Epidemiology and Health

Review

Monkeypox: the resurgence of forgotten things: Sun Bean Kim, Jaehun Jung, Kyong Ran Peck; Epidemiol Health. 2022;44:e2022082. Published online September 26, 2022; DOI: https://doi.org/10.4178/epih.e2022082

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Abstract

Monkeypox, a rare zoonotic disease, is primarily prevalent in Central and Western Africa. However, monkeypox is emerging as a worldwide concern due to the 2022 monkeypox outbreak, which is the first instance of widespread community transmission outside Africa. Monkeypox is caused by the monkeypox virus, which belongs to the genus <i>Orthopoxvirus</i> and presents as a vesicular-pustular disease that may be preceded by fever, malaise, and other constitutional symptoms. If present, lymphadenopathy may distinguish it from chickenpox or smallpox. However, contrary to previous manifestations, most monkeypox patients presented with atypical features during the 2022 outbreak. Monkeypox is usually a self-limiting disease with symptoms lasting between 2 weeks and 4 weeks and is mainly transmitted when a person comes into contact with an infected animal, person, or fomites contaminated with the virus. Very few treatment options are available for this disease. Tecovirimat has been licensed in some countries for the treatment of smallpox and monkeypox infections. Two other medications, cidofovir and brincidofovir, have been found to be effective against poxviruses in in vitro and animal studies, but data on human cases of monkeypox are limited. Although Imvamune (JYNNEOS), a vaccine against monkeypox, is authorized in the United States, there are currently no established routine vaccination programs. Current preventive strategies focus on the detection of probable cases and containment of the outbreak through the implementation of selected ring vaccination programs. Fundamental principles to prevent the spread of monkeypox, including maintaining personal hygiene and avoiding close contact with symptomatic patients, are of paramount importance.

Summary

Korean summary
원숭이두창은 orthopoxvirus에 속하는 원숭이두창 바이러스에 의해 발생하며, 중앙아프리카와 서아프리카에서 주로 발견되는 희귀한 인수공통감염병이었으나 2022년에 집단 발병했던 원숭이두창 환자들은 이전부터 널리 알려진 증세와 달리 비전형적인 임상 특징을 보이고 있고, 전 세계적으로 아프리카와의 역학적 연관성없이 아프리카 이외의 여러 지역에서 원숭이두창이 집단 발병하면서 보건학적 화두로 대두되었다. 원숭이두창에 대한 치료는 증상 호전을 위한 대증 요법이 주가 되며, 매우 제한적인 항바이러스제가 치료 약제로 이용된다. 2019년 미국에서 Imvamune (Jynneos)가 성인을 대상으로 원숭이두창 백신으로 사용이 승인되었다. 하지만 예방 접종뿐만 아니라 손씻기 등의 개인위생 유지, 의심 혹은 확진 환자와의 긴밀한 접촉을 피하는 것 등이 원숭이두창 확산을 막기 위한 가장 중요한 기본 원칙이다.

Key Message
Monkeypox is caused by the monkeypox virus, which belongs to the genus Orthopoxvirus and presents as a vesicular-pustular disease that may be preceded by fever, malaise, and other constitutional symptoms. Contrary to previous manifestations, most monkeypox patients presented with atypical features during the 2022 outbreak. Very few treatment options are available for this disease and current preventive strategies focus on the detection of probable cases and containment of the outbreak through the implementation of selected ring vaccination programs. Fundamental principles to prevent the spread of monkeypox, including maintaining personal hygiene and avoiding close contact with symptomatic patients, are of paramount importance.

Citations

Citations to this article as recorded by

Breaking Barriers: Current Advances and Future Directions in Mpox Therapy
Bhumi M. Shah, Palmi Modi
Current Drug Targets.2024; 25(1): 62. CrossRef
How to cope with suspected mpox patients in the outpatient clinic
Nam Joong Kim, Sun Huh
Journal of the Korean Medical Association.2023; 66(5): 325. CrossRef
An International Outburst of New Form of Monkeypox Virus
Kiran Dobhal, Pallavi Ghildiyal, A.N.M. Ansori, Vikash Jakhmola
Journal of Pure and Applied Microbiology.2022; 16(suppl 1): 3013. CrossRef

COVID-19: Original Article

Inequitable distribution of excess mortality during the COVID-19 pandemic in Korea, 2020: Jin-Hwan Kim, Saerom Kim, Eunhye Park, Chang-yup Kim; Epidemiol Health. 2022;44:e2022081. Published online September 26, 2022; DOI: https://doi.org/10.4178/epih.e2022081

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Abstract PDF Supplementary Material

Abstract

OBJECTIVES
This study analyzed inequities in excess mortality according to region and socioeconomic position to explain the distribution of excess mortality in Korea in 2020.

METHODS

We acquired weekly all-cause mortality data from January 2015 to December 2020 from (1) the National Health Insurance Database and (2) Vital Statistics. Excess mortality for 2020 was calculated by comparing the weekly observed and expected deaths from the same period (2015-2019) using quasi-Poisson regression.

RESULTS

An inequitable distribution of excess mortality was identified. The estimated excess mortality in Korea was -29,112 (95% confidence interval, -29,832 to -28,391), corresponding to -55 per 100,000, and the ratio of observed deaths to expected deaths was 0.91. Negative excess mortality was observed except for females in the 0-14 age group. Male Medical Aid beneficiaries showed positive excess mortality, while non-disabled and disabled groups showed similar negative values. When the standardized mortality ratio was calculated for the top 10 causes of death, deaths from Alzheimer’s disease and septicemia increased, whereas those from diabetes mellitus and cerebrovascular disease decreased. The decrease in mortality was primarily concentrated in older adults, while the mortality of young females increased due to increased intentional self-harm.

CONCLUSIONS

This study adds essential evidence regarding the overall performance of Korea. The observed inequalities according to various socioeconomic variables indicate that the results of strict measures to control coronavirus disease 2019 were not distributed equitably. Efforts should be made to properly evaluate the current and future problems related to the pandemic.

Summary

Citations

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Did the socioeconomic inequalities in avoidable and unavoidable mortality worsen during the first year of the COVID-19 pandemic in Korea?
Rora Oh, Myoung-Hee Kim, Juyeon Lee, Rangkyoung Ha, Jungwook Kim
Epidemiology and Health.2023; 45: e2023072. CrossRef

Original Article

The associations of the national health and productivity management program with corporate profits in Japan: Yuichiro Yano, Hiroshi Kanegae, Koichi Node, Atsushi Mizuno, Akira Nishiyama, Hiromi Rakugi, Hiroshi Itoh, Kaori Kitaoka, Naoki Kashihara, Fumiaki Ikeno, Ichiro Tsuji, Kunio Okada; Epidemiol Health. 2022;44:e2022080. Published online September 23, 2022; DOI: https://doi.org/10.4178/epih.e2022080

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Using a dataset from a survey on national health and productivity management, we identified health and productivity factors associated with organizational profitability.

METHODS

The Ministry of Economy, Trade and Industry conducted an annual survey on Health and Productivity Management between 2014 and 2021. We assessed the associations of organizational health and productivity management using survey questions collected in 2017 and 2018, with the rate of change in profits from 2017 and 2018 to 2020. We identified factors associated with organizational profitability using eXtreme Gradient Boosting, and calculated SHapley Additive exPlanation (SHAP) values for each factor.

RESULTS

Among 1,593 companies (n= 4,359,834 employees), the mean age of employees at baseline was 40.3 years and the proportion of women was 25.8%. A confusion matrix for evaluating model performance had an accuracy of 0.997, precision of 0.993, recall of 0.997, and area under the precision-recall curve of 0.999. The most important factors related to an increase in corporate profits were the percentage of current smokers (SHAP value, 0.121), per-employee cost of health services (0.084) and medical services (0.050); the percentage of full-time employees working in sales departments (0.074) and distribution or customer service departments (0.054); the percentage of employees who slept well (0.055); and the percentage of employees within a company who regularly exercised (0.043).

CONCLUSIONS

Employees’ lifestyle-related health risk factors and organizations’ management systems were associated with organizational profitability. Lifestyle medicine professionals may demonstrate a significant return on investment by creating a healthier and more productive workforce.

Summary

Key Message
Lifestyle medicine professionals may demonstrate a significant return on investment by creating a healthier and more productive workforce

Citations

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Role and Value of the Corporate Medical Director
Gregg M. Stave, Wayne N. Burton, Richard J.L. Heron, T. Warner Hudson, J. Brent Pawlecki, David Roomes, Martin J. Sepulveda, Michael Rendel, Pamela A. Hymel
Journal of Occupational & Environmental Medicine.2023; 65(12): e797. CrossRef

Data Profile

The National Hospice and Palliative Care registry in Korea: Kyuwoong Kim, Bohyun Park, Bonju Gu, Eun Jeong Nam, Sue Hyun Kye, Jin Young Choi; Epidemiol Health. 2022;44:e2022079. Published online September 21, 2022; DOI: https://doi.org/10.4178/epih.e2022079

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Abstract

The National Hospice and Palliative Care (NHPC) registry is a nationwide database in Korea that systematically collects information on terminally ill cancer patients receiving inpatient hospice care. From 2018 to 2020, a total of 47,911 patients were enrolled in the NHPC registry from hospitals providing inpatient hospice care. The NHPC database mainly contains the socio-demographic and clinical information of the registered patients. Among these patients, approximately 75% were 60 years or older, and the ratio of males to females was 1:1.41. Lung, liver, colorectal, pancreatic, and gastric cancer made up nearly 90% of the cancer sites among the registered patients. Upon their initial admission to the hospice ward, around 80% of the patients were aware of their terminal illness. About half of the patients had mild pain at the time of the initial admission to the hospice ward, and the duration of hospice care was 14 days (interquartile range, 6-30) in 2019 and 2020. The NHPC registry aims to provide national statistics on inpatient hospice care to assist health policy-making.

Summary

Korean summary
본 논문에서 소개된 국가 호스피스·완화의료 등록시스템은 국내 입원형 호스피스 환자의 인구사회학적 특성과 임상정보에 관한 정보를 포함하고 있습니다. 등록시스템은 국내 호스피스·완화의료 현황에 대한 국가통계 생산, 근거기반 호스피스·완화의료 정책 개발 및 연구 등에 활용될 수 있습니다.

Key Message
The National Hospice and Palliative Care registry contains information on demographics and clinical information of patients receiving inpatient hospice care in Korea. Along with its primary purpose to provide national statistics on the current status of hospice care in the country, the registry could also be used for evidence-based health policy or research pertaining to hospice in Korea.

Citations

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For the Universal Right to Access Quality End-of-Life Care in Korea: Broadening Our Perspective After the 2018 Life-Sustaining Treatment Decisions Act
Hye Yoon Park, Min Sun Kim, Shin Hye Yoo, Jung Lee, In Gyu Song, So Yeon Jeon, Eun Kyung Choi
Journal of Korean Medical Science.2024;[Epub] CrossRef
Advance Care Planning in South Korea
Yu Jung Kim, Sun-Hyun Kim
Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen.2023; 180: 68. CrossRef
Changes in the Place of Death of Patients With Cancer After the Introduction of Insurance-Covered, Home-Based Hospice Care in Korea
Il Yun, Sung-In Jang, Eun-Cheol Park, Suk-Yong Jang
JAMA Network Open.2023; 6(11): e2341422. CrossRef
Application of Acceptance and Commitment Therapy (ACT) in Hospice and Palliative Care Settings
So-Young Park
The Journal of Hospice and Palliative Care.2023; 26(3): 140. CrossRef

Original Articles

The association between metabolic syndrome and heart failure in middle-aged male and female: Korean population-based study of 2 million individuals: Tae-Eun Kim, Hyeongsu Kim, JiDong Sung, Duk-Kyung Kim, Myoung-Soon Lee, Seong Woo Han, Hyun-Joong Kim, Sung Hea Kim, Kyu-Hyung Ryu; Epidemiol Health. 2022;44:e2022078. Published online September 21, 2022; DOI: https://doi.org/10.4178/epih.e2022078

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Abstract PDF

Abstract

OBJECTIVES
Although an association is known to exist between metabolic syndrome (MetS) and heart failure (HF) risk, large longitudinal studies are limited. We investigated metabolic status as a risk factor for HF in middle-aged male and female and considered sex differences in various risk factors for HF using nationwide real-world data.

METHODS

Data obtained from the Korean National Health Insurance Service from 2009 to 2016 were analyzed. A total of 2,151,597 middle-aged subjects (between 50 and 59 years old) were enrolled. Subjects were divided into 3 groups (normal, pre‐ MetS, and MetS). Cox proportional hazard models were used to estimate the association between MetS and incident HF after adjusting for clinical risk factors.

RESULTS

At baseline, MetS existed in 23.77% of male and 10.58% of female. Pre-MetS and MetS increased the risk of HF: the hazard ratios of pre-MetS for incident HF were 1.508 (95% confidence interval [CI], 1.287 to 1.767) in male and 1.395 (95% CI, 1.158 to 1.681) in female, and those of MetS were 1.711 (95% CI, 1.433 to 2.044) in male and 2.144 (95% CI, 1.674 to 2.747) in female. Current smoking, a low hemoglobin level, underweight (body mass index < 18.5 kg/m2), a high creatinine level, and acute myocardial infarction were also predictors of HF in both sexes.

CONCLUSIONS

Pre-MetS and MetS were identified as risk factors for HF in middle-aged male and female. The effect of MetS on the occurrence of HF was stronger in female than in male. Pre-MetS was also a predictor of HF, but was associated with a lower risk than MetS.

Summary

Citations

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Integrating machine learning and nontargeted plasma lipidomics to explore lipid characteristics of premetabolic syndrome and metabolic syndrome
Xinfeng Huang, Qing He, Haiping Hu, Huanhuan Shi, Xiaoyang Zhang, Youqiong Xu
Frontiers in Endocrinology.2024;[Epub] CrossRef
17-year follow-up of association between telomere length and all-cause mortality, cardiovascular mortality in individuals with metabolic syndrome: results from the NHANES database prospective cohort study
Lijiao Xiong, Guangyan Yang, Tianting Guo, Zhaohao Zeng, Tingfeng Liao, Yanchun Li, Ying Li, Fujuan Chen, Shu Yang, Lin Kang, Zhen Liang
Diabetology & Metabolic Syndrome.2023;[Epub] CrossRef
Modifications of long-term heart rate variability produced in an experimental model of diet-induced metabolic syndrome
W. M. Lozano, J. E. Ortiz-Guzmán, O. Arias-Mutis, A. Bizy, P. Genovés, L. Such-Miquel, A. Alberola, F. J. Chorro, M. Zarzoso, C. J. Calvo
Interface Focus.2023;[Epub] CrossRef

Risk of dementia according to the severity of chronic periodontitis in Korea: a nationwide retrospective cohort study: Seon-Rye Kim, Minkook Son, Yu-Rin Kim, Hyun-Kyung Kang; Epidemiol Health. 2022;44:e2022077. Published online September 21, 2022; DOI: https://doi.org/10.4178/epih.e2022077

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
We investigated the risk of dementia in older adults with chronic periodontitis according to the severity of periodontitis.

METHODS

Data on patients with chronic periodontitis were extracted from the National Health Insurance Service-Senior cohort database from 2002 to 2014. Among 52,728 subjects eligible for inclusion, 11,953 subjects had newly diagnosed mild chronic periodontitis (MCP), and 40,775 subjects had newly diagnosed severe chronic periodontitis (SCP). Two 1:1 propensity score matched cohorts were created with 8,624 patients each in the MCP and SCP groups. To analyze the risk of dementia, a Cox proportional-hazard model was used to calculate hazard ratios with 95% confidence intervals (CIs).

RESULTS

In the Kaplan-Meier curve, the disease-free probability was significantly lower in the SCP group than in the MCP group (p for log-rank=0.001). In the multivariable-adjusted model, the HR for the occurrence of dementia in the SCP group compared to the MCP group was 1.15 (95% CI, 1.04 to 1.27; p=0.009). A subgroup analysis revealed a significant association between dementia and the severity of periodontitis, especially in subjects who were male, aged ≥70 years, and had comorbidities.

CONCLUSIONS

Reducing the severity of chronic periodontitis can help to reduce the risk of dementia. Therefore, it is necessary to aggressively conduct early dementia-prevention programs for males under the age of 70 that include dental health to prevent the progression of periodontitis from mild to severe.

Summary

Korean summary
본 연구는 만성치주질환을 가진 노인의 만성치주질환 중등도에 따른 치매 발생위험 차이를 분석하였다. 그 결과, 만성치주질환 중등도가 높은 그룹에서 만성치주질환 중등도가 낮은 그룹에 비해 치매 발생위험이 높았으며, 특히, 남성과 70세 이상 그룹에서 유의한 차이가 있었다. 따라서 70세 이하 남성 노인을 대상으로 만성치주질환이 진행되지 않도록 효과적인 구강관리가 필요할 것이다.

Key Message
In this study, we confirmed that the severity of chronic periodontitis is related to the risk of dementia, so efforts for effective oral care will be needed.

Citations

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With Teeth, Broken, or Fixed: The Challenges of Linking Periodontitis, Neuroepidemiology, and Biomarkers of Disease
James M. Noble, Panos N. Papapanou
Journal of Alzheimer's Disease.2023; 93(3): 991. CrossRef
Periodontal Pathogens and Their Links to Neuroinflammation and Neurodegeneration
David Visentin, Ivana Gobin, Željka Maglica
Microorganisms.2023; 11(7): 1832. CrossRef
Association between statin compliance and risk of dementia among patients with chronic periodontitis
Yu‐Rin Kim, Minkook Son, Seon‐Rye Kim
Oral Diseases.2023;[Epub] CrossRef

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

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Abstract Summary PDF Supplementary 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.

Prediction of cancer survivors’ mortality risk in Korea: a 25-year nationwide prospective cohort study: Yeun Soo Yang, Heejin Kimm, Keum Ji Jung, Seulji Moon, Sunmi Lee, Sun Ha Jee; Epidemiol Health. 2022;44:e2022075. Published online September 13, 2022; DOI: https://doi.org/10.4178/epih.e2022075

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study aimed to investigate the factors affecting cancer survival and develop a mortality prediction model for Korean cancer survivors. Our study identified lifestyle and mortality risk factors and attempted to determine whether health-promoting lifestyles affect mortality.

METHODS

Among the 1,637,287 participants in the Korean Cancer Prevention Study (KCPS) cohort, 200,834 cancer survivors who were alive after cancer diagnosis were analyzed. Discrimination and calibration for predicting the 10-year mortality risk were evaluated. A prediction model was derived using the Cox model coefficients, mean risk factor values, and mean mortality from the cancer survivors in the KCPS cohort.

RESULTS

During the 21.6-year follow-up, the all-cause mortality rates of cancer survivors were 57.2% and 39.4% in men and women, respectively. Men, older age, current smoking, and a history of diabetes were high-risk factors for mortality, while exercise habits and a family history of cancer were associated with reduced risk. The prediction model discrimination in the validation dataset for both KCPS all-cause mortality and KCPS cancer mortality was shown by C-statistics of 0.69 and 0.68, respectively. Based on the constructed prediction models, when we modified exercise status and smoking status, as modifiable factors, the cancer survivors’ risk of mortality decreased linearly.

CONCLUSIONS

A mortality prediction model for cancer survivors was developed that may be helpful in supporting a healthy life. Lifestyle modifications in cancer survivors may affect their risk of mortality in the future.

Summary

Korean summary
현재 암 생존자의 사망 위험을 평가하는 데 유용한 한국형 암 생존자 사망률 예측 모델은 없습니다. 본 연구에서는 고령, 남성, 현재 흡연, 당뇨병 병력을 포함한 생활양식 요인이 사망의 고위험 요인인 반면, 운동 습관 및 암의 가족력은 사망 위험을 감소시키는 것으로 나타났습니다. 현재 흡연과 운동 습관은 사망 위험에 영향을 미치는 수정 가능한 두 가지 요소로써, 이러한 생활습관 요인으로 구성된 예측모형은 생활습관 교정을 통해 우리나라 암 생존자의 사망률을 낮출 수 있음을 시사합니다.

Key Message
Currently, there is no Korean mortality prediction model for cancer survivors that would be useful in evaluating their risk of mortality. The present study showed that lifestyle factors, including older age, male sex, current smoking, and history of diabetes were high-risk factors for mortality, while exercise habits and a family history of cancer reduced the risk of mortality. Current smoking and exercise habits are the two modifiable factors that affected the risk of mortality. The prediction model comprising these lifestyle factors implies that the risk of mortality of cancer survivors in Korea can be reduced through lifestyle modification.

Citations

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COVID-19 Mortality and Severity in Cancer Patients and Cancer Survivors
Jae-Min Park, Hye Yeon Koo, Jae-ryun Lee, Hyejin Lee, Jin Yong Lee
Journal of Korean Medical Science.2024;[Epub] CrossRef
Weight maintenance and gain were significantly associated with lower risk of all-cause and cancer-related mortality in Korean adults who were newly diagnosed with cancer based on the Korean NHIS-HEALS cohort
Yong-June Kim, Seung Park, Won Tae Kim, Yoon-Jong Bae, Yonghwan Kim, Hee-Taik Kang
Medicine.2023; 102(47): e36184. CrossRef

Exploring the relationships between anthropometric indices of adiposity and physical performance in middle-aged and older Brazilian women: a canonical correlation analysis: Rafaela Andrade do Nascimento, Mariana Carmem Apolinário Vieira, Juliana Fernandes, Ingrid Guerra Azevedo, Mayle Andrade Moreira, José Vilton Costa, Saionara Maria Aires da Câmara, Álvaro Campos Cavalcanti Maciel; Epidemiol Health. 2022;44:e2022074. Published online September 13, 2022; DOI: https://doi.org/10.4178/epih.e2022074

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Abstract Summary PDF: Abstract
OBJECTIVES
This study analyzed the influence of anthropometric indices of adiposity on the physical performance of middle-aged and older women.
METHODS
A cross-sectional study was conducted among 368 women from 50 years to 80 years old. Anthropometric and biochemical characteristics were analyzed, and physical performance was evaluated. The statistical analysis used measures of central tendency and dispersion for descriptive data, Pearson correlations to demonstrate the initial associations between the variables, and canonical correlation (CC) to evaluate the relationship between the set of anthropometric adiposity indices and performance-related variables.
RESULTS
The participants had a mean age of 58.57±8.21 years, a visceral adiposity index of 7.09±4.23, a body mass index of 29.20±4.94 kg/m<sup>2</sup>, and a conicity index of 1.33±0.07. The average handgrip strength was 25.06±4.89 kgf, gait speed was 1.07±0.23 m/s, and the mean Short Physical Performance Battery (SPPB) score was 10.83±1.36. The first canonical function presented the highest shared variance, CC, and redundancy index (cumulative percentage of variance, 82.52; Wilks’ lambda, 0.66; CC, 0.532; p<0.001). From the analysis of this canonical function, the conicity index (-0.59) displayed inverse correlations with handgrip strength (0.84) and the SPPB (0.68), as well as a direct correlation with gait speed (-0.43).
CONCLUSIONS
In middle-aged and older women, there was an inverse relationship between the conicity index and muscle strength and power, while a direct relationship was found between the same index and gait speed.; Summary

Key Message
In aging process there is an increase in body adiposity and reduction in muscle size, mainly in women, due to the consequences of menopause and lower level of physical activity. This study analyzed the influence of anthropometric indices of adiposity on the physical performance of middle-aged and older women (50-80 years old), using canonical correlation analysis. The findings showed an inverse relationship between the conicity index and muscle strength and power, while a direct relationship between the same index and gait speed. Therefore, physical performance is influenced by changes in body composition that occur with age in this population group

Effect of Pap smears on the long-term survival of cervical cancer patients: a nationwide population-based cohort study in Korea: Xuan Quy Luu, Kyeongmin Lee, Jae Kwan Jun, Mina Suh, kyu-won Jung, Myong Cheol Lim, Kui Son Choi; Epidemiol Health. 2022;44:e2022072. Published online September 7, 2022; DOI: https://doi.org/10.4178/epih.e2022072

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
This study aimed to investigate the effect of cervical cancer screening by Papanicolaou (Pap) smears on the long-term survival of cervical cancer patients.
METHODS
We constructed a retrospective cohort of 14,903 women diagnosed with invasive cancer or carcinoma in situ in 2008 and 2009 and followed up until December 31, 2019, by using individual-level data from 3 national databases of the Korean National Cancer Screening Program, the Korean Central Cancer Registry, and death certificates. Cox proportional-hazards regression was used to investigate the effect of cervical cancer screening on mortality.
RESULTS
In total, 12,987 out of 14,867 patients (87.4%) were alive at the end of the follow-up period (median: 10.5 years). Screened patients had a 38% lower risk of cervical cancer death than never-screened patients (hazard ratio [HR], 0.62; 95% confidence interval [CI], 0.54 to 0.70). Screening was associated with 59% and 35% lower risks of death, respectively, in screened patients with localized and regional stages. Furthermore, lower HRs among women who received screening were observed in all age groups, especially women aged 50–59 years (HR, 0.54; 95% CI, 0.42 to 0.69). The lowest HR for cervical cancer death was reported among patients screened within the past 2 years (HR, 0.54; 95% CI, 0.47 to 0.63), and the HRs increased with increasing time intervals.
CONCLUSIONS
Pap smear screening significantly reduced the risk of cervical cancer-specific death in Korean women across all cancer stages.; Summary

Korean summary
한국은 자궁경부암 발생과 사망을 낮추기 위하여 국가암검진사업으로 자궁경부암 검진을 실시하고 있다. 이 연구는 2008-2009년 자궁경부암 진단을 받은 30세-79세 14,903명을 대상으로 과거 자궁경부세포검진 여부에 따른 장기생존율을 추적 조사하였다. 그 결과 자궁경부암 검진을 받은 환자에서 사망 위험비가 약 38% 낮았으며, 2년 이내에 검진을 받은 환자군에서 사망 위험이 가장 낮았다.

Key Message
The Korean National Cancer Screening Program (KNCSP) has provided cervical cancer screening by Pap smear test. However, the survival, particularly long-term survival of cervical cancer patients, has never been evaluated in the KNCSP. This study reports a significant improvement in the long-term survival of screened cervical cancer patients, which persist in subgroup analysis by cancer stage. Patients who were screened within two years before the diagnosis had the best survival.

The associations of job strain and leisure-time physical activity with the risk of hypertension: the population-based Midlife in the United States cohort study: Xinyue Liu, Timothy A. Matthews, Liwei Chen, Jian Li; Epidemiol Health. 2022;44:e2022073. Published online September 7, 2022; DOI: https://doi.org/10.4178/epih.e2022073

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Job strain is positively associated with incident hypertension, while increasing leisure-time physical activity (LTPA) can reduce incident hypertension. However, the joint associations of job strain and LTPA with incident hypertension among United States workers have yet to be investigated. This study examined the independent and joint associations of job strain and LTPA with incident hypertension.

METHODS

This prospective cohort study (n=1,160) utilized data from the population-based Midlife in the United States study. The associations of job strain and LTPA at baseline with incident hypertension during follow-up were examined using Cox proportional hazards models. High job strain was derived from a combination of high job demands and low job control, and high LTPA was defined as engagement in moderate or vigorous LTPA at least once per week.

RESULTS

During 9,218 person-years of follow-up, the hypertension incidence rate was 30.6 (95% confidence interval [CI], 27.3 to 34.3) per 1,000 person-years. High job strain was associated with a higher risk for hypertension than low job strain (adjusted hazard ratio [aHR], 1.29; 95% CI, 1.00 to 1.67). High LTPA was associated with lower hypertension risk than low LTPA (aHR, 0.77; 95% CI, 0.60 to 0.98). Hypertension risk was higher among workers with high job strain and low LTPA than among those with low job strain and high LTPA (aHR, 1.70; 95% CI, 1.18 to 2.43).

CONCLUSIONS

Job strain and LTPA showed positive and inverse associations, respectively, with incident hypertension. The combination of high job strain and low LTPA was associated with the highest risk for hypertension.

Summary

Key Message
High job strain and low leisure-time physical activity are independent risk factors for hypertension among workers, and those with high job strain and low leisure-time physical activity are at the highest risk, so it is critical that policy interventions target job strain and leisure-time physical activity to reduce hypertension.

Citations

Citations to this article as recorded by

2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension
Giuseppe Mancia, Reinhold Kreutz, Mattias Brunström, Michel Burnier, Guido Grassi, Andrzej Januszewicz, Maria Lorenza Muiesan, Konstantinos Tsioufis, Enrico Agabiti-Rosei, Engi Abd Elhady Algharably, Michel Azizi, Athanase Benetos, Claudio Borghi, Jana Br
Journal of Hypertension.2023; 41(12): 1874. CrossRef
Adulthood Psychosocial Disadvantages and Risk of Hypertension in U.S. Workers: Effect Modification by Adverse Childhood Experiences
Timothy A. Matthews, Yifang Zhu, Wendie Robbins, Mary Rezk-Hanna, Paul M. Macey, Yeonsu Song, Jian Li
Life.2022; 12(10): 1507. CrossRef
Associations of COVID-19 Related Work Stressors with Psychological Distress: Racial and Ethnic Disparities in Californian Workers
Timothy A. Matthews, Megan Guardiano, Negar Omidakhsh, Lara Cushing, Wendie Robbins, OiSaeng Hong, Jian Li
International Journal of Environmental Research and Public Health.2022; 20(1): 144. CrossRef

Data Profile

Integrated dataset of the Korean Genome and Epidemiology Study cohort with estimated air pollution data: Hae Dong Woo, Dae Sub Song, Sun Ho Choi, Jae Kyung Park, Kyoungho Lee, Hui-Young Yun, Dae-Ryun Choi, Youn-Seo Koo, Hyun-Young Park; Epidemiol Health. 2022;44:e2022071. Published online September 7, 2022; DOI: https://doi.org/10.4178/epih.e2022071

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Abstract Summary PDF Supplementary Material

Abstract

Public concern about the adverse health effects of air pollution has grown rapidly in Korea, and there has been increasing demand for research on ways to minimize the health effects of air pollution. Integrating large epidemiological data and air pollution exposure levels can provide a data infrastructure for studying ambient air pollution and its health effects. The Korean Genome and Epidemiology Study (KoGES), a large population-based study, has been used in many epidemiological studies of chronic diseases. Therefore, KoGES cohort data were linked to air pollution data as a national resource for air pollution studies. Air pollution data were produced using community multiscale air quality modeling with additional adjustment of monitoring data, satellite-derived aerosol optical depth, normalized difference vegetation index, and meteorological data to increase the accuracy and spatial resolution. The modeled air pollution data were linked to the KoGES cohort based on participants’ geocoded residential addresses in grids of 1 km (particulate matter) or 9 km (gaseous air pollutants and meteorological variables). As the integrated data become available to all researchers, this resource is expected to serve as a useful infrastructure for research on the health effects of air pollution.

Summary

Korean summary
대기오염이 건강에 미치는 정도를 파악하고 이를 최소화하는 과학적 근거 생산 마련을 위하여 한국인유전체역학조사사업(KoGES) 자료와 대기오염 및 기상 자료를 연계하여 연구 기반을 마련하고자 하였다. 배출량, 기상자료 및 공기의 확산 등을 고려하는 화학수송모델(CMAQ)을 통하여 2005년에서 2017년 사이의 대기오염 및 기상자료를 예측하였으며, 이후 관측소 자료 및 인공위성자료인 에어로졸 광화학두께(AOD)를 추가 적용하여 최종 생산하였다. 미세먼지 자료는 1 km 격자로 기체상 오염물질 및 기상 자료는 9 km 격자 단위로 구성되었다. 생산된 자료는 KoGES 참여자의 주소를 기반으로 연계하여 최종 KoGES-대기오염 연계DB를 구축하였으며, 구축된 자료를 이용하여 KoGES 참여자의 대기오염 노출 수준을 공간적 시간적 분포로 살펴보았다. 구축된 자료는 내외부 연구자에게 공개가 되고 있어 대기오염에 의한 건강영향평가 및 피해를 최소화하는 방안 마련 연구를 위한 좋은 기반 자료가 될 것으로 기대된다.

Key Message
The Korean Genome and Epidemiology Study (KoGES) cohort were linked to air pollution data as a national resource for studying air pollution and its health effect. Air pollution data (2005~2017) were produced using community multiscale air quality modeling with additional adjustment of monitoring data, satellite-derived aerosol optical depth, normalized difference vegetation index, and meteorological data to increase the accuracy and spatial resolution. The modelled air pollution data were linked to the cohort based on participants’ geocoded residential addresses in grids of 1 km (particulate matter) or 9 km (gaseous air pollutants and meteorological variables).

Citations

Citations to this article as recorded by

Association between short-term exposure to ambient air pollutants and biomarkers indicative of inflammation and oxidative stress: a cross-sectional study using KoGES-HEXA data
Ji Hyun Kim, Hae Dong Woo, Jane J Lee, Dae Sub Song, Kyoungho Lee
Environmental Health and Preventive Medicine.2024; 29: 17. CrossRef
Edible mushroom intake and risk of all-cause and cause-specific mortality: results from the Korean Genome and Epidemiology Study (KoGES) Cohort
Hyein Jung, JiAe Shin, Kyungjoon Lim, Sangah Shin
Food & Function.2023; 14(19): 8829. CrossRef
Association between ambient particulate matter levels and hypertension: results from the Korean Genome and Epidemiology Study
Sewhan Na, Jong-Tae Park, Seungbeom Kim, Jinwoo Han, Saemi Jung, Kyeongmin Kwak
Annals of Occupational and Environmental Medicine.2023;[Epub] CrossRef

Systematic Review

Systematic review and meta-analysis of cancer risks in relation to environmental waste incinerator emissions: a meta-analysis of case-control and cohort studies: Kiook Baek, Jong-Tae Park, Kyeongmin Kwak; Epidemiol Health. 2022;44:e2022070. Published online September 1, 2022; DOI: https://doi.org/10.4178/epih.e2022070

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
Various toxic substances can be generated from incinerators, exposing nearby residents, and epidemiological studies have shown wide variations in risk estimates for cancer risk in populations living close to incinerators.
METHODS
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a literature search and systematic review were conducted to identify studies conducted on general populations exposed to environmental incinerator emissions and cancer outcomes. Meta-analysis was performed according to the cancer types for which 2 or more studies were reported. Subgroup analysis was done for sex, the exposure estimation method, the study period, and the type of outcome.
RESULTS
Eleven studies were found for the qualitative review and meta-analysis. Seven studies had a case-control design, and 4 had a cohort design. The pooled effect size was not significant for breast, colorectal, liver, lung, lymphohematopoietic, stomach, bladder, central nervous system, and laryngeal cancers, non-Hodgkin lymphoma, sarcoma, leukemia, and all cancers. In the subgroup analysis, the pooled effect size of laryngeal cancer in females was 1.82 (95% confidence interval, 1.10 to 3.01), although only 2 studies were identified.
CONCLUSIONS
The meta-analysis did not provide evidence of an increased risk for any cancer among populations living near waste incinerators, except for laryngeal cancer in females. However, since relatively few studies were reviewed and some cancer types showed significant increases in individual studies, this evidence needs to be updated regularly.; Summary

Korean summary
본 연구에서는 현재까지 소각장 인근 주민들의 암 위험도에 대해 보고된 환자-대조군 연구 및 코호트 연구를 체계적 문헌고찰과 메타분석법을 활용하여 분석하였다. 총 11개의 문헌에서 보고한 암 위험도를 암종별로 분석한 결과 소각장 인근 거주로 인한 암 위험도 상승이 유의하게 상승한 암종은 없었다. 세부 그룹 분석에서 여성의 후두암이 비록 단 2개 문헌에서만 보고하고 있었지만 유의한 상승을 보였다. 본 연구는 현재까지 논란이 많은 소각장 인근 거주와 암 발생 위험도의 증가에 대해 관찰연구로서 생태학적 연구를 배제하고 비교적 역학적 증거로서 가치가 높은 연구방법인 환자-대조군 연구와 코호트 연구를 고찰한 의의가 있으며, 본 연구의 방법론을 활용하면 추후 같은 주제의 증거를 지속적으로 갱신하여 종합할 수 있으리라 기대한다.

Key Message
This meta-analysis showed a lack of evidence of elevated risk of specific cancers after pooling the effect sizes by cancer type, except for laryngeal cancer in women. However, due to the small number of included studies, the evidence needs to be monitored and updated on a regular basis in the future.

Original Articles

High frequency of colonization by extended-spectrum beta-lactamase-producing Gram-negative bacilli in hemodialysis patients and their household contacts in Colombia: dissemination between the community and the hospital: Daniela Montoya-Urrego, Sara Tellez-Carrasquilla, Johanna M. Vanegas, Judy Natalia Jiménez Quiceno; Epidemiol Health. 2022;44:e2022069. Published online August 27, 2022; DOI: https://doi.org/10.4178/epih.e2022069

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Abstract

OBJECTIVES
Increasing colonization by beta-lactam-resistant Gram-negative bacilli (BR-GNB) represents a risk for infections and bacterial resistance spread, both in hospitals and the community. Hemodialysis patients and their household contacts regularly transit between these environments. This study investigated the clinical and epidemiological characteristics of BR-GNB colonization in hemodialysis patients and their household contacts, as well as the genetic relationship between their isolates.

METHODS

A cross-sectional study was conducted on hemodialysis patients at a hospital-associated dialysis center in Medellín, Colombia and their household contacts. Clinical and epidemiological information was collected. Colonization was assessed from stool or rectal swab samples. Bacterial identification and susceptibility were determined using chromogenic media and Vitek-2. Molecular characterization included beta-lactamase detection by polymerase chain reaction, multiple-locus sequence typing (MLST), pulsed-field gel electrophoresis, and identification of Escherichia coli phylogroups by the Clermont protocol.

RESULTS

This study included 36 hemodialysis patients and 90 household contacts. Colonization by BR-GNB occurred in 58.3% of patients and 22.2% of household contacts. The main beta-lactamase detected was CTX-M group-1 (40.5%). In 3 of the 9 homes that had more than 1 colonized individual, a genetic relationship was found. MLST showed a high diversity in E. coli isolates, and the most frequent phylogroups were B1 and B2.

CONCLUSIONS

These results show a high frequency of colonization and the presence of potentially pathogenic BR-GBN both in hospitals and the community. This highlights the importance of populations who move between those 2 environments, and the need to prevent the spread of bacterial resistance outside hospitals.

Summary

Key Message
Colonization by beta-lactam-resistant Gram-negative bacilli has increased in hospitals and communities. Populations that constantly move between these 2 environments, such as hemodialysis patients and their household contacts, can transport these bacteria and turn their homes into potential reservoirs. In this work, a high frequency of colonization was found in patients and household contacts, as well as a high diversity of E. coli isolates, suggesting different sources of acquisition. However, there could be an exchange of potentially pathogenic resistant bacteria in homes. This highlights the importance of including these populations in epidemiological surveillance and interventions to prevent bacterial resistance spread.

Citations

Citations to this article as recorded by

Molecular and Clinical Data of Antimicrobial Resistance in Microorganisms Producing Bacteremia in a Multicentric Cohort of Patients with Cancer in a Latin American Country
Sergio Andrés Cruz-Vargas, Laura García-Muñoz, Sonia Isabel Cuervo-Maldonado, Carlos Arturo Álvarez-Moreno, Carlos Humberto Saavedra-Trujillo, José Camilo Álvarez-Rodríguez, Angélica Arango-Gutiérrez, Julio César Gómez-Rincón, Katherine García-Guzman, Aur
Microorganisms.2023; 11(2): 359. CrossRef

Awareness of and practice toward cancer prevention recommendations: results of the Korean National Cancer Prevention Awareness and Practice Survey in 2021: Jin-Kyoung Oh, Eunjung Park, Byungmi Kim, Yoon-Jung Choi, E Hwa Yun, Min Kyung Lim, Jeong-Soo Im, Eun Young Park; Epidemiol Health. 2022;44:e2022068. Published online August 26, 2022; DOI: https://doi.org/10.4178/epih.e2022068

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Abstract

OBJECTIVES
This study reports data regarding the awareness and practice of cancer prevention among Koreans in 2021 and behavioral changes during the coronavirus disease 2019 (COVID-19) pandemic.

METHODS

We collected Cancer Prevention Awareness and Practice Survey data through face-to-face interview surveys using a structured questionnaire completed by 4,000 randomly selected men and women aged between 20 years and 74 years in 17 provinces. We examined the awareness and practice of 10 cancer prevention recommendations and evaluated their associations with potential risk factors through multiple logistic regression analysis adjusted for age, gender, residence, marital status, education, and income.

RESULTS

Eighty percent of participants knew that cancer is preventable, while 45% practiced cancer prevention. Cancer prevention practice tended to be more common among older participants (adjusted odds ratio [aOR], 1.39 per 10-year increment; 95% confidence interval [CI], 1.29 to 1.49) and less common among rural inhabitants (aOR, 0.66; 95% CI, 0.51 to 0.86) than among urban residents and among single people (aOR, 0.55; 95% CI, 0.45 to 0.66) than among married people. Practices were the highest for avoiding burned or charred foods (87.6%) and lowest for vaccination against human papillomavirus (14.5%). Refusal to follow recommendations was most common for avoiding alcohol consumption (7.9%). The most difficult recommendations to follow were (1) regular exercise (57.7%); (2) maintaining a healthy body weight (46.1%); and (3) avoiding alcohol (40.1%). The most significant COVID-19-related changes were less exercise (32.5%) and increased body weight (25.6%).

CONCLUSIONS

The awareness of cancer prevention was high, but the practice was low. Recommendations targeting awareness and practice need to be further promoted.

Summary

Korean summary
2021년 국민 암예방 인식 및 실천행태 조사에 따르면, 국민의 80%는 암이 예방 가능하다는 사실을 알고 있으나, 45%만이 암예방을 위한 건강생활을 실천하고 있음. 암예방수칙 중 가장 지키기 어려운 항목으로는 ‘운동하기’(57.7%)를 꼽았고, 그 다음으로 ‘건강체중 유지하기’(46.1%)와 ‘소량음주도 피하기’(40.1%)순으로 나타났음. 코로나19 유행으로 인한 가장 흔한 변화는 운동 감소(32.5%)와 체중 증가(25.6%)로 나타났음.

Key Message
According to the data collected from the Cancer Prevention Awareness and Practice Survey in 2021, 80% of participants knew that cancer is preventable, while 45% practiced cancer prevention. The most difficult recommendations to follow were (1) regular exercise (57.7%); (2) maintaining a healthy body weight (46.1%); and (3) avoiding alcohol (40.1%). The most significant COVID-19-related changes were less exercise (32.5%) and increased body weight (25.6%).

Citations

Citations to this article as recorded by

Risk Factors of Gastric Cancer and Lifestyle Modification for Prevention
Kwang-Pil Ko
Journal of Gastric Cancer.2024; 24(1): 99. CrossRef
Factors Affecting Adherence to National Colorectal Cancer Screening: A 12-Year Longitudinal Study Using Multi-Institutional Pooled Data in Korea
Dae Sung Kim, Jeeyoung Hong, Kihyun Ryu, Sang Hyuk Lee, Hwanhyi Cho, Jehyeong Yu, Jieun Lee, Jong-Yeup Kim
Journal of Korean Medical Science.2024;[Epub] CrossRef
Imposing stragies for health promotion fund for alcohol
Kwang Wook Koh, Hye Sook Kim, Seong Hyun Koh
Korean Journal of Health Education and Promotion.2023; 40(4): 45. CrossRef
Cancer risk based on alcohol consumption levels: a comprehensive systematic review and meta-analysis
Seunghee Jun, Hyunjin Park, Ui-Jeong Kim, Eun Jeong Choi, Hye Ah Lee, Bomi Park, Soon Young Lee, Sun Ha Jee, Hyesook Park
Epidemiology and Health.2023; 45: e2023092. CrossRef

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