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A Population-Based Case-Control Study on the Risk Factors of Congenital Heart Malformations.
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Soon Ho Soh, Byung Chul Chun, Soon Duck Kim, Bae Jung Yoon, Yong Tae Yum
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Korean J Epidemiol. 1999;21(2):234-247.
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Abstract
The multifactorial hypothesis is proposed as a working hypothesis which encompass both the genetic and environmental factors known to participate in the etiology of congenital heart malformations. So, it is believed that avoidance of suspected environmental factors in early pregnancy is the most certain preventive measure of congenital heart malformations. This study has been undertaken in order to find the possible environmental risk factors for congenital heart malformations in Korea.
A total of 114 mothers of first graders of the elementary schools with congenital heart malformations confirmed through the screening program in Kyonggi Province from 1992 to 1995 were included as cases. And 206 mothers of healthy students matched by sex and elementary schools comprised the control group. Environmental risk factors including drug use during the first trimester of pregnancy, and other confounders were collected by telephone interview using standardized questionnaires by well trained interviewers.
The result of multivariate logistic regression analysis showed that congenital heart malformation were associated with family history of congenital heart malformations(OR=2.94, 95% CI: 1.08, 7.96), the order of birth(OR=0.49, 95% CI: 0.31, 0.79). And the coffee consumption over 14 cups/week during early pregnancy showed marginal significance(OR=3.52, 95%CI: 0.98, 12.62). The mother's age at the subject birth and father's smoking at home were significant in linear trend test(p<0.05). It is recommended that the genetic counselling and the avoidance of known environmental risk factors in early pregnancy were needed to prevent congenital heart malformations.
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Indigenous Malaria Surveillance in Korea.
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Dae Seong Kim, Soon Duck Kim, Yong Tae Yum, Chae Seung Lim, Kab Ro Lee, Mi Sook Park, Bae Jung Yoon
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Korean J Epidemiol. 1997;19(2):180-189.
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Malaria, one of the compulsory notifiable diseases, has been diappeared from Korea based on that fact no notification on malaria case was received from local health agencies during the last decade or so. Recently, Indigenous malaria has been re-emerged since 1993 and 549 cases was notificated till 1996. We conducted a surveillance system on the resurgent malaria outbreaks in the northern area of Kyonggi Province around the Imjin River. Malaria Surveillance Networks(MSNs) were established in Paju and Yoncheon between August 1996 and December 1996. When a febrile patient visits a clinic or a hospital, clinician takes a blood sample and refer to district malaria laboratory for the sample. The blood sample is examined in the malaria laboratory(public health center), and if malaria parasites are found, a radical or curative treatment is offered to patients. MSNs took 94 febrile cases and identified 23 malaria cases(24.5%). All malaria cases were infected by the indigenous vivax malaria. In Paju, 14 of 62 febrile cases(22.6%) were malaria outbreaks and 9 of 32 febrile cases(28.1%) in Yoncheon. In Korea resurgent malaria, malaria surveillance system should be operated for a program based on the district public health center with the coupled laboratory and dispensary.
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Cohort Study.
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Yong Tae Yum, Soon Duck Kim
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Korean J Epidemiol. 1994;16(1):116-135.
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The cohort study is an observational epidemiological study which selects the specific study population attempting to study the relatiqnship between an exposure to the purported cause and the subsequent risk of developing disease in accordance of time direction. Since Doll and Hill had studied the association between lung cancer and smoking behavior among the British medical doctors in the years of the last fifties, the defined group cohort studies analysing the relationship between an exposure and the occurence of a disease have become very popular. Cohort studies can be classified as either prospective or retrospective, depending on the temporal relationship between the initiation of the study and the occurence of the disease. Cohort studies are admitted as the very valuable studies for demonstrating the association between an exposure and a disease because it is possible to drive relative and attributable risks and often incidence measures. They can even examine multiple effects of a single exposure. However, they are usually expensive to carry out and large cohorts are required for rare diseases in addition to the time consum ing works. There are also very significant problems associated with selection of appropriate groups to be studied as far as complete ascertainment of disease occurence in them. Usually it is necessary that we must compromise to provide the opportunity for various types of bias such as selection bias, follow-up bias, information bias or misclassification, confounding bias and post hoc bias to occur which can result in incorrect conclusions. Only the success of a cohort study would be expected when the investigator pay the deep care in recognizing and correcting for these biases.
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A rural health study through screening approaches.
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Gil Soo Son, Yong Tae Yum, Soung Hoon Chang
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Korean J Epidemiol. 1991;13(2):197-203.
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Screening deseases for community health is the search for previously unrecognized diseases or physiologic conditions whether they are caused or influenced by work-associated factors or not. In Korea it has been of a large-scale prevention effort by employers of which industries hired more than 5 workers each.
Screening results may be useful in a surveillance system to be analyzed epidemiologically for the protection of the community people both living in rural and urban areas. However, the safety and health law for industry of Korea excluded rural people from target of screening. Unique way to cope with is approaching for research purpose of selected study areas in terms of pilot primary health care programs.
In this study, a total of 4,500 rural people who were living in Yeoju Kun, Kyonggi Province are selected as research target people asking to participate in screening test. Of them, the total of 2,753 persons participated in the screening tests and interview.
The results were as follows.
1. Examinee consisted of 45.8% of male and 54.2% of female where as standard population showed 49.6 v/s 50.4.
2. Highest participation rate of 18.7% was shown in the 50~54 age group. However, participation rate ratio of 2.93 was shown in the age group of 55~59.
3. The highest participation rate ratio by educational level was shown in primary school group and in order of no education, middle school and high school group.
4. Most of participation (80.7%) were aggriculture group whereas rate ratio was highest (2.70) in employee including simple labourers.
5. Motivation of participation was to confirm their health in 40.1% and rest of them was to check their bad or ill health.
6. Most of participation (94.9%) expressed the regular check-up (screening) would be necessary.
7. According to the screening tests 20.9% of hypertensives, 7.8% of hearing defect, 1.4% of positive urine sugar, 11.4% of abnormally high sugar level in blood, 0.1% of positive urine protein, about 2% of abnormal liver function tests, 5.0% of positive HBsAg, 13.6% of Anti-HBs and 2.5% of active lung tuberculosis were detected.
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A study on the behavioral determinants of compliance with health screening of some urban people
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Hyun Chang Moon, Yong Tae Yum, Myung Sook Lee
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Korean J Epidemiol. 1990;12(2):184-190.
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The government has implemented primary health service programs in several target areas of Seoul. One of them was established in Guro 6 Dong for which Korea University provided consultant services. This research was conducted to explore preventive health behavior which was one of the special programs performed in Guro Project.
The data were collected by conducting free health screening examinations for married women and interviews with 688 participants and 429 non-participants on motives for participation and reasons of non-participation.
The survey included the evaluation of behavioral determinants such as health concerns, benefits, barriers and of others. The results were as follows.
1. Majority of participants (74.4%) expressed that confirmation of their good health was the reason for participating in the health screening program. These people had no subjective symptoms.
2. Majority of nonparticipants gave lack of free time as their reason for nonparticipation in the health screening program. Among these people, 78.1% had no known symptoms and 14.0% complained of some ill health.
3. As a part of preventive health action, health belief study was carried out to reveal that both of health concern and benefit components were higher in participants as well as the barrier of hospital time, barriers of hospital cost and procedure components of barriers.
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An epidemiological study on outbreaks of food poisoning in some industries
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Yong Tae Yum, Dong Yun Seo
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Korean J Epidemiol. 1988;10(2):204-209.
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Since the author was asked to be in charge of special epidemiological investigation on outbreaks of food poisoning among workers of 3 industries(A, B and C) in Goo-Mee industrial complex, a survey team had made an epidemiological study to confirm diagnosis, and to verify source of infection and course of transmission for 5 days in Oct. 1986. The summarized results were as follows;
1. A total of 130 cases(6.5%) out of 2,000 workers in A industry on 29 August, 41 cases(14.7%) out of 880 workers in B on 14 October, and 30 cases(1.6%) out of 1,900 workers in C on 15 October 1986 were admitted to S. Hospital in Goo-Mee industrial complex complaining of high fever, vomiting, nausea, chillness, abdominal pain, headach under the impression of food poisoning.
2. Microorganisms of Vibrio parahemolyticus were cultured from stools of 39(33.6%) cases among 116 sampled cases.
3. Case-control studies to detect source of infection revealed that brown seaweeds in A and green lavers(sea lettuces) in B and C industries were the sources showing odd ratios of 12.5 and 16.2 with P values of less than 0.001.
4. In industry A, heated brown seaweeds were contaminated again with organisms in sea water from original container, and in industry B and C, raw green lavers which were immersed in sea water were served only after salting and seasoning without boiling process. Vibrio parahemolyticus in sea water was the source of contamination.
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