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Original Articles
Long-term effectiveness of a primary care chronic disease management program in Korea
Seo-Hyun Lee, Kyoung-Hoon Kim
Epidemiol Health. 2026;48:e2026023.   Published online May 27, 2026
DOI: https://doi.org/10.4178/epih.e2026023
  • 1,128 View
  • 54 Download
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
This study evaluated the long-term effectiveness of Korea’s Primary Care Chronic Disease Management Program (CDMP) on major clinical outcomes among patients with type 2 diabetes mellitus (T2DM).
METHODS
Patients aged ≥18 years who received outpatient care for T2DM in 2019 were identified using Korea’s National Health Insurance Claims Database. Patients with a prior history of inpatient or outpatient care for ischemic heart disease (IHD) or stroke, or a history of hospitalization for diabetes before the index date were excluded. The final cohort included 1,817,682 patients, who were followed from the index date to December 31, 2023, for preventable diabetes-related hospitalization and incident IHD and stroke. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).
RESULTS
The study included 49,449 CDMP participants and 1,768,233 non-participants. The mean ages of the CDMP and non-CDMP groups were 62.2 years and 61.5 years, respectively. Compared with non-participants, CDMP participants had significantly lower risks of any adverse health outcome (HR, 0.87; 95% CI, 0.85 to 0.89), IHD (HR, 0.94; 95% CI, 0.91 to 0.97), stroke (HR, 0.85; 95% CI, 0.82 to 0.89), and diabetes-related hospitalization (HR, 0.73; 95% CI, 0.70 to 0.76).
CONCLUSIONS
Participation in the CDMP was associated with improved long-term health outcomes among patients with T2DM. These findings support the importance of continuous, structured, primary care–based chronic disease management and provide empirical evidence for expanding and institutionalizing the CDMP within Korea’s National Health Insurance system.
Summary
Korean summary
제2형 당뇨병은 보건체계에 큰 부담을 주는 질환이며, 한국에서는 일차의료 중심의 체계적인 만성질환 관리를 강화하기 위해 2019년부터 일차의료 만성질환관리 시범사업을 운영 중이다. 본 연구는 후향적 코호트 연구로, 제2형 당뇨병 환자를 대상으로 일차의료 만성질환관리 시범사업의 장기적 효과를 분석하였다. 분석한 결과, 시범사업에 참여한 환자들이 비참여군에 비해 당뇨 관련 입원이나 허혈성 심장질환, 뇌졸중과 같은 중증 합병증 발생 위험이 낮았다. 이는 일차의료 기반의 지속적이고 구조화된 관리가 당뇨 환자의 장기적인 건강 성과를 개선하는데 실질적인 효과가 있음을 시사하며, 현행 사업이 본 사업으로 확대되기 위한 정책적 근거를 제시한다.
Key Message
Although Korea’s Primary Care Chronic Disease Management Program (CDMP) was introduced to strengthen diabetes care, evidence on its long-term clinical effectiveness has been limited. In this nationwide study of patients with type 2 diabetes mellitus, participation in the CDMP was associated with reduced risks of preventable hospitalization, major cardiovascular and cerebrovascular events, and emergency department use over extended follow-up. These findings provide epidemiological evidence that structured, continuity-based primary care can improve long-term outcomes in chronic disease management and support the expansion and institutionalization of primary care–centered chronic disease programs within the National Health Insurance system.
Causal effect of fasting serum glucose on atherosclerotic cardiovascular disease: a multivariable Mendelian randomization
Su Hyun Lee, Heejin Kimm, Byung-Wan Lee, Chung Mo Nam, So Young Kim, Sunmi Lee, Sun Ha Jee
Epidemiol Health. 2024;46:e2024096.   Published online December 6, 2024
DOI: https://doi.org/10.4178/epih.e2024096
  • 11,768 View
  • 174 Download
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Observational studies have reported that diabetes is a risk factor that increases the risk of atherosclerotic cardiovascular disease (ASCVD). However, the causal relationship remains a matter of debate. This study aimed to analyze the relationship between fasting serum glucose (FSG) and ASCVD.
METHODS
This study used data from the Korean Cancer Prevention Study-II (KCPS-II) Biobank, consisting of 159,844 people recruited with consent from 18 health examination centers from 2004 to 2013. Outcomes were confirmed based on diagnoses on hospital discharge summaries from National Health Insurance System. We used linear and non-linear Mendelian randomization (MR) methods. The outcome data were obtained from KCPS-II, and the exposure data were derived from the Korean Genome Epidemiology Study.
RESULTS
First, a prospective cohort study estimated that for each 10 mg/dL increase in FSG level, the risk of ASCVD increased by 4% (hazard ratio [HR], 1.04; 95% confidence interval [CI], 1.03 to 1.05). Second, the 2-sample MR study showed that every 10 mg/dL increase in FSG influenced the risk of ASCVD (odds ratio [OR], 1.11; 95% CI, 1.04 to 1.18). Third, the multivariable MR study showed that the OR per 10 mg/dL increase in FSG on ASCVD was 1.14 (p<0.001). Similar results were found for a 10 mg/dL increase in FSG and ischemic heart disease (IHD), but a significant relationship with stroke was not found. When performing non-linear MR, a linear relationship was observed between fasting blood sugar and ASCVD, including IHD and stroke.
CONCLUSIONS
FSG showed a linear and causal association with IHD, but not with stroke.
Summary
Korean summary
그동안 당뇨병이 심뇌혈관질환 발생에 위험요인이라는 역학적인 관찰연구는 많이 발표되었지만, 이러한 관련성에 대한 인과적 관련성에 대부분 연구는 서양인을 대상으로 발표되었고, 한국인 자료를 통해 발표된 적은 없었다. 이 연구는 관찰연구의 제한점으로 부각되는 혼란변수와 측정오류에 덜 영향을 받는 새로운 방법론으로써 다변수 멘델리언 무작위화 방법을 사용하여 공복혈당과 심뇌혈관질환의 인과성을 분석하였다. 분석결과, 공복혈당은 허혈성 심질환 발생위험에 인과적인을 관련성을 보였고 뇌졸중에 대해서는 인과적이지 않았다.
Key Message
Over the years, numerous epidemiological observational studies have reported that diabetes is a risk factor for cardiovascular and cerebrovascular diseases. However, most of these studies examining this association were conducted on Western populations, and no studies have been published using Korean data. This study employed a new methodology—multivariable Mendelian randomization—which is less affected by confounding factors and measurement errors, often highlighted as limitations of observational studies, to analyze the causal relationship between fasting glucose levels and cardiovascular and cerebrovascular diseases. The analysis revealed a causal relationship between fasting glucose levels and the risk of ischemic heart disease, while no causal association was observed with stroke.

Citations

Citations to this article as recorded by  
  • Progress in Mendelian Randomization Studies on the Causal Association of GLM7 Index Components with Stroke
    一婷 王
    Advances in Clinical Medicine.2026; 16(05): 3483.     CrossRef
Systematic Review
Adverse health effects of climate change and air pollution in people with disabilities: a systematic review
Nakyung Rhim, Seohyun Lee, Kyung-Hwa Choi
Epidemiol Health. 2024;46:e2024080.   Published online September 27, 2024
DOI: https://doi.org/10.4178/epih.e2024080
  • 17,843 View
  • 356 Download
  • 10 Web of Science
  • 9 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
Global warming and air pollution adversely affect the health of the entire human population, particularly older adults, people with disabilities (PWDs), and children. In this systematic review, we investigated the adverse health effects of climate change and air pollution in PWDs. We conducted a comprehensive literature search of the PubMed database using the terms “disab*,” “air pollution,” and “climate change” on July 4, 2023, and August 8, 2023 and searched the Web of Science (WOS) database on December 28, 2023. We identified 425 and 1,169 studies on climate change cited in PubMed and WOS, respectively, as well as 333 studies on air pollution in PubMed and 495 studies on air pollution in WOS. The studies were classified by type of exposure, and full-text screening was conducted to confirm that the population, intervention or exposure, comparator, outcome statement, and inclusion and exclusion criteria were met. The Newcastle-Ottawa Scale was used to assess the quality of the included cohort and case-control studies and for data analysis. In extreme temperatures, PWDs experienced higher rates of injury, heat-related illness, functional impairment, heart disease, mental disorders, and mortality than people who were non-disabled (ND). Exposure to air pollution resulted in higher rates of obesity, cardiovascular disease, poststroke neurological and functional disability, and mortality in PWDs than in people who were ND. Therefore, because PWDs were more affected by climate change and air pollution than people who were ND, sensitive policies and preparedness measures should be developed for PWDs.
Summary
Korean summary
전체 인구, 특히 취약 계층의 건강은 기후 변화와 대기 오염으로 인해 부정적인 영향을 받을 수 있습니다. 본 체계적 고찰 연구는 장애인이 비장애인에 비해 환경적 요인에 노출되어 더 심각한 신체적, 정신적 건강 문제를 겪는다는 것을 보여줍니다.
Key Message
The health of the entire human population, especially vulnerable people, might be negatively impacted by climate change and air pollution. This systematic review study implies that people with disabilities (PWDs) suffer more severe physical and mental health consequences from exposure to environmental challenges compared to non-disabled individuals.

Citations

Citations to this article as recorded by  
  • Duration-specific effects of extreme heat on mortality among people with disabilities in Korea: a nationwide population-based study
    Kyung-Hwa Choi, Jonghyuk Choi, Ho-Jang Kwon, Mina Ha, Yoonhyeok Choi, Hyungryul Lim
    Environmental Research.2026; 289: 123375.     CrossRef
  • Differential relationships between physical activity and mental health among adults with disabilities in Korea
    Shiva Raj Acharya
    BMC Public Health.2026;[Epub]     CrossRef
  • Leave no one behind: a call to include people with disabilities in climate change and health research
    Sera Kim, Yejin Kim, Jinah Park, Ranyeong Kim, Whanhee Lee, Michelle L Bell, Jong-Tae Lee
    The Lancet Planetary Health.2026; 10(3): 101440.     CrossRef
  • Subjective well-being of people with disability in Tasmania: Exploring the role of neighborhood environments, socioeconomic, and housing circumstances
    Maria Hobbs, Kim Jose, Ceridwen Owen, Verity Cleland
    Journal of Urban Affairs.2026; : 1.     CrossRef
  • Impacts of climate change on mental health and its underlying mechanisms: an umberella review
    Arezoo Davariniamotlaghquchan, Zeinab Niazmand, Mohsen Shafiee, Abbas Ostadtaghizadeh
    Annals of General Psychiatry.2026;[Epub]     CrossRef
  • Mediation of Fine Particulate Matter on the Association Between Daily Temperature and Mortality
    Dajeong Ham, Youn-Hee Lim, Soontae Kim, Ho-Jang Kwon, Sanghyuk Bae
    Journal of Korean Medical Science.2025;[Epub]     CrossRef
  • Ambient fine particulate matter and mortality risk among people with disability in Korea based on the National Health Insurance database: a retrospective cohort study
    Jonghyuk Choi, Hyungryul Lim, Ho-Jang Kwon, Mina Ha, Soontae Kim, Kyung-Hwa Choi
    BMC Public Health.2025;[Epub]     CrossRef
  • Cardiometabolic Diseases and Mental Health Disorders in Korean Adults With Disabilities: A 3-Year Retrospective Analysis and Risk Comparison
    Shiva Raj Acharya, NamKwen Kim, Navin Ray, Diwash Timilsina
    American Journal of Preventive Medicine.2025; 69(3): 107938.     CrossRef
  • Climate Change, Air Pollution and the Global Obesity Syndemic: a Review of Current Evidence
    Natalia G. Vallianou, Dimitris C. Kounatidis, Eleni V. Geladari, Angelos Evangelopoulos, Vasileios Kaldis, Theodora Stratigou, Apostolos A. Evangelopoulos, Irene Karampela, Maria Dalamaga
    Current Obesity Reports.2025;[Epub]     CrossRef
Original Articles
The association between migraine and Parkinson’s disease: a nationwide cohort study in Korea
Woo-Seok Ha, Jaeho Kim, Hee Won Hwang, Sue Hyun Lee, Ji In Kim, Jin Yong Hong, Sang Hyun Park, Kyung Do Han, Min Seok Baek
Epidemiol Health. 2024;46:e2024010.   Published online December 18, 2023
DOI: https://doi.org/10.4178/epih.e2024010
  • 65,535 View
  • 292 Download
  • 5 Web of Science
  • 5 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Clinical studies have suggested an association between migraine and the occurrence of Parkinson’s disease (PD). However, it is unknown whether migraine affects PD risk. We aimed to investigate the incidence of PD in patients with migraine and to determine the risk factors affecting the association between migraine and PD incidence.
METHODS
Using the Korean National Health Insurance System database (2002-2019), we enrolled all Koreans aged ≥40 years who participated in the national health screening program in 2009. International Classification of Diseases (10th revision) diagnostic codes and Rare Incurable Diseases System diagnostic codes were used to define patients with migraine (within 12 months of enrollment) and newly diagnosed PD.
RESULTS
We included 214,193 patients with migraine and 5,879,711 individuals without migraine. During 9.1 years of follow-up (55,435,626 person-years), 1,973 (0.92%) and 30,664 (0.52%) individuals with and without migraine, respectively, were newly diagnosed with PD. Following covariate adjustment, patients with migraine showed a 1.35-fold higher PD risk than individuals without migraine. The incidence of PD was not significantly different between patients with migraine with aura and those without aura. In males with migraine, underlying dyslipidemia increased the risk of PD (p=0.012). In contrast, among females with migraine, younger age (<65 years) increased the risk of PD (p=0.038).
CONCLUSIONS
Patients with migraine were more likely to develop PD than individuals without migraine. Preventive management of underlying comorbidities and chronic migraine may affect the incidence of PD in these patients. Future prospective randomized clinical trials are warranted to clarify this association.
Summary
Korean summary
편두통 환자들은 편두통이 없는 이들보다 장기적으로 파킨슨병이 발병할 위험이 더 높습니다. 더불어, 이 관계는 편두통의 아형(전조 vs. 무전조)보다는 편두통의 빈도(삽화성 vs. 만성)와 더 밀접한 연관성을 갖는 것으로 보입니다.
Key Message
Patients with migraine are more likely to develop Parkinson’s disease than individuals without migraine. Furthermore, this association appears to be more strongly linked to the frequency of migraines (episodic vs. chronic) rather than the subtype of migraine (with aura vs. without aura).

Citations

Citations to this article as recorded by  
  • Telecoaching and Migraine: Digital Approach to Physical Activity in Migraine Management. A Scoping Review
    Ignazio Leale, Vincenzo Di Stefano, Angelo Torrente, Paolo Alonge, Roberto Monastero, Michele Roccella, Filippo Brighina, Valerio Giustino, Giuseppe Battaglia
    Journal of Clinical Medicine.2025; 14(3): 861.     CrossRef
  • Association Between β‐Adrenoreceptor Agonists and Antagonists and Parkinson's Disease: Systematic Review and Meta‐Analysis
    Agnieszka Szmigiel, Miguel Monteiro da Rocha, Kate Browne, Daniel Morales, David Benee Olsen, Charlotte Warren‐Gash, Ian Douglas, Krishnan Bhaskaran, Helena Carreira
    Pharmacoepidemiology and Drug Safety.2025;[Epub]     CrossRef
  • Migraine with and without aura—two distinct entities? A narrative review
    Olga Grodzka, Ketevan Dzagoevi, Tayla Rees, Goncalo Cabral, Piotr Chądzyński, Stefano Di Antonio, Patryk Sochań, Antoinette MaassenVanDenBrink, Christian Lampl
    The Journal of Headache and Pain.2025;[Epub]     CrossRef
  • Gut neuropeptide involvement in Parkinson’s disease
    Hayley N. Templeton, Stuart A. Tobet, Luke A. Schwerdtfeger
    American Journal of Physiology-Gastrointestinal and Liver Physiology.2025; 328(6): G716.     CrossRef
  • Parkinson's disease and migraine
    Z. A. Zalyalova, E. A. Katunina, D. V. Pokhabov
    Neurology, Neuropsychiatry, Psychosomatics.2025; 17(3): 98.     CrossRef
Risk factors for early-onset lung cancer in Korea: analysis of a nationally representative population-based cohort
Jihun Kang, Taeyun Kim, Kyung-Do Han, Jin-Hyung Jung, Su-Min Jeong, Yo Hwan Yeo, Kyuwon Jung, Hyun Lee, Jong Ho Cho, Dong Wook Shin
Epidemiol Health. 2023;45:e2023101.   Published online November 21, 2023
DOI: https://doi.org/10.4178/epih.e2023101
  • 20,624 View
  • 271 Download
  • 7 Web of Science
  • 6 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We examined the associations of socioeconomic factors, health behaviors, and comorbidities with early-onset lung cancer.
METHODS
The study included 6,794,287 individuals aged 20-39 years who participated in a Korean national health check-up program from 2009 to 2012. During the follow-up period, 4,684 participants developed lung cancer. Multivariable Cox regression analysis was used to estimate the independent associations of potential risk factors with incident lung cancer.
RESULTS
Older age (multivariable hazard ratio [mHR], 1.13; 95% confidence interval [CI], 1.12 to 1.14) and female sex (mHR, 1.62; 95% CI, 1.49 to 1.75) were associated with increased lung cancer risk. Current smoking was also associated with elevated risk (<10 pack-years: mHR, 1.12; 95% CI, 1.01 to 1.24; ≥10 pack-years: mHR, 1.30; 95% CI, 1.18 to 1.45), but past smoking was not. Although mild alcohol consumption (<10 g/day) was associated with lower lung cancer risk (mHR, 0.92; 95% CI, 0.86 to 0.99), heavier alcohol consumption (≥10 g/day) was not. Higher income (highest vs. lowest quartile: mHR, 0.86; 95% CI, 0.78 to 0.94), physical activity for at least 1,500 metabolic equivalent of task-min/wk (vs. non-exercisers: mHR, 0.83; 95% CI, 0.69 to 0.99) and obesity (vs. normal weight: mHR, 0.89; 95% CI, 0.83 to 0.96) were associated with lower lung cancer risk, whereas metabolic syndrome was associated with increased risk (mHR, 1.13; 95% CI, 1.03 to 1.24).
CONCLUSIONS
In young adults, age, female sex, smoking, and metabolic syndrome were risk factors for early-onset lung cancer, while high income, physical activity, and obesity displayed protective effects.
Summary
Korean summary
나이, 여성, 흡연, 그리고 대사 증후군은 조기 발생 폐암의 위험도 증가와 연관이 있었다. 반면에 높은 소득, 신체 활동, 비만은 젊은 성인에서 폐암 발생의 위험도 감소와 연관성을 나타내었다.
Key Message
Age, female sex, smoking, and metabolic syndrome were risk factors for early-onset lung cancer. While, high income, physical activity, and obesity displayed protective effects on the development of lung cancer in young adults.

Citations

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    Zheng Lu, Peilan Zheng, Yi Liao, Haiyan Wang, Keyu Zhu, Yiyang Chen, Zhixin Lin, Xinyan Huang, Yu Wang, Jingrong Yang
    International Journal of Surgery.2026; 112(2): 3989.     CrossRef
  • Association between lifestyle and risk of early-onset cancer: Evidence from the European Prospective Investigation into Cancer and Nutrition and the UK Biobank
    Isabella Sala, Edoardo Botteri, Paula Berstad, Emma Fontvieille, Semi Zouiouich, Maria-José Sánchez, Marcela Guevara, Ane Dorronsoro, Anja Olsen, Cecilie Kyrø, Raul Zamora-Ros, Renée Turzanski Fortner, Rudolf Kaaks, Matthias B. Schulze, Sandar Tin Tin, Cl
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    Ye Tian, Rui Ma, Wenchang Zhao, Shumin Wang, Chuanjiang Zhou, Weibing Wu, Bo Yang, Hua Xin, Hongyan Wang, Pengfei Li, Ranhua Li, Changhong Liu, Yao Lu, Qian Yu, Chengyang Song, Han Zhang, Ruipu Liang, Lei Zhang, Di Zhou, Xitong Zhao, Zhuo Wu, Yafei Qi, Ru
    Nature Communications.2025;[Epub]     CrossRef
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    Roselle B. De Guzman
    Frontiers in Oncology.2025;[Epub]     CrossRef
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    Lynn Y.-W. Shong, David C.-L. Lam
    Seminars in Respiratory and Critical Care Medicine.2025; 46(05): 409.     CrossRef
  • Association between long-term exposure to a mixture of ambient air pollutants and the incidences of bladder and kidney cancers
    Chung Ho Kim, Seyoung Kim, Yoon-Hee Kang, Soontae Kim, Byungmi Kim, Bomi Park
    Environmental Research.2025; 285: 122667.     CrossRef
Special Article
Evidence integration on health damage for humidifier disinfectant exposure and legal presumption of causation
Mina Ha, Taehyun Park, Jong-Hyun Lee, Younghee Kim, Jungyun Lim, Yong-Wook Baek, Sol Yu, Hyen-Mi Chung, Kyu Hyuck Chung, Hae-Kwan Cheong, Review Committee for the Epidemiological Correlations between Humidifier Disinfectants Exposure and Health Effects
Epidemiol Health. 2023;45:e2023095.   Published online October 24, 2023
DOI: https://doi.org/10.4178/epih.e2023095
  • 20,706 View
  • 226 Download
  • 6 Web of Science
  • 7 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Inhalation exposure to humidifier disinfectants has resulted to various types of health damages in Korea. To determine the epidemiological correlation necessary for presuming the legal causation, we aimed to develop a method to synthesize the entire evidence.
METHODS
Epidemiological and toxicological studies are systematically reviewed. Target health problems are selected by criteria such as frequent complaints of claimants. Relevant epidemiologic studies are reviewed and the risk of bias and confidence level of the total evidence are evaluated. Toxicological literature reviews are conducted on three lines of evidence including hazard information, animal studies, and mechanistic studies, considering the source-to-exposure-to-outcome continuum. The confidence level of the body of evidence is then translated into the toxicological evidence levels for the causality between humidifier disinfectant exposure and health effects. Finally, the levels of epidemiological and toxicological evidence are synthesized.
RESULTS
Under the Special Act revised in 2020, if the history of exposure and the disease occurred/worsened after exposure were approved, and the epidemiological correlation between the exposure and disease was verified, the legal causation is presumed unless the company proves the evidence against it. The epidemiological correlation can be verified through epidemiological investigations, health monitoring, cohort investigations and/or toxicological studies. It is not simply as statistical association as understood in judicial precedents, but a general causation established by the evidence as a whole, i.e., through weight-of-the-evidence approach.
CONCLUSIONS
The weight-of-the-evidence approach differs from the conclusive single study approach and this systematic evidence integration can be used in presumption of causation.
Summary
Korean summary
저자들은 가습기살균제 노출로 인한 건강피해의 법적 인과관계 추정요건인 역학적 상관관계를 확인하기 위한 과정으로서 체계적 문헌고찰과 역학과 독성학의 전체 과학적 근거를 체계적으로 종합하는 방법을 제시하였다. 이것은 법적 증거 방법에서 개별 연구가 가지는 제한점이나 불확실성을 이유로 배척하지 않고, 전체 증거의 부분으로서 종합적으로 접근하는 것을 통해 사실 관계에 도달하는 방법이다. 이 전체증거접근법은 향후 인과관계 추정에서 전범(model)이 될 수 있다.
Key Message
We establish a systematic method for integrating a body of scientific evidence of epidemiology and toxicology to verify the epidemiological correlation, which is essential for presuming legal causation of health damages due to exposure to humidifier disinfectants. In terms of a legal proof, this method does not exclude individual studies due to their limitations or uncertainty but integrates them as part of a body of evidence to arrive at a conclusion that better reflects the truth of the evidence. This weight-of-the-evidence approach can be a model for future causal inference.

Citations

Citations to this article as recorded by  
  • CMIT/MIT produces mitochondrial ROS via inhibiting mitochondrial complex I and II
    Donghyun Kim, Yusun Shin, Jong-In Park, Taecheol Kwak, Hangoo Kang, Haewon Kim, Youngmee Lee, Wondong Kim, Yong Joo Park, Ha Ryong Kim, Kyu Hyuck Chung, Ok-Nam Bae
    Free Radical Biology and Medicine.2026; 244: 505.     CrossRef
  • Association of respiratory diseases with humidifier disinfectants exposure and its latency: A study of health damage reporter cohort in South Korea
    Jaiyong Kim, Kyoung Sook Jeong, Seungyeon Heo, Youngmee Lee, Taksoo Kim, Hye-Jin Kim, Suejin Kim, Hae-Kwan Cheong, Mina Ha
    Ecotoxicology and Environmental Safety.2026; 309: 119552.     CrossRef
  • Prenatal and Childhood Exposure to Humidifier Disinfectants and Attention-Deficit/Hyperactivity Disorder (ADHD): Insights from a Retrospective Cohort Design
    Hyowon Choi, Hunju Lee, Yeon-Soon Ahn
    Toxics.2025; 13(2): 78.     CrossRef
  • Risk of non-cancer respiratory diseases attributed to humidifier disinfectant exposure in Koreans: age-period-cohort and differences-in-difference analyses
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Cohort Profile
Cardiovascular and Metabolic Diseases Etiology Research Center (CMERC) cohort: study protocol and results of the first 3 years of enrollment
Jee-Seon Shim, Bo Mi Song, Jung Hyun Lee, Seung Won Lee, Ji Hye Park, Dong Phil Choi, Myung Ha Lee, Kyoung Hwa Ha, Dae Jung Kim, Sungha Park, Won-Woo Lee, Hyeon Chang Kim
Epidemiol Health. 2017;39:e2017016.   Published online April 1, 2017
DOI: https://doi.org/10.4178/epih.e2017016
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AbstractAbstract AbstractSummary PDF
Abstract
Although the etiologies of cardiovascular disease (CVD) are widely understood, the goal of finding a globally effective solution for preventing CVD is unrealistic. Therefore, we aimed to conduct a community-based prospective study on the prevention and management of CVD in Korean adults. This study was designed to recruit 8,000 healthy adults over the course of 5 years. The baseline assessment includes a wide range of established CVD risk factors, including demographic characteristics, medical history, health behaviors, psychological conditions, body size and composition, blood pressure, the augmentation index, carotid ultrasonography, an electrocardiogram, and biochemical indicators, as well as some novel factors, such as social network characteristics, exposure to environmental pollutants, inflammatory markers, hemostatic markers, and immunosenescence markers. Annual telephone interviews and follow-up health examinations at 5-year intervals after the baseline assessment are planned to collect information on changes in health status and its determinants. Additionally, indirect follow-up using secondary data sources will be conducted to obtain information on health services utilization and death. So far, more than 6,000 adults have been enrolled during the first three and a half years, and almost all participants have been tracked by annual telephone follow-up surveys. The data have been uploaded to iCReaT, the clinical research information management system of the Korea National Institute of Health.
Summary
Korean summary
심뇌혈관 및 대사질환 원인연구센터(Cardiovascular and Metabolic Diseases Etiology Research Center)에서는 심뇌혈관질환 및 대사질환의 새로운 발병 원인을 찾고 효율적인 예방 전략을 개발하고자 코호트(CMERC cohort와 CMERC-HI cohort)를 구축하였다. 지역사회에 거주하는 만 30-64세 건강한 성인을 대상으로 하는 CMERC cohort는 2013년부터 2018년 까지 총 5년 동안 8000명 등록을 목표로 기반조사를 진행 중이며(2016년 12월 현재 6000여명 등록), 이미 알려진 다양한 위험요인 이외에 사회연결망 정보와 면역노화 관련 바이오마커 등 새로운 위험 요인에 관한 광범위한 정보가 수집되고 있다. CMERC cohort는 심뇌혈관 및 대사질환 예방연구의 기초자료로 활용되어 과학적 데이터에 근거한 예방 전략 수립에 기여하게 될 것이다.

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Original Articles
Epidemiological Comparison of viral hepatitis-hepatocellular carcinoma(HCC) and non viral hepatitis-hepatocellular carcinoma(HCC).
Pae Gun Park, Song Gyu Yoon, Hee Sup Lee, Jin Kun Jang, Ju Hee Maeng, Gee Hyun Lee, Jong Soo Choi
Korean J Epidemiol. 2003;25(1):32-38.
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AbstractAbstract PDF
Abstract
BACKGROUND
Korea is one of high incidence areas of Hepatocellular carcinoma (HCC) and major etiologic factor is hepatitis B virus (HBV). In future incidence of HBV related HCC may decrease and non viral hepatitis HCC (Non-B,C HCC) relatively increase because of widely used vaccination for HBV. To evaluate epidemiological characters of Non-B,C HCC, We divided HCC by viral or non-viral feature and compared each others.
METHODS
185 patients firstly diagnosed HCC and 455 normal subjects included from January 1997 to December 2000 and divided into 3 groups, HBV group (positive HBsAg), HCV group (positive anti-HCV Ab) and Non-B,C group (both negative HBsAg and anti-HCV Ab).
RESULTS
136 cases were HBV group (73.5%), 19 cases were HCV group (10.3%) and 27 cases were Non-B,C group (14.6%). Mean age of Non-B,C group at diagnosis was higher than HBV group (64.1+/-7.1 vs 55.6+/-7.7). Non-B,C HCC were more associated with alcohol abuse and rural residence (p<0.01). There was no difference of family history of liver disease, coexistence rate of liver cirrhosis and occupation.
CONCLUSION
Non-B,C HCC tended to be older in mean age than HBV HCC and more associated with alcohol abuse and rural residence. This characteristics of Non-B,C HCC supposed to be from difference in alcohol consumption and environment.
Summary
An Epidemiologic Investigation on the Mode of Transmission of the Lethal Salmonellosis Outbreak in Hamyang County.
Jang Rak Kim, Sang Won Lee, Hong Bin Kim, Jin Cha, Kwang Hyun Lee, Kang Woo Bae
Korean J Epidemiol. 1999;21(2):185-194.
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AbstractAbstract PDF
Abstract
An outbreak of Salmonella enteritidis epidemic involving about 200 inpatients of gastroenteritis and 1 death occurred among about 750 participants from Hamyang County who attended 4 wedding lunch parties at one buffet restaurant on April 25, 1999. There were also many patients including 1 death among about 500 participants outside Hamyang County who attended same parties. Person to person interviews made to 155 inpatients revealed that distribution of incubation periods was between 1 to 34 hours with median time, 13-14 hours. A retrospective cohort study was conducted to investigate the mode of transmission. Telephone interviews were made to party participants (except 61 inpatients who already had been interviewed personally) on symptoms and on which they had eaten among 40 served foods including water at the parties and data among 288 persons were available for the analyses. One hundred and ninety one interviewees had more than two symptoms among symptoms of diarrhea(more than 3 times), abdominal pain, and fever, which gave an attack rate of 66.3%(191/288). The relative short incubation period and high attack rate suggested the presence of higher infecting dose in this epidemic. Logistic regression analysis revealed that the probable infective foods were boiled cockle, gamju, boiled midodok, fried rices, eomook, and boiled pig's trotter. Salmonella enteritidis were identified in the specimens of boiled cockle, cooked beef, and uncooked beef. Only boiled cockle was both an epidemiological and microbiological infective food. There might be cross-contaminations between several served foods, which meant presence of many contaminated foods by Salmonella enteritidis with different stage of their multiplications. Efforts to inspect food service areas and educate foodhandlers in good personal hygiene and proper foodhandling practices should be strengthened to reduce the incidences of salmonellosis in Korea.
Summary
Epidemiol Health : Epidemiology and Health
© Korean Society of Epidemiology.
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