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Estimated trends in hospitalizations due to occupational injuries in Korea based on the Korean National Hospital Discharge In-depth Injury Survey (2006-2019)
Seong-Uk Baek, Won-Tae Lee, Min-Seok Kim, Myeong-Hun Lim, Jin-Ha Yoon
Epidemiol Health. 2023;45:e2023042.   Published online April 5, 2023
DOI: https://doi.org/10.4178/epih.e2023042
  • 2,864 View
  • 128 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
In recent years, occupational injuries have sparked a huge social and political debate. Thus, in this study, we focused on the characteristics and trends of occupational injuries requiring hospitalization in Korea.
METHODS
The Korea National Hospital Discharge In-depth Injury Survey was designed to estimate the annual number and characteristics of all injury-related hospitalizations in Korea. The annual number of hospitalizations due to occupational injuries and the age-standardized rates (ASRs) were estimated from 2006 to 2019. The annual percentage change (APC) and average annual percentage change (AAPC) of ASRs and their 95% confidence intervals (CIs) were calculated using joinpoint regression. All analyses were stratified by gender.
RESULTS
In men, the APC of the ASRs of all-cause occupational injuries was -3.1% (95% CI, -4.5 to -1.7) in 2006-2015. However, a non-significant upward trend was observed after 2015 (APC, 3.3%; 95% CI, -1.6 to 8.5). In women, the APC of all-cause occupational injuries was -8.6% (95% CI, -12.1 to -5.1) in 2006-2012. However, a non-significant upward trend was observed after 2012 (APC, 2.1%; 95% CI, -0.9 to 5.2). A recent upward trend in stabbing injuries was observed after 2012 (APC, 4.7%; 95% CI, -1.8 to 11.8) in women. A non-significant overall increasing trend was also observed for occupational injuries caused by exposure to extreme temperatures (AAPC, 3.7%; 95% CI, -1.1 to 8.7) in women.
CONCLUSIONS
A recent upward trend in all-cause injury hospitalizations and hospitalizations caused by stabbing injuries was observed. Therefore, active policy interventions are required to prevent occupational injuries.
Summary
Korean summary
본 연구는 퇴원환자 심층조사를 사용하여 2006년부터 2019년까지 우리나라에서 발생한 업무상 손상의 추세를 연령표준화발생률을 구함으로써 분석하였다. 남녀 모두에서 2010년대 초반 까지는 발생률이 유의하게 감소하는 추세를 보였지만, 2013-2015년 이후부터는 통계적으로 유의하지 않은 점진적 상승 추세가 관찰되었다. 이러한 연구 결과는 업무상 손상을 예방하기 위해 적극적인 정책적 개입이 필요하다는 것을 시사한다.
Key Message
This study analyzed the trends in work-related injury occurrences in South Korea from 2006 to 2019 based on a nationally representative, repeated cross-sectional dataset. Age-standardized rates were calculated and their annual trend was estimated using a JointPoint regression. While both males and females exhibited a significant decline in occupational injury rates until the early 2010s, a non-significant but gradual upward trend has been observed since 2013-2015. These findings underscore the need for active policy interventions to prevent work.
Type 2 diabetes mellitus increases the severity of non-fatal injuries, but not the risk of fatal injuries, among driver victims of motor vehicle crashes in Taiwan
I-Lin Hsu, Wen-Hsuan Hou, Ya-Hui Chang, Chung-Yi Li
Epidemiol Health. 2022;44:e2022076.   Published online September 16, 2022
DOI: https://doi.org/10.4178/epih.e2022076
  • 3,564 View
  • 107 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Limited information is available on whether diabetes increases the severity of injuries from motor vehicle crashes (MVCs). This study aimed to investigate the association of type 2 diabetes with injury severity among driver victims of MVCs.
METHODS
This cohort study involved 75,737 adult driver victims with type 2 diabetes from Taiwan’s Police-Reported Traffic Accident Registry in 2015-2017, along with 150,911 sex-, age-, and calendar year-matched controls. The severity level of non- fatal injuries was derived from the International Classification of Diseases Programs for Injury Categorization based on the diagnostic codes of National Health Insurance claims within 3 days after an MVC. Information on fatal injuries within 3 days after an MVC was obtained from the Taiwan Death Registry. Logistic regression models were used to estimate the odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) of injury severity in association with type 2 diabetes.
RESULTS
After adjusting for potential confounders, driver victims with type 2 diabetes experienced significantly higher risks of mild and severe non-fatal injuries than their counterparts without diabetes, with covariate-adjusted ORs of 1.08 (95% CI, 1.05 to 1.11) and 1.28 (95% CI, 1.20 to 1.37), respectively. By contrast, the adjusted OR for fatal injuries was not significantly elevated, at 1.02 (95% CI, 0.89 to 1.18). Similar results were found when car and scooter driver victims were analyzed separately.
CONCLUSIONS
Type 2 diabetes was found to moderately increase the severity of non-fatal injuries from MVCs among car and scooter driver victims.
Summary
Key Message
With 75,737 driver victims with diabetes and 150,911 matched controls, this study showed an 8% and 28% increase in mild and severe non-fatal injury, respectively among driver victims with diabetes. Such increase in risk was equally applied to both car and scooter drivers. No increase in risk of 3-day mortality after crash was found.
The effects of mental health on recurrent falls among elderly adults, based on Korean Community Health Survey data
Kyung Hee Jo, Jong Park, So Yeon Ryu
Epidemiol Health. 2020;42:e2020005.   Published online February 2, 2020
DOI: https://doi.org/10.4178/epih.e2020005
  • 12,643 View
  • 293 Download
  • 9 Web of Science
  • 9 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aimed to identify the effect of mental health on frequency of falls (single and recurrent falls) among elderly adults.
METHODS
Data were drawn from the 2015 Korean Community Health Survey. A chi-square test was conducted to compare differences in fall frequency according to health-related behaviors, chronic diseases, and mental health. Subsequently, multinomial logistic regression analysis was used to identify the effects of mental health on single and recurrent falls based on variables found to be significant in the chi-square test.
RESULTS
Recurrent falls were found to be more risky than single falls. Depression was significantly related to single falls (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.12 to 1.44). Depression (OR, 1.56; 95% CI, 1.38 to 1.76), sleep disorder (5 hours or less: OR, 1.12; 95% CI, 1.02 to 1.23; more than 9 hours: OR, 1.24; 95% CI, 1.07 to 1.44, respectively), and subjective stress (OR, 2.30; 95% CI, 1.90 to 2.78) were significantly related to recurrent falls.
CONCLUSIONS
The study’s findings suggest that specialized fall prevention programs are needed to address different types of falls in elderly adults. To prevent recurrent falls, systematic treatment strategies and rehabilitation training must improve physical function and mental health.
Summary
Korean summary
우리나라 노인에서 정신건강이 낙상에 미치는 영향을 확인하였고, 그 결과 단순낙상은 우울감 경험을 한 경우 낙상발생 위험이 증가했으며, 반복낙상은 우울감을 경험하고, 수면장애가 있으며(수면시간 6시간 미만, 9시간 이상), 주관적 스트레스가 커질수록 낙상 위험이 증가하였다. 최종적으로 노인의 정신건강이 반복낙상에 미치는 영향이 더 큰 것을 확인하였다. 본 연구결과를 통해 낙상 예방 및 관리를 위한 보건사업을 제시하고, 반복낙상자의 정신적/신체적 기능 증진을 위한 치료전략과 재활훈련 계획의 근거자료로 활용할 수 있을 것으로 생각된다.

Citations

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  • The understanding and experience of falls among community-dwelling adults aged 50 and over living with mental illness: A qualitative study
    Ling Koh, Lynette Mackenzie, Mandy Meehan, Diane Grayshon, Meryl Lovarini
    Aging & Mental Health.2023; 27(4): 789.     CrossRef
  • Factors Associated with Fear of Falling by Fall Experience in the Community-dwelling Elderly
    Yeong Mi Seo, Eun Sook Lee
    Research in Community and Public Health Nursing.2023; 34: 12.     CrossRef
  • Physical strength and mental health mediate the association between pain and falls (recurrent and/or injurious) among community-dwelling older adults in Singapore
    Vanessa Koh, David B. Matchar, Angelique Chan
    Archives of Gerontology and Geriatrics.2023; 112: 105015.     CrossRef
  • The genetics of falling susceptibility and identification of causal risk factors
    Matt C. Smith, Jessica O’Loughlin, Vasileios Karageorgiou, Francesco Casanova, Genevieve K. R. Williams, Malcolm Hilton, Jessica Tyrrell
    Scientific Reports.2023;[Epub]     CrossRef
  • Classification of community-dwelling older people based on their physical, mental, cognitive, and oral functions and comorbidities and its relationship with the fall history
    Sadaya Misaki, Hiroshi Murayama, Mika Sugiyama, Hiroki Inagaki, Tsuyoshi Okamura, Chiaki Ura, Fumiko Miyamae, Ayako Edahiro, Keiko Motokawa, Shuichi Awata
    Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics.2023; 60(4): 364.     CrossRef
  • Joinpoint Regression About Injury Mortality and Hospitalization in Korea
    Hyun Jin Park, Ui Jeong Kim, Won kyung Lee, Bohyun Park, Yoonhee Shin, Seonhwa Lee, Eun Jeong Choi, Nam-eun Kim, Ju Ok Park, Hyesook Park
    Journal of Korean Medical Science.2022;[Epub]     CrossRef
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    Shaoliang Tang, Meixian Liu, Tongling Yang, Chaoyu Ye, Ying Gong, Ling Yao, Yun Xu, Yamei Bai
    BMC Geriatrics.2022;[Epub]     CrossRef
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    Mi Young Kim, Yujeong Kim
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    Hyunmok Son, Jae Woon Lim, Sangbae Park, Byeongjoo Park, Jinsub Han, Hong Bae Kim, Myung Chul Lee, Kyoung-Je Jang, Ghiseok Kim, Jong Hoon Chung
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Analysis of the severity of occupational injuries in the mining industry using a Bayesian network
Mostafa Mirzaei Aliabadi, Hamed Aghaei, Omid kalatpuor, Ali Reza Soltanian, Asghar Nikravesh
Epidemiol Health. 2019;41:e2019017.   Published online May 11, 2019
DOI: https://doi.org/10.4178/epih.e2019017
  • 11,044 View
  • 227 Download
  • 11 Web of Science
  • 7 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Occupational injuries are known to be the main adverse outcome of occupational accidents. The purpose of the current study was to identify control strategies to reduce the severity of occupational injuries in the mining industry using Bayesian network (BN) analysis.
METHODS
The BN structure was created using a focus group technique. Data on 425 mining accidents was collected, and the required information was extracted. The expectation-maximization algorithm was used to estimate the conditional probability tables. Belief updating was used to determine which factors had the greatest effect on severity of accidents.
RESULTS
Based on sensitivity analyses of the BN, training, type of accident, and activity type of workers were the most important factors influencing the severity of accidents. Of individual factors, workers’ experience had the strongest influence on the severity of accidents.
CONCLUSIONS
Among the examined factors, safety training was the most important factor influencing the severity of accidents. Organizations may be able to reduce the severity of occupational injuries by holding safety training courses prepared based on the activity type of workers.
Summary

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  • A fuzzy Bayesian network DEMATEL model for predicting safety behavior
    Mohsen Mahdinia, Iraj Mohammadfam, Ahmad Soltanzadeh, Mostafa Mirzaei Aliabadi, Hamed Aghaei
    International Journal of Occupational Safety and Ergonomics.2023; 29(1): 36.     CrossRef
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    Fakhradin Ghasemi, Hamed Aghaei, Taleb Askaripoor, Farhad Ghamari
    International Journal of Occupational Safety and Ergonomics.2022; 28(1): 440.     CrossRef
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    Dan Tian, Hao Liu, Shu Chen, Mingchao Li, Chengzhao Liu
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    Safety Science.2021; 133: 105000.     CrossRef
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Predicting needlestick and sharps injuries and determining preventive strategies using a Bayesian network approach in Tehran, Iran
Hamed Akbari, Fakhradin Ghasemi, Hesam Akbari, Amir Adibzadeh
Epidemiol Health. 2018;40:e2018042.   Published online August 20, 2018
DOI: https://doi.org/10.4178/epih.e2018042
  • 15,170 View
  • 277 Download
  • 19 Web of Science
  • 20 Crossref
AbstractAbstract PDFSupplementary Material
Abstract
OBJECTIVES
Recent studies have shown that the rate of needlestick and sharps injuries (NSIs) is unacceptably high in Iranian hospitals. The aim of the present study was to use a systematic approach to predict and reduce these injuries.
METHODS
This cross-sectional study was conducted in 5 hospitals in Tehran, Iran. Eleven variables thought to affect NSIs were categorized based on the Human Factors Analysis and Classification System (HFACS) framework and modeled using a Bayesian network. A self-administered validated questionnaire was used to collect the required data. In total, 343 cases were used to train the model and 50 cases were used to test the model. Model performance was assessed using various indices. Finally, using predictive reasoning, several intervention strategies for reducing NSIs were recommended.
RESULTS
The Bayesian network HFACS model was able to predict 86% of new cases correctly. The analyses showed that safety motivation and fatigue were the most important contributors to NSIs. Supervisors’ attitude toward safety and working hours per week were the most important factors in the unsafe supervision category. Management commitment and staffing were the most important organizational-level factors affecting NSIs. Finally, promising intervention strategies for reducing NSIs were identified and discussed.
CONCLUSIONS
To reduce NSIs, both management commitment and sufficient staffing are necessary. Supervisors should encourage nurses to engage in safe behavior. Excessive working hours result in fatigue and increase the risk of NSIs.
Summary

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  • Shift work organization on nurse injuries: A scoping review
    Christopher C. Imes, Nicole J. Barthel, Eileen R. Chasens, Jacqueline Dunbar-Jacob, Sandra J. Engberg, Christine A. Feeley, Laura A. Fennimore, Cassandra M. Godzik, Mary Lou Klem, Faith S. Luyster, Dianxu Ren, Lynn Baniak
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    International Journal of Occupational Safety and Ergonomics.2022; 28(1): 440.     CrossRef
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    International Journal of Occupational Safety and Ergonomics.2022; 28(3): 1342.     CrossRef
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    International Journal of Occupational Safety and Ergonomics.2022; 28(3): 1822.     CrossRef
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  • Analysis of the severity of occupational injuries in the mining industry using a Bayesian network
    Mostafa Mirzaei Aliabadi, Hamed Aghaei, Omid kalatpuor, Ali Reza Soltanian, Asghar Nikravesh
    Epidemiology and Health.2019; 41: e2019017.     CrossRef
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Effects of human and organizational deficiencies on workers’ safety behavior at a mining site in Iran
Mostafa Mirzaei Aliabadi, Hamed Aghaei, Omid Kalatpour, Ali Reza Soltanian, Maryam SeyedTabib
Epidemiol Health. 2018;40:e2018019.   Published online May 18, 2018
DOI: https://doi.org/10.4178/epih.e2018019
  • 12,400 View
  • 203 Download
  • 21 Web of Science
  • 24 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Throughout the world, mines are dangerous workplaces with high accident rates. According to the Statistical Center of Iran, the number of occupational accidents in Iranian mines has increased in recent years. This study investigated and analyzed the human and organizational deficiencies that influenced Iranian mining accidents.
METHODS
In this study, the data associated with 305 mining accidents were analyzed using a systems analysis approach to identify critical deficiencies in organizational influences, unsafe supervision, preconditions for unsafe acts, and workers’ unsafe acts. Partial least square structural equation modeling (PLS-SEM) was utilized to model the interactions among these deficiencies.
RESULTS
Organizational deficiencies had a direct positive effect on workers’ violations (path coefficient, 0.16) and workers’ errors (path coefficient, 0.23). The effect of unsafe supervision on workers’ violations and workers’ errors was also significant, with path coefficients of 0.14 and 0.20, respectively. Likewise, preconditions for unsafe acts had a significant effect on both workers’ violations (path coefficient, 0.16) and workers’ errors (path coefficient, 0.21). Moreover, organizational deficiencies had an indirect positive effect on workers’ unsafe acts, mediated by unsafe supervision and preconditions for unsafe acts. Among the variables examined in the current study, organizational influences had the strongest impact on workers’ unsafe acts.
CONCLUSIONS
Organizational deficiencies were found to be the main cause of accidents in the mining sector, as they affected all other aspects of system safety. In order to prevent occupational accidents, organizational deficiencies should be modified first.
Summary

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Estimation of the population attributable fraction of road-related injuries due to speeding and passing in Iran
Fatemeh Khosravi Shadmani, Hamid Soori, Kamyar Mansori, Manoochehr Karami, Erfan Ayubi, Salman Khazaei
Epidemiol Health. 2016;38:e2016038.   Published online August 29, 2016
DOI: https://doi.org/10.4178/epih.e2016038
  • 14,961 View
  • 282 Download
  • 4 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Speeding and passing are considered to be the main human factors resulting in road traffic injuries (RTIs). This study aimed to estimate the population attributeable fraction (PAF) of speeding and passing in RTIs in rural Iran during 2012.
METHODS
The contribution of speeding and passing to RTI-related morbidity and mortality was estimated using the PAF method. The prevalence of speeding and passing was obtained from the national traffic police data registry. A logistic regression model was used to measure the association between the above risk factors and RTIs.
RESULTS
Speeding accounted for 20.96% and 16.61% of rural road-related deaths and injuries, respectively. The corresponding values for passing were 13.50% and 13.44%, respectively. Jointly, the PAF of these factors was 31.63% for road-related deaths and 27.81% for injuries.
CONCLUSIONS
This study illustrates the importance of controlling speeding and passing as a high-priority aspect of public-health approaches to RTIs in Iran. It is recommended that laws restricting speeding and passing be enforced more strictly.
Summary

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    Meisam Abolvardi, Nader Sharifi, Karamatollah Rahmanian, Vahid Rahmanian
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Association of Subway Driver's Depressive Symptoms and Experience of Work-Related Problems
Sun-Jin Jo, Hyeon Woo Yim, Hyoung-Ryoul Kim, Kang Sook Lee, Jong-Ik Park, Sung Man Chang
Epidemiol Health. 2010;32:e2010010.   Published online December 3, 2010
DOI: https://doi.org/10.4178/epih/e2010010
  • 14,333 View
  • 92 Download
  • 8 Crossref
AbstractAbstract PDF
Abstract
<sec><title>OBJECTIVES</title><p>Subway drivers experience various types of work-related problems during their driving, and those experiences can act as risk factors for depressive symptoms. This study was conducted to investigate the association between work-related problems and subway driver's depressive symptoms.</p></sec><sec><title>METHODS</title><p>We recruited all of the 961 current subway drivers of a subway company located in Seoul, South Korea and conducted a survey of their socio-demographic and vocational characteristics, hospital visits as an outpatient or inpatient, and work-related problem experiences during the last year. Work-related problems included an accident resulting in death or injury, a conflict with a customer, a sudden stop from an emergency bell, or a near accident. Depressive symptoms were measured with the Center for Epidemiologic Studies-Depression (CES-D) instrument. The survey was performed using a self-report questionnaire from April 16 to July 13, 2007. The data of 827 drivers (86.2%) were analyzed.</p></sec><sec><title>RESULTS</title><p>Experience of a conflict with a passenger (p=0.011), a sudden stop from an emergency bell (p=0.001), or a near accident (p=0.001) increased the prevalence of depressive symptoms among subway drivers. A multiple logistic regression analysis revealed that a sudden stop from an emergency bell increased the risk of depressive symptoms significantly (OR=2.59, p=0.026). Near accidents were marginally associated with a higher risk for depressive symptoms (OR=1.62, p=0.062).</p></sec><sec><title>CONCLUSION</title><p>The experience of a sudden stop from an emergency bell increased subway driver's depressive symptoms, and near accidents may increase the risk of depressive symptoms. Therefore, interventions for the drivers who had experienced these work-related problems are needed.</p></sec>
Summary

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  • Comments on Jo and Colleagues' Paper (2010) "Association of Subway Driver's Depressive Symptoms and Experience of Work-Related Problems"
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A Case-Control Study to Identify the Risk Factors of School Accidents.
Mi Young Ji, Young Sool Park, Sung Eun Yi
Korean J Epidemiol. 2005;27(2):80-94.
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AbstractAbstract PDF
Abstract
The purpose of the study was to analyze the risk factors of school accidents. The study subjects were 408 students of a middle school in a municipal city. Among them, 204 students who met with an accident and received first-aid treatment in school health room at any time from March 2 to July 15, 1999, were selected as the school accident group. And the remaining 204 students were cases' matched control, who had never been experienced any school accident from elementary school days to July 15, 1999, For data collection, the structured questionnaire, and interview were adopted. The findings of this study were as below: There were significant differences personal and familial characteristics residential form(p=0.04); active disposition (p=0.02); impatient disposition(p=0.02); family environment(p=0.01); and father image(p=0.00), and the school life characteristics; achievement(p=0.00); observance of school order(p=0.00); school adjustment(p=0.00), the health characteristics; school health room(p=0.00); medical institute they usually used(p=0.00); sleeping hours(p=0.03); bath or shower(p=0.01); hand washing(p=0.04), and wearing glasses(p=0.02), and the characteristics of accident disposition; accident experience(p=0.00); the characteristics of accident disposition(p=0.00). Multiple logistic analysis were showed that religion, adaption to school life and school accomplishment were the significant predictors to school accident prevalence. To reduce school accident, accident-prevention program should be developed practically and concretely in consideration of student's personal characteristics. In addition, accident-prevention education should be implemented under the link between home and school, so that students could prevent accident for themselves.
Summary
Accidents Status of Freshmen for 2 Months before Entrance University.
Young Sun Min, Hyun Sul Lim
Korean J Epidemiol. 2005;27(1):173-181.
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AbstractAbstract PDF
Abstract
OBJECTIVES
In recent years, Korea has experienced a loss of manpower and economy due to accidents. The consequences have been comprehensive. Nevertheless, there have been few recent Korean studies on adult accidents. Therefore, this study was carried out to examine the incidence pattern of accidents for 2 months before entering university among university freshmen.
METHODS
The subjects were 1,920 university freshmen who visited the university health center for health examination from March 8 to 12, 2004, and self-reported questionnaire was given to the subjects. The authors developed a questionnaire including age, gender, place and type of high school, experience of accidents, occurrence time and type of accidents and so on.
RESULTS
The monthly incidence of accident was 9.9 per 1,000 population. The accident cases were 28 in male and 10 in female, and the incidence of males was significantly higher than females. The frequent accident states were 15 cases in 'Ordinary life' (39.8%), 10 in 'Sports activities' (26.3%), 9 in 'Walking' (23.7%) and so on. The accident types were 13 cases of 'Tumbling over' (34.2%), 12 of 'Crash' (31.6%), 8 of 'Traffic accident' (21.0%) and so on. The frequent injury types were 19 cases of 'Sprain' (50.0%), 15 of 'Contusion' (38.4%) and 2 of 'Laceration' (5.3%). One's own carelessness was the most frequent cause of accident (65.8%). After the accident, 28 cases(73.7%) visited the hospital, 7 (18.4%) were hospitalized, and 3 (7.9%) underwent surgery.
CONCLUSIONS
Because the most frequent cause of accidents was one's own carelessness, self-consciousness and attention are needed. The authors expect that this study will go far toward increasing concern of researchers and administrators for the accidents among adults.
Summary
A study on epidemiologic characteristics and factors associated with excess hospitalization of the patients injured by traffic accident.
Mi Woon Kim, Joung Soon Kim, Min Kyung Lim
Korean J Epidemiol. 1998;20(2):279-287.
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AbstractAbstract PDF
Abstract
The occurrence of injuries and death caused by traffic accidents have been increasing during last few decades in Korea, which resulted in enormous personal, social and economic loss in terms of death, disability, labour days and medical costs incurred for treatment. Generally, it is well known and even became an hot sociopolitical issue that the duration of hospital stay for traffic accident patients are much longer than that of other patients with the similar condition. The objective of the study is to find out epidemiologic characreristics and management pattern of traffic accident patients in a general hospital of medium-sized, industrialized town. This study was carried out on 177 cases injured by motor vehicle accidents, who were admitted and treated in a general hospital from Feb. 1, 1997 to Sept. 30, 1997. The results obtained are as followings: The most of the patients(44%) were 20-30 years old age group although the occurrence of injuries was more frequent among older ages, 50's for male and 60's for female being 2.1 times more frequent among male. The traffic accidents occurred most frequently(14.1%) in the morning(06:00-08:00) and afternoon(14:00-16:00), and on Saturdays(20.3%); the (14.1% traffic accidents were frequent during weekends for passengers whereas it was more frequent during weekdays for pedestrian. Old and child pedestrians were most vulnerable subjects to traffic accidents. The most common site injured was head(19.9%) and the injury types were fracture of lower extremity(9.3%), skull fracture(8.6%) and rib fracture(8.6%) for both sexes; rib fractures/thoracic spine fractures(12.0%) for female and tibia/ fibula fractures(11.6%) for male. Mean days of hospital stay presumptively judged by the doctor who examined, made diagnosis and admitted the patient was 43.8 days compare to 38.4 days of actual mean days of hospitalixation. On the other hand, the optimal mean days of hospital stay for the patients determined by two doctors independently was estimated to be 26.6 days. Thus the difference between actual days of hospitalization and optimal days of hospitalization was 11.7 days, which can be regarded as excess hospitalization days. It consists 30.5% of actual hospitalization days, an enormous waste of resources. The only factor associated with this excess hospitalization was payment responsibility for the hospital cost; when the hospitalization expenses are to be paid by the person inflicted the injury there were always excess days of hospitalization regardless of insurance status.
Summary
A Sociomedical Research on Oriental Hospital Out and Inpatients of Cerebrovascular Accident.
Byung Ha Kim, Chul Hyun Nam, Gwang Bog Wie, Gi Yoel Kim, Seung Hee Yang
Korean J Epidemiol. 1997;19(2):240-257.
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Abstract
This study is comprehend the reality and characteristics of C.V.A. patients and to be helpful to its prevention and cure by resarching C.V.A. outpatient or inpatients who visited some of the oriental hospitals during three months from April 1 to June 30 1996 which are located in Taegu and Kungbuk Province, and concluded as follow: 1. The general characteristics of the subjects were: (1) 52.3% of the subjects were male. (2) In terms of age, 34.7% of them were in the sixties. (3) In terms of job, 28.5% of them were housewives(the highest percentage). (4) 77.6% of them had their spouses. (5) 67.2% of them were middle class. (6) In terms of educational background, 24.6% of them were literate of korean alphabets, and 23.4% were elemantary school gradurates. (7) 51.6% of them were outpatients. 2. 73.3% of the subjects experienced C.V.A. for the first time, and 23.1% were at recurrence, and 3.6% were chronic. 3. In terms of C.V.A. types, 49.8% of the subjects had cerebral hemorrhage, and 41.9% had cerebral infarction, and 8.3% had the others. In cerebral hemorrage, the percentage in "male, forties, job of sales service, unmarried, middle class, high educational background" were higher than the others respectively. And in cerebral infarction, the percentages in female, over seventies, official job, married, upper class were higher than the others respectively. 4. In terms of reasons of C.V.A. 49.5% of them were high blood pressure, and 24.2% were high stress, and 18.8% were overwork, and 4.0% were fatness, and 2.5% were heredity. In high blood pressure, the percentages in "high age, teacher, unmarried, lower class, low educa-tional background" were higher than the others respectively. 5. In terms of family members' C.V.A. , 56.7% of the subjects answered negatively, and 43.3% positively. In terms of the diseases which they had now except for C.V.A., 33.6% of them had hypertention, and 16.2% had diabetes, and 9.4% had neuralgia, and 4.0% had heart disease, and 16.6% had the otehrs, and 20.2% had no other disease. In heart disease, the percentages in "male, teachers, middlelower class, middle school graduates, inpatients" were higher than the others respectively. In neuralgia, the percentages in "fifties and sixties, housewives, spouse alive, upper class, literate of Korean alphabet" were higher than the others respectively. In terms of the diseases which they had now except for C.V.A., 33.6% of them had hypertension, and 16.2% had diabetes, and 9.4% had neuralgia, and 4.0% had heart diseases, the percentages in "fifties and sixties, housewives, spouse alive, upper class, literate of Korean alphabets" were higher than the others respectively. 6. In terms of the diseases which they had before C.V.A., 22.4% of them had hypertension, and 18.8% had diabetes, and 8.1% had heart diseases, and 11.2% had neuralgia and arthritis, and 7.8% had cancer, and 21.7% had the others. 7. In terms of exercise behaviors before C.V.A., 41.2% of them did nothing, and 58.8% did sometimes. 8. In terms of fatness level by self judgement, 36.1% of them thought "proper", and 41.1% thought themselves "fat(the highst percentage), and housewives(45.5%) thought themselves "fat". 9. In terms of favorite food, 50.2% of them liked meat, and 33.2% liked vegetables, and 13.0% liked fish. 10. In terms of fancy things of C.V.A. patients, 57.0% of them were non-smokers, and 53.1% were non-drinkers, and 55.2% disliked coffee. In smoking level, 16.6% of them smoked less than five pieces a day. In drinking, 18.0% of them drank half a glass of soju. In coffee, 25.3% of them drank a cup of coffee a day. 11. The level of satisfaction with C.V.A. patient-healing methods ; In medical therapy, 43.3% of C.V.A. patients thought it "usual", and 44.1% thought it "satisfactory" and 7.9% thought it "unsatis-factory". In acupunture and moxibustion 39.7% of the C.V.A. patients thought it "usual", and 53.0% thought it satisfactory" and 3.3% thought it "unsatisfactory". The level of satisfaction With Physiotherapy was average 61.7% and 4.0% was "unsatisfactory". From above statement, by considering those characteristics we should develop programs and materials to be health to the prevention and cure of C.V.A. and we should help hospitals and medical personnel families concerned to make use of them.
Summary

Epidemiol Health : Epidemiology and Health