public Health.2022; 19(3): 1675. CrossRef - Association of Handgrip Strength with Diabetes Mellitus in Korean Adults According to Sex
Sung-Bum Lee, Ji-Eun Moon, Jong-Koo Kim
Diagnostics.2022; 12(8): 1874. CrossRef - Smoking trajectory and cancer risk: A population-based
cohort study
Minh Luu, Minji Han, Tra Bui, Phuong Thao Tran, Min-Kyung Lim, Jin Oh
Tobacco Induced Diseases.2022; 20(August): 1. CrossRef - Awareness of and practice toward cancer prevention recommendations: results of the Korean National Cancer Prevention Awareness and Practice Survey in 2021
Jin-Kyoung Oh, Eunjung Park, Byungmi Kim, Yoon-Jung Choi, E Hwa Yun, Min Kyung Lim, Jeong-Soo Im, Eun Young Park
Epidemiology and Health.2022; 44: e2022068. CrossRef
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Risk of cancer, cardiovascular disease, thromboembolism, and mortality in patients with rheumatoid arthritis receiving Janus kinase inhibitors: a real-world retrospective observational study using Korean health insurance data
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Hong Ki Min
, Hyeongsu Kim
, Ho Jin Jeong
, Se Hee Kim
, Hae-Rim Kim
, Sang-Heon Lee
, KunSei Lee
, Soon-Ae Shin, Jong Heon Park
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Epidemiol Health. 2023;45:e2023045. Published online April 15, 2023
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DOI: https://doi.org/10.4178/epih.e2023045
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3,466
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256
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2
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Abstract
Summary
PDF
Supplementary Material
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Abstract
OBJECTIVES
This study investigated whether Janus kinase inhibitors (JAKis) raise the risk of cardiovascular disease (CVD), venous thromboembolism (VTE), and cancer in patients with rheumatoid arthritis (RA).
METHODS
We conducted a real-world retrospective observational study using data obtained from the Korean National Health Insurance Service database. Two data sets were analyzed: tumor necrosis factor inhibitor (TNFi)/JAKi-naive RA patients (set 1) and all RA patients who used TNFis or JAKis (set 2). The incidence rate ratios (IRRs) and hazard ratios (HRs) for acute myocardial infarction (AMI), stroke, cardiovascular (CV)-related mortality, major adverse cardiovascular events (MACE), VTE, arterial thromboembolism (ATE), cancer, and all-cause mortality were compared between the JAKi and TNFi groups.
RESULTS
Set 1 included 1,596 RA patients (JAKi group: 645; TNFi group: 951), and set 2 included 11,765 RA patients (JAKi group: 2,498; TNFi group: 9,267). No adverse events (AEs) showed significantly higher IRRs in the JAKi groups than in the TNFi groups of sets 1 and 2. The HRs for MACE in the JAKi groups of sets 1 and 2 were 0.59 (95% confidence [CI], 0.35 to 0.99) and 0.80 (95% CI, 0.67 to 0.97), respectively. The JAKi group of set 2 showed a significantly higher risk of all-cause mortality (HR, 1.71; 95% CI, 1.32 to 2.20), but the other AEs did not demonstrate increased risks in the JAKi groups.
CONCLUSIONS
In this study, JAKis did not increase the risk of AMI, stroke, CV-related mortality, MACE, VTE, ATE, or cancer in Korean RA patients relative to TNFis.
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Summary
Korean summary
1. 한국인 류마티스관절염 환자를 대상으로 한 실제임상자료 결과, JAK 억제제가 종양괴사인자 억제제에 비해 심혈관질환, 혈전증, 암 등의 심각한 부작용을 증가시키지는 않았다.
2. 본 연구를 토대로 한국인 대상자에서 JAK 억제제가 심혈관질환 등의 심각한 부작용을 증가시키는지에 대한 재평가가 필요하다.
Key Message
1. The real word-data based results showed that risks of MACE, thromboembolism, and cancers were not increased in Korean RA patients with JAK inhibitor when compared to Korean RA patients with TNF inhibitors.
2. Therefore, the risk of serious adverse events of JAK inhibitors in Korean population should be reconsidered and reassessed before adding black box warning of JAK inhibitors.
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- Safety and Effectiveness of Baricitinib in Chinese Patients with Moderate-to-Severe Rheumatoid Arthritis: 24-Week Results from a Post-Marketing Safety Study
Chan-yuan Wu, Qian Wang, Jian Shi, Xiu-ying Zhang, Rong Du, Jie-ruo Gu, Qi-huan Liu, Jiao Yu, Jia-wei Xu, Yan-jie Zhang, Hao Zhu, Meng-tao Li, Xiao-feng Zeng
Rheumatology and Therapy.2023; 10(6): 1609. CrossRef - Comparative cardiovascular safety with janus kinase inhibitors and biological disease-modifying antirheumatic drugs as used in clinical practice: an observational cohort study from Sweden in patients with rheumatoid arthritis
Hannah Bower, Thomas Frisell, Daniela di Giuseppe, Benedicte Delcoigne, Johan Askling
RMD Open.2023; 9(4): e003630. CrossRef
COVID-19: Special Article
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Obesity, hypertension, diabetes mellitus, and hypercholesterolemia in Korean adults before and during the COVID-19 pandemic: a special report of the 2020 Korea National Health and Nutrition Examination Survey
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Ga Bin Lee
, Yoonjung Kim
, Suyeon Park
, Hyeon Chang Kim
, Kyungwon Oh
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Epidemiol Health. 2022;44:e2022041. Published online April 25, 2022
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DOI: https://doi.org/10.4178/epih.e2022041
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9,676
View
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588
Download
-
15
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Abstract
Summary
PDF
Supplementary Material
-
Abstract
OBJECTIVES
We investigated trends in obesity, hypertension, diabetes, and hypercholesterolemia before and during the coronavirus disease 2019 (COVID-19) pandemic in the Korean adult population.
METHODS
Data from 60,098 participants in the Korea National Health and Nutritional Examination Survey between 2011 and 2020 aged ≥19 were used. The age-standardized prevalence and annual percent changes (APCs) were calculated for obesity (body mass index ≥25 kg/m2), hypertension (systolic/diastolic blood pressure ≥140/90 mmHg or under treatment), diabetes (hemoglobin A1c ≥6.5%, fasting glucose ≥126 mg/dL, physician diagnosis, or under treatment), and hypercholesterolemia (total cholesterol ≥240 mg/dL or under treatment).
RESULTS
Over the past decade (2011-2020), the age-standardized APCs (95% confidence intervals) for obesity, hypertension, diabetes and hypercholesterolemia were 3.0% (2.1 to 3.8), 0.1% (-1.3 to 1.5), 1.5% (-1.0 to 4.0) and 8.0% (5.7 to 10.3), respectively, in men; and -0.2% (-1.5 to 1.2), -0.5% (-1.9 to 0.9), -0.1% (-2.3 to 2.2) and 5.9% (3.9 to 8.0), respectively, in women. In 2020 compared to the previous 3 years (2017-2019), obesity, hypertension, diabetes, and hypercholesterolemia increased in men (6.0, 1.8, 1.9, and 2.8%p, respectively), but an increase was not apparent in women (2.5, -1.1, 0.8, and 0.7%p, respectively).
CONCLUSIONS
An increase in major chronic diseases was observed in Korean adults, especially men, during the COVID-19 pandemic. In order to reduce the burden of cardiovascular and metabolic diseases in the future, effective intervention strategies need to be developed according to the characteristics of the target groups.
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Summary
Korean summary
한국인의 비만, 고혈압, 당뇨 및 고지혈증 유병률은 지난 10년간 전반적으로 증가하는 경향을 보였다. 특히, 코로나 19가 유행한 2020년에 남성의 주요 만성질환 유병률은 지난 3년 평균치와 비교하였을 때 모두 유의하게 증가하였다. 반면, 여성에서 만성질환 유병률의 뚜렷한 증가는 관찰되지 않았다.
Key Message
During COVID-19 pandemic, the overall increase in major chronic diseases was observed in Korean adults, and this trend was prominent in men. Accordingly, target-specific intervention strategies need to be developed to reduce the burden of cardiovascular and metabolic diseases in the future.
-
Citations
Citations to this article as recorded by

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Mi-Joon Lee, Bum-Jeun Seo, Inmyung Song
Sustainability.2023; 15(3): 2586. CrossRef - Gene–Nutrient Interactions in Obesity: COBLL1 Genetic Variants Interact with Dietary Fat Intake to Modulate the Incidence of Obesity
Junkyung Kwak, Dayeon Shin
International Journal of Molecular Sciences.2023; 24(4): 3758. CrossRef - Identifying the Associations of Nightly Fasting Duration and Meal Timing with Type 2 Diabetes Mellitus Using Data from the 2016–2020 Korea National Health and Nutrition Survey
Junkyung Kwak, Kyeong-A Jang, Haeng-Ran Kim, Min-Sook Kang, Kyung Won Lee, Dayeon Shin
Nutrients.2023; 15(6): 1385. CrossRef - Changes in the Prevalences of Obesity, Abdominal Obesity, and Non-Alcoholic Fatty Liver Disease among Korean Children during the COVID-19 Outbreak
Kyungchul Song, Juyeon Yang, Hye Sun Lee, Su Jin Kim, Myeongseob Lee, Junghwan Suh, Ahreum Kwon, Ho-Seong Kim, Hyun Wook Chae
Yonsei Medical Journal.2023; 64(4): 269. CrossRef - Revisiting the Diabetes Crisis in Korea: Call for Urgent Action
Jun Sung Moon
The Journal of Korean Diabetes.2023; 24(1): 1. CrossRef - Changes in dietary habits and chronic diseases before and after COVID-19 by regions using data from the 2018-2020 Korea Community Health Survey and Consumer Behavior Survey for Foods: a cross-sectional study
Surim Park, Eun-hee Jang, Seungmin Lee
Korean Journal of Community Nutrition.2023; 28(2): 124. CrossRef - Trends in socioeconomic inequalities in obesity among Korean adolescents: the Korea Youth Risk Behavior Web-based Survey (KYRBS) 2006 to 2020
Eunji Kim, Ga Bin Lee, Dong Keon Yon, Hyeon Chang Kim
Epidemiology and Health.2023;[Epub] CrossRef - Changes in food and nutrient intakes in Korean adults before and during the coronavirus disease 2019 pandemic : data from the 2011-2020 Korea National Health and Nutrition Examination Survey
Kyungwon Oh, Suyeon Park, Sihyun Park, Sungha Yun, Hongseok Choi, Eun Kyeong Jeong
Epidemiology and Health.2023;[Epub] CrossRef - Clinical Features and Visual Prognosis of Retinal Vein Occlusion in Those under 50 Years Old
Soyeon Jung, Haeeun Shin, Hee Seung Chin
Journal of the Korean Ophthalmological Society.2023; 64(6): 490. CrossRef - Korea hypertension fact sheet 2022: analysis of nationwide population-based data with a special focus on hypertension in the elderly
Hyeon Chang Kim, Hokyou Lee, Hyeok-Hee Lee, Gabin Lee, Eunji Kim, Moses Song, Jenny Moon, Yeeun Seo
Clinical Hypertension.2023;[Epub] CrossRef - Comorbidity in patients with arterial hypertension in therapeutic practice
D.V. Korsunsky, S.A. Berns, A.R. Novikova, O.M. Drapkina
Profilakticheskaya meditsina.2023; 26(8): 100. CrossRef - The Effect of Baekhogainsam-tang on Metabolism through Modulation of the Gut Microbiota and Gene Expression in High-Fat Diet Induced Metabolic Syndrome Animal Model
Min-Jin Cho, Song-Yi Han, Soo Kyoung Lim, Eun-Ji Song, Young-Do Nam, Hojun Kim
Journal of Korean Medicine Rehabilitation.2023; 33(3): 1. CrossRef - Prevalence and management of hypertension in Korean adults
Hyeon Chang Kim
Journal of the Korean Medical Association.2022; 65(10): 633. CrossRef - Association between Mental Health and Hand Hygiene Practices in Adults with Hypertension and Diabetes during the COVID-19 Pandemic: The 2020 Korea Community Health Survey
Pius Kim, Hae Ran Kim
Healthcare.2022; 10(10): 1912. CrossRef - Changes in the prevalence of metabolic syndrome in Korean adults after the COVID-19 outbreak
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Epidemiology and Health.2022; 44: e2022101. CrossRef
Original Article
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Cancer incidence among male construction workers in Korea: a standardized incidence ratio analysis, 2009-2015
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Soonsu Shin
, Woo-Ri Lee
, Jin-Ha Yoon
, Wanhyung Lee
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Epidemiol Health. 2023;45:e2023060. Published online June 19, 2023
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DOI: https://doi.org/10.4178/epih.e2023060
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Abstract
Summary
PDF
Supplementary Material
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Abstract
OBJECTIVES
Construction workers face an elevated risk for several types of cancer. Nevertheless, there is a lack of large-scale epidemiological studies examining the risk of all cancers in construction workers. This study aimed to investigate the risk of various cancers in male construction workers using the Korean National Health Insurance Service (NHIS) database.
METHODS
We used data from the NHIS database from 2009 to 2015. Construction workers were identified using the Korean Standard Industrial Classification code. We calculated the age-standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) for cancer occurrence in male construction workers compared to all male workers.
RESULTS
Compared to all male workers, the SIRs for esophageal cancer (SIR, 1.24; 95% CI, 1.07 to 1.42) and malignant neoplasms of the liver and intrahepatic bile ducts (SIR, 1.18; 95% CI, 1.13 to 1.24) were significantly higher in male construction workers. The SIRs for malignant neoplasms of the urinary tract (SIR, 1.19; 95% CI, 1.05 to 1.35) and non-Hodgkin lymphoma (SIR, 1.21; 95% CI, 1.02 to 1.43) were significantly elevated in building construction workers. The SIR for malignant neoplasms of the trachea, bronchus, and lung (SIR, 1.16; 95% CI, 1.03 to 1.29) was significantly higher in heavy and civil engineering workers.
CONCLUSIONS
Male construction workers have an increased risk for esophageal cancer, liver cancer, lung cancer, and non-Hodgkin’s cancer. Our results indicate that tailored strategies for cancer prevention should be developed for construction workers.
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Summary
Korean summary
건설 노동자는 작업환경에서 수많은 유해 인자에 노출되지만, 건설 노동자에서 암의 연령 표준화 발생비를 조사한 역학 연구는 부족하다. 이번 연구에서 식도암과 간담도암의 연령 표준화 발생비는 전체 남성 근로자에 비해 남성 건설 근로자에게서 증가하였다. 이러한 결과는 건설 근로자에서 암 위험이 증가했음을 나타내며, 이 직업군에서 암 예방을 위한 추가 연구와 정책이 필요함을 의미한다.
Key Message
Despite the exposure of construction workers to numerous hazardous substances at workplace, epidemiological studies investigating the risk of all cancers in this occupational group are lacking. In this study, the age-standardized incidence ratio of esophageal cancer and hepatobiliary cancers increased in male construction workers compared to all male workers. Our results underscore the increased several cancer risks faced by male construction workers, necessitating the development of tailored strategies for cancer prevention in this occupational group.
Systematic Reviews
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The prevalence of functional disability and its impact on older adults in the ASEAN region: a systematic review and meta-analysis
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Phei Nie Yau, Clairen Jia Ern Foo, Nicholas Li Jie Cheah, Kar Foong Tang, Shaun Wen Huey Lee
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Epidemiol Health. 2022;44:e2022058. Published online July 12, 2022
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DOI: https://doi.org/10.4178/epih.e2022058
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5,452
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248
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7
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Abstract
Summary
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Supplementary Material
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Abstract
OBJECTIVES
Functional disability is a common consequence of the ageing process and can lead to poor health outcomes due to the inability to perform activities of daily living (ADL) and instrumental activities of daily living (IADL) independently. However, the prevalence of functional disability among older adults in the Association of Southeast Asian Nations (ASEAN) region is poorly documented. This study aimed to assess the prevalence of functional disability and its impact on older adults in the ASEAN region.
METHODS
A systematic literature search was performed on 4 databases from inception until March 2021 to identify studies examining individuals aged 60 years and above reporting functional disabilities in the ASEAN region. Information on the prevalence and impact of functional disability was extracted, assessed for bias, summarised, and analysed using a random-effects meta-analysis.
RESULTS
Thirty-four studies with 59,944 participants were included. The pooled prevalence of ADL disability was 21.5% (95% confidence interval [CI], 16.2 to 27.3) and that of IADL disability was 46.8% (95% CI, 35.5 to 58.3). Subgroup analyses showed higher prevalence among those of advanced age and women. Adverse impacts included increased years of life with disability and poor health-related quality of life.
CONCLUSIONS
Nearly a quarter of the older adult population in the ASEAN region experience functional disability. These findings highlight the need for further research on the burden and impact of functional disability within this region to allow decision-makers to gauge the severity of the issue, develop policies to reduce the risk of developing functional disabilities, and foster healthy ageing.
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Summary
Key Message
Highly common and disabling among older adults in ASEAN region, functional disability limits the ability to carry out activities of daily living, and markedly reduces life quality.
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Citations
Citations to this article as recorded by

- Concentrated disadvantage and functional disability: a longitudinal neighbourhood analysis in 100 US cities
Daniel Semenza, Ian Silver, Richard Stansfield, Courtney Boen
Journal of Epidemiology and Community Health.2023; 77(10): 676. CrossRef - Functional disability and associated factors in older adults seen at a primary health care unit
Paulo José Cortez, Paulo Eduardo Aliaga da Silveira, Beatriz Carvalho, João Vitor Medeiros de Abreu, Yan Lyncon, Gerson Souza Santos, Luciano Magalhães Vitorino
Geriatrics Gerontology and Aging.2023;[Epub] CrossRef - Suitable ultrasound screening method for older adults with disability to identify low muscle mass
Huaying Ding, Xia Lin, Sha Huang, Jie Liao, Zhouyu Li, Lanlan Chen, Li Zhu, Yukuan Xie, Qian Nie, Xiaoyan Chen
Frontiers in Medicine.2023;[Epub] CrossRef - Unmet needs for care for activities of daily living among older adults with functional disabilities in Vietnam
Phong Manh Phi, Long Thanh Giang, Tham Thi Hong Pham
Frontiers in Public Health.2023;[Epub] CrossRef - Frailty but not low muscle quality nor sarcopenia is independently associated with mortality among previously hospitalized older adults: A prospective study
Jarson Pedro da Costa Pereira, Alcides da Silva Diniz, Maria Conceição Chaves de Lemos, Cláudia Porto Sabino Pinho Ramiro, Poliana Coelho Cabral
Geriatrics & Gerontology International.2023; 23(10): 736. CrossRef - Mental distress and incident functional disability among a rural ageing population in South Africa
Supa Pengpid, Karl Peltzer
International Journal of Geriatric Psychiatry.2022;[Epub] CrossRef - Bidirectional association between functional disability and multimorbidity among middle-aged and older adults in Thailand
Supa Pengpid, Karl Peltzer, Dararatt Anantanasuwong
Frontiers in Public Health.2022;[Epub] CrossRef
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Prevalence of high-risk HPV genotypes in sub-Saharan Africa according to HIV status: a 20-year systematic review
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Jude Ogechukwu Okoye
, Chukwudi Amaechi Ofodile
, Oluwaseun Kelechi Adeleke
, Okechi Obioma
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Epidemiol Health. 2021;43:e2021039. Published online May 25, 2021
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DOI: https://doi.org/10.4178/epih.e2021039
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10,751
View
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331
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14
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Abstract
Summary
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Abstract
OBJECTIVES
This review assessed the rate of high-risk human papillomavirus (HPV) infection among women living in sub-Saharan Africa. It also determined the prevalence of high-risk HPV (hrHPV) among human immunodeficiency virus (HIV) seropositive (HIV+) and seronegative (HIV-) women in sub-Saharan Africa, pre-2010 and post-2010.
METHODS
In this systematic review, Google Scholar, PubMed Central, and Embase were searched to identify cohort and case-control studies that investigated the relationship between HIV and HPV infection. The database searches yielded 17 studies published between 1999 and 2018.
RESULTS
In the general population, the prevalence of any HPV/multiple HPV infections was higher among HIV+ (53.6/22.6%) than among HIV- women (26.5/7.3%) with odds ratios of 3.22 and 3.71, respectively (95% confidence interval, 3.00 to 3.42 and 2.39 to 5.75, p< 0.001). The prevalent HPV genotypes among HIV+ and HIV- women diagnosed with invasive cervical cancer (ICC) were HPV-16/18 and HPV-45. The prevalence of HPV-16, HPV-18, and HPV-45 was lower in 1999-2010 (3.8, 1.7, and 0.8%, respectively) than in 2011-2018 (19.1, 6.0, and 3.6%, respectively). Among women diagnosed with ICC, HIV+ women had a higher prevalence of HPV-56, HPV-31, and HPV-51 (7.3, 5.3, and 3.3%, respectively) than HIV- women (1.3, 2.2, and 0.4%, p< 0.001, p= 0.050, and p= 0.013, respectively).
CONCLUSIONS
The prevalence of HPV infection, multiple HPV infections, and non-vaccine HPV types were higher among HIV+ women than among HIV- women in sub-Saharan Africa. Although HIV infection influences the distribution of HPV types, this study suggests that cervical cancer incidence in sub-Saharan Africa is primarily driven by the prevalence of vaccine hrHPVs, especially HPV-16 and HPV-18.
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Summary
Key Message
Despite increasing awareness of Human papillomavirus (HPV) among women and availability of HPV vaccines, mounting evidence shows that the age-standardized incidence rate of cervical cancer is increasing in sub-Saharan Africa. This review revealed the influences of some viruses on the trends of the disease between 1999-2010 and 2011-2018.
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Citations
Citations to this article as recorded by

- Comparison of human papillomavirus‐based cervical cancer screening strategies in Tanzania among women with and without HIV
Crispin Kahesa, Louise T. Thomsen, Ditte S. Linde, Bariki Mchome, Johnson Katanga, Patricia Swai, Rachel Manongi, Myassa Kjaerem, Thomas Iftner, Marianne Waldstrøm, Julius Mwaiselage, Vibeke Rasch, Susanne K. Kjær
International Journal of Cancer.2023; 152(4): 686. CrossRef - Human papillomavirus testing using existing nucleic acid testing platforms to screen women for cervical cancer: implementation studies from five sub-Saharan African countries
Jessica Joseph, Owen Demke, Lola Ameyan, Joseph Bitilinyu-Bango, Blandine Bourgoin, Mamadou Diop, Babacar Guèye, Jibrin Kama, Marvin Lubega, Bernard Madzima, Tatenda Maparo, Tasimba Mhizha, Andrew Musoke, Susan Nabadda, Twambilire Phiri, Timothy Tchereni,
BMJ Open.2023; 13(1): e065074. CrossRef - Utilizing first void urine for high-risk HPV testing for cervical cancer screening in HIV-positive women in Katete, Zambia
Marian Kaoma, Oladapo Olayemi, Mwila Hilton Mwaba, Kapembwa Sikwewa
BMC Women's Health.2023;[Epub] CrossRef - High-risk human papillomavirus genotype distribution among women living with and at risk for HIV in Africa
Mkunde Chachage, Ajay P. Parikh, Anifrid Mahenge, Emmanuel Bahemana, Jonathan Mnkai, Wilbert Mbuya, Ruby Mcharo, Lucas Maganga, Jaqueline Mwamwaja, Reginald Gervas, Hannah Kibuuka, Jonah Maswai, Valentine Singoei, Michael Iroezindu, Abiola Fasina, Allahna
AIDS.2023; 37(4): 625. CrossRef - The state of human papillomavirus research in Africa
Kehinde Kazeem Kanmodi, Eyinade Adeduntan Egbedina, Jimoh Amzat, Kafayat Aminu, Lawrence Achilles Nnyanzi
Public Health Challenges.2023;[Epub] CrossRef - Measuring the impact of COVID-19 social distancing measures on sexual health behaviours and access to HIV and sexual and reproductive health services for people living with HIV in Botswana
Samuel Ensor, Imogen Mechie, Rebecca Ryan, Aamirah Mussa, Bame Bame, Lefhela Tamuthiba, Neo Moshashane, Chelsea Morroni
Frontiers in Global Women's Health.2023;[Epub] CrossRef - Malignancy and viral infections in Sub-Saharan Africa: A review
Mahamadou Diakite, Kathryn Shaw-Saliba, Chuen-Yen Lau
Frontiers in Virology.2023;[Epub] CrossRef - Cervicovaginal Microbiota Profiles in Precancerous Lesions and Cervical Cancer among Ethiopian Women
Brhanu Teka, Kyoko Yoshida-Court, Ededia Firdawoke, Zewditu Chanyalew, Muluken Gizaw, Adamu Addissie, Adane Mihret, Lauren E. Colbert, Tatiana Cisneros Napravnik, Molly B. El Alam, Erica J. Lynn, Melissa Mezzari, Jhingran Anuja, Eva Johanna Kantelhardt, A
Microorganisms.2023; 11(4): 833. CrossRef - High-risk human papillomavirus genotype distribution among women living with HIV; implication for cervical cancer prevention in a resource limited setting
Patrick Kafui Akakpo, Sebastian Ken-Amoah, Nancy Innocentia Ebu Enyan, Elizabeth Agyare, Emmanuel Salia, Ibrahim Baidoo, Leonard Derkyi-Kwarteng, Matthew Asare, George Adjei, Stephen Ayisi Addo, Dorcas Obiri-Yeboah
Infectious Agents and Cancer.2023;[Epub] CrossRef - HPV prevalence among young adult women living with and without HIV in Botswana for future HPV vaccine impact monitoring
Nancy McClung, Anikie Mathoma, Julia W. Gargano, Naledi Gape Nyepetsi, Troy D. Querec, Juanita Onyekwuluje, Madisa Mine, Chelsea Morroni, Rebecca Luckett, Lauri E. Markowitz, Doreen Ramogola-Masire
BMC Infectious Diseases.2022;[Epub] CrossRef - Acting on the call for cervical cancer elimination: Planning tools for low- and middle- income countries to increase the coverage and effectiveness of screening and treatment
Tara Herrick, Kerry A. Thomson, Michelle Shin, Sarah Gannon, Vivien Tsu, Silvia de Sanjosé
BMC Health Services Research.2022;[Epub] CrossRef - The preference of women living with HIV for the HPV self-sampling of urine at a rural HIV clinic in Uganda
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Philip E. Castle, Mark H. Einstein, Vikrant V. Sahasrabuddhe
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