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Association between Metabolic Syndrome and Alcohol drinking and Smoking histories in a rural area of Korea.
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Hee Sung Ha, Hyeon Woo Yim, Yong Moon Park, Jin Hee Lee, Seung Hwan Lee, Hyuk Sang Kwon, Kun Ho Yoon, Ho Young Son, Moo Il Kang, Won Chul Lee
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Korean J Epidemiol. 2008;30(2):281-293. Published online December 31, 2008
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DOI: https://doi.org/10.4178/kje.2008.30.2.281
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PURPOSE
Prevalence of metabolic syndrome is increasing markedly in rural area of Korea. Alcohol drinking and smoking are the main risk factors which shows the highest prevalence rate among the risk factors of metabolic syndrome. The aim of this study was to investigate the association between metabolic syndrome and alcohol drinking and smoking histories in a rural area of Korea.
METHODS Data was obtained from 1,332(507 men, 825 women) individuals aged over 40 years who lived in rural area of Chungju city in 2007. Metabolic syndrome was defined by NCEP ATP III criteria and waist circumference was defined by WHO-APR(Asia Pacific Region). Data analysis was carried out using SAS version 8.02.
RESULTS In men, adjusted odds ratio for metabolic syndrome was 2.78(1.09-7.05) for current alcohol drinker, 2.75(1.38-5.51) for past alcohol drinker, 3.25(1.58-6.67) for under 21 years old at start of alcohol drinking, 2.62(1.12-6.11) for light alcohol drinker, 6.01(2.65-13.64) for heavy alcohol drinker. In women, all the alcohol related risk factors were not statistically significant with metabolic syndrome. For all the smoking related risk factors were not statistically significant with metabolic syndrome in men and women. Adjusted odds ratio of alcohol drinking habits for each components of diagnostic criteria of metabolic syndrome was significant for high blood pressure, high fasting glucose and hypertriglyceridemia in men and abdominal obesity in women. Adjusted odds ratio of cigarette smoking habits for each components of diagnostic criteria of metabolic syndrome was significant for abdominal obesity in women.
CONCLUSION Controlling alcohol drinking habits in men should be reinforced in order to prevent the metabolic syndrome in a rural area of Korea.
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Changes of Hepatitis B Surface Antigen Seroprevalence in Korea, 1998-2005.
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Seunghee Jeong, Hyeon Woo Yim, Si Hyun Bae, Won Chul Lee
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Korean J Epidemiol. 2008;30(1):119-127. Published online June 30, 2008
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DOI: https://doi.org/10.4178/kje.2008.30.1.119
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PURPOSE
The purpose of this study was to investigate the prevalence rate of HBsAg and the epidemiological characteristics of hepatitis B virus (HBV) infection from 1998 to 2005. National Health and Nutrition Examination Survey (NHANES) data of 1998, 2001 and 2005 were analyzed.
METHOD Study population was consisted of 24,093, aged 10 year or over who performed NHANES self reported surveys and blood tests. Statistical analysis was performed by age, sex, and the year of survey. Also the prevalence of HBsAg was compared by self reported family history of liver disease.
RESULTS The prevalence rate of HBsAg was reduced from 4.5% in 1998 to 3.7% in 2005. Also age-specific prevalence rate of HBsAg was significantly decreased in persons born after introduction of the hepatitis B virus vaccination. HBsAg seropositivity was slightly higher in male than in female.
Among the people with the family history of liver diseases, the risk of HBsAg seropositive was much higher than those without. Study subjects with mother's liver disease history showed much higher HBsAg serepositive rate. Although after the implementation of hepatitis B virus vaccination program prevalence of HBsAg decreased, but persons with history of liver disease showed still higher rate Of HBsAg seropositive rate.
CONCLUSION Although the introduction of the HBV vaccination program has resulted in a decline of HBV infection, the family history of liver diseases was still an important factor for transmission of HBV in Korea. In addition to the mother-to-child transmission prevention program from 2002, it might be advisable to introduce a screening program for persons with family history of liver diseases for further reduction of HBV infection.
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Summary
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Citations
Citations to this article as recorded by  - Are there differences in hepatitis-B immunization status between diabetes and non-diabetes subjects in Korea?
Ji Young Park, Su Kyoung Kwon
Kosin Medical Journal.2018; 33(1): 41. CrossRef - Study of the Associations Between TT Virus Single and Mixed Infections With Leukemia
Ramin Yaghobi, Marjan Shaheli, Abbasali Rezaeian, Mahdiyar Iravani Saadi, Mani Ramzi
Jundishapur Journal of Microbiology.2015;[Epub] CrossRef - Reactivation of hepatitis B (reverse seroconversion) after melphalan/dexamethasone therapy for primary amyloidosis: a case report
Woo-Ram Moon, Do-Sik Moon, JoA Kim, Young-min Yoon, Byung-Seok Choi, Choon-Hae Chung, Sang-Gon Park
Journal of Medical Case Reports.2015;[Epub] CrossRef - Hepatitis B virus infection, diabetes mellitus, and their synergism for cholangiocarcinoma development: A case-control study in Korea
Ban Seok Lee
World Journal of Gastroenterology.2015; 21(2): 502. CrossRef - Association between Hepatitis B Surface Antigen Seropositivity and Metabolic Syndrome
Tae-Heum Chung, Moon-Chan Kim, Chang-Sup Kim
Korean Journal of Family Medicine.2014; 35(2): 81. CrossRef - Lamivudine prophylaxis for hepatitis B virus carrier patients with breast cancer during adjuvant chemotherapy
Hyun Jung Lee, Dae Young Kim, Bhumsuk Keam, Jeong Hoon Lee, Sae-Won Han, Do-Youn Oh, Jung Hwan Yoon, Tae-You Kim, Yu Jung Kim, Keun Wook Lee, Jin-Wook Kim, Sook-Hyang Jeong, Jong Seok Lee, Jee Hyun Kim, Seock-Ah Im
Breast Cancer.2014; 21(4): 387. CrossRef - Factors Influencing on Perinatal Outcomes of Asian Marriage Immigrant Women: Ten-year Experience in a Single Center
Hye Young Lee, Gi Cheol Park, Mi Kyung Kim, Oh Kyung Lee
Korean Journal of Perinatology.2013; 24(3): 168. CrossRef - Changes in Birth Rate, Perinatal Risk Factors and Outcome in Newborns in Multi-cultural Family: Ten-year Experience in One Center
Hae In Jang, Joon Sik Choi, Eun Song Song, Young Youn Choi
Neonatal Medicine.2013; 20(1): 146. CrossRef - Treatment of Rheumatoid Arthritis Patients with Chronic Hepatitis B: Analysis of Korean National Health Insurance Claims Data
Kichul Shin, Hyeongap Jang, Won Mo Jang, Jin-Seok Lee, Yeong-Wook Song
Journal of Rheumatic Diseases.2013; 20(1): 24. CrossRef - Prevention of Viral Hepatitis and Vaccination
Yoo-Kyung Cho, Byung-Cheol Song
Korean Journal of Medicine.2012; 82(2): 123. CrossRef - Prevalence and clinical significance of occult hepatitis B virus infection among renal transplant recipients in Korea
Eunsin Bae, Chang-Hun Park, Chang-Seok Ki, Sung-Joo Kim, Wooseong Huh, Ha-Young Oh, Eun-Suk Kang
Scandinavian Journal of Infectious Diseases.2012; 44(10): 788. CrossRef - Occupational Infections of Health Care Personnel in Korea
Jung Oak Kang
Hanyang Medical Reviews.2011; 31(3): 200. CrossRef - Predictors of HBsAg Seroclearance in HBeAg-Negative Chronic Hepatitis B Patients
Min-Sun Kwak, Eun-Ju Cho, Eun-Sun Jang, Jeong-Hoon Lee, Su Jong Yu, Yoon Jun Kim, Jung-Hwan Yoon, Hyo-Suk Lee
Digestion.2011; 84(s1): 23. CrossRef - New Insight for HBV DNA and HBsAg Quantitation during Antiviral Therapy in Patients with Chronic Hepatitis B
Yoo-Kyung Cho, Byung-Cheol Song
The Korean Journal of Gastroenterology.2011; 57(3): 144. CrossRef - High prevalence of hepatitis B and hepatitis C virus infections in Korean patients with hematopoietic malignancies
Jun Kang, Jeong Hyun Cho, Cheol Won Suh, Dae Ho Lee, Heung Bum Oh, Yong Hak Sohn, Hyun Sook Chi, Chan Jeong Park, Sung Soo Jang, Kyoo Hyung Lee, Je-Hwan Lee, Jung Hee Lee, Sang Wook Lee, Young Hwa Chung, Tae Hyup Kim, Hai-Rim Shin, Jooryung Huh
Annals of Hematology.2011; 90(2): 159. CrossRef - Shifting in Seroprevalence of HBsAg and Anti-HCV during Recent 10 Years in Adults Resident in Daegu and Gyeongbuk Province
Kyung In Lee, Kyung Sik Park, Hye Jin Seo, Tae Yul Kim, Eun Soo Kim, Byoung Kuk Jang, Woo Jin Chung, Kwang Bum Cho, Jae Seok Hwang
The Korean Journal of Gastroenterology.2011; 58(2): 82. CrossRef - Development of the Guideline for HIV Testing in South Korea with Low Prevalence of HIV-1 Infection Based on the Expert Consensus
Hee Jung Choi, Kyoung Ae Kong, Jung Won Min, Hun-Jae Lee, Hae-Sook Park
World Journal of AIDS.2011; 01(04): 155. CrossRef
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Bias in Cancer Screening Evaluation.
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Sang Heon Yoon, Hyeon Woo Yim, Won Chul Lee
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Korean J Epidemiol. 2008;30(1):12-24. Published online June 30, 2008
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DOI: https://doi.org/10.4178/kje.2008.30.1.12
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Cancer screening evaluation will be a important issue in Korea in near future. Bias in cancer screening evaluation is well known by concept, but it is not applied yet using the data from screening program of Korea. So introducing the way how the bias is adjusted will be helpful. This review deals with the type, meaning, the way how the bias is adjusted, and examples. Especially, lead-time bias, length bias and self-selection bias were focused. Adjusting bias is one of the imperative step for epidemiologic analysis.
Understanding the background concept and experience using the screening program data will be helpful for estimating the effectiveness of national screening program of Korea.
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Summary
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Citations
Citations to this article as recorded by - Evidence-based National Cancer Screening program of Korea
Won-Chul Lee
Journal of the Korean Medical Association.2011; 54(10): 1028. CrossRef
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A Prospective Study of the Epidemiology of Out-of-Hospital Pediatric Cardiopulmonary Arrest.
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Seung hoon Hahn, Won chul Lee
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Korean J Epidemiol. 2007;29(2):211-221.
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PURPOSE
Data regarding out-of-hospital pediatric cardiopulmonary arrest have been limited to the retrospective study. This study was performed to analyze the epidemiology and outcome of out-of-hospital pediatric cardiopulmonary arrest(CPA) with the international consensus in a single hospital.METHODS Children less than 15 years old who entered emergency department with CPA, between 1st March 2004 and 31st July 2007, were included this study. Data were recorded prospectively following Utstein's template. The characteristics and outcomes of patients were analyzed.RESULTS Cardiopulmonary arrests occurredin total of 37 of 21,339 children presented to emergency department during 41 months study period. 15 out of 37 with CPA had return of spontaneous circulation (ROSC) after resuscitation, 4 survived to be discharged from the hospital. The rate of ROSC in the respiratory arrest is higher than the cardiac arrest. Trauma was the most common cause of out-of-hospital pediatric cardiopulmonary arrest. No children who had more 20 minutes of cardiopulmonary resuscitation (CPR) or took more than 3 doses of epinephrine survived.CONCLUSIONS The 10.4% survival rate after out-of-hospital pediatric CPA is poor. The respiratory arrest is more favorable. Education of basic life support for publics is needed to increase the rate of ROSC and survival from out-of-hospital pediatric cardiopulmonary arrest.
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Bias related to Nutritional Epidemiology.
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Won Chul Lee, Jin Hee Lee
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Korean J Epidemiol. 2003;25(1):39-46.
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Bias is the main problem that should be considered in epidemiologic research. Information bias caused by measurement error and confounding caused by total energy intake are listed as the main biases in nutritional epidemiology and the concept, fact and the methods for adjusting effects of these biases are discussed. The biases which can be caused during the nutritional epidemiologic research process are listed and discussed. The pros and cons of the continuous data and categorical data of the nutrients and the ways how to categorize the data are reviewed. During the analysis of food and nutrient data, multiple comparison and publication bias are prone to be encountered, and these should be considered in interpretation of the results.
Understanding of the biases will lead us to make valuable nutritional epidemiologic research and these lead the application of the research results to control the prevalent noncommunicable diseases.
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Development of Stress Measurement Tools in Korean Dental Laboratory Technicians.
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Ji Hwan Kim, Won Chul Lee, Kang Sook Lee, Chul Lee, Kinam Jin
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Korean J Epidemiol. 2000;22(2):171-171.
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PURPOSE
This study was performed to develop a proper self-administered survey instrument which can be used to measure psychiatric stress symptoms in Korean dental laboratory technicians, and to investigate the relationship between the symptom dimensions and stress inducing factors, such as psychological distress, stress inducing overload, work demand, work procedure and so forth in them.METHODS Prepared questionnaires were mailed to 1,000 dental laboratory technicians who were systematically selected. There were 786 responses to the questionnaires.
All the data obtained were analyzed with SAS program.RESULTS Fifty items for the stress symptom checklist for dental technician(SCLD) were selected after a pilot test, interviews and literature reviews. Stress symptoms were classified into the following 6 categories, i.e, somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, and hostility symptom.
Factor analysis for validity was carried out for corroboration, using the SCL-90-R as a standard.CONCLUSION SCLD had the reasonable reliability and validity. We believe that this study provides validity and reliability for new self-report questionnaire, it will make a significant contribution to assessment of stress symptoms.
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Obesity and Physical Activity Related to Colorectal Adenoma by Anatomic Sites in Korea.
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Mi Kyung Kim, Won Chul Lee, Kyu Yong Choi, Se Young Lee, Sukil Kim, Yang Cha Lee-Kim, Kwang Ho Meng
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Korean J Epidemiol. 1999;21(2):254-265.
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Although the etiology of colorectal adenoma is not yet clear, numerous epidemiologic studies of colorectal adenoma(precursors of cancer) have shown a positive association with obesity and an inverse association with physical activity. The difference of the possible association of colorectal adenoma with body mass index(BMI= wt(kg)/ht2(m2) and physical activity(kcal/day) according to anatomic sites and gender was investigated in this case-control study. Between July 1994 and october 1998, 345 cases of patients(male 181, female 164) with pathologically confirmed incident colorectal adenoma and 1655 control subjects(male 598, female 1,057) were collected from Our Lady of Mercy Hospital, The Catholic University of Korea.
After colonoscopy, self-reported weight and height, together with measures of intensity and time of exercise and lifetime job activity was obtained by the interviewers. Site- and gender-specific odds ratios relative to the lowest tertile of BMI and physical activity were determined using unconditional logistic regression after adjusting for potential confounders. Compared with subjects in the lowest terile of body mass index, multivariate-adjusted odds ratio of right colon for male and female in highest tertile were 1.49(95% CI:0.74-3.01) and 1.96(95% CI:0.93-4.15), respectively. Compared with subjects in the lowest tertile of physical activity, multivariate-adjusted odds ratio of right colon for male and female in highest tertile were 0.66(95% CI:0.35-1.26) and 0.83(95% CI:0.50-1.39), respectively. These results support a positive association between body mass index and occurrence or progression of adenoma in left colon and physical activity is associated with an elevated risk of right colon.
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Incorrect Disease Coding in Medical Insurance Claims and the Effect of Official Intervention: Based on Medical Insurance Claims of 6 Notifiable Acute Communicable Diseases.
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Yong Mun Park, Kwang Ho Meng, Euichul Shin, Kidong Park, Won Chul Lee, Sukil Kim, Jung Hee Jang
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Korean J Epidemiol. 1999;21(2):142-150.
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BACKGROUND
Because of their large size and excellent computerized records of illness and services rendered, the importance of national insurance program is getting much attentions from the public health researchers and the national and local health authorities. In reality, however, most health records from medical insurance program suffer very much from inaccurate disease coding, and therefore, they are practically in no use.METHODS Pattern of incorrect disease coding of 6 Notifiable Acute Communicable Diseases that believed not to have been occurred in Korea lately was reviewed. The reasons of such incorrect codings in different level of medical institutions were studied. This study also attempted to see how an official intervention asking the medical institutions to correct their coding behavior works by comparing the frequencies of incorrect disease coding before and after the intervention.RESULTS Study results showed that more incorrect disease codings came from clinics than hospitals, and non-physician personnel in clinics and hospitals seemed to be responsible for most of the incorrect disease codings. Most frequent diseases coded incorrectly such as cholera and poliomyelitis were the ones that physicians and non-physician personnel in the clinics and hospitals had been familiar with for a long time period.CONCLUSION Even a simple official intervention asking the clinics and hospitals to correct their coding behavior was very effective : total number of incorrect disease codings before intervention (398 cases from 144 institutions) dramatically decreased (14 cases from 8 institutions) after intervention. Significant decrease in incorrect disease coding was found more in small institutions such as clinics and public health facilities than large institutions.
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An Analysis on the Factors Associated with Cancer Screening in a City.
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Woon Nyung Roh, Won Chul Lee, Young Bok Kim, Yong Mun Park, Hong Jae Lee, Kwang Ho Meng
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Korean J Epidemiol. 1999;21(1):81-92.
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This study is aimed at preparing basic data required for establishment of a cancer screening program by examining the status of cancer screenings performed by residents in a community and the factors that have an effect on determination for a cancer screening by residents.
Cervix, breast and stomach cancers were chosen as target cancers of the study due to the fact that merits of screening for these cancers have been proved by studies done in different countries.
In order to find out the status of cancer screening and the factors having an effect on the determination for a cancer screening, 10 Dongs and a total of 1988 people were selected as study area and subjects by a random cluster sampling method, and the subjects were questioned on different aspects by questionnaires. Additionally, in order to find out how cancer screening is performed at medical facilities and how cancer screening is recommended by doctors, medical facilities doing cancer screening were also questioned.
The results of the study are as follows: 1. In the case of the screening of the stomach cancer, 16.1% of male subjects and 25.6% of female subjects turned out to have had one or more screening for the cancer. In the cases of the breast and the cervical cancers, 21.6% and 62.6% of the subjects turned out to have had one or more screenings respectively.
2. As to the screening for the stomach cancer, there was a tendency that more of the subjects with lower level education, excepting those without education, had themselves screened for the cancer. Higher screening rates were shown by the subjects in higher ages, those who visited doctors regularly.
3. As to the screening rate by education levels, a high rate of screening was shown by the subjects with above-university education level and there was not a big difference between the screenings done for high school graduates and for those with lower education levels.
Regarding the rates of screening by age groups the screening rate turned out to be higher with the higher ages. Screening rates, checked on the basis of the income levels, did not show a big differences between income levels.
4. The highest rate of screening for the breast cancer was shown by the subjects with postgraduate level of education and regarding the rate by income level, a slightly higher level was shown by the subjects with the monthly income of the 2,010,000 won, but the difference between the rates of screening by subjects at different income levels was overall not significant.
5. The rates for selecting the health screening facilities were higher in orders of the reasons that 1) they were close: 2) service was excellent and 3) equipment and facilities were good.
Based on the above-mentioned results obtained by the study, it is anticipated that this study will play a vital role as basic data for the development and execution of cancer screening program for a community, and the analysis, done on the basis of the status of the cancer screening, of the factors related to the determination for the cancer screening showed that for the development of a cancer screening program, factors like income levels, education levels, whether people consult doctors regularly and the local government' care for health in a community should be considered, and in addition to which active participation of doctors in the program is also requested.
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A Study on the Behavioral Factors Related to Stomach Cancer Screening among Adults in a Rural Area.
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Young Bok KIM, Won Chul Lee
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Korean J Epidemiol. 1999;21(1):20-30.
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The purpose of this study was to investigate the behavioral factors related to stomach cancer screening among adults in a rural area. The number of subjects were 270 who were consisted of 133(49.3%) of male and 137(50.7%) of female. To predict the behavior, we used the health belief model. Using methodology was self-questionnaire which included the perceived health status, the severity for stomach cancer, preventive knowledge for stomach cancer, the threat for stomach cancer, the experience of cue to action, the benefit of cancer screening and the barrier of participating screening. The associations between the behavioral factors and the experience and intention of examination of endoscopy were evaluated by the odds ratio(OR). The results were as follows : 1. 78.1% of subjects responded that they had the good health, and 56.3% of them perceived the severity of stomach cancer. The 49.6% of them were evaluated as the moderate on the preventive knowledge for stomach. Also 39.3% had the threat for stomach cancer, and 79.2% had the experience of cue to action. The almost of respondents thought the endoscopy as available method for stomach cancer screening.
The major barrier factors on stomach cancer screening were fear to endoscopy, discomfort for endoscopy, high cost of examination and lack of time.
2. Although the experience for examination of endoscopy was showed to the difference by sex, age, educational level and BMI, it was not significant. However, the experience for examination of endoscopy was showed to the significant difference by the perceived health status(OR:3.47, 95% CI:1.27-9.51), the preventive knowledge for stomach cancer(OR:0.42, 95% CI:0.19-0.96) and the experience of cue to action(OR:2.57, 95% CI:1.05-6.34).
3. Also although the intention for examination of endoscopy was showed to the differences by sex, age and BMI, it was not significant. However, the intention for examination of endoscopy was showed to the significant difference by the benefit for endoscopy(OR:2.35, 95% CI:1.02-5.42) and the experience of stomach cancer screening(OR:3.47, 95% CI:1.78-6.78). In case of the preventive knowledge for stomach cancer and the experience of cue to action, it did not influence to the intention for examination of endoscopy.
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A Case-Control Study on dietary Factors of Colorectal Adenomatous Polyps by Sites.
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Mi Kyung Kim, Won Chul Lee, Kyu Yong Choi, Su Kil Kim, Se Young Lee, Yang Cha Lee-Kim, Kwang Ho Meng
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Korean J Epidemiol. 1998;20(1):154-166.
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Colorectal adenomas are benign neoplasm in the large bowel that are thought to be precursors lesion to colorectal cancer. So, studying adenomatous polyps instead of cancer might allow one to measure the diet of relatively asymptomatic subjects closer to the time of the initial neoplastic process. Some dietary factor, or set of factors, apparently plays an impotant role in the etiology of colorectal adenomatous polyps. The difference of the possible association of colorectal adenomatous polyps with dietary risk factors by anatomic subsite and gender was investigated in this case-control study. Between July 1994 and April 1998, 314 cases of patients with pathologically confirmed incident colorectal adenomatous polyps and 88 control subjects were collected from Our Lady of Mercy Hospital, The Catholic University. After colonoscopy, infor-mation on exposure was obtained by the interviewers.
Also, subjects were interviewed using the semiquantitative food frequency questionnaire, and average daily nutrient intakes were calculated. Site- and gender-specific odds ratio relative to the lowest tertile of intake for each nutrient were determined using unconditional logistic regression after adjusting for a number of potential confounders. In females, significant odds ratio were found for b-carotene(0.31, 95% CI, 0.10~0.95), vitamin C(0.11, 95% CI, 0.02~0.61), vitamin-E(0.11, 95% CI, 0.02~0.78) in right colon but only the odds ratio of vitamin E(0.17, 95% CI, 0.03~0.90) was statistically significant in left colon.
Among food groups, the odds ratio of green yellow vegetables was significant(OR=0.21, 95% CI, 0.05~0.96) in right colon.
In males, almost all the above dietary factors were statistically not significant. In males, cigarette smoking appears to be a signigicant risk factor(OR=8.86, 95% CI, 1.10~71.5) in left colon, it was statistically not signigicant(OR=1.63, 95% CI, 0.42~4.76) in the right colon.
Findings fron this study show that many associations of the nutrients with colorectal adenomatous polyps risk are different by anatomic subsite and gender and support the hypothesis that high intake of antioxidant vitamins and green yellow vagetables decreases the risk of polyps.
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Epidemiologic Characteristics of the Pneumoconiosis Patients in Manufacturing Industries.
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Won Chul Lee, Hyeon Woo Yim, Kyung Jae Lee, Se Yong Lee, Kwang Ho Meng, Young Gyu Phee, Hyun Wook Kim, Jung Wan Koo, Young Lim, Im Goung Yun
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Korean J Epidemiol. 1998;20(1):141-153.
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Pneumoconiosis was the first reported occupational disease in Korea and was the most common one until 1990. In the past, most pneumoconiosis patients were found among underground workers in various mines. Recently this occupational disease has increasingly affected workers in manufacturing industries such as ship building, briquette, glass, foundry industries, and so on. In order to investigate the scale of pneumoconiosis in manufacturing industries, we evaluated the detailed medical examination records and insurance deliberation data from 1989 until 1994. Information about work history, medical history, and exposure dust type were collected for each member of the study population. All chest X-rays were interpreted and classified using the International Labor Organization(ILO) scale by three radiologist who have had extensive experience evaluation pneumoconiosis. For the calculation of the incidence rate of manufacturing pneumoconiosis, we analyzed the Specific Health Examination data and estimated the population at risk as a denominator of the incidence rate.
We divided manufacturing industry into 9 subclasses by industrial classification and estimated the incidence rate of pneumoconiosis per 100,000 workers at risk respectively.
The results were as follows, 1. 485 workers were newly diagnosed with pneumoconiosis during 6 years from 1989 to 1994. 482 workers had radiographs consistent with simple pneumoconiosis and three with progressive massive fibrosis.
Among those with radiographs consistent with simple pneumoconiosis, 395 workers(81.4%) had category 1 profusion, 76 workers(15.7%) had category 2 profusion and 11 workers(2.3%) had category 3 profusion. 2. Almost all of them were male(97.9%) and their average age was 48.3 uears.
Manufacturing pneumoconiosis patients were more common in their forties and fifties. 3. The average duration of dust exposure required for the occurrence of pneumoconiosis was 13.5 years. In the case of metal products manufacturing which is mostly related to welding, the average duration of dust exposure was 12.0 years. It was slightly shorter than other manufacturing industries. The average duration of dust exposure required for the occurrence of pneumoconiosis seemed to be shorter in welding operators, even though the welders lung has a weak tissue reaction and the condition is reversible. 4. According to the Industrial classification, 299 cases(61.6%) were found in workers of non-metal mineral products manufacturing, and 56 cases(11.5%) in basic metals industry. 5. The average annual incidence rate of pneumoconiosis in manufacturing industries from 1990 to 1994 was 56.6 per 100,000 workers at risk. On sub-classification, the average annual incidence rate of pneumoconiosis in non-metal mineral products manufacturing industry was the highest among them, showing 479 per 100,000 workers at risk.
6. Radiologic prevalence rate of tuberculosis in these cases was 6.6%. 7. X-ray category profusion in newly diagnosed manufacturing pneumoconiosis varied according to sub-classification. The proportion of category 1 profusion in metal products manufacturing is higher than that in non-metal mineral products manufacturing. 8. The type pattern of small round opacities varied according to sub-classification in manufacturing industry. In non-metal mineral products manufacturing, the small round opacity were observed 25.9% cases with p type, 72.1% with q type and 2.0% with r type respectively. But in metal products manufacturing, the small round opacity were observed 51.4% cases with p type and 48.6% with q type respectively. The cause might be that the exposed dust is different according to job. 9. The type pattern of small round opacities varied according to dust type. Metal dusts showed similar radiologic shape to the coal dusts, but welding fume showed more frequent p type(60.3%) and less frequent q type(377%).
rock dust showed less frequent p types(18.3%) and more frequent q types(75.3%). Since the incidence rate of non-metal manufacturing workers showed higher rate than other manufacturing industry, Preventive measures and health care education should be carefully carried out in these workers.
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Current Status of Cancer Screening Rate and Epidemiologic Study for Evaluating the Effectiveness of Cancer Screening in Korea.
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Won Chul Lee
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Korean J Epidemiol. 1998;20(1):1-9.
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Current status of cancer screening rate and epidemiologic study for evaluating the effectiveness of cancer screening in Korea are reviewed. There are only few studies for an analysis of the current cancer screening status and associated factors in a community. Among these, a study which were done at Uijongbu city, showed the results on follows ; in the case of the screening of the stomach cancer, 16.1% of male subjects and 25.8% of female subjects turned out to have had one or more screenings for the cancer. In the cases of the breast and cervical cancers, 21.6% and 62.6% of the subjects turned out to have had one or more screenings respectively. The main epidemiologic studies which were for cancer screening effectiveness evaluation were case-control studies for stomach, cervix and breast cancer. According to these studies ; odds ratio was 0.71(95% confidence interval 0.36-1.40) for stomach cancer, 0.53(95% confidence interval 0.33-0.85), cervix cancer and 0.43(95% confidence interval 0.25-0.75) for breast cancer.
Establishing cancer screening recommendation to promote national cancer control program and increasing cancer screening rate are needed to reach the goal of reducing cancer mortality and morbidity.
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Problems and Suggestions for Improvement in Epidemiological Study of Coal Workers' Pneumoconiosis in Korea.
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Im Goung Yun, Young Lim, Won Chul Lee, Kwang Ho Meng, Hyeong Woo Yim
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Korean J Epidemiol. 1996;18(2):131-141.
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Pneumoconisosis was the first reported occupational disease in korea and was the most common occupational disease until 1990. Nowadays pneumoconiosis is the second most common occupational disease which accounts for more than at least 40% of all the occupational diseases in Korea. Many studies have been carried out in the prevalence rate, incidence rate, and risk factors assessment of pneumoconiosis. Workers exposed to dust used to take health examination once annually by the Industrial Safety and Health Act(1981). The number of coal workers has steadily decreased due to coal rationalization projects which have been strongly driven by the government since 1988 and the occupational environment has been improving. So, the incidence rate of pneumoconiosis will probably be lower in the future. But a disease control system administed for patient control and compensation, which is not involved in epidemiologic studies may not figure out the prevalence rate, incidence rate, mortality rate and the extent of severity of pneumoconiosis. Several problems and expected solutions are mentioned here as follows: 1. workers exposed to dust and pneumoconiosis patients are under government control, but the retired workers are not. Since we evaluate only visiting retired workers, we don't know exactly the current status and whole scale of the retired workers. If possible, the construction of cohort in all the retired workers is needed. 2. Since most of pneumoconiosis patients retired from the work and had changed their job, it is difficult to figure out the prevalence rate of pneumoconiosis just depending on the annual health exam for those workers at risk. So, systemic control for all pneumoconiosis patients is needed. 3. It is difficult to diagnose the onset of pneumoconiosis. We make a decision the time when the patient is diagnosed with pneumoconiosis on its onset. It is difficult to estimate it, especially in the case of retired workers because we can evaluate only persons with respiratory symptoms. The solution of such a problem is construction of cohort in all of the retired workers. 4. Because the patients who died outside of hospital don't seem to be reported, the mortality rate of pneumoconiosis is underestimated. So, systemic control and follow-up observation for all pneumoconiosis patients is needed. 5. A definite severity classification criteria for pneumoconiosis hasn't been established in Korea. We should try to make one. 6. Since workers who had exposed to dust in various mines at least 1 yr are subject to pneumoconiosis laws, workers easily don't report their full dust exposure history. Therefore we can't obtain the exact lifetime dust exposure from administrative data. We should try to make basic raw data of whole dust exposure in workers. It's concluded that the construction of cohort in workers who are or were exposed to dust in various mines is required and epidemiologic study of pneumoconiosis should be carried out with the administrative control of pneumoconiosis side by side. With the database of these materials, we can speculate and devise the measure for the further affecting subjects who are presumed to be most common in manufacturing industries.
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The Comparison of the Somatization and Hypochondriacal Trends Between Labor Workers and Managerial Workers.
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Chul Lee, Hee Sook Park, Won Chul Lee, Kwang Ho Meng
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Korean J Epidemiol. 1995;17(2):225-234.
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This study was designed to investigate the difference of somatization and hypochondriacal trends between labor workers and managerial workers. The subjects consisted of 302 workers who were employed at 13 small scale industries in a city of Kyung Kee province. Data collection was done from February 25, 1993 to March 10, 1993. Symptom Check List-90-Somatization(SCL) and Illness Attitude Scale(IAS) which are composed of self-report questionnares were used as measuring instruments. The results were as follows: 1. Mean scores of SCL-90-R-Somatization in labor workers were significantly higher than those in managerial workers and there were significant differences in 7 subscales (pain in heart or chest, nausea of upset stomach, muscle soreness, trouble breathing, hot or cold spells, numbness, lump sensation in throat between to two groups. 2. There was no significant difference in mean scores of illness attitude Scales between labor workers and managerial workers.
However, among the subscale of IAS mean scores of "hypochondriacal beliefs" and "effects of symptom" in labor workers, the mean scores of IAS in labor workers were significantly higher than those in managerial workers. 3.
When compared by educational level, middle school graduates and college graduates of labor workers showed significantly higher mean scores of SCL than those of managerial workers.
4. When compared by employment duration, labor workers who worked less than 5 years showed significantly higher mean of SCL and IAS than those of managerial workers. 5. There were no significant differences in mean scores of SCL and IAS between the levels of subjectively evaluated environmental conditions by the workers themselves of the illumination, organic solvent, noise and dust.
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A case-control study on the risk factors of colorectal adenomatous polyp.
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Mi Kyung Kim, Yang Cha Lee, Kyu Yong Choi, Won Chul Lee, Kyung Jae Lee, Kwang Ho Meng, Yoon Kyong Lee, In Mee Kim
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Korean J Epidemiol. 1995;17(2):167-187.
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The possible association of colorectal adenomatous polyps, a precursor lesion for colorectal cancer, with risk factors including cigarette smoking, alcohol consumption, coffee consumption, family history and dietary factors was investigated in a case-control study. Between January 1993 and March 1995, 143 cases of patients with pathologically confirmed incident colorectal adenomatous polyps and 301 control subjects were collected from Our Lady of Mercy Hospital. Information on exposure was obtained by structured interviews. After adjustment for age and sex, statistically significant odds ratio (highest-lowest tercile) were found for cigarette smoking(5.53; 95% confidence interval CI, 3.26 9.38), coffee consumption (2.01 ; 95% CI 1. 15-3.53). For dietary factors, significant odds ratio were found for yogurt consumption (0.35 ; 95% CI 0.14-0.85) and milk consumption (0.34; 95% CI 0.17-0.70). No significant associations were observed for total fat intake and total fiber intake after adjustment for age, sex and total calorie. Odds ratio of family history of colorectal cancer and/or polyp was 3.05(95% CI 0.84-11.05). Cigarette smoking, coffee consumption, appears to be a significant risk factor, and milk consumption, yogurt consumption appears to be a significant protective factor for colorectal adenomatous polyps.
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A Descriptive Epidemiologic Study on Accidents of the Closed-Ward Patients in a Psychiatric Hospital.
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Eun Sook Kim, Won Chul Lee
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Korean J Epidemiol. 1994;16(2):181-196.
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This study was done to investigate some selected epidemiological characteristics of accidents occured in the closed-ward of a psychiatric hospital in Seoul during one year period from Jan. 1, 1993 toDec. 31, 1993. For this study, 1,570 accidents(702 patients) reported from 1,833 discharged patients were analysed. Major findings obtained from this study were as follows; 1. Prevalence rate of the accidents were 38 persons per 100 discharged pateints and 86 accident spells per 100 discharged patients. 2. The highest risk of accident was noticed in the group of male, 20-29 age, middle school graduate, and divorced. 3. By diagnostic category, accident rates per 100 discharged patients were 339 spells in seizure disor-der, 102 in substance abuse, 93 in schizophrenia, 69 in alcoholism, and 61 in mood disorder.
4. By the period, the accident rate was higher within I month after admission, and the rate was higher in April and November, Wednesday, the day of family visiting, and during day time. 5. Accident types were violent behavior(53%), alcohol drinking(12%), emergency for physical episode(9%), elopement(7%), property damage (5%), self-inflicted injury and suicidal attempt (4%). Severity of damage was usually minimal, and the persons who were commonly involved in the accidents were the petients rather than him self and therapist.
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Adjustment of confounders on statistical inference: analysis using a statistical package
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Won Chul Lee
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Korean J Epidemiol. 1990;12(1):24-37.
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Controlling of confounders is one of the most important methodological issues in epidemiological studies because the associations of exposures and outcomes are very much influenced by confounders.
Matching, stratification and multivariate statistical methods are frequently used to control the effects of confounders.
This paper introduces two statistical package programs: Mantel-Haenszel method for stratification and logistic regression analysis for multivariate analysis. For explanation of the package programs, data on the association of body mass index with adenomatous polyp of colon in the United States was used.
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Dietary fat and breast cancer
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Won Chul Lee, Kwang Ho Meng
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Korean J Epidemiol. 1988;10(2):164-173.
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Many correlational (ecologic) studies and analytic (i.e., case-control and cohort) studies have been conducted to investigate whether fat and other dietary items contribute to the etiology of breast cancer or not. However, these studies has not established firm conclusion yet. The estimated relative risks could not reveal the strong association and the cohort studies haven’t found positive association. The major problems in these analyses stem from the methodological limitations related to methods of dietary data collection and quantification.
The possible protective role of yellow-green vegetables to breast cancer was discussed, and the need of standardization of the questionnaire to evaluate dietary habits was suggested.
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The effects of age, birth cohort and body mass index on blood pressure in Korean young adults
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Chung Yill Park, Won Chul Lee, Kwang Ho Meng
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Korean J Epidemiol. 1987;9(2):228-235.
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This study used longitudinal data of 1,348 men and 1,115 women who were employed in financial businesses and followed up for more than 5 years by the Catholic Industrial Medical Center, Catholic University Medical College from 1964 to 1986 to investigate whether there are differences in blood pressure and body mass index among different birth cohorts and whether blood pressure is associated with age and body mass index in each birth cohort. Subjects were classified into 5 birth cohorts in males (1940-44, 1945-49, 1950-54, 1955-59, 1960-64) and into 3 birth cohorts in females (1954-54, 1955-59, 1960-64). An association between systolic blood pressure and age was shown in 3 birth cohorts (1960-64 cohort in males, 1955-59, 1960-64 cohort in females) and the association between diastolic blood pressure and age was shown in 3 birth cohorts (1955-59, 1960-64 cohort in males, 1960-64 cohort in females).
The association between body mass index and age was statistically significant in all 5 cohorts in males. In females, it showed U shape (decreased until 24 yrs old and after that it increased) in all 3 cohorts. The mean blood pressure of each birth cohort was not statistically different among different birth cohorts but mean body mass index showed increasing trends as years go by. Stepwise multiple regression demonstrated that age and body mass index were explaining less than 5% of total variance of systolic blood pressure (and diastolic pressure) in males and females.
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Coffee and pancreas cancer : how is the relationship explained?
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Won Chul Lee, Kwang Ho Meng
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Korean J Epidemiol. 1987;9(1):1-8.
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A descriptive epidemiological study on cancer statistics on Korea based on published literatures on hospital cancer patients
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Kwang Ho Meng, Won Chul Lee
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Korean J Epidemiol. 1987;9(1):139-150.
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There have been many studies on frequencies and characteristics of cancer patients seen at the hospitals in Korea since 1960s. However, each study gives only limited information on cancer in Korea because the relative frequencies of cancer vary so much among the studies mainly because that the specialized fields of cancer is different among the study hospitals.
This study, therefore, summarized and reanalyzed the relative frequency of cancer in Korea according to the personal and other epidemiological characteristics by aggregating all the data that were separately used in those studies in between 1960 and 1984.
This observation indicates that, since 1960, the stomach cancer has increased both in males and females in its relative frequency among all cancers. Liver cancer and lung cancer are the ones that have also markedly increased in recent years particularly in males. In males, those three cancers consists of about 57% of all cancers now.
In females, cervical cancer is the most common cancer in its relative frequency since 1960s. However this cancer has substentially been decreased in recent years whereas the breast cancer has increased.
In age distribution, the relative frequency of cancer has sharply increased at the age of 40 and over both in males and females. Increasing tendency of relative frequency of cancer in the age group of 70 and over in noticeable.
Trends in age distribution of relative frequency of stomach cancer from 1960s to 1970s is very interesting. This analysis shows that the stomach cancer is increasing in younger age group both in males and females while it is decreasing in old age groups. Considering the increased proportion of aged population in recent years, this reveals quite a decrease of stomach cancer in old ages.
On the other hand, the cervical cancer tends to occur more in younger age group. This may be partly because the young women today visit doctors more frequently than before.
Five year survival rates of stomach cancer, colon & rectum cancer, cervical cancer, and female breast cancer are 12.9%, 20.3%, 84.3% and 46.3% respectively. The survival rates showed very wide range among different studies.
The relative low 5-year survival rates we have than expected might be due delayed diagnosis and inappropriate treatment. Only about half of the patients visit hospitals within 6 months after they had noticed symptoms.
Considering that there is relatively easy way of self examination technique, the low frequency of early hospital visits in breast cancer is noticeable.
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A review on standardized mortality ratio and proportionate mortality ratio
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Won Chul Lee, Kwang Ho Meng
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Korean J Epidemiol. 1986;8(2):249-259.
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Standardized mortality ratio (SMR) and Proportionate mortality ratio (PMR) are two major indices that are being widely used for studying the risk of death in employed populations because of their simplicities in calculation and their usefullness.
Recently, however, these indices have been known to suffer from several methodological defects. This article reviews these criticisms and some alternative approaches for solving the problems.
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