Epidemiology and Health

Volume 17 (2); December 1995

Original Articles

The Accuracy of Self-Reported Weight and Height.: Yun Mi Song, Jong Lull Yoon; Korean J Epidemiol. 1995;17(2):257-268.

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The use of self reported height and weight is very common in epidemiologic studies and clinical settings. In this study we assessed the accuracy of selfreported weight, height and body mass index by comparing with measured data. Data were obtained from 1065 persons(657 men, 358 women) who visited a health care center for routine medical check-up during the period September 1994-February 1995. The correlation between reported and measured height and weight was very strong. There were some discrepancies between two data, however, and men and women differ ed somewhat in their pattern of misreporting. Weight was overestimated by 0.27kg in men and underestimated by 0.09kg in wo men whereas height was overestimated in men(0.88cm) and women(2.15cm). These misreported data resulted in an underestimation of body mass index and low sensitivity for diagnosing overweight in men and women. The size of error was larger in women than in men. So it suggests that the self reported height and weight data could be used as a continuous variable with little error, but misclassification could be occured when the self reported data were used as a categorical variable. Errors in self reported weight and height, BMI were related to a person's over-weight status. The more people overweighed the more they underestimated their weight. Educational level and age, exercise, marri age had no relationship with the accuracy of self reported data. In conclusion, the use of self reported weight and height in epidemiologic studies and clinical settings could result underestimation of obesity, especially in obese female group.; Summary

Validation of a Semi-Quantitative Food Frequency Questionnaire.: Young Sik Kim, Eun Soo Shin, Hye Soon Park, Moo Song Lee; Korean J Epidemiol. 1995;17(2):249-256.

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The relationships between diet and the occurence of the major diseases of our civilization are of both epidemiological and practical importance to public health problems. Diseases associated with dietary factors rank among the leading causes of illness and death in Korea. Not only for assessment for clinical evaluation, but also for epidemiological concern, we need for rapid and inexpensive methods to assess dietary intake in relating nutrition to health. The validity of a self-administered semi-quantitative food frequency questionnaire was evaluated for a group of 103 men and women aged 26 to 65. Intakes of 8 nutrients computed from the questionnaire were compared with those derived from 3-months diet record. The questionnaire estimates of mean nutrient intake were within about 10% of the mean diet record measurements for nutrients evaluated but iron and vitamin A. The correlation coefficients comparing unadjusted nutrient intakes measured by two methods ranged from 0.27(iron) to 0.57(fat). The correlation coefficients comparing nutrient intakes measured by two methods adjusted for age and sex ranged from 0.26(iron) to 0.50(calories). After adjusted for age and sex or caloric intake, the intakes in iron did not show correlation measured by two methods. A simple and relatively inexpensive questionnaire could be useful information on dietary intake for macronutrients. The modification and revision would be required for assessments of intakes in micronutrients.; Summary

The Percieved Health Status of Female Workers and It's Determinants in the Small and Medium Scaled Industries.: Jae Eog Ahn, Joo Ja Kim, Seung Hyun Han; Korean J Epidemiol. 1995;17(2):235-248.

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458 female workers working in the small and medium scaled industries in Inchon area were surveyed to study their general characteristics, health behavior, working and environmental conditions, current health status etc. Self-administered questionnaire was developed by authors and distributed to the female workers with the explanation by trained interviewer on the purpose of survey and the method how to answer. The results were as follows: t. General characteristics showed that most(75.3%) of workers were living in their own home, and their age distribution was relatively even from teenagers to the forties. The level of education was high school graduate(including drop-out) in 69.4%, suggesting that the education level of female workers was increasing gradually. The marrital status was 69% in unmarried, and 31% in married state. 2. Survey on their health status showed that more than 20% of female workers complained that they have some kind of disease and most of them complained that they have chronic symptoms more than three kinds. Also, they complained at least two or three symptoms in physical, mental or sensoryneural symptoms respectively. But their medical care utility rate was only 22%. 3. There were no significantly correlated variables between health status and general characteristics(by x2-test). Among the variables on the health behavior, only alcohol drinking was significant to health status. Perceived health status related to the working environment was significantly different to the degree of work satisfaction and awareness for the exposure to harzadous materials. 4. Multivariable analysis showed that work satisfaction, awareness for the exposure to harzadous materials, alcohol drinking, type of employment were significantly related to the physical or mental health index, and also marrital status was to the physical health index. Work satisfaction, awareness for the exposure to harzadous materials, marrital status were related to the sensoryneural health index. Alcohol drinking, work satisfaction, awareness for the exposure to harzadous materials, marrital status were significantly related to the number of complained chronic symptoms. In summary, this study showed that inspite of wide and various range of the general characteristics of female industrial workers in Korea comparing to the past, there was high prevalence of disease due to the poor working conditions and low work satisfaction etc. Therefore, more detailed disease preventive policies or improvement of the work environment, and systematic management to raise the work satisfaction of female workers are urgently needed. And also, occupational health policies increasing the access to health care to provide the adequate health service for the workers who have perceived need are necessary.; Summary

The Comparison of the Somatization and Hypochondriacal Trends Between Labor Workers and Managerial Workers.: Chul Lee, Hee Sook Park, Won Chul Lee, Kwang Ho Meng; 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.; Summary

Accident as a public health problem in Korea and strategies of epidemiologic study on road traffic accidents.: Joung Soon Kim; Korean J Epidemiol. 1995;17(2):214-224.

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Mortality and morbidity caused by accidents among Koreans have been increasing steadily and more strikingly from motor vehicle traffic accidents since 1980's, when owning and driving car became a fashionable and ubiquitous life style among Koreans. The proportion of deaths from accidents among all deaths was 9. 5% in 1983 and increased to 14. 8% in 1993. Moreover the mortality rate from the motor vehicle traffic accident increased more than three folds along with eight folds increased number of vehicles during the same period.; Summary

Risk Factors of Hypertension and The Effect of These Factors on Blood Pressure.: Hae Sook Sohn, Chae Un Lee, Jin Ho Chun, Jung Hak Kang, Hwi Dong Kim, Kui Oak Jung, Kyu Il Cho; Korean J Epidemiol. 1995;17(2):201-213.

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This study was conducted to find out the risk factors of hypertension and the effect of thesefactors on blood pressure. The eighteen factors were collected on the subjects of 932 from November 1994 to January 1995 through questionnaire and laboratory test - those were age, sex, education level, body mass index(BMI), family history of hypertension (FHH), triglyceride (TG), blood sugar and lactate dehydrogenase(LDH), etc. The status of blood pressure was classified by the classification of hypertension proposed by Joint National Committee of hypertension, USA. The prevalence of diastolic hypertension was 17.7% and the prevalence of systolic hypertension was 11.6 %. In the frequency analysis on the status of blood pressure, by age, education level, smoking habit, RM, BMI, FBS, LDH, TG, the prevalences were significantly different for both diastolic and systolic hypertension(p(0. 05). By stepwise logistic regression with dichotemization of blood pressure, the following odds ratios were significantly high (p, 0.05) - for diastolic hypertension, age 1.973, BMI 2. 106, FHH 2, 102, LDH 2. 773, TG 1.715, and for systolic hypertension, age 4.414, BMI 1.563, FHH 2.125, RM 0.487, LDH 3.814, TG 2. 707. By multiple regression analysis with blood pressure as dependent variable and these factors as independent variables, the regression equationswere diastolic hypertension =51.07+0.20.age+0.07 BMI+0.02.TG+0.02.LDH+3.22.FHH, and systolic hypertension = 88. 59+0.23.age+0.06.BMI+5.46.FHH-2.62.RM+0.03.LDH+0,03.TG By this study, the significant risk factors of hypertension were age, BMI, TG, family history of hypertension, LDH, and efficient control of hypertension would be expected through control of these factors.; Summary

The Geographic Patterns of The Adult Male Bladder Cancer Patients in Korea: Clue as to the Occupational Exposure.: Do Myung Paek, Young Hahn Moon, Jung Sun Park, Ki Beom Lee, Kyung Yong Rhee, Kwan Hyung Yi; Korean J Epidemiol. 1995;17(2):188-200.

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We calculated the age specific Proportionate Morbidity Ratio(PMR)' for different areas as the outcome index by using the national cancer registry data(1988 1991) to assess the patterns of stomach cancer and bladder cancer. Also, we calculated 'Manufacturing workers Concentration Index(MCI)' for different areas as the exposure index by using the census data reported in 1980 to assess the relationship between cancer site specific PMRs and MCIs. As a result, we found the significant correlation(r=0.61, p=0.002) between the bladder cancer in the age of 40s and the industrial exposure indicator. Future analytic studies should be fruitful in identifying more occupational risk factors for bladder cancer. Investigation of cancer incidence including geographic variations and difference by age may identify patterns suggesting occupational exposures.; Summary

A case-control study on the risk factors of colorectal adenomatous polyp.: Mi Kyung Kim, Yang Cha Lee, Kyu Yong Choi, Won Chul Lee, Kyung Jae Lee, Kwang Ho Meng, Yoon Kyong Lee, In Mee Kim; 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.; Summary

A Seroepidemiologic Study on Rubella Antibody Positivity: Primary School Students in Gyenggi-Do.: Bo Youl Choi, Hung Bae Park, Young Jeon Shin, Bae Joong Yoon, Jong Surk Hahn; Korean J Epidemiol. 1995;17(2):156-166.

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PURPOSE
The purpose of this seroepidmiologic study was to examine the immunization and infection history of rubella, positivity of rubella specific antibody, seroconversion rate of two rubella vaccines and to develop an adequate immunization program of rubella. Research Methods : Subjects of the study were 2.071 students of 8 priamary schools in Gyenggi-Do. Questionnaire and blood sampling were done. Test method of Rubella specific antibody was ELISA (Abbott IMx autoanalyzer). The anayltic methods for the study were chi-square-test, t-test and ANOVA.
RESULTS
The results of the study were as follows : (1)The number of subjects who had infection history of rubella were only 28 students(1.5%). (2)The immunization rate of rubella was the highest in 6 year-old group(65%), it decrease as subjects grow older. (3)The positivity of rubella antibody was 76. 6%, it is the highest in 6 year old group and the lowest in 7 year-old group and it increase again as subjects grow older. (4)Average antibody titer was 53.3 IU(SD 79.2), the trend of antibody titer by age was similar to that of positivity. (5)The seroconversion rates of both vaccines, vaccine A,vaccine B, were 99.5% and 99.6%, the ratio of increase of antibody titer after immunization was higer than 400. it means that both vaccines are very efficacious.
CONCLUSION
Results of the study suggest that it is necessary to increase the coverage of rubella immunization, and further studies are necessary to get more information for rubella.; Summary

A Study on Epidemiological Characteristics of Nosocomial Infection in Korea.: Joung Soon Kim, Sung Eun Lee; Korean J Epidemiol. 1995;17(2):137-155.

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In Korea, the nosocomial infection control program is not well estabilished. This study was carried out to investigate the incidence rate of nosocomial infection occurred among patients of 18 hospitals for 7 days ; cases of hospital infection per 10,000 patients discharged during the same period in Korea. The study was done in 18 volunteer hospitals and nosocomial infection cases for 7 days were collected retrospectively. The result was as follows; 1. The incidence rate of nosocomial infection for 7 days was 578 cases per 10, 000 patients discharged. 2. Pneumonia was the most prevalent nosocomial infection ; the incidence rate 112.7 cases per 10,000 discharges. The incidence rate of urinary tract infection was 85. 7 cases and that of septicemia was 36. 7 cases per 10, 000 discharges. 3. The incidence rate of nosocomial infection among patients of neurosurgery department was the highest(2,742 cases per 10,000 discharges). And the incidence rate of nosocomial infection was 6 times higher among the patients of intensive care unit than that of general ward. The reasons of higher nosocomial infection rate of intensive care unit and neurosurgery appeared to be due to many invasive procedures. Thus the priority in nosocomial infection control program must be given to those groups.; Summary

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